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Information for Parents

OCD Spectrum Disorders and Related Conditions

Some people who have OCD also have other mental health disorders such as depression, attention deficit disorder or a tic disorder.

If another condition occurs concurrently with OCD, it can be confusing to try to pinpoint just what is going on and what disorder (or combination of disorders) the person actually has.  A cognitive behavior therapist can help identify related disorders and also determine what to do so that not only OCD but any related disorder is also treated.

Some of these related conditions (which are not OCD) are:

MAJOR DEPRESSION.  Depressed children or adolescents typically are persistently sad, feel “empty” or hopeless.  There can be loss of interest in usually pleasurable activities (such as sports, hobbies, or friendships),  decreased energy, difficulty concentrating, insomnia or oversleeping, irritability, weight gain or loss, and thoughts of death or suicide (which should be treated right away). In some cases, OCD is misdiagnosed as depression.  (Resource: National Institutes of Mental Health).

ANXIETY DISORDERS.  OCD is classified as an anxiety disorder.  Other anxiety disorders include Generalized Anxiety Disorder, Post-Traumatic Stress Disorder, Panic Disorder (panic attacks), Social Anxiety Disorders and specific phobias such as fear of snakes or heights. All of these disorders include symptoms such as excessive worrying and fear and because each disorder is different, symptoms can be quite varied.  (Resource: Anxiety Disorders Association of America).

EATING DISORDERS. Approximately 40% of individuals with anorexia also have OCD.  Anorexia nervosa (self-starvation and excessive weight loss), bulimia (binge eating with accompanying “compensatory” behavior such as self-induced vomiting) and binge eating (recurrent overeating without compensatory behavior) are disorders that involve serious disturbances in eating behaviors, and should be treated. (Resource:  National Eating Disorders Association).

Because there can be intense peer pressure about appearance, it’s normal to be concerned about weight.  But if you recognize an eating disorder is taking place, you should seek help by seeing a doctor (who can conduct an evaluation to determine what disorder to treat).

ATTENTION DEFICIT DISORDERS.  ADD and AD/HD (Attention Deficit/Hyperactivity Disorder) can occur at any age.  Symptoms include inattentiveness, physical restlessness or hyperactivity, difficulty beginning or completing tasks and impulsivity.

Children or adolescents with ADD or AD/HD have symptoms such as poor listening skills, making careless mistakes in class work, difficulty completing homework assignments, fidgeting or not remaining seated in class, excessive talking or interrupting teachers or peers.  A therapeutic assessment can determine if the symptoms you experience are from ADD or AD/HD. (Resource: Children and Adults with Attention Deficit/Hyperactivity Disorder).

In some cases, OCD is misdiagnosed as AD/HD. The attention of individuals with OCD may be consumed by obsessions and/or mental rituals (e.g., mental praying, trying to think of something to “undo” an obsession). As a result, little, if any, attention is available for the task at hand. What appears to be inattentiveness, then, may lead to a diagnosis of AD/HD. A mental health clinician will be able to distinguish between the two disorders, however. It is also important to note that children and adolescents may have BOTH OCD AND AD/HD. The coexistence of OCD and AD/HD in children has been documented in many research studies and young people with both disorders may experience more impairment (such as problems in school and social functioning or depression) than children and adolescents with OCD alone.

TOURETTE SYNDROME OR TIC DISORDERS.  Motor and vocal “tics” are involuntary movements, facial expressions and vocalizations that include shrugging, rapid blinking, sudden head movements, sniffing, clearing the throat, humming, making other sounds, blurting out repetitive words or phrases or uttering exclamations or obscenities.  (Resource:  Tourette Syndrome Association of America).

ASPERGER SYNDROME:  An autism spectrum disorder, Asperger Syndrome is characterized by problems with communication, social interaction and patterns of thought.  Many people with Asperger syndrome also have intense or “obsessive” interests in certain subjects, but focusing on these interests brings them pleasure—unlike OCD, which produces anxiety. (Resource: National Institute of Child Health & Human Development).

OCD Spectrum Disorders

Some conditions tend to coexist with OCD and are thought to be biologically linked to the disorder as part of an obsessive compulsive “spectrum”.  These conditions also should be treated by a qualified mental health therapist.

BODY DYSMORPHIC DISORDER.  A person with Body Dysmorphic Disorder (BDD) has an intense preoccupation with their appearance—specifically an imagined or exaggerated defect in their appearance.  They may think of themselves as ugly, and are often obsessed with a perceived flaw, such as a mole, the size of their nose, or some other facial feature.  They have difficulty controlling negative thoughts about how they believe they look, even when others believe they look fine. 

While everyone has some concern about their appearance (or how others perceive them) a person suffering with Body Dysmorphic Disorder is truly miserable and cannot be consoled or reasoned with about their appearance.  When the concern causes overwhelming distress, and the preoccupation interferes with normal activities, it requires treatment.  (Resource: Mayo Clinic Tools for Healthier Lives).

TRICHOTILLOMANIA, SKIN-PICKING and NAIL BITING.  Compulsive hair-pulling (“Trich”), skin-picking, and nail biting are considered body-focused repetitive behaviors.  Some signs of these conditions include noticeable hair loss from pulling hair out by the roots; chewing on hair pulled out multiple scars, sores or scabs (and the person continues to pick at these, causing bleeding), nails that are bitten so that they are uneven and no nail extension is present; nails bitten until they bleed. 

(Resource: Trichotillomania Learning Center).

If you know you have any of these symptoms, it’s best to discuss it with your doctor and ask for a referral to a qualified cognitive behavior therapist.

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