Could This Be OCD?

Obsessive compulsive disorder or OCD can look like other concerns and so an evaluation with a clinician with expertise can be crucial in finding the right treatment.

In young kids, developmentally normal behaviors such as rigidity in routine and repetitive thinking/speech can sometimes worry parents who wonder if their child may have OCD. An important thing to consider is that typical kids will usually be able to be flexible when pressed by their parents or a peer even if there is pushback. With OCD, parents may see that these children cannot be flexible even when given commands or offered a reward. They may also display similar behaviors across multiple settings. When in doubt, it can be helpful to check in with a mental health expert or your child’s pediatrician.

Kids can have a tough time following directions from adults for many reasons. For example, ADHD and other disruptive disorder can make it hard to listen and follow instructions because of not attending or listening to instructions, or acting too quickly without thinking, or even unwillingness to cooperate due to mood or relationship with caregivers. Other times anxiety or intrusive thoughts/need to ritualize can make kids act out or appear noncompliant. A clear diagnosis and understanding of the function of the behavior is important to get the right help.

Tics and repetitive behaviors may be confused with rituals as well. Tics or other Body Focused Repetitive Disorders (BFRB’s) like hairpulling, skin picking, typically involve a premonitory urge the occurs just before the behavior (kind of like a tingle before a sneeze) and followed by a sense of relief. In OCD, the behavior is accompanied by anxiety or discomfort. While both are unwanted and hard to resist, the mechanism of why someone engages in the behavior is different.

Eating disorders overlap with OCD and experts think they are similar in how they impact the brain. While both may involve avoiding eating or engaging in ritualized behavior, OCD may or may not involve fears or overconcern about weight and shape. Sometimes, kids with OCD will not eat because of fears about getting sick or being harmed in some other way. One eating disorder, ARFID involves difficulties growing, gaining weight, or even losing weight due to not eating for some reason which might include experiencing a traumatic event like choking or vomiting. Eating disorders may involve severe malnourishment and so early medical intervention is important.

Brandywine Psychology can help you better understand what might be going on and guide you to the right treatment.