OCD in Children

Obsessive-Compulsive Disorder (OCD) is an anxiety disorder characterized by uncontrollable, repetitive thoughts (obsessions) and the compulsive behaviors performed to relieve those thoughts (compulsions). OCD can cause significant difficulties in daily life and negatively impact social and academic performance.

What is OCD in Children?

As with adults, OCD in children manifests through obsessions and compulsions; however, due to their age, the symptoms may be perceived differently. Children often have difficulty understanding what is happening and struggle to describe their condition. In children, OCD presents as persistent, distressing thoughts, images, or urges. For example, they may fear contamination, worry about harming loved ones, or have a strong need for order. These thoughts can cause children to feel anxious and distressed.

To reduce the anxiety caused by obsessions, children engage in repetitive behaviors or mental acts, such as excessive handwashing or repeating certain words. While these rituals temporarily relieve anxiety, they do not eliminate it.

Comparison of OCD in Adults and Children

1. Adults can clearly express their obsessions and compulsions, while children have difficulty articulating them and may express their struggles through play.

2. Adults recognize that their obsessions and compulsions are irrational, often attempting to hide them, while children are unaware of their irrationality and may not realize there is a problem.

3. Adults typically seek help for their condition, whereas identifying OCD in children relies on observations and feedback from parents and teachers.

What Are the Symptoms of OCD?

1. Mental Symptoms: Children cannot control persistent, distressing thoughts, which trigger anxiety and fear. These uncontrollable obsessions negatively impact daily life, leading to the development of compulsions as coping mechanisms. While compulsions provide temporary relief, children may avoid daily activities, struggle with concentration, and withdraw from social settings.

2. Behavioral Symptoms: Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions. Anxiety lessens temporarily, but the inability to eliminate these actions restricts the child’s life. Children cannot feel at ease without completing their rituals, disrupting daily activities.

3. Physical Symptoms: OCD can also have adverse effects on physical health. For example, constant handwashing may damage the skin, causing wounds. Persistent stress may lead to stomachaches, headaches, and sleep disturbances.

4. Academic and Social Symptoms: OCD can negatively impact school performance and social relationships, creating significant challenges in daily life. These difficulties may harm self-confidence, peer relationships, and overall quality of life. Coping with anxiety may result in concentration problems, exam anxiety, and reduced academic performance. Additionally, children with OCD may isolate themselves from social life due to difficulties in social interactions.

What Are the Causes of OCD?

1. Genetic and Biological Factors: Children with first-degree relatives who have OCD or other anxiety disordersare at higher risk of developing OCD. Research shows that genetic predisposition affects the child’s neurological structure and chemical balance, increasing the risk of OCD. Twin studies indicate that if one identical twin develops OCD, the other is also at high risk. Abnormal functioning of neurotransmitters like serotonin (regulates mood and anxiety) and dopamine (involved in motivation and reward systems) contributes to OCD development. Studies have found structural and functional differences in the brains of individuals with OCD.

2. Environmental Factors: Children raised in homes with family conflicts are at higher risk of developing OCD. Overly strict or authoritarian parenting may make children feel unsafe, negatively impacting emotional well-being. If a child’s emotional needs are unmet, they must cope with stress and anxiety alone, increasing the risk of developing OCD. Traumatic events experienced within the family can also trigger obsessive-compulsive behaviors.

3. Psychosocial Factors: Low self-esteem and insecurity play a significant role in OCD development. Children may develop compulsive behaviors to alleviate distress caused by negative beliefs such as “I am inadequate,” “I am worthless,” “I am a failure,” or “I am unloved.” Rituals provide a sense of safety and comfort. Children who experience bullying or parental pressure regarding performance may turn to these rituals for comfort, but over time, they become dependent on them, hindering friendships, social interactions, and academic success.

Diagnostic Criteria for OCD

1. Does the child experience involuntary, repetitive thoughts, images, or urges that cause distress?

2. Does the child engage in repetitive behaviors or mental acts to reduce the discomfort caused by obsessions?

3. Do obsessions or compulsions negatively impact the child’s daily life, relationships, and academic performance?

During the diagnostic process, the child is observed and evaluated. Detailed interviews with the child and family gather information on the duration, frequency, and severity of symptoms. The child’s school, social life, and daily activities are assessed, and family history is considered to determine genetic predisposition. Significant life changes or traumatic events in the child’s life are also taken into account. The specialist gathers additional insights from teachers and uses psychological tests and scales to evaluate the situation.

What Are the Treatment Methods for OCD?

The treatment process involves psychotherapy, medication, alternative and complementary therapies (such as yoga, meditation, music, dance, drama, writing, and animal-assisted therapies), and support from family and school.

How Can We Cope with OCD?

1. Establish daily routines.

2. Increase tolerance for uncertainty (help the child become more adaptable to unexpected events).

3. Use stress management techniques such as breathing exercises, relaxation techniques, and mindfulness.

4. Reinforce positive behaviors with small rewards and verbal praise.

5. Support social skill development by encouraging participation in social groups like drama and theater.