After almost two years of hand-washing, sanitizing and fear of a scary sounding virus, it is unsurprising that OCD in childhood is on the rise as children are suffering from fears of getting ill and germs in general.
With such an emphasis on hygiene, and daunting news reports of deaths and disease ever present on TV, newspapers, and social media, there is a high risk for health anxieties and OCD in childhood to develop.
Research studies estimate that between 1.9% and 3% of children suffer from OCD. It is likely that this could rise post-pandemic. So, it’s important to notice if your child is showing signs of OCD or symptoms of health anxiety. Recognizing common traits could mean that you can help them to negotiate triggering situations, and realize when they may need professional or medical assistance.
Spotting early signs of anxiety and OCD in childhood is important, the sooner a child can be diagnosed, the quicker they can receive the treatment and help they need. Children as young as 5 have been diagnosed with OCD, so getting help early could mean that they find coping mechanisms that help them for the rest of their lives, or even never experience a bout of OCD again.
In this article, we will explore the similarities and differences between health anxiety and OCD as well as how they cross over. We will then look at signs you can look out for to identify if your child is suffering from OCD, where you can go for support, and the many ways that OCD can be treated.
What is health anxiety?
Health anxiety, sometimes also called hypochondria, is a challenging condition that means sufferers spend a lot of time worrying that they are, or will get, ill. These thoughts can be all-consuming and overwhelming, and impact the quality and enjoyment of their day-to-day life.
Often, but not always, traumatic events can result in health anxiety. It can also be triggered by experiencing a serious illness, the death of someone close, or other early years trauma. Other times, it can have no clear origin.
In the midst of a pandemic, where children may have experienced the loss of loved ones due to COVID-19, and lockdowns potentially inducing trauma, we could see a rise in health anxieties in children in a post-pandemic world.
What is Obsessive Compulsive Disorder (OCD)
Like health anxiety, OCD was originally classified as an anxiety disorder, due to the intense anxiety linked to its symptoms. But since 2013, it has its own, separate classification. As the name suggests, OCD is related to obsession and compulsions, so severe that they can be debilitating; they can take over those suffering, leaving them unable to perform basic tasks.
Obsessions are intrusive, involuntary thoughts, ideas or worries that constantly run through the person’s mind. Compulsions, or rituals, are repetitive behaviours that are performed to reduce the anxiety brought on by obsessive thought.
There is no recognized ‘cause’ for OCD in childhood, though it is believed that some children may be more vulnerable. This could be genetic, with some being more prone to anxiety-related disorders. Sometimes OCD can be triggered by an event that a child may perceive as frightening.
There are many types of OCD in childhood. This could include fears about contamination and germs, and health-related obsessions, like fear of catching a sickness bug. This makes it hard, at times, to differentiate between health anxiety and obsessive-compulsive discovery.
During this public health crisis, the constant emphasis on washing hands, social distancing, and being hygienic may trigger OCD in childhood or could result in relapses for those formerly managing their symptoms.
Signs Your Child May be Suffering From Health Anxiety
Health anxiety can be more obvious, as sufferers are often vocal about their concerns. Look out for these common symptoms or signs of health anxiety in your child:
- Constantly worry about their health
- Frequently check their body for signs of illness, such as lumps or a temperature.
- Are always asking you for reassurance that they’re not ill.
- Act as if they are ill, but more seriously than ‘pretending’.
- Requesting to stay home from school, for fear of catching a bug at school.
Often you will be able to tell quite quickly if your child is actually ill. Be careful though, as anxiety itself can cause symptoms like headaches or a racing heartbeat. These symptoms can easily be mistaken for signs of illness.
Signs of OCD in Childhood
A big difference between OCD and health anxiety is that those suffering OCD may try to hide their compulsions, and often lots of their obsession is internal. That being said, there are some physical symptoms you may notice in a child suffering from OCD, which includes:
- Repetitive behavior, such as asking the same questions over and over.
- Touching things a specific number of times, or counting steps
- Checking things multiple times, like if a door is locked.
- Avoiding touching certain surfaces, for fear of catching germs
- Obsessive and repetitive washing of hands
- Preoccupation with death, illness, or abstract concepts such as good/evil
Some things that you may not notice as easily include counting, perhaps under their breath or even in their head (look out for them being distracted, or unable to focus on what you are saying to them) or repeating compulsions, like repeating certain phrases in your head or out loud, to a point of obsession.
It is worth remembering, some of these behaviours are part of normal childhood development. All children process worries at different stages. If it lasts a long time or begins to interfere with daily living, that’s when it becomes a problem!
The relationship between health anxiety and OCD in Childhood.
There are overlapping symptoms, and triggers, with health anxiety and OCD. Some treatment techniques can be used by people suffering either. However, they are defined as separate disorders.
One significant difference between OCD and health anxiety is awareness of the sufferer of their problem. While someone with OCD may, deep down, realize that their thoughts are intrusive and often irrational, someone with a health disorder truly believes that they have a serious illness. However, for a child suffering either, it may be unclear if they are aware of the rationality of their fears, given their continued development in early years, through to preadolescence.
Managing these conditions can feel impossible for children, young people, and their families. What are the ways to treat health anxiety and/or OCD, and how can you support your children?
How to support your child with health anxiety or OCD
In a time of ‘unprecedented’ and ‘unforeseen’ circumstances, and lots of ‘unknowns’, it could be hard to offer your child reassurance about their health worries. However, there are ways that you can support them, before and alongside formal diagnosis and medical treatment.
Talk openly about their fears and give them a safe space to share any worries they may have. This could also mean talking about COVID-19, as it could lighten the fear of the unknown. Being honest means you will build trust, and show that you aren’t angry about their anxieties.
It can be easy to facilitate fears in your desire to lessen stress and suffering in your children. But in the long run, this could be more detrimental and strengthen their fear. Similarly, it can be tempting to try and overly explain why a fear is irrational by making them face it. While this is a similar method seen in exposure therapy, it should only be practiced by mental health professionals and/or practitioners. Forcing your child to ‘face their fear’ could, actually, mean they hide more from you.
Routine can really help with anxiety. So work with your child to create a schedule or regime that suits your entire family, yet offers comfort for your suffering child. Explore mindfulness options, and try some easy mindfulness activities that are perfect for children.
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Learn what triggers your children, and see if there are ways you can avoid stressors, without leaning into their fears. For example, when entering a triggering situation, warn your child ahead of time, and build an action plan of how to tackle the occasion, with clear boundaries and even a code word if it all gets too much.
Seeking Further Support
Even if you are practicing some of the above ways to help manage your child’s health anxieties or OCD symptoms, it’s important to seek support and advice from professionals.
Ensure that your child knows before you speak with their GP about symptoms, as they may be able to explain better how they are feeling. Speaking with your doctor is usually the first step towards getting a referral to CAMHS (Child and Adolescent Mental Health Service).
There are 2 main treatment paths for health anxiety and OCD; psychological therapy and/or medication. Psychological therapy, such as Cognitive Behaviour Therapy (CBT), can help to face your fears and obsessive thoughts, gradually, without “putting them right” with compulsions. Therapy like this gives sufferers the tools, coping mechanisms, and strategies to manage their symptoms, and deepen their understanding of their condition.
Sometimes, medicinal routes are taken, often in very severe cases. Certain types of antidepressant medication can help to alter and stabilize, the balance of chemicals in the brain. This can be used alone, or alongside therapy.
Both health anxiety and OCD can be overwhelming and difficult conditions to manage at the best of times, let alone during a pandemic. It is unclear now what the ongoing, lasting impact the past two years may have on our children’s mental health.
But, looking out for early signs of health anxiety or OCD in your children could mean that you are able to get them professional help, and maybe even prevent these conditions developing into more severe, disabling issues in later life.