OCD – Obsessive-compulsive disorder in children and teenagers

When a child or a teenager has obsessive-compulsive disorder, they notice that they have to think in a certain way or do certain things in a special way. Otherwise, they will have anxiety or think that something awful will happen. There is good treatment for obsessive-compulsive disorder.

This text is primarily aimed at you who are custodians or close relatives of a child or teenager. If you want to read about  obsessive-compulsive disorder in adults, read more here . If you yourself are a teenager can  read more on UMO.se .

The word child in this text refers to both children and teenagers.

How is obsessive-compulsive disorder marked in children and teenagers?

Everyone can have compulsive thoughts and ideas sometimes. This can be about avoiding stepping on a well cover in the ground or checking that the door is locked an extra time. It is called obsessive or magic thoughts and is common in children. 

If the thoughts affect how someone works in everyday life it may have started to develop into a compulsive syndrome, or OCD as it is also called. OCD is an abbreviation of English’s obsessive-compulsive disorder.

Compulsive syndrome consists of thoughts and actions. Developing a compulsive disorder is not something that happens suddenly, but something that happens over time. Often periods are interspersed with and without obsessive thoughts and compulsory actions. Sometimes they disappear by themselves.

What are obsessions?

A compulsive thought can come suddenly and is usually perceived as intrusive, unpleasant and scary. Compulsive thoughts can feel very difficult to control and often arouse feelings of shame, disgust and guilt. To calm the chaotic thoughts, the person can sometimes count things over and over again to create order.

Examples of common obsessions are:

  • What if I touched something contagious.
  • What if I accidentally swallow something poisonous? 
  • What if I forgot to lock the door or close the window properly? 

It is also common to have obsessive thoughts with sexual content, thoughts of harming others, or thoughts that someone close to you will be harmed. The compulsive thoughts are precisely thoughts, and does not mean that the child actually harms anyone.

The compulsive thoughts that create strong  anxiety  and fear can develop into compulsive actions.

What are coercive acts?

An act of coercion is something you do to reduce the anxiety that the compulsive thoughts arouse. The action may resemble a ritual. This means that the child often repeats the action many times according to a particular pattern. 

For those who look at it, the act of coercion may seem illogical or unnecessary, but for those who perform it there is a link between the act and what they are afraid of.

For example, anyone with obsessive-compulsive disorder may feel compelled to wash their hands for an hour after taking a handle, thinking that the handle may have been infected with a dangerous disease.

At the moment, obsessions and compulsions can relieve anxiety. But over time, they can become difficult to stop, and they can also take longer to perform. It leads to being prevented from doing different things in life. It can mean that you stay home from school, stop hanging out with friends or participate in leisure activities.

Not always marked outwards

The compulsive actions can sometimes consist of thoughts or something you do quietly for yourself. Examples of such coercive acts are: 

  • To repeat certain words for themselves.
  • To calculate according to a special pattern, for example backwards in steps of three.

Sometimes the compulsive actions are clearly marked to the surroundings as a deviant and compulsive behavior. Examples of common coercive acts that are noticed are:

  • The person washes his hands or showers for a very long time. 
  • The person arranges things in a special order, or according to a certain pattern.
  • The person collects things or saves things that others may perceive as unimportant or as rubbish.

When should I seek care?

If you think a child in your area has obsessive-compulsive disorder, contact your health care provider. Depending on the child’s age, you can contact one of the following places: 

  • childcare center, bvc  – for children up to six years
  • medical center or pediatric clinic
  • child and adolescent psychiatry, bup
  • student health – for children who attend school .

In most regions there are receptions that have a specific mission to take responsibility for the mental health of children and young people. It’s called first-line psychiatry. It can be at a health center or pediatrician and is often called a call center.

In some county councils there are receptions for young adults. In some parts of the country there are specialist clinics for obsessive-compulsive disorder.

Treatment of obsessive-compulsive disorder

Obsessive-compulsive disorder in children is primarily treated with knowledge of obsessive-compulsive disorder, called psychoeducation, and  psychotherapy . Drugs can be combined with psychotherapy or, if needed, used as a single treatment. 

The psychotherapy recommended in obsessive-compulsive disorder is cognitive behavioral therapy, KBT. It is a therapy that is about changing the thoughts, feelings and behaviors that are linked to obsessive-compulsive disorder.

Description of the problem

At the beginning of treatment of obsessive-compulsive disorder, it may be good if you as a close relative or guardian meet with the therapist with the child to describe how the compulsive syndrome manifests.

Then you discuss how the treatment should be designed. Treatment is planned specifically for each person. It is important that you are involved and have the opportunity to influence the treatment as much as possible. If you have questions about the treatment, it is important that you get answers to them. 

Exposure – training to deal with anxiety

In therapy, the child is helped to meet what feels uncomfortable and creates compulsion. The method is called KBT with exposure. The aim of the treatment of obsessive-compulsive disorder is to reduce the obsessions and compulsions when the person notices that what they are afraid of will not happen.

The treatment also involves the child discovering that the anxiety is manageable through the new approach, and that it always goes away after a while. 

How long does the treatment last?

The treatment time is different for different people. Sometimes, some treatment may suffice, while others may require treatment over a longer period of time. 

Often, the child is given home tasks to perform between visits. It is important to practice often. Relatives and other people all around play an important role in therapy.

Treatment with drugs

SSRIs are a group of  drugs used for depression  but also for anxiety and obsessive-compulsive disorder.

It is important to know that it may take several weeks for these drugs to produce the desired effect. During these weeks you can even feel worse.

There are SSRIs that can be given to children from the age of six and up. They can be given at the same time with other treatment.

Advice and support for healthy habits

Sometimes the treatment may also include advice and support for getting healthy, regular habits.

In order to feel good, it is important to take care of basic needs such as eating well , moving around and getting enough sleep and rest.

If there is a suspicion that the child or teen uses alcohol, drugs or tobacco, it is important to tell your doctor.

Why do you get obsessive-compulsive disorder?

Knowledge about why some people get obsessive-compulsive disorder is limited. It is common for obsessive-compulsive disorder to develop during periods of stressful events, such as during a move or if the child changes to a new school. There may be an innate sensitivity.

It is not uncommon for other disorders to be linked to obsessive-compulsive disorder. Examples of such disorders are  Tourette’s syndrome , problems with  tics , autism ,  phobias  and  depression .

Being the parent of a child with obsessive-compulsive disorder

When a child begins to show signs of worry and compulsive behavior, it often creates a concern in you as an adult. It can feel daunting if coercion starts to affect everyday life. You may feel both powerless and scared, and perhaps unsure of what to do.

You who feel guilt may need to remind you that obsessive thoughts or compulsions do not depend on you as a parent.

Get knowledge

You can be a better support if you have knowledge of the child’s specific problems. The first advice is to learn more about obsessive-compulsive disorder and anxiety, for example by reading books and articles on the subject. You can also talk to someone who works with children and adolescents with obsessive-compulsive disorder, such as in student health or children and adolescent psychiatry, bup. 

It is important that you as a parent or guardian take the child’s problems seriously from the beginning. Do not hesitate to seek professional help, preferably in consultation with the child.

When you feel bad yourself

Many parents get frustrated and maybe even angry when the child is unable to break an act of coercion and do everyday things on time.

It is not strange to lose patience or get angry sometimes, but it can be good to know that it does not help to bark or get angry at a child who is already feeling anxious and anxious.

Some may also feel ashamed and worried about what others will think of their children. That feeling is often mixed with a feeling of guilt and concern about having caused the child’s obsessive-compulsive disorder, even if it does not match reality.

Talk to someone

As a relative, you may need help and support yourself. It may be good to talk to someone about how you feel.

It is common to feel frustrated, feel guilt or worry, which can make it harder to cope with your own everyday life. Often, feelings of shame and self-aggression decrease when you put words to one’s thoughts and tell someone else. In addition, you can access other people’s experiences when you share your own.

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