How to handle child's OCD/anxiety/?
May 26, 2015 8:21 PM   Subscribe

My daughter is afraid of getting sick and asks everyday about the dangers of different substance. I am unsure of how long to let this go before looking for professional help, even if just to help me not go insane over her behavior.

About two months ago a child threw up on the school bus. This is the first time I can remember my daughter reacting. She was concerned that she might have touched the vomit and therefore would get sick. I told her she was not likely to get sick and if she did, she would be okay. Fast forward and now I cannot remember a day when she has had some irrational fear of getting sick/poisoned everyday. Here are some examples:

1) the bag of carrots says best by May 25th, and today is the 26th, she is afraid they will make her sick.
2) Her cheese stick says must keep refrigerated, I put one in her school lunch she is afraid to eat it.
3) She put lotion on her arms & legs, the bottle says do not ingest the lotion, she is afraid that the residual lotion on her hands might accidentally get in her mouth and make her sick
4) She was leaning near a painting and was afraid her hair touched the painting, the (dry) paint may have gotten in her hair, and her hair might end up in her mouth.
and on and on every day for at least the last two weeks. I've been trying to keep track but I remember this first starting about two months ago.

She is seven, the youngest in her class, and very academically bright. Part of me thinks she just needs reassurance so we talk about all of the scenarios. For example, I showed her all the different types of food labels that exist (e.g, best by, sell by, use by, etc.) Once I talk to her for awhile her "anxiety" dissipates and we move on. I've told her that these are just feelings and that we can try different strategies to manage feelings. Her school teaches mediation techniques and I remind her of different ways of breathing to redirect her feelings. These strategies "work" insofar as she can move on and change her focus. But this is exhausting me! While on the outside my calm, patient strategies appear to work, I want to bang my head against the wall and say are your f-ing kidding me! You are not going to get sick from your hair touching a piece of paper. This is happening every day, often multiple times a day.

Is this a phase she is likely to grow out of? Like I said, I can get her to move on but it is driving me crazy. Would a therapist be able to help us? Part of me feels like it is not that extreme of behavior since I can redirect it but are there other signs I should be looking for? Any strategies for remaining calm and not telling your child they are full of it?
posted by turtlefu to Human Relations (18 answers total) 1 user marked this as a favorite
 
I don't really know much about OCD in kids, but this book on anxiety really helped my niece, and my own therapist told me she loved it when I got her one to look at for her sessions with kids. There's one for OCD though I haven't read that one but if it's as good at the other one, then it must really help.
posted by CrazyLemonade at 8:32 PM on May 26, 2015 [3 favorites]


I am a therapist, I am not your daughter's therapist.....

Yes, therapy would help, there are some pretty specific modalities to deal with this type of OCD thinking... Cognitive Behavioral Therapy can be useful, and it will be more effective to do some intervention now than to wait until these fears and thoughts are more deeply embedded.

There are also medications (disclaimer, I am not one to jump to this as a solution, but it's worth mentioning) that are useful, keep this thought on the back burner as you seek other solutions.

I certainly understand that this is frustrating and exhausting for you as a parent, seeking out some professional help for both you and your daughter might make life a bit easier....

Remain calm as you deal with this, it sounds like you're doing well with the techniques you're using as you help her (as it appears you have been) to reframe some of her thinking about these fears.
posted by HuronBob at 8:54 PM on May 26, 2015 [1 favorite]


As a lifelong sufferer of health focused anxiety, I don't think this will just go away. Your daughter's health fears are very sophisticated and very specific. I'd imagine that professional intervention now could save her years upon years of suffering and heartache.
posted by pazazygeek at 8:56 PM on May 26, 2015 [4 favorites]


I was your daughter. I just sent you a memail with more detail, but the short version is that it just passed. If you want to try to calm her now you might try finding some kid friendly examples/explanations of the concept that the poison is in the dose. It sounds like this hasn't been going on very long. I don't think you should be assuming OCD just yet. Kids get all kinds of thoughts stuck in their heads and mostly they pass.
posted by If only I had a penguin... at 8:58 PM on May 26, 2015 [4 favorites]


I second the Worry book CrazyLemonade suggests above. I got it for my son after it was mentioned in another AskMe. He liked it and found it helpful.
posted by jacanj at 8:59 PM on May 26, 2015 [2 favorites]


When I was a kid, I had irrational fears about things that, in my precocious four- or five-year-old mind, could plausibly happen. My thought processes were something like: "it's raining really hard and we're in the car and cars aren't as strong as houses... the roof is gonna cave in!!" Or "it's really windy, the wind just took my school project out of my hands... it wasn't that heavy... I'm not that heavy... what if I blow away???"

I can't remember how I got over these fears, but I do remember pretty vividly what it was like to have them. People kept reassuring me that the roof wasn't going to cave in because of the rain and I wasn't going to blow away because of the wind, but how did they know? They kept reassuring me, but they couldn't tell me how it worked. Like the heavy rain example, I remember my dad and I were going to go to a baseball game but we had to turn around since I was crying uncontrollably because he couldn't tell my WHY this extremely loud, heavy rain was not going to eventually collapse the roof of the car and I just couldn't take his word for it about something so dire.

Before you consult a therapist, I would give a crack at explaining why she is not going to get sick from all of the above scenarios and see if that helps at all. And it would probably be best to do this when she is feeling calm and not right after you pour her some "possibly spoiled" carrots etc. Like for point 1, maybe you could read an article together about how there is some leeway in the dates they stamp on various foods.
posted by sevenofspades at 9:14 PM on May 26, 2015 [1 favorite]


I really wish, for whatever it's worth, that my parents had taken my worrying and perfectionism in elementary school as signs of something that needed dealing with. Therapy as an adult helped me with coping with it even in the absence of medication. A lot of my issues now are not the same issues I had as a kid, but my brain still doesn't work quite like the standard model, and failure to take that seriously had a profound academic impact for me by high school. Adequate treatment made a huge difference in college, but it would have been nice to get help earlier.
posted by Sequence at 9:30 PM on May 26, 2015 [11 favorites]


Smart kids have an as yet small data base, but big area for computation. With this boundless potential they know they need to know more, but their accumulation of knowledge, at certain stages, can't keep up with their fears. Things like The Big Book of How Every Thing Works, are good. They give good basic knowledge about lots of every day things. Building the hard knowledge base helps with making better assumptions, and finding good answers. Around that age, I started reading the paper, horrifying. I grew out of fears regarding everyday reality. I think this is a difficult time for you, but right now, you are her hero, and safe haven. It doesn't get better in terms of having the answers. She will grow out of her fears, but not of her trust in you.
posted by Oyéah at 9:55 PM on May 26, 2015 [3 favorites]


Well, what would it hurt to consult a psychologist? To me, the examples you give seem to suggest a problem. Maybe she will grow out of it, but maybe she won't. Going for a consultation doesn't commit you to anything.

The reassurance you are attempting to give her, while a perfectly reasonable and loving response to run of the mill fears, actually makes anxiety much worse in adults with anxiety disorders, and I assume the same is probably true of children. You reassure, the feelings go away. The feelings come back, you explain them away, but a new issue arises and the feelings come back....The trick is teaching her how to tolerate those feelings, and that often involves exposing her to what she fears in a controlled manner.

If you go in for a consultation, just make sure the person specializes in the treatment of OCD and other anxiety disorders.
posted by girl flaneur at 10:12 PM on May 26, 2015 [4 favorites]


I really wish, for whatever it's worth, that my parents had taken my worrying and perfectionism in elementary school as signs of something that needed dealing with.

Ditto. I'm fine, and I'm not saying my parents "screwed up" or anything, but it took me until my 30s to get the hang of dealing with my anxiety. Even just partnering with her in learning to deal with it consciously would be better than, say, laughing it off or telling her to just stop. These thought processes are manifesting visibly now but will go underground; she'll learn to hide them, for instance. Help her figure out how to cope now while she's learning to cope with everything else.
posted by salvia at 10:47 PM on May 26, 2015 [3 favorites]


I was going to ask whether your daughter had stomachaches (before I glanced over previous questions and saw that you asked about her stomachaches five months ago) because a fairly recent study suggests that stomachaches can cause anxiety:
Children with chronic stomach pains are at high risk for anxiety disorders in adolescence and young adulthood, a new study has found, suggesting that parents may wish to have their children evaluated at some point for anxiety.

Researchers at Vanderbilt University tracked 332 children with recurring stomachaches that could not be traced to a physical cause — so-called functional abdominal pain — comparing them as they reached young adulthood with 147 children who had never had such stomachaches.

About half the teenagers and young adults who had had functional abdominal pain as children developed an anxiety disorder at some point, compared with 20 percent of the control group, the researchers found. The vulnerability to anxiety persisted into adulthood even if the pain had disappeared, although the risk was highest if the pain continued.
The lead author of the study thinks the problem might best be addressed through therapy for anxiety, but others prefer therapy to learn to control the stomach pains.

It's interesting that the child with stomach pains the author of the NYT piece profiles for the story also developed her anxiety problems after an incident involving vomiting.
posted by jamjam at 11:10 PM on May 26, 2015 [6 favorites]


I second Sequence — I wish my parents had taken this seriously when I was a child. Don't get me wrong, I have a great life, I'm happy and successful and all the things you probably hope for your daughter, but my OCD put a huge strain on my relationship with my family (to this day), mostly because it was unacknowledged and I was told to just get over it.

It might be helpful for you to read about the experience of having an anxiety disorder, if you've never had one yourself. I know it sounds strange to think that germs could stick to a person's hair, then travel to her mouth, and somehow make her sick. I have trouble taking out the garbage because I imagine/sense illnesses venting up from the bag and into my lungs. It's not rational — if it was, it wouldn't be a disorder ;)
posted by third word on a random page at 2:45 AM on May 27, 2015 [1 favorite]


Count me in as someone who wishes their parents had taken her childhood anxiety seriously, although I must say, talking her through her fears and meditation is a hell of a lot more than I got, and I am jealous. I was instead told to chill out and that I was too sensitive, and I still deal with food-related health anxiety today as an adult in my 30s. Give her the tools she needs now - get her to a therapist!
posted by chainsofreedom at 5:12 AM on May 27, 2015 [3 favorites]


Best answer: The best case scenario if you take her to therapy is that it really works and makes her feel better and makes her life measurably better.

The worst case scenario if you take her to therapy (assuming you present it as, "let's go talk to this nice man/lady doctor who might be able to help us figure out ways to make you feel better" and not, "you are broken and I am taking you to a stranger to fix you." But you seem like a very caring parent, so I'll assume you have that part down) is that it doesn't work or it turns out she didn't need it, and then you've wasted some time and some money.

The best case scenario if you do not take her to therapy or otherwise seek professional help is that she grows out of it, and this ends up having been just an unpleasant phase.

The worst case scenario if you do not seek professional help is that this turns out to be a real problem that grows and gets worse as she gets older and really messes up her life.

I'd say that the pros and cons are in favor of an evaluation with a mental health professional with experience in childhood anxiety issues.
posted by decathecting at 6:42 AM on May 27, 2015 [2 favorites]


At 7 I had fears like this and by middle school I needed hospitalization. Maybe if I had gotten professional help when I was small I wouldn't have spent so many years trying to fix myself. So yes, I think no harm can come of a consultation--even if it passes, you did your due diligence. If this is something she'll struggle with the rest of her life, however, the sooner she can learn skills to handle it, the better.

For this kind of anxiety, there are specific types of therapy that work much better than others. Look for someone who says they do cognitive behavioral therapy, but especially look for someone who has experience what they call "exposure and response prevention." I have found that many therapists who are trained in CBT will still end up doing a lot of talking and very little actual work on hands-on practice. OCD (including health anxiety) is very treatable but a lot of professionals really don't have the experience to treat it effectively.
posted by epanalepsis at 6:48 AM on May 27, 2015


Also--it sounds like you are doing the right thing but please avoid the temptation to reassure her that nothing is really wrong. She is asking over and over because her anxiety wants reassurance, and I know it probably breaks your heart, but reassurance just feeds the Worry Monster. You'll end up in a repetitive spiral of begging/reassurance/begging and that will makes everything worse for both of you. What works better, IMO, is "these are feelings and feelings pass" and "if that did happen, then what? I have skills to handle that situation." Both of those responses can be framed in an age-appropriate way and increase her resilience and internal skills.
posted by epanalepsis at 6:53 AM on May 27, 2015 [2 favorites]


I was your daughter! At age 7, I developed a pretty severe emetophobia and that extended to all things Illness and Injury. Now, in my 30s, I'm pretty even-keeled. Here is what helped/helps:

- Learning how vectors work, how viruses and bacteria and etc. etc. can and cannot infect you. I am able to eat expired carrots now because I understand at what point a carrot is really rotten and if/how it could make me ill. I am able to spend time with a vomiting family member now because I understand what is/isn't contagious and what will happen if I get ill myself. Knowledge is so, so important here. I stopped asking my dad questions like "if a person had cholera, they'd know it, right?" after I learned about cholera and other waterborne diseases. Etc., etc.

- ...So rather than blindly reassuring her, it'd be more effective to explain, or hand her a book, or say "let's go look it up" and figure it out together. Telling a smart child "don't worry about it you're FINE" does nothing helpful whatsoever.

- Anti-anxiety meds (small dose of an SSRI, daily). I don't know if I'd recommend this for a child, but it has helped me immeasurably as an adult.
- Anti-nausea meds. I rarely (if ever) take one, but it gives me peace of mind to have a Zofran prescription and to have one in my purse if an "emergency" happens. Again, I don't know if this would work for a child and/or if she wouldn't just take them every time a twinge of stomach upset came on.

What didn't work: The therapist my parents had me see, who had me explore "what's the worst that can happen?" every time I had a concern. I felt like she was just telling me to knock it off, and I wanted to say, hey, no, you idiot, I know I'm not going to die if I eat this rotten carrot. I just don't want to be sick!

So, in short: just help her learn more about the world and how it works and treat her anxiety as curiosity. Be kind to her and don't shame her for being silly and irrational. Don't try to force "exposure therapy" on her at home by making her eat/touch/smell things. And she will grow out of it, or at the very least will probably adapt so that it's not round-the-clock questioning.
posted by witchen at 7:35 AM on May 27, 2015 [3 favorites]


My daughter, who is seven, has a similar issue. It started in January when my mother-in-law got sick and then died. She became obsessed with worry that I would die. She already sees a psychologist (to help her deal with chronic pain) and the psychologist talked with her about worrying. She used some zen language with her - about how worries are like plants and attention is like water to them. She encouraged me to not try to be rational and try and talk through them or explain things but rather to talk about the fact that my daughter was worrying and what that might be about. It pretty quickly broke the connection between remembering Oma and worrying about me.

Then a few weeks ago our small dog ran into traffic (he was hit but fine) and she again became terrified that I would die, this time by being hit by a car. She did not want me to drive or to walk through parking lots, etc. For some reason, I decided to teach her about trauma. I talked with her about how seeing the dog get hit by a car was a trauma and I explained to her what happens in the body and brain when we experience a trauma. This really helped her talk about what had happened and has brought her anxiety way down. Maybe your daughter was traumatized by what she saw on the bus?

My daughter has a history of trauma (she's adopted through foster care) and my experience has taught me to not address the specifics of the anxiety because it focuses on the symptom rather than the cause.

Your daughter's anxiety may not be trauma related, but may be a panic disorder showing up. In either case, she needs tools to manage the feelings and there are people who are skilled in this area. I would suggest that you go talk to a child psychologist and see what they say.

Good luck!
posted by orsonet at 8:57 AM on May 27, 2015 [3 favorites]


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