Understanding Obsessive Compulsive Disorder


Q: I know that my 10-year old daughter has a lot of anxiety. I think she may also have a problem with obsessive compulsive disorder. Can you explain some of the behavior associated with this disorder?



A: We define anxiety as feelings of worry, nervousness or unease, typically about an upcoming event or something with an uncertain outcome. Anxiety can be communicated behavior, non-verbal behavior or aggression. There are different types of anxiety, with one being obsessive compulsive disorder (OCD).

Obsessions are linked with OCD. They can include upsetting or scary thoughts that pop into a child’s mind and are difficult to control. Some obsessions are harmless such as balloons, cars or fictional characters. Others can be harmful such as dirt/germs, attention from others or delusional thinking. Another indicator of OCD are worries about things not being “in order” or “just right.” People with OCD may worry about losing things, sometimes feeling the need to collect items, even though this may seem useless to other people. Children may also feel strong urges to do certain things repeatedly, which are called rituals or compulsions. When asked why he or she does these things, the child may not be able to explain the behavior, but it usually helps relieve anxiety or worry.

OCD in children has also been defined as the “overactive alarm system” in which children perform a compulsion, task or ritual just to make sure nothing bad will happen. OCD can become a problem when the child feels he or she simply has to complete the task, otherwise there is impending doom and despair. When rituals, obsessions and compulsions interfere with daily activities such as going to school, sports practice or doing homework, then it is probably best to call your child’s doctor.

We don’t know what causes these behaviors but they may be linked to serotonin levels. Serotonin is a neurotransmitter. Neurotransmitters are the chemicals that carry signals in the brain and when the flow of serotonin is blocked, the brain overreacts and misinterprets information. These “false alarms” mistakenly trigger danger messages. Instead of the brain filtering out these messages, the mind dwells on them — and the person experiences unrealistic fear and doubt. Genetics may also play a role. Having a relative with OCD doesn’t mean that someone will develop it, but there is a stronger chance. OCD can suddenly start after an illness or traumatic event in a person who is genetically prone to develop it.

OCD is not something that is easily stopped. Parents must remember they are not the reason for the child’s rituals, obsessions or compulsions. OCD is a disorder, just like any physical disorder such as diabetes or asthma, and is not something kids can control or have caused themselves. Talk with your child’s doctor about behavior modification and counseling as treatments if your child struggles with OCD.

Hannah Nail Coble is the lead clinical social worker with Cone Health Behavioral Medicine. Send questions to Sherri McMillen at sherri.mcmillen@conehealth.com.

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