In an attempt to fully understand Emma Pillsbury and get inside her head, I have delved into the world of OCD. There are numerous websites containing insightful information into the disorder but Kidshealth.org is one of the most informative, succinct and clearly layed out websites I’ve come across. The information below is from it.
About OCD
OCD is a type of anxiety disorder. Kids with OCD become preoccupied with whether something could be harmful, dangerous, wrong, or dirty — or with thoughts about bad stuff that might happen. With OCD, upsetting or scary thoughts or images, called obsessions, pop into a person's mind and are hard to shake. Kids with OCD may also worry about things being out of "order" or not "just right." They may worry about losing "useless" items, sometimes feeling the need to collect these items.
Someone with OCD feels strong urges to do certain things repeatedly — called rituals or compulsions — in order to banish the scary thoughts, ward off something dreaded, or make extra sure that things are safe or clean or right. Children may have a difficult time explaining a reason for their rituals and say they do them "just because." But in general, by doing a ritual, someone with OCD is trying to feel absolutely certain that something bad won't happen.
Think of OCD as an "overactive alarm system." The rise in anxiety or worry is so strong that a child feels like he or she must perform the task or dwell on the thought, over and over again, to the point where it interferes with everyday life. Most kids with OCD realize that they really don't have to repeat the behaviors over and over again, but the anxiety can be so great that they feel that repetition is "required" to neutralize the uncomfortable feeling. And often the behavior does decrease the anxiety- but only temporarily. In the long run, the rituals only worsen OCD severity and prompt the obsessions to return.
Doctors and scientists don't know exactly what causes OCD, although recent research has led to a better understanding of OCD and its potential causes. Experts believe OCD is related to levels of a normal chemical in the brain called serotonin. When the proper flow of serotonin is blocked, the brain's "alarm system" overreacts and misinterprets information. Danger messages are mistakenly triggered like "false alarms." Instead of the brain filtering out these unnecessary thoughts, the mind dwells on them — and the person experiences unrealistic fear and doubt.
Genetic Link
Evidence is strong that OCD tends to run in families. Many people with OCD have one or more family members who also have it or other anxiety disorders influenced by the brain's serotonin levels. Because of this, scientists have come to believe that the tendency (or predisposition) for someone to develop the serotonin imbalance that causes OCD can be inherited through a person's genes.
Having the genetic tendency for OCD doesn't mean people will develop OCD, but it means there is a stronger chance they might. An imbalance of serotonin levels can also result in other types of anxiety or depression.
An estimated 1% of children in the United States experience OCD, which is characterized by a pattern of rituals and obsessive thinking that generally lasts more than an hour each day, causes a child distress, or interferes with daily activities. It's more prevalent than many other childhood disorders or illnesses, but kids often keep the symptoms hidden from their families, friends, and teachers because they're embarrassed by them.
OCD in kids is usually diagnosed between the ages of 7 and 12. Since these are the years when kids naturally feel concerned about fitting in with their friends, the discomfort and stress brought on by OCD can make them feel scared, out of control, and alone.
It's important to understand that the obsessive-compulsive behavior is not something that a child can stop by trying harder. OCD is a disorder, just like any physical disorder such as diabetes or asthma, and is not something kids can control or have caused themselves. It is also not something that parents have caused, although life events may at times worsen or trigger the onset of OCD in kids who are prone to develop it.
Common OCD Behaviors in Kids
OCD can make daily life difficult for the kids that it affects and for their families. The behaviors often take up a great deal of time and energy, making it more difficult to complete tasks, such as homework or chores, or to enjoy life.
In addition to feeling frustrated or guilty for not being able to control their own thoughts or actions, kids with OCD also may suffer from low self-esteem or from shame or embarrassment about what they're thinking or feeling (since they often realize that their fears are unrealistic, or that their rituals are not realistically going to prevent their feared events).
They also may feel pressured because they don't have enough time to do everything. A child might become irritable because he or she feels compelled to stay awake late into the night or miss an activity or outing to complete the compulsive rituals. Kids might have difficulties with attention or concentration because of the intrusive thoughts.
Among kids and teens with OCD, the most common obsessions include:
• fear of dirt or germs
• fear of contamination
• a need for symmetry, order, and precision
• religious obsessions
• preoccupation with body wastes
• lucky and unlucky numbers
• sexual or aggressive thoughts
• fear of illness or harm coming to oneself or relatives
• preoccupation with household items
• intrusive sounds or words
These compulsions are the most common among kids and teens:
• grooming rituals, including hand washing, showering, and teeth brushing
• repeating rituals, including going in and out of doorways, needing to move through spaces in a special way, or rereading, erasing, and rewriting
• checking rituals to make sure that an appliance is off or a door is locked, and repeatedly checking homework
• rituals to undo contact with a "contaminated" person or object
• touching rituals
• rituals to prevent harming self or others
• ordering or arranging objects
• counting rituals
• hoarding and collecting things
• cleaning rituals related to the house or other items
Treating OCD
The most successful treatments for kids with OCD are behavioral therapy and medication. Behavioral therapy, also known as cognitive-behavioral psychotherapy (CBT), helps kids learn to change thoughts and feelings by first changing behavior. It involves exposing kids to their fears, with the agreement that they will not perform rituals, to help them recognize that their anxiety will eventually decrease and that no disastrous outcome will occur.
For example, kids who are afraid of dirt might be exposed to something they consider dirty on numerous occasions. For exposure to be successful, it must be combined with response prevention, in which the child's rituals or avoidance behaviors are blocked. For example, a child who fears dirt must not only stay in contact with the dirty object, but also must not be allowed to wash repeatedly. Some treatment plans involve having the child "bossing back" the OCD, giving it a nasty nickname, and visualizing it as something the child can control. Over time, the anxiety provoked by dirt and the urge to perform washing rituals gradually disappear. The child also gains confidence that he or she can "fight" OCD.
OCD can sometimes worsen if it's not treated in a consistent, logical, and supportive manner. So it's important to find a therapist who has training and experience in treating OCD. Just talking about the rituals and fears have not been shown to help OCD, and may actually make it worse by reinforcing the fears and prompting extra rituals. Family support and cooperation also go a long way toward helping a child cope with OCD.
Many kids can do well with behavioral therapy alone while others will need a combination of behavioral therapy and medication. Therapy can help your child and family learn strategies to manage the ebb and flow of OCD symptoms, while medication, such as selective serotonin reuptake inhibitors (SSRIs), often can reduce the impulse to perform rituals.
Helping Kids With OCD
It's important to understand that OCD is never a child's fault. Once a child is in treatment, it's important for parents to participate, to learn more about OCD, and to modify expectations and be supportive.
Kids with OCD get better at different rates, so try to avoid any day-to-day comparisons and recognize and praise any small improvements. Keep in mind that it's the OCD that is causing the problem, not the child. The more that personal criticism can be avoided, the better.
It can be helpful to keep family routines as normal as possible, and for all family members to learn strategies to help the child with OCD. It is also important to not let OCD be the "boss" of the house and regular family activities. Giving in to OCD worries does not make them go away.
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