Sheldon Cooper in The Big Bang Theory. Adrian Monk of Monk. The Odd Couple's Felix Unger. For many folks, with the mention of obsessive-compulsive disorder (OCD), these well-known, quirky fictional characters come to mind.
However, for those afflicted, OCD is anything but quirky. Conversely, when left untreated, OCD can be a debilitating struggle.
What is OCD?
Obsessive-compulsive disorder is characterized by the presence of frequent obsessions and compulsions to such an extent that they take up an inordinate amount of a person's waking hours and interfere with daily activities.
The two major components of OCD are obsessions and compulsions. Obsessions are defined as continuously occurring thoughts, feelings, and fears outside of a person's control. Compulsions manifest as a result of an OCD sufferer's all-consuming obsessions and are defined as repetitious behaviors or thoughts a person feels they "must" do. Those with OCD feel forced to engage in compulsions or rituals in order to reduce their anxiety.
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OCD in children
According to Stanford Children's Heath, currently about 1 in 200 children and adolescents suffer from obsessive-compulsive disorder. A child's OCD diagnosis typically affects not only the afflicted child, but also parents, family members and school faculty.
Jessica Westover of Highland knows now that her 14-year-old daughter first exhibited signs of OCD at the age of 4, but she admits she did not recognize it at the time. "Her OCD at that point was confessional or "bad thought" OCD, where she constantly confessed worries that she had done something wrong, even when she had not," explains Westover. "This eventually faded, only to be replaced with other OCD behaviors. For example, in first grade she was convinced that if she didn't have a Chapstick, her lips would bleed. She'd have a panic attack if her Chapstick went missing."
By fifth grade, Westover's daughter was struggling with a debilitating case of emetophobia, an overwhelming fear of vomiting. This fear manifested as compulsions such as constantly asking
questions about the possibility of becoming sick, refusing to eat past 7pm, and even avoiding words pertaining to the act of vomiting.
Take note of red flags
When OCD occurs in childhood, there is a high likelihood of co-occurrence with other disorders. Some common coexisting disorders include tic disorders, ADHD, and anxiety disorders. Katie Bowman of New Paltz is currently in the process of getting her preschool-aged son, who currently has an anxiety diagnosis, tested for OCD. "It may well be that his obsessive-compulsive behaviors are a part of his anxiety," says Bowman, "but there's that fine line that can separate anxiety from anxiety with OCD, which is what we're potentially exploring."
Bowman references behavioral red flags her son has displayed both at school and at home that may be indicative of OCD. "At home," says Bowman, "he will ask the same question to the point of it only being for the reassurance of the familiarity of the question- answer routine, sometimes upward of two dozen times. He seems to use that as a way to soothe himself."
How to treat OCD
While there is no cure for OCD, it can be effectively treated. Besides employing the services of child psychologists and psychiatrists, Jennifer Colucci of Hopewell, whose son has a dual
diagnosis of OCD and tic disorder, has, in her words, "gone the holistic route, doing Nutrition Response Testing for food sensitivities to see if cutting out certain foods like gluten or sugar can help decrease the OCD behaviors."
Medication can also frequently be part of an OCD treatment plan. According to KidsHealth.org, serotonin reuptake inhibitors (SSRIs), such as Zoloft and Prozac are typically prescribed in cases of pediatric OCD.
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Regarding therapeutic treatment, mother Jessica Westover says, "I've come to realize just how very few therapists truly recognize or understand pediatric OCD." For a time, because her daughter's therapies did not specifically target her OCD, her OCD actually got worse. Fortunately, through diligent research along with speaking to other parents of similarly afflicted children, Westover learned of exposure and response prevention (ERP).
ERP therapy forces the patient to face their biggest fear, beginning with small tasks and progressing to more difficult exposures. "The child has to feel the panic and anxiety and just ride it out," says Westover. She credits ERP therapy with an incredible change in her daughter. "She and our family have our lives back. It's like our little girl was gone and now she's with us again."
Coping as a family
Jennifer Colucci says, "Living with an OCD-afflicted child takes a lot of patience and understanding from all family members." Regarding her other two children, she states, "As they get older, I plan to continue educating them about OCD and how best to support their brother." Additionally, Colucci makes sure to give her son frequent reminders that in the grand scheme of things, he's not all that different from anybody else. "Everyone has challenges in life that they must deal with, everyone's brain is special, and everyone's brain works differently," says Colucci.
Jill Valentino is a wife, mom of two, elementary educator and lifelong resident of the Hudson Valley.