Obsessive-Compulsive Disorder (OCD)

OCD is a type of anxiety disorder characterized by repeated thoughts (obsessions) and repeated behaviors (compulsions). The obsessive thoughts are intrusive, unpleasant, and typically rooted in fear. The compulsive behaviors, or rituals, are strategies used to calm the anxiety.

Often the compulsive behaviors are not directly related to the fear they are designed to manage, and can appear outwardly irrational. For example, a child may believe they must hold their breath for a certain amount of time to stop something terrible from happening to their family. These instances of “magical thinking” nevertheless provide some relief from the intrusive thoughts.

What are the Signs of Childhood OCD?

Signs your child may have OCD include:

Obsessions

• Fears about their safety, or the safety of their loved ones. These can include things like a family member getting in an accident, or the house setting on fire

• Preoccupation with symmetry, neatness and orderliness, for example, their handwriting at school

• Fear of catching germs from everyday objects

• Excessive attention to detail

• Obsession with specific numbers, for example only doing things in threes

Compulsions

• Counting and recounting

• Checking and rechecking

• Hoarding

• Excessive hand washing

• Repeatedly asking questions

• Grouping and ordering objects

• Following strict rituals for doing things, such as tidying up

How is Childhood OCD Diagnosed?

In order for a child/adolescent to be diagnosed with OCD, their obsessions and compulsions cause significant distress or interfere with their ability to function in daily life. The symptoms must be continuous, severe and disruptive, and occupy more than one hour per day.

The Y-BOCS (Yale-Brown Obsessive-Compulsive Scale) is a clinically administered scoring instrument that can be used to determine the severity of a child or adolescent’s OCD symptoms.

How Common is Treatment-Refractory Childhood OCD?

Between 25-33% of children do not experience relief from their symptoms in response to first-line treatments (cognitive-behavioral therapy and/or medication) for OCD. Even those who do respond often have persistent symptoms.

Factors that can influence resistance to OCD treatment can include the severity of the symptoms, higher related parental stress and greater functional impairment.

Integrative Approaches to Childhood OCD

If your child/adolescent has not fully responded to OCD treatment, you may wish to consider an integrative approach to treatment. This can include therapy, supplements, dietary interventions and lifestyle modifications.

Therapy for Childhood OCD

The main treatment for OCD is Exposure Response Prevention Therapy (ERPT), which is a form of CBT. This type of therapy exposes those diagnosed with OCD to the thoughts, images, objects and situations that make them anxious.

The response prevention part of ERPT is about making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.” In continuing to do these exposures, the body realizes that it isn’t “under attack” and starts to mount less of an anxiety response which is called “habituation.” Over time, the body may come to not mount any anxiety response at all.

Development of OCD often has a strong relationship with exposure to childhood trauma, such as emotional abuse or neglect, and the level of maltreatment is associated with symptom severity. If this is the case, then it is important to take measures to treat the trauma to help with the OCD symptoms.

Integrative cognitive therapies explore a range of psychological factors that can impact your child’s OCD. These include areas such as your child’s core beliefs, vulnerabilities, early attachment experiences, developmental history, and distorted thinking, amongst other things.
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Diet & Supplements for Childhood OCD

There are several supplements that can have an impact on your child’s OCD.

For instance, Vitamin D can play a role in reducing the severity of OCD symptoms. Vitamin D is not only essential for healthy brain functioning, but is also involved in the inflammatory response, which may play a role in OCD.

Since oxidative stress has been suggested to play a significant role in OCD, antioxidant-rich foods, such as strawberries, raspberries and kale, may also have a positive impact on your child’s OCD symptoms.