Obsessive Compulsive Disorder (OCD)
Most of us have little rituals that we perform that make us feel more comfortable or to help remember things; for example, we may check windows are shut or close doors before bed. Whilst these rituals comfort and reassure us, sometimes they can become intrusive, annoying or even disturbing if the compulsion to carry out a ritual is so strong that we can’t settle until we have completed it in a certain way. This is when we might call our habits or rituals obsessions or compulsions.
Repetitive intrusive thoughts or impulses are often referred to as obsessions. Compulsions usually refer to actions/behaviours that a person feels they are driven to perform by their obsessive thoughts. Obsessive thoughts and compulsive rituals can be distressing to children and adolescents if they start to take over their normal lives. They tend to be more common in children when another family member has a similar problem and they are more likely to experience these difficulties when they are under stress or during significant life changes.
HOW TO RECOGNISE WHEN SOMEONE MIGHT BE STRUGGLING:
Are they taking much longer to complete normal tasks, such as getting dressed?
Are they taking longer to complete work at school?
Are they anxious about putting things in a certain order?
Do they show or describe an excessive fear of dirt and germs?
Do they appear to be continually repeating particular behaviours, like touching things such as light switches or door handles?
Do they become very upset by disorder and mess?
Do they complain of thinking about certain things like words or numbers all the time?
Are they showing excessive concern about order and symmetry?
What can you do as a parent/carer?
- Remember the child/adolescent may feel frightened or embarrassed by their thoughts and rituals – approach them sensitively and in private.
- Encourage the child or adolescent to describe their fears and rituals.
- Find out how intrusive and disruptive the thoughts or rituals are, and what areas of life are affected.
- Enquire about any stressors in their life; such as bullying, exams, family.
- Reassure them that intrusive thoughts and rituals are fairly common and that we all experience them to a greater or lesser extent, but do not trivialise their experience.
- Explain that you understand how difficult it is to control these thoughts and behaviours.
- Explain that continuing to act on their thoughts by carrying out rituals tends to encourage the thoughts or rituals to become stronger and more difficult.
- If possible, speak to other parents/carers to gain information and support.
- Teach relaxation techniques. However, this should not be used at the time the child or adolescent is trying to avoid the ritual; relaxation at these times could become part of the ritual.
- Encourage them to do their rituals less often or for shorter periods and give them support.
- The child or adolescent should be encouraged to experience feelings of anxiety, not to try and block them out; these feelings will subside naturally when they are being supported by you to stop carrying out their ritual.
- Try and build up the child or adolescent’s confidence by getting them to focus on times when the thoughts and rituals do not occur.
- With younger children, consider using a behaviour chart to encourage and motivate.
When to consider asking for more specialist help
CONSIDER SEEKING HELP:
If the child or adolescent is experiencing extreme distress and the thoughts/rituals are interfering with day to day functioning (e.g. unable to get to school).
If the symptoms continue to increase despite your intervention, or continue for 4 weeks without signs of improvement.
If the thoughts or behaviours occur in combination with other concerning behaviours.
Further support, advice and self-help
Young Minds gives free, relevant, practical information about a range of mental health issues in children and young people. It has information about feelings and symptoms, conditions and looking after yourself. It also has some specific information about self-harm and what to do about self-harm.
Minded is a free educational resource on children and young people’s mental health for adults, but can also be really useful for teenagers. It covers lot of topics.
Relate gives specific advice for different types of worries and problems aimed at young people.