Speaker 1Hello and welcome to the How Not To Screw Up Your Kids podcast. So, pour yourself a cuppa, find a comfy seat and enjoy the conversation. In today's episode, I want to talk about obsessive compulsive disorder. What it is, what it isn't, why we have seen a three-fold increase in the past decade, what are the early warning signs and how can we help and support our children and teens who may be affected by it. Now, we're doing this episode slightly differently. So, you're going to get the usual audio episode. As I record, that'll be produced by my incredibly talented producer, Liam. I'm also recording this with video, which will go straight on to the YouTube channel, which we will give you the links in the show notes so you can go and have a look, just in case you're interested. What I look like when I'm recording, my hand gestures, or you're someone who likes video content. It's definitely a medium that I particularly enjoy. What I will say is it's going to be raw and uncut because we're not producing the video in any beautiful way. You are going to get the absolute raw episode recording that hasn't been tidied up and made slick without my little hesitations or whatever sidetracks that I tend to go on with the episode. So, I just thought I would just highlight that. I will highlight that for you. And if you do see me wandering with my eyes, it is just because I'm just checking my notes as I'm recording. So, the reason why I decided to record this particular episode was I'm forever having conversations with my sister. We're both early risers, so we tend to kind of like chew the fat or talk about something particular or a challenge that we're both facing. One of the conversations that we have was that about my level of need and very strong desire for control and for order. So, I'm going to talk a little bit more about that. And it got me thinking, particularly, I am super, super guilty of using the terminology of obsessive compulsive disorder, OCD. I think sometimes in a flippant way. It's not intended to be so, but we are often, and I certainly am really guilty of talking about this idea that we're all OCD to some extent. And it really got me thinking because there has been a recent article that has come out that has looked at the data when it comes to the numbers, of young children and teens that are affected by obsessive compulsive disorder. And it's gone up threefold in the past decade. So, it prompted me to do an episode, you know, what is it? How might we know that our child has got it? Now, obsessive compulsive disorder at its extreme is a debilitating disorder, so much so that young people cannot go about living an ordinary life. And therefore, I would highly encourage you, if you've got a child, after you listen to this, a child or a teen that you're really identifying with as probably at that extreme end, and you're noticing, I'll be very surprised if you haven't already noticed it, if it's at that level, then I really would encourage you to seek professional help because it's so important. It isn't something that as parents that we really can help and support them through. Of course, we can do our bit as part of the broader whole picture, but we do need to be guided and having the support and the intervention and the tools and strategies of a professional. And for some, that might also include supplementing with some antidepressants. So, that would be my general suggestion for that. What I would say for the rest of us is that we may notice as I go through obsessive compulsive disorder, which I will refer to as OCD, just to simplify it. What you will notice, I think, is that we may notice that we may notice that we may notice that we might notice that we may notice that there may well be some patterns of behavior that your child has that demonstrates that they have OCD. And if we're picking it up, certainly in the early stages or before it's become debilitating in their lives, then there are things that we can start to try and do. And if that does not work and we see the symptoms and the challenges within it extending and amplifying, that's when we can seek some help. So, let's start off with what it is. Now, it's characterized by repeating particular tasks or actions to get rid of intrusive thoughts. So, bad things are likely to happen. It's the sort of the intrusive thoughts, and it's often to loved ones if they don't repeat or perform a certain task. So, when we think about OCD, obsessive compulsive disorder, there are the obsessions, and then there are the compulsions. So, the obsessions will be the unwanted, intrusive thoughts that come to mind. You know, I talk often about this idea about the inner critic. We all have an internal dialogue. For those with OCD, the obsessions, these thoughts sort of appear to be inserted into their brain at these random moments. And some of those intrusive thoughts, for example, might be, they think that they might be burgled, or they might get sick. So, you have the obsessions, and then you have the compulsions, and then you have the compulsions. And what happens with the compulsions is these are the actions or the behaviors that are then taken out, that the child then works through, does, because what, by doing that, by those behaviors and actions, that gets rid of the intrusive thought. So, they're almost like these must-dos that they need to do. So, for example, if they are, if the obsession, the intrusive thought is around that they might be burgled. So, what they must do then ends up being, you know, I need to check all the windows and the doors. And it may well be that they need to check the windows and the doors a number of times. It might be twice, three times, four times. If, let's say, that the obsession is around that they might become sick, then the compulsion, the behavior then might be that they might then need to wash their hands to keep away, to make sure that they get rid of the germs, for example. So, these, I've just given you just a couple of examples, but it can look in lots of different ways. And for some, it's so debilitating that children or teens are almost paralyzed by the rituals because it almost becomes a, you know, if this is my obsession and this is the compulsion I need to do. Now, if the compulsion is I need to go and check all the windows and the doors are closed and I need to do that three times, for example, if that child gets interrupted in that process of doing it, what often then happens is because of the obsession, something bad might happen if I have to go back and begin all over again. So, it can literally take over their lives so they can't function and fulfill normal activities such as going to school, hanging out with their friends and those, you know, taking part in things that they enjoy. So, what it isn't, and let's sort of talk a little bit about that. So, you know, as I said before, we often trivialize OCD, not intentionally, but by saying things such as, you know, I'm so OCD. When we think about wanting things in a particular way, which as I said before, I'm hugely guilty about. By doing that though, we diminish those who are profoundly affected by it. And I know that I have become more intentional in my use of that. There is a certain element of us wanting things in a particular way, but I've just become more mindful not to use the terminology OCD, but simply say, you know, I've got a thing about things being tidy or being ordered. So, that's what it isn't. Why has there been a threefold increase? So, let's just look at the stats. So, in 2014, OCD was thought to affect 113,000 16 to 24 year olds. This is what the data for this particular age has revealed. Obviously, OCD has gone up across all of the age groups, but the specific data that I'm referring to is for that age group. For the year 2023-2024, it's 370,000 and it's now the same age group. So, it's 370,000 and it's now the same age group. So, it's 370,000 and it's now the second most prominent mental health challenge that children face behind anxiety. So, it is huge and we know that it can affect children as young. We can begin to see it from around the age of six. Well, there's been, as we've seen with all other mental health challenges and issues and reporting of disorders, there has been a significant increase across all. In lots of ways, as we start looking through and talking, a little bit more about how we spot the signs and how we can support our children. It's obviously, for some, it has come about because the pandemic would have had a huge effect, particularly around the notion of obsessive around germs and keeping things clean and avoiding people becoming sick. Part of it is obviously, we've got young people in that decade between 2014 and now have got more access. So, it's obviously, we've got young people in that decade to information in terms of through their devices. And of course, we have a whole generation of young children that are growing up, not yet being able to regulate and manage their emotions, sort of really having those challenges about self-regulating and having their own toolkit that seems to be sort of permeating much more into older children. Whereas previously, they would have been better equipped. They would have had less of the overwhelm of life. So, they would have had more opportunity to develop those skills. So, I think that's where we've seen the increase. And it means that in essence, it's more important than ever. to be able to pick up on the signs of this as early as we possibly can so there I think it's probably helpful to talk a little bit about the causes what might cause this because that also explains a lot around the threefold increase so there is evidence that there is family history so if you have a member within your family and obviously the closer relative that it is the higher the likelihood is that the child will also have it there is a genetic link so if you have a parent with OCD that means that you are more likely to be OCD if you've got an aunt or a grandfather or a great-grandparent then obviously the further removed the further away from us in our family the lower the statistic but in essence if we have got a family member then children are much more likely to do that and I believe particularly where the likelihood when it comes to parents who've got OCD in my view is speaks not only to the genetic piece but you can't unravel the modeling piece as well your child obviously inherits aspects of your genetics from both sets of parents but when they're living around somebody with OCD and observing and seeing those patterns of obsessions and compulsions that will also have an effect so if you are somebody listening to this with OCD and your child has not yet shown any signs and they may not know what they're doing but it will or you have a child that does working on our own the strategies to help ourselves with our own OCD can have a really profound impact for our children so family history can have a big impact a life event can also be a trigger we I talk a lot about this idea about transitions when our children sort of transition maybe from preschool to to school they'll go from maybe infant school to junior school they move from their primary schools to their secondary schools to their secondary schools to their secondary schools to their secondary schools or they move then on to university those can be big life events because they are big changes in terms of familiar going from familiarity making new friends and all that that brings with it so that can be but other life events can also impact it it can be a life event in terms of moving home it can be a life event in terms of a new sibling coming along bullying any of these situations a separation so please don't beat yourself up when you hear that particular thing and particularly if you're someone that's going through a separation at the moment life events affect us all and in fact if you look at the specific scale that looked at life events and the biggest impact which is where we get so much of our data when we talk about one of the most stressful things that anyone can go through is a house move that's a life event so when we look at the life event scale that was created by Holmes and Rahi decades ago on that life event scale there are positive things like winning the lottery but they can still have a profound impact on us in a less than positive way because of what happens for example with the lotteries often people will then move home or do things with their wealth that takes them away from their tribe and their community and so that can have a negative impact so please don't think that the life events always have to be profound the negative ones life events for the positive can also be a trigger it's about adaptation it's about how much it changes the familiarity that can impact it which is why the pandemic and the lockdown would have would have had an effect on some children because of course that was a huge life event for them and that would have changed the way that they lived their lives and for some children at certain ages and stages it would have affected them more profoundly than for others personality can also impact the likelihood that your child or team will get OCD so if you've got a child who's already anxious then there is a likelihood that they could also then be OCD and particularly we see that when we've got those that seem to demonstrate perfectionist tendencies they can also be more susceptible doesn't mean that they will be they're just more susceptible and the last thing that I would say is with Tourette's syndrome OCD is one something that's called comorbid and all that simply means is that if you have a child who's already anxious then there is a likelihood when there are some mental health disorders that sort of sit together so often when we talk about autistic spectrum disorder ASD anxiety sits with it it's a comorbid if you get one you get you often get the other well with Tourette's syndrome you often then also get OCD so those are generally speaking the causes so let's move on to early warning signs how might you be able to pick up that you're going to get OCD and how might you be able to pick up that you're going to get OCD symptoms can affect children as young as six years old all right so these are some of the things that I would be looking for so one of the things that I would definitely be looking for is a change in their sleep pattern so this is a child or a teen that is complaining about how long it takes them to fall asleep or complaining that they're really tired when they wake up and they're more so than normal so this is a shift and now we're going to take a quick pause for a word from our sponsors check engine abs or maintenance
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Speaker 3the guesswork out of your warning lights with O'Reilly Veriscan the service is free and provides a report with solutions verified by ASE certified master technicians and if you need help we could recommend a shop for you ask for O'Reilly Veriscan today obviously as our children go through adolescence and the
Speaker 1hormonal stage of puberty sleep can be impacted but this is where we can just look at sleep amongst a host of other potential warning signs so sleep is a very important part of our life and it's a very important part of our life sleep is one bit of it and sleep has been very much linked to well-being and emotional health and emotional well-being and so generally speaking if you've got a child whose sleep is being disrupted in a way that it hasn't been previously then it's it's a bit of an alert to us to be thinking right I just need to be checking what might be going on for my child it could just simply be they're going through a stressful time in their life they are they've got some friendship issues that they're going through at school or it could be the early warning signs of something like anxiety or OCD so that's the first thing to look out for then it's about looking out to see whether your child is embarking on some rituals whether you're noticing that they're checking things maybe repeatedly maybe they you're noticing that that they need to be the last person in your family to say I love you or maybe there's a pattern between you when they go to bed and you say I love you and they say I love you back and they've always got to be the last one for example now that it itself is not an issue where it becomes more noticeable and more of an issue that we want to tackle is if there is a disruption to that so let's take the example of you know a child needing to say I love you if they're they need to be the last one and that you've said I love you good night and they've said I love you and then their sibling interrupts and says I love you too and then they then have to start again that would then give you a bit more of an indication so it's about really it's the rigidity with which they may go about performing certain patterns of behavior so we're then also looking for some very specific are they doing some very specific and repetitive behaviors so looking out for those so we're sort of doing a bit of an audit we're being mindful where we're spotting these things so just taking that step back is your child excessively worried about possible harm to loved ones are they asking lots of questions are they asking lots of questions about you know what about whether something bad is going to happen or maybe they're getting really upset at the prospect that something awful might happen and they're talking and then you're noticing within that some small patterns of behavior because in you know if we go back to the idea about the obsessions and the compulsions the intrusive thoughts will be if you don't if you're not the last one to say good night and I love you something bad's going to happen to your parents or to your sister or to your brother or to your grandparents if you don't or your whole family so it's really you'll notice that they will then be asking more and more questions or or showing some real distress needing to know where you are all of the time as well now some of you might be saying well actually Mary Ann how do I know that the that it's OCD and not anxiety the difference that I would say is with anxiety you will get this excessive worry about possible harm but you won't necessarily see the same extent of the repetitive behavior the with the OCD there obviously there is an anxiety that drives it but it is driven by these intrusive thoughts whereas with anxiety is generally and more typically the thought processes rather than the actions that then that then happen so we've got sleep disruption we've got these very specific repetitive behaviors we've got this excessive worrying about possible harm you may you often then will also get some potentially get some excessive worrying about illness or disease, you know, will I catch this? Is it what will happen? happen to me if I get this? So-and-so is ill at school. Will I get that as well? I don't want to go there. I'm becoming really obsessive about the illness or disease. Also looking at things like counting, when they're checking things and then getting really angry and frustrated and almost feeling like they're going from zero to explosion in no second because they've been interrupted or disrupted in some way, either from someone else then saying something or a distraction so that they then have to start all over again. So looking out for that and also taking a long time to do things. So they seem to be taking a really long time brushing their teeth. They seem to be taking a really long time getting dressed and before they come downstairs. Now, of course, if you are only saying that your child is taking a long time to do things, that is not true. That is not true. That is not true. That is not true. That is not going to be a sign of OCD on its own. We're looking at the sort of the combination of these things. So you might have a child that will talk about some of the thoughts that they have. You may have a child that doesn't talk about it. But what you will see that will give you that indication of whether it's OCD rather than generalized anxiety or just general worry and stress is these patterns of behavior. And they're not always easy to pick up, but there will be an example of that. And so it's looking at that. And sometimes we'll get there's a certain element of symmetry. So if they knock their right shoulder by accident as they walk through a doorframe, you'll find that they'll then have to sort of maneuver themselves so that they then knock their left or that they'll have to switch their light on and off three or four times. There'll be numbers and sequences that will give some of that away. So hopefully that gives you a bit of an idea in terms of the early warning signs and how it might affect your child. But what do we do? How can we if we are then beginning to notice some of these things and it's not yet reached a point of fever pitch? And what we're talking about when we're talking about the debilitation is that you may have a child who, if they've got to have a particular routine before they leave, leave the house or do certain things at a certain number of times, if they keep getting interrupted, and particularly if you think about it in that early morning routine, and when you're trying to get out of the house is you will find then that they'll, you know, the fact that they need to just makes it all so overwhelming. So for the rest of us that are not in a situation where you're now picking up and thinking, right, I need to really look for some outside expert help. The things that I would say in terms of how can we help and support. So the first one is just be observant so that we can pick it up as quickly as possible. And I would also say, be observant of your own behavior. Are you having listened to this aware that you might have OCD? You might already realize OCD, but are you demonstrating certain patterns that you can then be observant and mindful yourself in terms of what you're then modeling? So that's the first thing I would say, if you suspect you have a child with OCD, or you don't have a child with OCD at all, I'm a really big fan. While we talk a lot about the fact that routine gives our children and our teens a great framework and some comfort, routine is great, that predictability, but I also think it can get in the way. It can impact it because then there is this always, well, this is the way that things always happen. So I like to vary routines regularly so that children and teens get that kind of experience of unpredictability, that things are different and that they might not always be the same all of the time. And if you have a child who finds this tough, it may well be that you've got a child who just really likes routine. They're not OCD at all, but they just don't like change. I think it's helpful to do it anyway because what we're doing is we're helping our children in terms of life skills. Life is unpredictable. And so if we can encourage our children to, we don't have to do it all of the time. We can have that routine 80% of the time, 90%, 95% of the time, but that 5% at least, I think it's really good to mix things up because as we know, life happens. That morning routine that we've always had in terms of getting out of the house and going to all the various places that we go to, sometimes doesn't happen. Someone becomes ill and we have to, or you become ill and someone has to come in and help. The bedtime routine where your children really love the fact that you do the bedtime story, we'll want some flex with that because we want to be able to go out and then other people to come in and to be able to do bedtime. We want to be able to swap with our partner so that we're not always doing it. And that's one of the questions that comes up so often is that, you know, my child won't brush their teeth or won't go to bed unless I do it. And my partner's not being allowed to do anything. So I think it's really helpful to play around with some of that unpredictability. I think that that's good. And what it also does is it helps potentially safeguard against OCD as well as building that life skill. So that's one that I would also add. I would, you know, help them begin to become aware of the intrusive thoughts of that internal dialogue that they are having and then challenge their thoughts. Now, it's not going to be easy because these thoughts are intrusive and they are so hinged on this notion that something awful will happen to people that they care about deeply or something terrible will happen if they don't. So remember that when they're in the middle of that obsession that leads to the compulsion, they're not thinking from their logical brain. They're in that emotional brain, which is at the back. And so when we're sort of encouraging them to become aware of the thoughts that they're having and then to challenge those, we want to be doing that at a time when they are not in that big emotional perspective. And different things will work for different children and different teens. I love using a, where's the evidence? And that works for some. So you can kind of say, well, where's the evidence that something bad, you know, if you don't check the windows three times that we're going to be burgled, for example. And I often will then go back. So if I've got a 10 year old, I might say, okay, so you've been doing this checking maybe for a few weeks, but before that you had 10 years and one month of not checking. How many days is that? Multiply it by 365. And sometimes the data, you know, the fact that you've not done it for 3,680 days and nothing bad has happened might work for some. It doesn't necessarily work for all. So instead we can pose, the question, what might happen if you did it two times, for example, rather than three, or you didn't do it at all, depending on what that is. How would that feel now for the child who's got OCD, that's going to be massively overwhelming. It's like something awful is going to happen. So it's about helping them understand the thought pattern and then also the what ifs, what might happen and how might we go about tackling it that way. So that they feel armed and equipped. And so that's where I would go back to the ladder analogy that I use so often, whether it's goal setting or whether it's helping our children face and ramp up their situations that they feel overwhelmed and anxious with, but use the ladder. Talk about ways that the top of the ladder is being able to do whatever it is and whatever task it is without these big rituals or to be able to do a task without having, you know, worrying about this obsession and then leading to that compulsion, but breaking down what might be more manageable. What are the small steps that they could take? And it might be that we create some distance between the intrusive thought and then the behavior, because what we can then do is the bigger the gap becomes, the more empowered they might feel to not do it. So it's really getting creative. There are lots of different ways that you can approach it, but really looking at small steps. Feeling uncomfortable, having had that intrusive thought and that strong urge and desire to act on it in whatever behavior that might be. And instead taking that step back and saying, right, can I count to 10? Can I count to 20? Can I say a mantra that says everyone's safe? Nothing bad's going to happen. I don't need to do this. I'm safe. There are people here to help me. Whatever those might be, but we're going to do it. And so we can't expect our child who has these intrusive thoughts to then be able to immediately pause and take some time before they act if we haven't given them some tools and strategies that they can practice first so that they can then put themselves on that first rung of that ladder and experience that first uncomfortable feeling and then use their tools to be able to overcome. And then they can go up. Once they've consolidated that multiple times, they can then go up to the next level. So I hope that that has been helpful in terms of giving you a bit more of an insight into what OCD is so that you're able to, I guess, be a bit more understanding and compassionate to those that have got it. Maybe like me, you'll be more mindful with the terminology, but also in terms of helping you identify obsessive, you know, OCD potentially in your own child, but also the tools and the strategies we've spoken about are really great for a child who just feels overwhelmed by things, who has has thoughts that don't necessarily aren't obsessions that lead to compulsions, but has thoughts that then lead them to making choices of behavior that aren't always in their best interests or serving them. Because then again, it's all about how can we challenge some of that narrative that is happening and then using that powerfully to choose a different pattern of behavior. So I hope that that was useful. Do let me know what you think. And for those of you who are watching on the video format, let me know what you think and whether you like it or not. And should we do more? As ever, if you enjoy the podcast, I would be eternally grateful if you could take a moment to rate and review the podcast. By doing that, what happens is on all the podcast platforms, it means that they are then more likely to suggest it to other parents who might benefit from either this episode or one of the many other episodes. And if you've really enjoyed this episode and you think it might be relevant to somebody that you know, then why not share it with friends, family, a work colleague, or a neighbor. And as ever, thank you very much for tuning in and I will see you next time.
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