Does My Child Have OCD? What Parents Need to Know While Waiting for Answers

If you have unwanted thoughts or images that are highly distressing and then you have behaviors that you don't entirely feel that you can stop, that you have to do to alleviate that distress, this can become, depending upon the severity, really paralyzing for people because your attention is focused on your OCD symptoms and not focused on living your life.

Welcome back to the Parenting Pair Podcast. I'm Dr. Suzanne Allen.

And I'm Dr. Annalise Caron.

When our teens act in ways that we don't like or are confusing to us, sometimes we jump to conclusions about that or we just want to get it to stop. But sometimes those behaviors are actually a sign of distress or maybe that something more is going on. Right.

And it's not always clear. We got a we got a really interesting letter from one of our listeners and so we thought we'd start with that and then sort of talk it through because so much of our teen and tween's behavior and our younger children's behavior can be hard to decipher.

Yeah. You know? Yep. Alright. Let me read this letter from a parent.

Dear parenting pair, I'm a mother of three and I'm very concerned that my middle child, my almost 12 year old son in sixth grade, may have OCD. Over the past seven months, he's become increasingly irritable, rigid, and difficult to reason with. After describing everything to our pediatrician, she suggested that his behavior might be anxiety based and possibly OCD related. Here's what's been happening. He's often late to breakfast, spending more time upstairs in his room, and saying he has to do certain things first, but can't explain what they are.

This causes our whole family to be late, leaving for work and school, and infuriates his siblings. He insists on controlling the TV remote, especially the volume, and becomes angry or screams if anyone else touches it. He'll only sit in one specific car seat behind mine and fights with his sister if she tries to sit there. No amount of reasoning seems to help, and it's creating tension for everyone in the family. I followed our pediatrician's advice and scheduled an evaluation, but the earliest appointment is six weeks away.

Things at home feel increasingly unmanageable. We're arguing constantly, and my other children are avoiding him. Please help. I'm not sure we can make it the six weeks.

Yeah. I have to compliment this mother that she was able to get that together because sometimes these behaviors present in the family and it can just you know, she really went and talked to the pediatrician. I'm not sure how long it took her to get to that point, but she has a good bit of knowledge already that this could be OCD. Sometimes parents will come to us describing these behaviors that sound really rigid or angry or getting upset about a TV remote or Yeah. You know, being stuck in the way.

And it can look just like, you know, either aggressive or Annoying. Annoying. Yeah.

Just They're really trying to make their siblings mad or be in control of everything. Right? We have a lot of assumptions about what that what might be causing

it. And then and when parents have assumptions like that, and this me included as a parent, if we don't quite understand what's going on underneath, we might think that they have more control over it than they do. And so parents oftentimes will try to negotiate between the siblings or talk through how to

make a better choice. Or give a punishment or consequence for

that behavior, for not handing over the remote or insisting on sitting in that seat. Right. And so knowing or even having the possibility that this mom does that it is OCD is even a step forward from what we sometimes hear. So I think that maybe is the first thing just to highlight. If you're seeing new or different behavior, right, there may be something going on that isn't entirely apparent right on the surface.

You know, it might not be willfully, you know, staying upstairs and making people late. It might be that that there's something else going on. Yes. As it sounds like it it really may be for this young man.

Yep. And so going and getting that information is a is a great plan and great way to get some extra help and support and understanding. So let's just talk a little bit about first what OCD is. Because I think both you and I read this letter and thought, this sounds like it could be OCD. Absolutely.

And I think a lot of there's a

lot of use of the term OCD kind of in And the oftentimes it's even used almost as a positive thing. Like, oh, I'm being so OCD about this. And it almost means quote unquote OCD. And it means, you know, I'm being Organized. Organized, purposeful, thorough, you know.

I've even heard some teenagers say, I wish I could be more OCD like my sister or something like that.

We're here to tell you, you don't wish for that at It's terribly painful and it causes people with OCD to suffer greatly. Right. So we don't want to inadvertently minimize what OCD actually is.

And I think it would be useful to take just a few moments to sort of explain it a little So OCD is an obsessive compulsive disorder. It's a mental health condition that really has two parts to it for most people. Some people have one or the other, but for most people it's these two parts working together. The first part are obsessions. Obsessions are unwanted intrusive thoughts, distressing thoughts or images or anxious feelings that are very intense that make the person feel very distressed, maybe ashamed, maybe embarrassed.

And they really feel like they don't have much control over those thoughts.

Like they kind of want those thoughts to go away and the thoughts keep coming back and keep providing anxiety or discomfort. These thoughts may sound familiar in some ways because they exist on a continuum. Most people report having intrusive thoughts, and there are some very common ones that people are used to experiencing. Stepping kind of close to a ledge that often people will say they have the thought like, what if I just jumped over? What if I fell over?

Driving behind one of those big rig trucks with all of the cars kind of on it.

Oh, the the cars are gonna fall down at me. Yes. And I can't get that thought out of my head. And then I change my behavior too. I might drive around or I might pull back, drive a little slower.

Mhmm. I never thought about that as an intrusive Yeah. I did have the first one you said, when I used to live in New York, I would think like, you know, what if I fell in or what if someone got pushed in?

Mhmm.

And I would that would just pop in my mind. I knew it it was sort of an intrusive thought, but I wasn't really just judged by it because I didn't really believe it or pay it much attention. Mhmm. Right? But for someone with OCD, the intrusive thoughts that they have, they kind of can't help but pay attention to them because the OCD is really strong.

And they also can't shift their attention away on their own from

those distressing thoughts. So those thoughts get stuck. And something that you mentioned is actually part two of OCD. When you said that that thought behind the truck leads you to sometimes change your behavior

Yes.

That is the other part. Outside of the obsessive thoughts or intrusive thoughts are compulsions.

Right. Compulsions are repetitive actions or things that you do, which a lot of the time is behaviorally something that you do, but it can be sort of a mental ritual as well, in order to kind of relieve that distress that that intrusive thought or obsession is giving you. Right? So the classic one that people understand is if someone has an intrusive thought that maybe the house is going to burn down or something is going to, you know, I left the pan on the stove still cooking as I'm leaving, they might go back to check. So the compulsion is I have to go back and check to make sure the oven is off.

The thing with OCD is that this happens frequently and sometimes it's a bit unrelenting where you have to kind of engage in that compulsion over and over again. So you can see how if you have unwanted thoughts or images that are highly distressing and then you have behaviors that you don't entirely feel that you can stop, that you have to do to alleviate that distress, this can become, depending upon the severity, really paralyzing for people because your attention is focused on your OCD symptoms and not focused on living your life. Right? So this young person, you know, I think we'll just highlight quickly in letter that you read, Suzanne, was doing some things, right? The breakfast delay, having, you know, staying up in their room.

It may be that this young person has a ritual that he needs to do before he can leave the room, right, in order to alleviate some distress he might be feeling, you know, from an obsessive thought. You know, a very common one for kids can be something bad will happen to me or to my parent, You know, the intrusive thought could even be of someone very important to them dying if they don't do this ritual. So you can imagine, you'd want to do the ritual. But if mom downstairs waiting to get the siblings out the door to school doesn't know that, it might seem like willful behavior. Kind of like, you know, you're being late and not caring about the rest of us.

Mhmm.

Right?

And you know, sometimes there are those intrusive thoughts. Like you mentioned, like something bad might happen. I can even imagine that with, let's say, the remote control, there's another part of OCD, right, that isn't a clear thought, but it's that something doesn't feel right. And so being able to hold the remote control or having the volume at a certain level, right, for someone with OCD, when something doesn't feel right, there's an incredible urge to try to make it right and take control of that situation. And often that can be misinterpreted by other people, understandably so, as being rigid, being difficult.

Being difficult, being problematic. But you're right, a

lot of, you know, with the remote control, and I'm making this up on the spot, but certainly sometimes there are numbers involved in OCD. So maybe this young man needs to have the volume as an even number. So it needs to be at 10 or eight, but it can't be at seven. So if someone puts it to seven, that can be highly distressing. And so then he might compulsively need to change it back, and that could be the reason to hold the room up.

There's any number of things, but I think the point we're highlighting here is sometimes the behavior that we see on the outside, whether it's OCD or any other mental health concern or other situation going on, it may not in our teen or tween's life, it may not be immediately apparent to us. So we want to try to get underneath that.

So I want us to shift now in two ways and kind of have two different, let's call them kind of plans or like playbooks for parents. One being for this parent who's written to us when you're in a period of uncertainty waiting for an evaluation, waiting to get more information to find out what to do. What can those parents do when you're uncertain? And then Playbook two will be for parents who have a child or teen who's been diagnosed with OCD, and what are just some thoughts and ways that they can continue to manage this at home?

To support their child.

Yep. Right. Right. Okay. So let's start with With this letter.

This parent and this letter. And really this parent has already taken an amazing first step, that is going to the pediatrician and then also seeking out a mental health evaluation. And I can understand probably her exhaustion and overwhelm about the six week wait. Unfortunately, that's the case in a lot of areas and in many areas, it may even be longer. Right?

So she has already, you know, done the first step to work on getting that goal or that evaluation done.

And so we would say, you know, as best you can to set the goal to just keep trying to build trust and support the relationship that you have with your teen in spite of whatever is going on and wherever you can to try to lower conflict. And so we have a couple of communication strategies that we thought might be helpful in service of this. The first one being the same team approach, that as best you can trying to align with your child or teen that you are on the same team with them, and that whatever this is that is going on, that you understand that they're suffering, you can see their suffering, you can imagine they don't want to be late and have everyone angry with them all the time, that they may not enjoy being screamed at in the car when they won't move seats, that you are with them, you understand their suffering, you're suffering too, and that you're on the same team and going to try to figure it out with them.

And this might to make this more explicit, this might be a situation where maybe for a period of time this parent, not understanding that there might be some OCD or some other concern going on here, might have gotten very frustrated with this child or teen, might have become very upset, and really acknowledging, you know what? It's occurred to me that this is a change for you in your behavior and something's going on and I'm sorry. You know, maybe even making that repair because I didn't understand that. Because that's very easy to not understand. You know?

And I think that can provide some relief for this child. So I don't know exactly what this is, right? You

and you

don't have to necessarily get into, you know, this may be OCD or not. But I can tell that the changes in your behavior mean that you're experiencing a good bit of distress and discomfort. And so I want to be on the same team with you and help you to the degree that I can before we can get to a professional that can, you know, really direct us to get you some relief. Mhmm.

I think you really added the layer to that also of that there could be this same team approach and that there also may be some necessary repairs here. Mhmm. Because when we don't know something, right, the approach that, you know, this parent may have or any parent might take could be punishment, criticism, you know, saying things that maybe you didn't mean or weren't helpful. And so just acknowledging that and saying, you know, I know I've lost my cool with you a couple of times, or I know I maybe called you this name or said this thing about how you were acting. And I didn't realize at the time that there was more going on.

I want to be on the same team with you. I can see your suffering. I'm sorry for that.

And I think that can provide such relief. And if they're if your child's willing, your child may not be willing, but if you could even, you know, take it a step further, I don't want that to happen, you know, again or I want to work on my own frustration. So if whatever is going on, and you can label this, you can call it whatever you want. If you get in one of those stuck moments where you can't come down on time or if something else is going on and you're suffering, you know, let me know that, you know, if you can. Because I might inadvertently, you know, be human and misinterpret what's happening, but I want to be on the same team.

If you're struggling with one of those tough moments, maybe just call my attention to it and that'll cue me to, you know, understand a little bit better.

Mhmm. Yep. And and just an example of a couple of things, you know, I've had teens say like, I'm having a sticky brain moment.

Or

Yep. My brain bully is is in the way right now. Or even if had some teens like give their brain bully a funny name, you know, like Gus, like, or Steve. Steve, Steve's really acting up today and I can't get him to stop. Yep.

And so if they're willing to do that, that can be kind of a way to just acknowledge or name what going on and bring some attention to it so that you can be on the same team together. And if they're not ready for that or unwilling or unsure about that, you can let that go.

Yeah. Yeah. I think it's a great idea if your child is able to be that reflective. Sometimes that does happen after there's a diagnosis and a therapist But can walk you through if you can just acknowledge it somehow and give your teen or tween or child the ability to cue you, kind of they're in charge to let you know that they're having one of those moments that can help you kind of temper your response until you can get to a mental health professional.

So those are some communication strategies. We wanted to offer a couple more like kind of concrete strategies, like here are some specific things that you can do. You know, one of the things that can happen with OCD is that parents and family members can get kind of pulled in, and we would say like bossed around by OCD as well. So there may be things that you're doing that are called accommodations, that sort of therapist would call them, where, you know, your teen is asking you to check the stove for them or turn the light off or say something to them in the same exact way every night before And going to this can be incredibly difficult And this will be something that you can get support on in therapy. We would say that in this time while waiting for an evaluation, you know, sometimes parents read or learn about OCD and decide, okay, I've got to stop doing all of these things.

Right. Right.

And that can be very jarring

Mhmm.

Without kind of education for everyone and a plan of how you're gonna go about and do this, that for a child or teen, it can feel like all of a sudden the things that you were doing that helped with these awful thoughts, now you're just ripping them away and taking them away from them and you're withdrawing support. Now we know that that is not that's actually supporting the OCD and not your teen or child, but it doesn't feel that way to them.

Right. And so I think you're absolutely right. Parents can become educated, but this is never, with obsessions and compulsions, something that we stop all at once or very quickly. That is something that once you're in therapy, and we'll talk about that a little bit more in just a few moments, would be done in a scaffolded way and with sort of a cognitive approach as well for the child to be able to do that. So we want to maybe for this family be able to talk about it, identify that distress, and if possible, not add in new rituals.

Like, oh, is that your sticky brain talking or is that distress coming back? Hey, let's try to regroup and not give that so much attention or, you know, and maybe become aware in yourself. If your child is pulling you into behaviors that help you accommodate and reinforce the OCD, you want to bring your awareness to that and maybe try not to add new things, you know, to it. So if it's like, you know, I can't hold any spoon because I have a rule that I can't hold any spoon. If suddenly your child wants so you have to give the spoon, your child wants you to give the fork as well.

Maybe you just say, oh, could you grab the fork? You know, and just see if you can not add new things in that you're being pulled into as a parent. But you can't really do everything as a parent until you have the support of a therapist.

Yeah. The other thing this parent brought up was siblings and the frustration of siblings and anger. And so, you know, while we respectful of, you know, every child or teen's kind of health and mental health issues, it's also fair within a family that a little bit of understanding can help create some empathy and also be very validating to the siblings who are experiencing all of this distress as well. So we often recommend to parents that, you know, you share a little bit of information with siblings. Like, hey, we see this too.

Your brother's going through something right now. We have a couple of ideas about what that might be. We're taking him to see a doctor. It's not your job to manage it. We are sorry because even though he's going through something, that doesn't mean it's okay that he's yelling at you about the remote or the seat.

We understand that this is hard for you too. And this is something that's out of his control. He's really struggling with something right now and we are going to address it.

Right. Just really letting them know that as a parent you see that this potential OCD is affecting the siblings and how hard that is for them. Because they may not understand why they can't sit in that seat in the car, why he gets so upset over the remote. And it may feel as though he is ruining things for the family. And that's really hard and can create a lot of distress.

So the more understanding that we can have without completely invading the young person who may have OCD, his privacy about it. Just letting the siblings know, he's really going through something and we're tending to it, but I see how this is affecting you. And we want to sort of acknowledge that too.

So let's shift to Playbook B. When a family has a child or teen who's already been diagnosed with OCD, what's some good information for them to have? I would say, let's start with treatment. What are treatment options for OCD? Because it is highly treatable, so there is a lot of hope and there's a lot

of support out there. 100%. And so certainly you want to see a mental health professional. If you have been diagnosed with OCD, your pediatrician has suggested that you have that, just for clarification of the diagnosis. The specific types of interventions, and there are a number of different ways to go, that help OCD, certainly there's therapy.

And the empirically supported therapy, the therapy that has the most research for OCD, is called exposure and response prevention therapy. And that is a therapy that's under the broad umbrella of cognitive behavioral therapies, But I will say, not all therapists or psychologists that do CBT necessarily know this specific treatment for OCD. So if you are in a place where there are a number of different therapists you can reach out to, having an initial conversation to find out if they are trained in and familiar with exposure and response prevention can be very helpful. Right? In addition, there is certainly medication treatment for OCD.

As well, there's another therapy called acceptance and commitment therapy that along with exposure and response prevention, or along with medication, also has excellent benefit for OCD. So I think looking for that skill set within a therapist can be very helpful. I do think we need to acknowledge though that there are some parts of the country, or certainly abroad if anyone's listening or watching, where there may not be a therapist in your immediate area that has that skill set. So I think talking with someone maybe who's a cognitive behavioral therapist but isn't an expert in OCD and seeing if they would be willing to, you know, maybe follow a manual, read more about it, and help guide your family through treatment for that. I will just tag note something we didn't mention when we were speaking about Playbook A for the family that may not be diagnosed yet.

There is a book by John Marsh that, you know, if you don't have information yet and you just want to learn a little bit, called Talking Back

We to

will link that in the show notes. But it's really for parents. You know, teens I've had teens and tweens read it as well. But just to get some information, and that book, and there's a companion book for therapists that maybe a therapist could work with to guide you through exposure response prevention therapy.

Great. Okay. So there wonderful therapies out there and ways to treat OCD. We would also say if you and your child or teen are working through therapy, to acknowledge wins. Because OCD can feel like a battle and sometimes it can feel like there are so many different battlefields to address with OCD.

And so being mindful and aware when you see your teen tolerate even minimal amounts of uncertainty or approach things or do things a little bit differently than they have before, that just acknowledging that for yourself and for them to call that out and celebrate that is really important.

And I think why Suzanne highlighted that is because with exposure and response prevention therapy, a big portion of that requires doing things that are very difficult and act against the OCD. Right? And so just briefly, exposure requires you to have the thoughts, the distressing thoughts that you don't want to have, guided by a therapist with homework plans and ways to do that. And the response prevention part of that ultimately involves decreasing and ultimately removing the compulsive behavior, again, over time, by a therapist in a systematic way. And that's really difficult.

So when you see that brave behavior or tolerating that uncertainty or doing exposures that maybe at the beginning are quite distressing, we really want to celebrate that because it's hard work.

For kids and for families.

Yeah. Yeah.

Okay. So treatment, being mindful, and celebrating wins, or just the hard work that is done. Similar to Playbook A, we would also say providing some information to siblings who are also living through this. Certainly siblings are not responsible for enacting any parts of treatment or exposure work or any of that. So reminding them that the adults are in charge, you're working with the therapist, but just giving them some information about what their sibling might be going through to help hopefully decrease some of that conflict in the home.

Yeah. And in the spirit of communication, not all of the time do schools need to be aware of this. But often, you know, depending on the nature of the OCD, this can be interfering with school. Mhmm. Whether it's getting work done, whether it's getting to school on time, whether it's engaging in rituals within the school Throughout the school day.

Mhmm. And so this is where seeking the support and reaching out for potentially a five zero four plan to offer some services. For accommodations Yep.

As you're working on the OCD can be extraordinarily helpful. And I think with Suzanne, you bringing up how this can expand from the home to school and other settings, it can affect friendships and relationships that certainly just to really acknowledge we've talked a lot about exposure and response prevention therapy, that medication really can be a very helpful part of treatment for people. Our recommendations, largely here in The US, is that for mild to moderate OCD, we typically, when possible, when it's available, recommend starting with therapy, right, with exposure and response prevention, maybe some acceptance and commitment therapy. But if within three to four months we don't have some real symptom reduction and relief, the typical recommendations, and this is individual, it depends, you to talk with your doctor about, is to really at that point consider medication. Because we don't want the combination is the best treatment for OCD and certainly if you have severe OCD when you're first going into treatment, medication will be suggested as a possible treatment for you to consider.

So just keep that in mind that we really have things that can help and oftentimes therapy is enough, but the medication is an important component. Yeah.

I think that brings us to what now? Yeah. Boy. What now, Suzanne? One thing I would say, have hope.

There's great treatment out there and things that really can help OCD.

And you don't have to do this alone. Seek guidance from your pediatrician. You as a parent, Suzanne and I as parents, don't always know what's going on for our kids or know exactly what's underneath the behavior that we're seeing that may be concerning. But there are professionals out there that can help you. If you have the thought that possibly your child might have OCD, go ahead and look for that Talking Back to OCD John March book.

Give that a read. See if it relates to what you're seeing and maybe bring that to the pediatrician or if you have a mental health professional. Maybe ask the school. You can reach out to the school, are you seeing any behaviors, rituals, you know, in my child? And work together.

You don't have to figure this out alone. Oftentimes we just can't.

Another, you know, kind of easier resource than reading an entire book, if you have some questions about OCD, is the IOCDF website.

That's the International OCD Foundation. Yep.

Excellent resources that can help you locate therapists, also provide a number of articles and information regarding OCD that can help you along the way. Right. So really, I think the take home is OCD is treatable,

and you can really live a big beautiful life and get the help you need.

Well, thank you so much for joining us today. If you know anyone who might benefit from listening to this episode, please share it with them or go online and rate and review the podcast. That helps get this information to more parents, we would appreciate that.

Yeah. And as always, if you have any feedback for us about this or any other episode or ideas or suggestions or a letter like we received, for this episode, a question you'd like us to address, don't hesitate to DM us on Instagram. We love hearing from people, and we look forward to hearing from you. With that, have a great week. And now a quick word from our lawyers.

The Parenting Pair Podcast is designed for informational and educational purposes only. Do not rely on the information presented in this podcast as a substitute or replacement for professional psychological or medical advice, diagnosis, or treatment. If you have concerns about you or a family member's well-being, please contact a licensed mental health professional or physician.