How to cope when your child has OCD

This story was originally titled "Dancing Queen" in the September issue. Subscribe to Canadian Living today and never miss an issue!

When my daughter made her own graph paper in Grade 7, I thought it was because she wanted black lines instead of the standard blue. When Tessa wanted to sleep on top of her beautifully made bed, rolled in a comforter, I thought it was a smart way to save time making her bed each morning. And when she wanted to hang fabric panels in her bedroom ("It's easier than painting, and I can change it when I get tired of it," she explained), I thought I had an interior designer in the family.

What I really had was a daughter with obsessive-compulsive disorder (OCD). It wasn't the colour that was the problem with store-bought graph paper; it was the fact that the lines weren't even enough. Tessa's bed had to be perfect, at all times, so nobody could actually sleep in the bed. The colour blocking was more difficult to understand, and started us winding through the labyrinthine world of a child afflicted with OCD.

What is OCD?
OCD is perplexing, torturous and weirdly bewitching. It's an anxiety disorder, in the same group of mental problems as separation anxiety, post-traumatic stress disorder, agoraphobia and social anxiety.

We all have anxieties – how will I get this job done on time, will Phil pass his exam, is 16-year-old Erika really responsible enough to drive? These are "normal" anxieties. Worrying about poisoning our siblings or about becoming a different person if we sit in their chair are not normal anxieties.

Dr. Sandra Mendlowitz, a psychologist specializing in OCD in children at The Hospital for Sick Children in Toronto, explains the difference between typical anxiety and OCD this way: "If there were a robbery in the neighbourhood, you might worry that it could happen again, and maybe in your own home. That is a normal, generalized anxiety. Thinking that there is someone in your house, and that checking and rechecking the locks, tapping, counting and retracing your steps will prevent it from happening to you, is OCD."

Two parts to OCD
The example illustrates the two parts to the OCD equation: obsessions and compulsions. Obsessions are thoughts or impulses that get stuck. Compulsions are behaviours or rituals that follow specific rules – for example, doing something in a certain way or in a certain order or a specific number of times – that are carried out to prevent the obsession.

Where do these obsessions and compulsions come from? In his book Brain Lock (HarperCollins, 1997), Jeffrey M. Schwartz explores the links between impairments in the frontal cortex – the area responsible for executive function and memory – and the basal ganglia, which controls voluntary movement. In someone with OCD, the frontal cortex is overstimulated and fires too often and too randomly, and the basal ganglia responds with activity that some people can't control.

A very common obsession among youngsters with OCD – including Tessa – is the fear of losing a loved one, usually their mom or dad, unless certain rituals are carried out. In Tessa's case, if a parting routine of a kiss, followed by a certain spoken phrase, then three waves and a turn to the right, is not followed exactly, the whole scenario has to be repeated, correctly. If it isn't, Tessa is convinced that I will die.

Page 1 of 6 — find out about common OCD obsessions on page 2.