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Is my child obsessive compulsive?
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Is my child obsessive compulsive?

I believe that my 9-year old daughter may be obsessive compulsive. Each night when she gets ready for bed she has to go through a routine, starting with making sure each door in her room is completely shut, two nightlites are on, as well as the hall light, asking the same questions, even though she knows the answers.  She is unable to fall asleep until everything is done exactly right.  She is also unable to fall asleep unless I stay awake.  She cannot function and breaks down emotionally if anything happens to upset her routines.  I cannot calm her down when this happens... she cannot be reasoned with.  She is a perfectionist at school, but will not participate because she is worried that what others will say or do in response.  She is unable to complete her assignments because she takes too much time correcting perceived writing errors.  These are some small examples of her behaivor.  I used to think that she would outgrow this, but it seems to only get worse as she gets older.
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Dear Kdb,

An obsession is a recurrent and intrusive thought, feeling, idea, or sensation. A compulsion is a conscious, standardized recurring pattern of behavior, such as counting, checking, or avoiding. Obsessions increase anxiety, whereas carrying out compulsions reduces it; but when a person resists carrying out a compulsion, anxiety is increased. Obsessive-compulsive disorder is disabling and often time consuming and interfere significantly with people's normal routine, occupational functioning, usual activities, or relationships with friends and family members. Well-controlled studies that medication and behavior therapy or a combination of both is effective in significantly reducing the symptoms of OCD.

Other conditions such as depression could have similar manifestations.  Children may also become more obsessive and compulsive during times of stress.  It appears though that your daughter has many features of Obsessive-Compulsive Disorder.  An evaluation by a mental health professional is recommended.

The information provided in this Forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personal physician or you may call Henry Ford Behavioral Health at(248) 689-7476 for an evaluation.

     I wish you the best,

     HFHS MD - RG

     *Keyword: OCD
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I recently did a report on the difference between OCD and other disorders - maybe it would help you. Here is is:
Amanda Conley
Obsessive Compulsive Disorder

We're all a little bit obsessive compulsive.  According to Tom Defrancesco, a psychologist at Charter Counseling Center, everyone exhibits some obsessive compulsive traits.
Obsessive Compulsive Disorder (OCD) is defined as the persistent intrusion of unwanted thoughts accompanied by ritualistic actions.  It is often associated with repetitive hand washing, and checking to see if doors have been locked or the stove has been turned off.
For OCD patients, these thoughts or impulses are not simply excessive worries about real life problems. Patients realize that their compulsions to perform various actions are unreasonable.  The disorder begins to significantly interfere with the patient's life and does not allow them to function normally. This causes distress to the patient, because they have no way to prevent these intrusive thoughts.  "Often, people know that these rituals are ridiculous, but they cannot stop them," says Susan Schneider, a psychologist at Schneider Psychological Services.
But if everyone exhibits some obsessive compulsive traits, then where do you draw the line?  What exactly sets a person who actually has OCD apart from those who only show some signs of it?  "When a person gets into a rigid structure, they begin to organize themselves to be successful, " says Schneider." However, when this rigidity begins to bring on emotional stress, they may be crossing the line from perfectionism to OCD."
There are many clinical and personality disorders that include some or many symptoms of OCD.  A very closely related disorder, Obsessive Compulsive Personality Disorder, shares a great number of traits with OCD.  Obsessive Compulsive Personality Disorder is defined as a preoccupation with orderliness and perfectionism.  It differs from OCD in that it has a lack of obsessions and compulsions, and patients who suffer from it are unresponsive to the medication that helps OCD patients.  ""People who are perfectionistic or overly superstitious may have Obsessive Compulsive Personality Disorder , which is different than OCD," says Richard Bednar of Kenosha Human Development Services.  "OCD is biochemically based, and the disorder occurs as a result of a defect in a person's neurological system, which is why it responds to medication.  Obsessive Compulsive Personality Disorder is a learned trait."
Patients who suffer from depression or generalized anxiety disorder have traits similar to that of OCD as well.  However, these patients don't consider their obsessive worries to be absurd, but rather very real and appropriate, and they make no attempt to block them from their minds.
Panic disorders can be confused with OCD, but, according to Mike DeFazio, a psychiatrist at the Psychiatric and Psychotherapy Clinic, "The difference is that while both need everything to be a certain way, people with OCD don't usually have a panic attack if something is out of place."
Patients with Anorexia Nervosa, a common eating disorder, show signs very similar to that of OCD.  However, because these symptoms occur within the context of another disorder, they are not linked to OCD.  
Hypocondriacs, people who have unrealistic preoccupations with physical disease, also suffer from intrusive thoughts that they cannot block, but they do not display compulsive rituals.  An exception would be patients of this disorder who make frequent doctor visits to reduce a level of anxiety, but this should not be confused with OCD.
Many other people exhibit signs of OCD without having any type of medical disorder at all.  According to DeFrancesco, "Most high achievers will exhibit obsessive compulsive behaviors even though they do not have the disorder."
Gamblers and substance abusers, differ from OCD sufferers because, while they do exhibit obsessive and compulsive behaviors, they initially find them to be pleasurable.
People who have perfectionistic traits show many signs of OCD.  However, there is a definite distinction between the two.  "A perfectionist strives to be constantly right or have everything right.  However, if a person becomes fanatical when one thing is out of place, this could be a sign that they have OCD, " says DeFazio.  
Schneider agrees.  "If there is a lot of emotional stress in a person's life, it is often something beyond perfectionism."  
Although OCD can be easily confused or associated with many other disorders, there are some key symptoms that will determine the difference.  In general, if a person who whose life is consumed with intrusive thoughts and the compulsion to perform ritualistic behaviors sees these symptoms as unrealistic and foreign, their symptoms can be linked to OCD.  When these symptoms begin to significantly interfere with their lives and they have no control over them, again, OCD is most likely the cause.
The specific criteria for OCD can be found at the American Association of Family Physicians website.  Bednar sums it up in saying that "If a person fits only some of the criteria for OCD, they more than likely do not have the disorder."
Anyone who thinks that they may be suffering from OCD should see a doctor and begin taking some sort of antidepressant so that their life is not consumed by fixing things, says Sue, of the Psychiatric Unit at St. Catherine's Hospital.  
According to the American Association of Family Physicians, 80-90% of patients with OCD are classified as "improved" after behavioral therapy.  
The best advice is simply to seek professional help if you think you may have the disorder.  Accoriding to DeFrancesco, "It's not necessary for anyone to be severely obsessive compulsive anymore."

Well, I hope this helped!  Good luck with your daughter!

Amanda
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