Children with Obsessive Compulsive Disorder (OCD) begin to worry about all sorts of other things. They develop obsessions and unwanted thoughts or images often accompanied by compulsions such as repeatedly washing, counting or checking.
Dr Isobel Heyman, a consultant child psychiatrist at the Maudsley Hospital explains: ‘Ritualistic repetitive behaviour is normal in young children. Children between the ages of three and six often have quite a lot of bedtime rituals, the door in the right place, the pink teddy in the right place and that’s really normal and is usually outgrown.’
Ritualistic behaviour is only a problem if it starts to get in the way of normal everyday life.
One in a hundred people will develop OCD at some time in their lives, many from an early age. OCD is the fourth most common mental health disorder and affects an estimated one to three per cent of the UK population (approximately 1.8 million people). The World Health Organization lists the illness as one of the top 10 disabling conditions - including physical ailments - in the world.
At least half of adults who get help for OCD started their symptoms as children but went undiagnosed. It is often referred to as the ‘secret’ illness because people are embarrassed about the symptoms and realise it isn’t logical. Yet if the illness is 'caught' and treated in time, the majority can make a full recovery.
‘We’ve seen seven year-old children with OCD,’ says Dr Heyman. ‘Sometimes with hindsight you hear of them beginning earlier but it would be very rare to diagnose it because it would be within normal limits at that age.’
Psychiatrists assess OCD in children by looking at how long they spend carrying out their rituals and routines and whether their behaviour is causing them stress. Generally if the rituals or thoughts take up more than an hour a day, are making the child miserable and preventing them from doing other things, then it’s time to seek help for OCD.
It could be that the child is consistently late to school because they are packing and unpacking their school bag until it feels just right, or walking to school avoiding the cracks in the pavement.
In extreme cases, the child could be up half the night washing. Dr Heyman recalls a recent case where a girl arrived to the clinic with such severe OCD that she was spending five or six hours in the bath or shower every night until all the hot water had run out.
In other cases the child may be worried about contamination, so they may avoid playing football with friends because they don’t want to get muddy.
‘It’s not just having a few rituals because we all have a few,’ explains Dr Heyman. ‘It’s about demonstrating that it’s reached the level of a disorder in the sense that it’s getting in the way.’
Studies have shown that OCD can affect anyone, regardless of class, background, ethnic group or age. And recent research has shown it can run in families. A child who has a parent or sibling with OCD is ten times more likely to develop the disorder.
For Becky, 12, it was a chance conversation with her mum, Helen that led to the realisation that they both had OCD.
Becky explains, ‘I started switching lights on and off then having horrible pictures in my head and I had to do things to stop it, like I had a picture of sharks killing my family. I used to have to walk a certain way, breathing in and out before my foot reached the ground, if I did it wrong I had to go back and start again. I thought I was going mad.’
Helen took Becky to the GP and she is now receiving Cognitive Behaviour Therapy (CBT), which she says is helping.
Joe Wells, author of the book – Touch and Go Joe: An Adolescent’s Experience of OCD - started developing symptoms around the age of nine. From an obsession with cleanliness, he moved on to tapping, counting and blinking to cancel out negative thoughts.
‘OCD is completely nonsensical and will not listen to reason,’ he says. ‘It was just so debilitating. You couldn’t live your life normally because you’ve got all these things occupying you.’
Following two years of intensive CBT from the age of 13, plus a course of drugs, Joe, now 19, helps others with OCD.
Get help with OCD visit ocdaction.org.uk or ocd-uk.org
