A psychologist writing for Psychology Today explains that OCD is a way children work out fear. Children are fearful for many reasons, family disharmony, a death in the family, a bully at school making their life miserable, or any number of fears and unknowns that beset children, as well as adults. Since they are obsessed with these fears their compulsions — their actions — are a means of controlling these fears. They do things in a repetitive manner and that releases their anxiety.
The author explains why it's necessary to get this diagnosis because so many other childhood psychological problems or disorders or labels can appear to be something other than OCD. It's hard to distinguish between and ADHD, Oppositional Defiant Disorder, Panic Disorder, and of course OCD and of course, the problems could relate to a mixture of all the above as well as others not mentioned.
In today's world labeling diseases and conditions and placing them in neat little blocks all to themselves is seemingly the goal of both physicians and their patients; while in truth often it's a combination of conditions rather than one neat little labeled disorder. This is sometimes good and sometimes it's not so good.
Diagnosing personality disturbances in children is harder to do because they outgrow a lot of these problems or sometimes they develop into other labeled disorders. An example of that is bipolar. It's often thought to be ADHD and medication for that sometimes rushes the child into a bipolar manic or depressive cycle. (In This Psychology Today article the author uses a particular child as an example to show how she diagnosed OCD. )
In obsessive-compulsive disorder a person suffers from persistent unwelcomed thoughts and ideas that seemingly come from out of nowhere to taunt them. To deal with these thoughts they act compulsively with repeated actions and this somehow relieves their symptoms and gives them a certain amount of relief. Children are yet to understand that ideas and thoughts do generally drop in unannounced and unwelcomed and this to a certain extent is normal.
Obsessions and compulsions, two distinct words, are descriptive of singular emotional problems. Children may have obsessions without the compulsions or compulsions without the obsessions manifesting themselves in other types of childhood misbehavior or disorders, but separately these are not OCD. Children don’t have the insight to deal with their bizarre ideas and thoughts or even of their actions.
According to the International OCD Foundation one in every 200 children in the United States have OCD. “OCD can make daily life very difficult and stressful for kids and teens. In the morning, they feel they must do their rituals right, or the rest of the day will not go well. In the evenings, they must finish all of their compulsive rituals before they go to bed. Some kids and teens even stay up late because of their OCD, and are often exhausted the following day.”
This causes problems at school, poor eating and sleeping habits and loss of self-esteem as well as other problems. How are children treated for OCD? (CBT) Cognitive Behavior Therapy and (ERP) Exposure and Response Prevention are the two best ways of treatment. Trained technologists under the guidance of a psychiatrist or psychologist, who fully understands the problems of childhood OCD, administer the treatments. Cognitive Behavior Therapy is getting the child to understand themselves and the ways in which they can deal with their unpleasant thoughts and ideas.
ERP treatment uses the opposite effect and teaches the child how to deal with conflicting ideas and notions but doing the opposite of what OCD tells them to do. In other words they don't give in to the rituals and experience will teach them that nothing bad will happen if they ignore or find ways of turning off bad thoughts and ideas.
The American psychiatric Association and the American Academy of Child and Adolescent Psychiatry sanction the use of anti-depressive medication for children, but probably the wiser choice is non-medicinal. Although a combination of both may also work will.