How to spot the most common OCD symptoms in children – and why lockdown is causing it to rise

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  • Worried about OCD symptoms in children at the moment? The COVID-19 pandemic is not just impacting our mental health, but our children's too.

    In fact, a recent survey by Benenden Health found that more than three million children in the UK could be struggling with poor mental health due to the current crisis. This has led to big behavioural changes, including being increasingly agitated, moody or upset, misbehaving and crying more. And, with a focus on washing hands properly key to stopping the spread of COVID-19, many children could be showing symptoms of Obsessive Compulsive Disorder (OCD).

    That’s why we asked Child Psychotherapist Joanna Fortune, author of 15 Minute Parenting: The Quick And Easy Way To Connect With Your Child (£9.99, Thread), to tell us everything you need to know about OCD symptoms in children.

    What are the signs and symptoms of OCD in children?

    “OCD in children involves obsessions, which are experienced as intrusive and unwanted thoughts, images, or urges that are repetitive and beyond the child’s control,” says Joanna. “These obsessions typically cause a lot of worry, anxiety, and distress. They also experience compulsions, which are behaviours the child feels they ‘must do’ in order to manage the distress and agitation caused by the obsessions. Sometimes children believe that engaging in these compulsions can control outcomes. Eg. ‘If I flick the light switch 14 times then the bad thing will not happen’.”

    Do symptoms of OCD in children differ from those of adults?

    “The symptoms will vary greatly between every person with an OCD diagnosis regardless of their age,” says Joanna.

    When is a child most susceptible to OCD?

    “There are generally two age ranges when it tends to first appear,” says Joanna. “Between ages 8 and 12 years (middle childhood) and in late teens into early adulthood as well. But OCD can actually start at any time from preschool to adulthood,” says Joanna.

    Does another family member have OCD?  There is a link. “OCD can sometimes run in families, although no specific genes have been linked to it,” says Joanna. “A person with OCD is four times more likely to have another family member with the condition compared with someone who does not have OCD. Studies have also shown that OCD may be related to other conditions, such as tics and Tourette’s syndrome.”

    What are the OCD symptoms in children and why is lockdown causing OCD to rise? Be kind to hands

    Are there any usual triggers for children to develop OCD?

    Joanna says:

    • Stress. “Stress alone isn’t thought to cause OCD. But a particularly stressful or upsetting life event (the death of a family member or friend, a family break-up) may trigger the condition in someone who already has a tendency for it.”
    • Chemical imbalance. “The chemical serotonin also seems to play a part in OCD. It’s a neurotransmitter, which is a chemical that the brain uses to transmit information from one brain cell to another. Experts still aren’t sure exactly what role it plays but medications that increase the serotonin levels, such as certain antidepressants, have successfully helped to treat the symptoms of OCD.”

    “The stress of a situation, like COVID-19 wouldn’t cause OCD alone,” says Joanna. “But it could, especially with the increased focus on almost ritual-style hand washing (frequency and duration) amplify pre-existing symptoms.”

    How is it best to deal with germs and COVID-19 around children?

    If they are showing OCD symptoms, Joanna advises:

    • Stay calm. “Do not get cross or irritated and remember they cannot control this.”
    • Make washing hands fun. “Sing a song together so the focus is on singing not just washing. Singing helps to co-regulate an anxious brain.”
    • Use grounding techniques. “Get them to look out of a window. This resets an anxious brain because it changes the field of vision. Ask them to identify five things they can see, four things they can hear, three things they could smell, two things that they could touch and one thing that they could taste. You are engaging the senses while calming the anxious brain. Plus, your close physical proximity serves to reassure and calm their anxious brain in the moment.”
    • Show hands love. “Say that you wash only for the duration of the hand washing song because by then your hands are clean. Rub lotion on to show hands are deserving of good care and are not just carriers of germs.”
    • Stay empathic. “Use distraction and redirection when you can to help compulsive behaviour. But understand that this is not easy for them to just stop.”
    • Do not feed into the symptom, but do not punish it. “Accept that this is your child’s belief in this moment and empathise with how hard this is for them while you hold a gentle yet firm limit to support them through.”

    When to seek professional help

    “As soon as it becomes a worry, seek a consultation with your GP who will refer you for treatment if warranted,” says Joanna. “OCD is a treatable condition, but you cannot diagnose yourself or your own children. Assessment tends to also look at the presentation of symptoms under the following headings, so discreetly observe and track symptoms.” Look for:

    Mild functional impairment: Obsessive thinking and compulsive behaviour occupies less than one hour of your day.

    Moderate functional impairment: Obsessive thinking and compulsive behaviour occupies one to three hours of your day.

    Severe functional impairment: Obsessive thinking and compulsive behaviour occupies more than three hours of your day.

    “Treatment can sometimes involve medication,” says Joanna. “But a number of therapies can be very effective in managing the symptoms and working on any underlying stress/anxiety.”