It is normal for a child to form certain habits as they develop. It is also normal for a child to develop certain preferences as they start to establish their own identity and individuality. However, these habits and behaviours can stretch so far that they end up setting the child with the mental disorder known as obsessive and compulsive disorder (OCD).

According to Johns Hopkins Medicine, this is a mental condition that causes a child to have unwanted feelings, thoughts and fears. “These thoughts, fears and feelings are known as obsessions, and they can make your child feel so anxious that he or she results to doing certain behaviours known as compulsions,” cites Johns Hopkins Medicine. The thoughts the child gets are obsessions and the behaviours the child does out of the thoughts are the compulsions.

According to Dr. Robert King, a psychiatrist and pediatric development and behavioural medicine consultant at the Yale Medicine Child Study Center, child with obsessive compulsive disorder will seem to be always cleaning, always checking, and always having to count.

“The family has to say things in exactly just the right way. If parents touch the wrong thing or don’t collaborate in helping the child perform the compulsion, the child gets very upset,” says Dr. King who is also the author of Suicide in Children and Adolescents.

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Although OCD can develop in an individual at any age, from preschool to adulthood, is most likely to appear during the pre-adolescent years. This means that it is more likely to affect children than young adults or grown up adults.

Symptoms

If your child has OCD, he or she may show symptoms that point to obsessions, compulsions, or both. According to Johns Hopkins Medicine, obsessions will involve fears that the child is unable to stop thinking about. “With obsessions, your child will realize that their fears and anxieties don’t make any sense, but they will still constantly think about them,” cites Johns Hopkins Medicine.

For example, they may have constant thoughts that they, or someone else, will get sick, get hurt, or die. In the same vein, compulsions will involve repetitive behaviors.

“The OCD condition causes children to feel that they have to do rituals to ‘just to make sure’ things are clean, safe, in order, even, or just right. To children with OCD, these rituals seem to have the power to prevent bad things from happening,” states Johns Hopkins Medicine.

For example, your child may have a repetitive habit of going in and out of doorways several times in a row or counting to a certain ‘good’ number, avoiding ‘unlucky’ numbers.

This is echoed by the Centre for Disease Control (CDC), which says that children carry out these behaviors because they have the feeling that the behaviors will prevent bad things from happening or will make them feel better.

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“The behavior is, however, not typically connected to actual danger of something bad happening, or the behavior is extreme, such as washing hands multiple times per hour,” the CDC states. Whereas behaviours such as regular washing of hands may indicate that the child is neat and orderly, not all cases of OCD revolve around cleanliness and orderliness. “In the majority of instances, someone with OCD is too focused on one thing that must be done over and over, rather than on being organized,” the CDC cites.

The child may at one point realize their thoughts don’t make sense, but they will still feel anxious about certain things. According to the Centre for Disease Control, the obsessive or compulsive symptoms your child may show include:

• Unwanted thoughts, impulses, or images that occur over and over. These will provoke their emotions and cause them intense bouts of anxiety or distress.
• Thinking about or saying something over and over (for example, counting, or repeating words over and over silently or loud).
• Having to do something over and over (for example, hand-washing, placing things in a specific order, or checking the same things over and over, for example whether a door is locked, if lights are off, and checking and re-checking homework). This may also involve a preoccupation with presentation, appearance and organization—for example, the symmetrical arrangement of objects.
• Doing something over and over according to certain rules that must be followed exactly in order to make an obsession go away.
• A profound fear of dirt, germs and contamination from people and the fear of touching surfaces.

Treatment

Treatment for OCD mainly involves behavior therapy and medication. According to the Centre for Disease Control, behavior therapy involves cognitive-behavioral therapy which is designed to help the child change negative thoughts into a more positive outlook and behaviour.

“Behavior therapy for OCD can involve gradually exposing the child to his or her fears in a safe setting. This helps him or her learn that bad things do not really occur when he or she doesn’t do the behavior,” cites the CDC.

In turn, this exposure works to alleviate their fears and decrease their anxieties. Some children with OCD may however need a combination of therapy and medications. Medications should only be prescribed by a licensed and certified mental health professional such as a practicing psychiatrist.

Clomipramine is one of the drugs used to manage obsessive and compulsive symptoms. This drug is sold under the name Anafranil and is used for the treatment of obsessive-compulsive disorders, major depressive disorders and panic disorders.