A closer look at Obsessive-compulsive disorder

Obsessive Compulsive Disorder

People often double check the lock on the door before leaving their house or wear their lucky clothes or keep a lucky charm with them on their special days. Such simple rituals or habits give us a sense of security. However, if these rituals or habits start to interfere with our daily functioning or causes significant distress this may be a cause of concern. Obsessive-compulsive disorder (OCD) goes beyond double checking something or practicing a simple special day ritual. People with OCD feel compelled to act out certain rituals repeatedly, even if they don’t want to or even if it gets too complicated to handle.  

OCD is an anxiety disorder that causes repeated unwanted thoughts or sensations and/or the urge to do something over and over again. These unwanted thoughts or fears are known as obsessions and repeated behaviours are known as compulsions. These obsessions and compulsions start to interfere with daily activities and can cause significant distress.

People try to ignore or stop these obsessions however this only leads to increasing anxiety. Ultimately compulsive acts are adopted in order to ease the distress. Despite the efforts to ignore obsessive thoughts or urges, they keep reoccurring. This in turn leads to more ritualistic behaviour leading to a vicious cycle.

Causes and risk factors

The causes of obsessive-compulsive disorder aren’t fully understood. However, like other anxiety disorders OCD could be caused by any combination of factors that relate to physical health, environmental factors, genetic vulnerability, and biochemical disturbances.

  • Biological Factors:

    A child who has a family member with any of the anxiety disorders is more likely to be similarly affected. Children might inherit genes that make them more prone to anxiety or anxiety disorders.

    Genetics help direct the way brain chemicals (called neurotransmitters) work. Imbalances in certain neurotransmitters might play a role in how the brain works, which can affect moods and emotions and increase the likelihood of developing anxiety disorders. If specific brain chemicals such as dopamine, norepinephrine or serotonin are in a short supply it can cause anxiety.
  • Environmental factors:

    A stressful, chaotic, or unstable family relationships and home environment can also make children more prone to experiencing anxiety. Bullying, abuse, trauma may also be a contributing factor. 
  • Learned behaviours:

    Growing up in a family where other members are fearful or anxious can also "teach" a child to be afraid or excessively worry. Obsessive fears and compulsive behaviours can be learned from watching family members or gradually learned over time.
  • Other mental health disorders: 

    OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Signs and symptoms

OCD disorder usually includes both obsessions and compulsions. But it might also be possible for someone to have the obsession symptoms only or the compulsion symptoms alone. In order to be characterised as OCD symptoms, the unwarranted thoughts and urges and repeated behaviours need to last more than an hour each day and interfere with daily routine and functioning.

Obsessions

These are the thoughts or impulses that repeatedly occur. People with OCD may try to suppress these thoughts and the anxiety associated with suppression can become too great to endure leading to indulgence in compulsive behaviours. 

Common obsessions include: 
  • Fear of contamination by germs or dirt
  • Having difficulty tolerating uncertainty
  • Fear of losing control and harming oneself or the others.
  • Needing things orderly and organised
  • Intrusive sexually explicit or violent thoughts and images.
  • Intense stress when objects aren't orderly 
  • Excessive focus on religious or moral ideas.
  • Fear of losing or not having things you might need.
  • Excessively superstitions
Compulsions

These are the repetitive acts/behaviours that seem to relieve the stress and anxiety brought on by an obsession. 

  • Excessive cleaning and/or hand washing
  • Double-checking things e.g., locks and switches.
  • Repeatedly checking in on family to ensure they are okay
  • Doing senseless things to reduce anxiety e.g., tapping or repeating certain words
  • Ordering or arranging things excessively in a particular way
  • Praying excessively or engaging in rituals triggered by religious fear.
  • Accumulating old things such as newspapers or empty food containers.
  • Compulsive counting

Treatment

The treatment for OCD generally depends on your child’s symptoms, age, general health and severity of the condition. A typical treatment plan may include therapy, medications or both. 

  • Therapy: Talking to a trained professional might help your child understand what's making them anxious and allow them to work through these stressful situations. Counselling helps a child learn how to better manage and cope with obsessive-compulsive behaviours.
    Cognitive behaviour therapy (CBT) and exposure and response therapy are types of therapy that might prove to be effective for many people.
  • Medication: If your child's anxiety problem does not get better with therapy, your doctor may talk to you about trying medication. They're usually only prescribed by doctors who specialise in children and young people's mental health. Antidepressant or anti-anxiety medicine may help some children feel calmer. A selective serotonin re-uptake inhibitor (SSRI) is usually used to reduce obsessive behaviours and compulsions.

How can I help my child with OCD?

Here are some of the things you can do to help your child:

  • Keep all appointments with your child’s therapists
  • Talk with your child’s therapist about other providers who will be included in your child’s care. 
  • Keep open lines of communication with your child. 
  • Discuss your child’s situation with their teachers and family members.
  • Reach out for support from local community services. Being in touch with other parents who have a child with OCD may be helpful.
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