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EDGES MAGAZINE Issue
43 |
January
2006 |
Worries and doubts are part of normal
everyday life. However, when these concerns affect normal functioning, it is a
sign that there might be a greater problem. Modern psychiatry classifies
Obsessive- Compulsive Disorder (OCD) as one of the Anxiety disorders.
Currently, 1 in 200 children and adolescents in the United States has
Obsessive-Compulsive Disorder. Fortunately, there is a lot that you as a parent
can do to help your child.
Obsessions are persistent and recurrent
impulses, thoughts, or images that are unwanted and cause distress. These are
usually irrational and are not the normal products of daily living. Compulsions
are repetitive actions, like washing hands or hoarding things, or mental
actions, like counting or repeating words silently. As the name implies
Obsessive-Compulsive Disorder is characterized by both.
Typically, the
person is plagued by repetitive thoughts, images, or impulses that are
disturbing, illogical, and out of the persons control. In an attempt to
make these obsessions go away the person develops and performs compulsively a
set of actions to relieve the discomfort caused by the obsessions.
For
example, a person who is obsessed with sickness may develop compulsive hand
washing. A person who is obsessed with fear of fire might continually check to
make sure that the stove is off. The person gets no pleasure from doing these
actions. Rather they provide temporary relieve from his unpleasant thoughts.
The person may spend hours over the course of the day doing compulsive actions
to relieve his obsessive thoughts.
At some point, most people realize
that the anxieties are only a product of their own minds and have nothing to do
with reality. However, they are unable to control the thoughts or the
behaviours. Obsessive- Compulsive Disorder can start as early as preschool age.
The way OCD shows itself in a child will vary with the childs age. A
younger child may have anxiety that harm will come to him or a family member.
He may repeatedly check to see if the doors of his house are locked.
An
older child may be afraid of germs and that his food is poisoned or that he
will get AIDS. He may constantly wash his hands or food. The child may even
know and can verbalize that it doesnt make sense. However, the compulsive
behaviour is beyond his control.
Children with OCD frequently don't
feel well physically. This may be because of the stress their anxieties cause
or it may be due to lack of sleep or poor nutrition. These children often have
stress related disorders such as headaches or stomach upset.
Frequently, children are angry with their parents. This usually occurs when the
parents are unable to comply with their childs behavioural quirks. These
children usually have trouble keeping friends because of their behaviours make
them stand out. These children often suffer from poor self-esteem.
The
diagnosis usually goes unrecognised for a very long time. Studies show that
most people dont receive the diagnosis of OCD until 9 years after the
symptoms first appear. It may take an additional 8 years before they receive
adequate treatment. The reason for this is two fold. Most patients are
embarrassed by their condition, so they avoid telling anybody. Secondly, many
doctors are not familiar with the condition, so that they are not quick to
recognize it nor do they know how to treat it.
Children with OCD
commonly have other psychiatric problems. Other anxiety disorders - Depression
ADHD ODD Learning disorders Hair pulling
Most children with OCD can be
treated effectively with a combination of psychotherapy and certain
medications. Family support and education are also central to the success of
treatment. Antibiotic therapy may be useful in cases where OCD is linked to
streptococcal infection.
Cognitive behavioural psychotherapy is the
psychotherapeutic treatment of choice for children, adolescents, and adults
with OCD. This method helps the patient internalise a strategy for resisting
OCD and has lifelong benefit. This therapy focuses on changing the
persons thoughts and feelings by first changing his behaviour. This form
of therapy has only moderate success. 25% of patients are unable to finish the
course of the program. Of those that do finish, between half and three quarters
report some degree of benefit after three to five months. These benefits last
after the therapy has stopped.
Therapy usually is administered on a
weekly basis for at least two months. There is an intensive form of therapy in
which the person works with the therapist in 2-3 hour periods three times a
week. If the person chooses the faster approach, he can complete treatment in
three weeks.
The current recommendation is to use cognitive behavioural
therapy in conjunction with medication.
No two children respond to
anti-OCD medication in exactly the same way. Some children dont respond
to any medication. Side effects also vary from person to person. For this
reason, your child may need to try more than one medication. Although we still
dont know for certain, no one has identified any long-term problems from
taking these medications.
If your child has Obsessive-Compulsive
Disorder, the most important thing you can do to help your child is to learn as
much as you can about the condition.
Children and adolescents often
feel shame and embarrassment about their OCD. Many fear it means they're crazy.
Good communication between parents and children can increase understanding of
the problem and help the parents appropriately support their child. Family
problems do not cause OCD, but the way the family deals with the symptoms can
affect the child. If your family is having difficulty dealing with a member who
has OCD, you should try to consult a Family Therapist for direction.
Try to be as kind to your child as possible. This is the best way to reduce the
symptoms of OCD. It will not work to command your child to stop the behaviour.
Your child is unable to stop and he will only feel even greater distress if he
is reprimanded or forced to stop his rituals. Remember, as much as your
childs behaviour bothers you, he is suffering even more. You have to be
your childs advocate in school. You must make sure that the childs
teacher and the school administrators understand the disorder.
Use
support groups. Sharing common problems with other parents is an excellent way
to help you feel that you are not alone and is great support. You also might
gain practical insights about what you can do to deal with the daily problems
that come up.
Make time for yourself and your own
life. You must not let yourself be trapped by your childs rituals. Your
child does not need a martyr as a parent. |
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