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Obsessive Compulsive Disorder (OCD): Questions & Answers

Questions & Answers

What does OCD stand for?

The "O" in OCD stands for obsessive, which means that people have intrusive, unwanted thoughts or images that cause a great deal of anxiety, doubt or worry. The "C" in OCD stands for compulsive, meaning that people may behave in repetitive and/or ritualistic ways in order to reduce the anxiety created by the obsession. Together, they make up obsessive compulsive disorder, which is a relatively common anxiety disorder. It affects boys and girls equally, and approximately 1 in 40 kids suffer from it.

What does OCD look like?

Many people have some degree of concern with the symptoms associated with OCD. However, in order to be diagnosed with the condition, the concerns must be excessive and cause distress in one's life, which for kids may mean dropping grades, increased social isolation, reluctance to attend school, etc. Some of the typical obsessions seen in children and adolescents are: concerns with germs or dirt, needing things to be ordered or arranged in certain ways, fears of harming oneself or others, concern with bodily waste or secretions, and having excessive issues of morality. Commonly observed compulsions in kids are: excessive hand washing or grooming, lining up toys or possessions in particular ways and getting very upset if disrupted, excessive erasures while writing or re-reading words/sentences over and over again and seeking multiple reassurances from others.

Did I do something to cause my child's OCD?

Absolutely not! Unfortunately, this is a question we are asked frequently by parents. Sometimes the symptoms of OCD appear relatively quickly, so it's understandable to think that perhaps it was caused by some environmental issue. OCD has several causes. First, there is a genetic component. If a biological parent has OCD, there is approximately a four to eight percent possibility that any child may inherit the gene. Second, there are biological issues at play. We know that OCD is related to a deficit in the neurotransmitter serotonin, which is why the medications that effect serotonin are so effective in the treatment. Third, there are a group of women who either develop OCD or have a reoccurrence of symptoms after childbirth. Lastly, there is a somewhat controversial debate about whether a condition called PANDAS can cause OCD. PANDAS stands for Pediatric Autoimmune Neuropsychiatric Deficits Associated with Streptococcal Infection, and some research implies that a certain group of children rapidly develop symptoms of OCD following strep infections. Although we don't know for sure yet about PANDAS, we do know for sure that you did not cause your child's OCD.

Are symptoms apt to change?

OCD symptoms generally change over time. Sometimes when a child gets rid of one symptom, another may develop. For example, a child may switch from hand washing to checking. Cognitive behavioral therapy teaches the child to deal with the symptoms no matter what they are. The child is taught to recognize symptoms early and to use the same approach.

Why can't we just tell him to stop?

Parents inadvertently may get drawn into a cycle. Telling the child to stop may accidentally reinforce the symptom; the attention may maintain the problem. In cognitive behavioral therapy the parent learns how to become a home-based therapist. Parents need to learn to walk away from the behavior and then reward the child when she copes with it appropriately.

Will it last a lifetime?

Children may always have this tendency, but treatment helps them recognize and manage the symptoms.

Okay, my child has OCD - now what?

Good news! Although there is no cure yet for OCD, there are highly effective treatments. The gold standard of treatment for OCD is Cognitive Behavioral Therapy (CBT). We provide children with a toolbox of skills that can be utilized anytime a symptom is present, and those skills can be used for a lifetime. We teach children how to face their fears and change their thoughts without needing to use the compulsions to reduce their anxieties. In many cases, medications are used to supplement the treatment. The medications that tend to be the most effective are known as Selective Serotonin Reuptake Inhibitors (SSRIs), and can provide substantial relief of symptoms, especially when used in conjunction with CBT.