[View original article published in Psych Central here] Megan felt miserable. She and her family had relocated in the middle of the school year to another city. She was missing her friends and changes were difficult for her. It seemed the problems began one morning when she was getting ready for school.

While washing her hair, she thought she had swallowed some of the shampoo. She wondered if it was toxic. She worried she’d get sick and die. She rinsed her mouth incessantly until she felt safe.

“Is it poisonous?” she would ask her mom, every day before taking a shower. Her mom would reassure her that it was harmless.

But Megan wasn’t satisfied with the answer. She couldn’t take a chance and took safety measures each time. Soon, her worries increased and transferred to other things like soap and toothpaste. Smells of certain products also became threatening to her. She avoided places, situations, people, and products that could cause her harm. Megan was unhappy, and her parents felt lost.

Many children are anxious for different reasons, and parents need to be aware of the difference between OCD and other mental and emotional challenges. When children wash, rinse, clean, check, repeat, fix, order, count, or show other outward manifestations of OCD, parents can easily determine the problem is probably OCD. However, children may experience violent, religious, sexual, and neutral obsessions that may accompany some outward but also internal compulsions. Parents may have more difficulty identifying the compulsions and thus recognizing the problem as OCD.

Maintaining a close relationship and open communication with your children can help you discover what they are thinking. Children afflicted with OCD may become irritable, demanding and bossy. They may ask you to do certain behaviors to ease their anxiety. Children may ask questions not necessarily for information purposes but to feel comforted and reassured. They may stay away from situations, places, and people they didn’t avoid previously. When you begin to feel overwhelmed by your child’s troublesome behavior, you know something is amiss.

Getting the right information can be the first step toward recovery. Find out your family’s mental health history. OCD is a physiological and behavioral illness. It’s also a genetic predisposition. You may discover ancestors and relatives who have suffered from OCD or similar illnesses. Then you can help your child realize OCD is heritable and is no one’s fault. This will help normalize the challenge.

OCD can be triggered by a stressful or traumatic experience. Puberty itself can be stressful enough that it could trigger OCD. Read reputable books and websites to help you understand OCD better.

Recognizing the OCD cycle (listed below) will be useful because books and websites cannot possibly list every symptom your child may be experiencing. There are as many variations of symptoms as there are people on the planet.

The OCD cycle can appear as follows:

• Trigger. It can be a thought, image, situation, place, event, animal, or just about anything that causes individuals to start obsessing about their fears.
• Obsessions. These are intrusive thoughts that won’t leave the person’s mind. One thought will lead to another and another. OCD sufferers find it difficult to redirect their attention away from these thoughts.
• Feelings. Feelings are intense and will vary according to the person’s target obsession. Most people will experience anxiety but guilt, depression, anger, frustration, and other feelings may ensue.
• Compulsions. Compulsions are whatever the person will do to get relief from the obsessions and feelings. The compulsions can be either behavioral or mental. Sometimes when individuals don’t receive treatment soon enough, their compulsions may become as automatic as their obsessions.
• Relief. Relief is obtained by doing the compulsions and is what every OCD sufferer wishes for. Unfortunately, it will only be temporary until the next trigger appears. Unbeknownst to the individual, the false sense of improvement and relief is actually reinforcing the OCD cycle.

Megan’s triggers were various products and substances that she suspected were poisonous. Her obsessions were the thoughts about what would happen if she were to inhale or swallow those products. She was afraid to get sick and die, so she felt anxious about it. Some of her compulsions were: rinsing incessantly, checking with her mom and obtaining reassurance she wouldn’t get sick and die. Avoiding products and situations that would possibly harm her was a compulsion as well.

You and your child need to remember that OCD is an illness like other illnesses that children and adults have. Talk about children who suffer from diabetes or asthma. They experience difficulties but learn how to cope. For instance, children who have asthma can still play sports. They get used to bringing their inhalers along. Children with diabetes learn certain skills and routines to manage their sugar levels. Likewise children who are challenged by OCD can learn new skills to deal with it and move on with their lives. Remind your child that people who have asthma or diabetes are not embarrassed or ashamed of their illness and neither should your child be.

Telling your child to “just stop it” won’t work, and you know this already. Criticism, overcorrecting and overreacting trigger more anxiety and frustration not only in your child but everyone else in the family — including you. Insensitivity will backfire, but accommodating your child’s OCD demands will be exhausting as well.

There is a fine balance and practicing reflective listening can decrease negative responses. Difficult situations go more smoothly when parents practice those skills. Parents can let their children know they care. Say something like, “I know you are having a really hard time! If I had those thoughts and worries, I’d probably feel the same way. Would you like to talk about it?”

It’s easier said than done. When your children want to involve you in their rituals, validating their feelings certainly won’t solve their anxiety, but they’ll know you understand. It will also delay the compulsions even it is just a few seconds or minutes.

Give your child hope: “We will be going to see someone who will help us learn how to deal with this challenge.” Your children need to know there are solutions. Let them know they’ll be learning skills to deal with OCD.

Sometimes parents hope their child’s behavior is just a temporary situation. When your child’s “current self” is no longer her “typical self,” consult with your pediatrician. Watch for the following symptoms: easily crying or irritated; declining grades; appetite changes; hopelessness; worthlessness; sleeping difficulties; increased periods of extreme anxiety; social conflicts or isolation; tardiness; concentration difficulties; underachieving; and inability to make decisions.

Find a specialist who is trained to treat OCD by implementing cognitive-behavioral therapy that includes Exposure and Response Prevention. Multiple studies have proven CBT to be the most effective treatment. When it comes to treating pediatric OCD, research also indicates that CBT with the focus on parents and family involvement provide positive outcomes. Visit the International OCD Foundation to locate a therapist specialized in treating OCD.

It is difficult to see one’s child suffer, but know that there is hope. You and your child can learn the skills needed to keep OCD at bay. Learn how to manage it, and the entire family can enjoy life again.