This diary entry describes the worries, distractions, irrational ideas, thoughts, rituals and urges of a number of students with whom you come into contact. Over 2% of students will have this anxiety related disorder and condition known as Obsessive Compulsive Disorder (OCD). Children are distressed by or limited in everyday functioning by obsessions and compulsions. For example, they might wish to continually wash their hands.
Tonight before going to bed, I had to keep going to the bathroom to wash my hands. The reason for this was because this afternoon I tried on a blouse that had a mark on it. To me the mark looked like blood and this worried me because I thought I might catch some illness from this mark. In my mind if I keep washing my hand it means no harm will come to me.
OCD is an anxiety related disorder in which the sufferer is distressed by or limited in everyday functioning by obsessions and compulsions. They have no control over certain thoughts, ideas or urges and these can often be frightening or distressing or seem so unacceptable that the sufferer cannot share them with other people. According to the World Health Organisation OCD is listed as one of the ten most debilitating illnesses. It occurs in males and females in equal numbers.
It is perfectly normal to have worries and normal worrying helps children to learn how to be safe and careful. However worries associated with OCD are so intense that the brain plays them over and over again and the feelings become obsessions. Sufferers will perform various actions that they think will make the worry go away or stop bad things happening. These actions are called compulsions and people can spend many hours a day doing them.
These are recurrent and persistent thoughts or impulses which are intrusive and inappropriate and cause a great deal of anxiety or distress. The person will recognise that the obsessional thoughts are not based on reality but will be unable to control them and will attempt to ignore or suppress such thoughts by performing some action (compulsion). For example an obsessional thought could be that the person is afraid of catching a particular illness and the compulsion will be repeated handwashing. In their mind the person thinks that unless they wash their hands they will get the illness.
Other examples of obsessions are
- Fear of contamination or germs
- Imagining doing harm
- ‘Forbidden thoughts’
- Pre-occupation with detail – rules, lists etc
- Making mistakes or getting things wrong
- Unable to throw away possessions that are no longer needed
- Fear of a loved one dying
Compulsions are repetitive behaviours a person needs to perform in response to an obsession. These compulsions are aimed at preventing or reducing distress or preventing some dreaded event or situation occurring. However there is no realistic connection between performing these acts and preventing that supposed dreaded situation. They don’t want to perform these rituals but it is the only way they feel they can stop these bad feelings.
Examples of compulsions are:
- Checking things over and over again
- Repeated handwashing
- Symmetry – ordering and arranging things in a particular way
- Rigid routines
- Not stepping on cracks on paving stones
- Repeating certain rituals
Children with OCD find it hard to concentrate on anything else and it can take the fun out of everything. They are driven to do these repetitive behaviours or mental acts in response to an obsession or according to their made up rules that they must apply rigidly.
OCD can be hereditary and it can also be a learned behaviour, especially if one or both parents have had a similar anxiety and shown similar behaviour. It can also be caused by an imbalance of a chemical called serotonin in the brain. It is also linked to trauma, often developing after bereavement or abuse and may be triggered by particular memories and experiences.