Recognizing OCD in your kids

Just like many misunderstand what is an actual clinical panic attack, versus the layman’s version of an anxiety attack, there are many who misunderstand the meaning of “OCD.”

Here is what you may think OCD is (what I have heard in my practice over the years)…

1. Being a “neat freak” (e.g., cleaning your own house all the time, cleaning others houses all the time)
2. Having a schedule and getting upset when someone or something messes it up
3. “OCD” is just what someone’s personality is and nothing can be done to change it
4. The need to control how “I” and/or someone else feels
5. Being inflexible
6. Being rigid

(and many others).

Clinically, OCD is diagnosed (according to the DSM-V) when there are the…

1. Presence of obsessions, compulsions or both (there are usually both, but having just obsessions can happen as well).
   1. Obsessions-recurrent thoughts, images, or impulses that cause significant anxiety
   2. Compulsions-an overt behavior or covert thought to reduce anxiety caused by the obsession
2. Obsessions and Compulsions are very time-consuming (e.g., usually take more than 1 hour per day) and cause distress in the family, school, or job environment.
3. Symptoms are not better explained by a medication, physical condition, or another anxiety disorder that is more prevalent.

It is important that I note, that in kids, OCD can look like:

1. Asking a lot of questions and reassurance, and no matter how much reassurance is given it is never enough
2. Temper tantrums that are frequent and consistent around certain places, situations, activities, and/or people
3. Repetitive behavior that may be hidden from the parents (e.g., turning a doorknob several times, re-taking steps, re-cleaning areas, etc.)
4. Not getting required chores or homework done in a timely fashion or not done at all (very frequently, the amount of time and effort compulsions take leaves little room for activities we already have to get done).

What’s the good news here?

1. Behavior therapy, particularly Exposure and Response (or Ritual) Prevention is a very effective treatment for OCD, for kids and adults.
2. PMT (Parent-management training) is also an effective behavioral management system that will help reinforce good behaviors at home and extinguish OCD-like ones.