OCD in Children: Signs, Symptoms, and When to Seek Help - Psychiatry

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Concern about Obsessive-Compulsive Disorder (OCD) in Children?


I have a daughter in the second year of junior high school.
After she started the first year, I noticed that she washes her hands multiple times a day, and the frequency has become increasingly severe.
Now that she is in the second year, she even washes her feet.
Whenever she touches something or picks something up, she feels the need to wash her hands and feet.
Every day after school, as soon as she puts down her backpack, she takes a wet cloth to wipe it down.
She also wipes the sofa where the backpack was placed, then rinses her lunchbox and helmet, and puts them out to dry.
After that, she washes her hands and feet, and then takes a shower.

I don't know when this started, but now she refuses to use the toilet paper in the bathroom and insists on using her own special pack from her room.
She also no longer wants me to help her with the towel I placed in the bathroom for washing her face; she only uses her hands to splash water on her face and refuses to use the towel.
Recently, she has been frequently expressing a desire to transfer schools, but when I ask her why, she cannot articulate a reason.
Sometimes she doesn't even copy notes from her contact book or brings it home.
Once, after I scolded her, she said, "Then I might as well just die!" (She has said this several times).
Tonight, after being scolded by her father, she suddenly got up, ran to the kitchen to grab a fruit knife, and hid on the back balcony, wanting to harm herself, which has caused me great distress and concern.
Doctor, is this obsessive-compulsive disorder? Does she need to see a doctor, and if so, which specialist? I hope you can provide advice to help my daughter.
Thank you very much.

Qi Qi, 30~39 year old female. Ask Date: 2016/10/18

Dr. Liang Sunyuan reply Psychiatry


Hello Qiqi: Your daughter's symptoms could indeed be indicative of obsessive-compulsive disorder (OCD).
She is not doing this intentionally; rather, she is experiencing significant anxiety that she cannot control, and she feels compelled to perform these actions to achieve a sense of relief.
It is advisable to understand your child's anxiety and concerns, as forcefully demanding changes may not be effective.
I recommend seeking assistance from a pediatric mental health specialist.
Best wishes to you.

Reply Date: 2016/10/18

More Info


Understanding Obsessive-Compulsive Disorder (OCD) in children is crucial, especially when you notice behaviors that seem excessive or distressing. Based on your description, it appears that your daughter is exhibiting signs that could be associated with OCD. This condition is characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) that the individual feels driven to perform in response to the obsessions.
In your daughter's case, her compulsive hand washing, the need to clean items she has touched, and her avoidance of certain towels suggest that she may be experiencing intrusive thoughts about cleanliness or contamination. These behaviors can become time-consuming and interfere with daily activities, which seems to be happening in her case. The fact that she is also expressing feelings of distress and has made concerning statements about self-harm is particularly alarming and should be taken seriously.


Signs and Symptoms of OCD in Children:
1. Compulsive Behaviors: As you've noted, excessive hand washing, cleaning, and organizing are common compulsions. Children may feel that these actions are necessary to prevent a feared event or to alleviate anxiety.

2. Avoidance: Avoiding certain situations or objects that trigger anxiety is another sign. Your daughter’s reluctance to use shared towels or bathroom supplies indicates a heightened sense of fear or anxiety.

3. Intrusive Thoughts: Children with OCD often experience distressing thoughts that they cannot control. These thoughts can lead to significant anxiety and the need to perform compulsive behaviors to alleviate that anxiety.

4. Emotional Distress: Expressions of hopelessness or thoughts of self-harm, as you've described, are serious and indicate that she may be struggling with more than just OCD. This could be a sign of depression or anxiety, which often co-occur with OCD.


When to Seek Help:
Given the severity of your daughter's symptoms, especially her thoughts of self-harm, it is essential to seek professional help as soon as possible. Here are some steps you can take:
1. Consult a Pediatrician: Start by discussing your concerns with your child's pediatrician. They can provide an initial assessment and refer you to a mental health specialist if necessary.

2. See a Child Psychologist or Psychiatrist: A mental health professional who specializes in childhood disorders can conduct a thorough evaluation. They can determine whether your daughter has OCD or another mental health condition and recommend appropriate treatment.

3. Therapeutic Interventions: Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is often effective for treating OCD. This therapy helps children gradually face their fears and reduce their compulsive behaviors.

4. Medication: In some cases, medication may be prescribed to help manage symptoms, especially if they are severe. Selective serotonin reuptake inhibitors (SSRIs) are commonly used for OCD.


Supporting Your Daughter:
While seeking professional help, it’s important to provide emotional support to your daughter. Encourage open communication about her feelings and reassure her that she is not alone in this struggle. Avoiding criticism of her behaviors can help reduce her anxiety. Instead, focus on understanding her feelings and helping her feel safe.


Conclusion:
Your daughter's behaviors are concerning and warrant immediate attention from a healthcare professional. OCD can significantly impact a child's quality of life, but with the right treatment and support, many children can learn to manage their symptoms effectively. Please prioritize her mental health and seek help as soon as possible.

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