Garrison Blog: OCD

We wanted to share some details and information about Claire and the OCD that she's been struggling with for the past 6 months. It's been an interesting journey already but we've learned a lot! Hopefully sharing this information will help you see that some of her personality traits, habits, and tantrum/feisty attitudes are actually results of her OCD.

To the beginning: Claire has always been occupied with 'order' but not out of the ordinary. To us, it was just a regular toddler stage: lining up cars according to color, wanting her room clean, etc. But every now and then, it would be alarming; like once we arrived at a splash pad to play and she spent a couple of minutes lining up all of the kids' shoes before she could play. I didn't worry or think much of it at the time though because these episodes weren't very often and never took her too much time. Then Ben lost his job and her world was rocked. She was very emotional about the experience and with him suddenly home every day, her schedule changed and I think it is what triggered it. She felt like this part of her life she could control.

"Evidence is strong that OCD tends to run in families. Many people with OCD have one or more family members who also have it or other anxiety disorders influenced by the brain's serotonin levels. Because of this, scientists have come to believe that the tendency for someone to develop a serotonin imbalance that causes OCD can be inherited.

Having the genetic tendency for OCD doesn't mean that someone will develop OCD, but it does mean there's a stronger chance that he or she might. Sometimes a stress-causing event may trigger the symptoms of OCD in a person who is genetically prone to develop it." Source here.

For the next two weeks after this change, she was developing more and more repetitive behaviors. Her hoarding (which hadn't been too bad up until this point) was out of control. I would be missing things all the time (even my mom noticed this at her house). I looked under her bed once and couldn't believe how many things were under there. Every nook and cranny of our house had piles of toys and nicknacks that she was hoarding/hiding. This was just a minor sign of OCD.

Then there were the questions. She would ask me the same thing over and over again, and not like any little toddler: "Are we there yet?"... it was deeper. It was like she heard me, but didn't feel good until I reassured her 5+ times. And before I knew it was OCD, I would get soo impatient.

"Mom, how many bowls are out on the counter?"
"Three"
"Mom, how many bowls are there?"
"Claire, I JUST answered you, did you hear me?"
"Yes, but tell me again."
"Why?"
"Because! Just tell me how many bowls are there?"
"Let's count together."
"NO!! Just tell me!"
...
Conversations like that happened multiple times a day. She would finish an episode on the iPad, point to it and ask me, "Mom, did I just watch this?" As she would go to bed, "Mom, are the books still in a line on my dresser?" ... "Is my room clean, mom?"

Then she started shutting the door to her room. And it HAD to be closed before she could start her day. She didn't want anyone in there. We let it go for about a week not thinking much of it. Then one night, she woke up with a nightmare. I went in to try and calm her down and it was impossible. Her subconscious was coming out and her worry and anxiety about the order in her room was so real. "Mom, is my box still on my dresser?" "Are my clothes away?" "Is the drawer shut?"

This is when I realized there was a problem and I googled on my phone, "OCD in children." Everything I read was what we were dealing with. Ben and I had a confirmation that she had Obsessive Compulsive Disorder and we wanted to be able to help her.

I read a book, "Freeing Your Child From OCD" and it was awesome. I learned so much about it. If left untreated, OCD will own you. It will interfere with daily life, run your schedule and be the boss of your routines. It can waste hours a day. We wanted to equip Claire now with the tools and knowledge she needs so she can learn how to boss it back. She needs to know she has it and be able to get past the anxiety and fear and compulsions it creates.

A little background on the disorder: Obsessive-compulsive disorder (OCD) is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (or obsessions) and behaviors that make them feel driven to do something (or compulsions).

The rise in anxiety or worry is so strong that a child feels like he or she must perform the task or dwell on the thought, over and over again, to the point where it interferes with everyday life:

takes up more than an hour each day
causes distress
interferes with daily activities

I thought for the first few months that we could just try battling it on our own. With the knowledge and skills I read, we started our own behavioral therapy. But then it just kept getting worse and worse; taking up too much of her time and creating too much distress (for both of us). This is when we turned to a child psychiatrist.

This will be a life-long battle. She won't outgrow it; but she will be able to function pretty normally with it if we continue to work with it. It takes daily effort and patience. The first treatment is behavioral therapy. And the second is medication.

Behavioral therapy involves gradually exposing kids to their fears, with the agreement that they will not perform rituals, to help them recognize that their anxiety will eventually decrease and that no disastrous outcome will occur.

Many kids can do well with behavioral therapy alone while others will need a combination of behavioral therapy and medication. Therapy can help your child and family learn strategies to manage the ebb and flow of OCD symptoms, while medication, such as selective serotonin reuptake inhibitors (SSRIs), often can reduce the impulse to perform rituals.

There is nothing wrong with needing medication, and if it gets to that point, then we will do it. But for now, we are going to try Behavioral Therapy. Her doctor is Brian Hansen and he is wonderful. They really connect and I feel like in just these last 3 weeks she has made progress. Her room, which was her biggest problem, isn't even a factor anymore. It's messy every day with drawers left open (almost to the point of making ME crazy:) ). There is almost ZERO anxiety about her room these days and it's wonderful.

Lately, her biggest struggle has been her drawing/coloring. She has to have things perfectly meeting (the ends of a circle), perfectly in the lines, matching colors, no wrinkles, etc or she has a freak out. We're now working on her with this. It will probably be like this her whole life, her anxiety will not go away, it will just move from one aspect of her life to the next. We just want her to be able to move on and not have them all build up in every thing she does.

Another thing lately is saying "I love you" or telling her she looks cute or asking us if Elisa is her best friend. She asks us hundreds of times a day. We tell her lately that we say "I love you" once in the morning and we don't say it, no matter what, the rest of the day (as harsh as that sounds). She will ask us and we remind her that we already said it and she knows the answer. My mom also taught her, "What does a hug mean, Claire?" And she said "It means 'I love you'" so we do that too in place of saying it.

We are starting with a list of her OCD, a hierarchy of her fear. And we're starting with the small tasks first and mastering one at a time. We have rewards for tackling her fear.

Family support and cooperation will go a long way toward in helping her. A couple of things to know that will really help us:

1) We call her OCD her "teaser monster" in her brain. She gave him the name "Koosha." If her anxiety starts, we remind her that Koosha is telling her it has to be perfect and she needs to show him it doesn't.

Here is Koosha:

2) We would ask that you refrain from reassuring her more than once. Please say "I love you" just once. Answer her question just once. It's all about consistency.

3) When she is coloring or drawing and has a freak out, hold back from trying to make her feel better or telling her how to solve her problem and instead validate her frustration, saying, "I know this is frustrating, Claire." and that's it. Let her sit and cry and have a tantrum (her anxiety) and let her try to solve or fix it herself. The anxiety will pass.

We expose her FEAR and prevent the ritual. Never give in. It's all about consistency. The doctor said we will have a whole lot more tantrums now that we are starting therapy and it will be hard to not just reassure her and move on without a tantrum. But that just reinforces the problem and her need for reassurance and she will begin to know that if she asks and gets her answer, it helps ease the anxiety and she'll keep doing it. He said "Things are going to get a lot worse before they get better. And that's how you'll know it's working."

Anyway, we're not experts on the matter, but have definitely learned a lot and continue to learn each day. Thank you for your help in this. It is definitely hard, but we know it could be worse and are thankful we caught it early. She is an intelligent, special little girl and we know she will be okay.

Thanks!

Camille & Ben

Some recent pics!

CLAIRE:

Weight: 33.6 lbs (33%)

Height: 39.5'' (36%)

ALEX:

Weight: 26.6 lbs (31%)

Height: 34.4'' (57%)

Alex likes to get in Claire's shoes and wait outside for her preschool carpool :) Stylish little dude.