Neurotic Disorders

Obsessive Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) in childhood is characterized by recurrent and persistent obsessions and/or compulsions that cause distress or interfere with everyday life.

Obsessions are involuntary thoughts or feelings that arise repeatedly in the child’s mind and which are frightening, disgusting, or bothersome. Obsessions are not simply excess worries about real-life problems. Examples of obsessions include thoughts that something bad will happen to a loved one if the child does not engage in a compulsion and fears of contamination or getting sick.

Compulsions are repeated behaviors or rituals that are done rigidly and in response to an obsession and which are usually aimed at preventing some dreaded event or situation. Examples of compulsions in children include repeated washing or dressing in a certain way; repeatedly checking things like doors, windows, light switches, or homework; erasing or rewriting; or repeating certain words/phrases or numbers over and over. Often children will ask family members for reassurance and will involve them in rituals. OCD can result in a lot of avoidance (e.g., not touching doorknobs) and distress.

Cognitive behavior therapy (CBT) and certain types of medication have been shown to be helpful in the treatment of OCD. Cognitive-behavior therapy for OCD is based on the techniques of exposure plus response prevention (ERP). In ERP, children are systematically exposed to the feared situations (exposure) while being instructed not to engage in their ritualistic behaviors (response prevention). Children are taught to challenge distorted thoughts and use other coping skills.

 

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) involves excessive worry about several life areas and frequent need for reassurance. Children with GAD may have muscle tension, restlessness, sleep problems, and/or concentration difficulties that accompany their worries. Their worries often concern possible catastrophic events, or performance in school and/or social activities. The worry is unrealistic, largely uncontrollable, and distressing. They may ask a lot of “what if…” questions and want reassurance that everything will be okay. Cognitive behavior therapy (CBT) and certain types of medication have been shown to be helpful in the treatment of anxiety disorders.

 

Separation Anxiety Disorder

Separation Anxiety Disorder is characterized by excessive anxiety related to separation from the home or a primary caregiver (e.g. parents). Children with this disorder are often preoccupied with thoughts of scary things that might happen to their caregiver. They may refuse to go to school or to engage in age-appropriate social activities without their parents present. Additionally, these children often have difficulty at bedtime. Cognitive behavior therapy (CBT) and certain types of medication have been shown to be helpful in the treatment of anxiety disorders.

 

Social Phobia

Social Phobia is a disorder in which the fear of social or performance situations is central. Children with social phobia usually appear as extremely shy and self-conscious with peers or with adults. They may avoid situations that might lead to embarrassment or looking foolish and this can prevent them from engaging in common activities such as speaking, eating, or writing in front of others. Cognitive behavior therapy (CBT) and certain types of medication have been shown to be helpful in the treatment of anxiety disorders.

 

Specific Phobia

Specific phobia is characterized by intense, persistent, and unrealistic fear of an identifiable object or situation (e.g., elevators, heights, water, certain animals or insects, blood, needles). A child with a phobia will do whatever he or she can to avoid confrontation with what is feared. When faced with the object or situation the child may express anxiety by crying, tantrums, clinging, or freezing. Since fears are typical among young children, treatment is usually not required unless the fear causes impairment or interference with the child’s functioning. Cognitive behavior therapy (CBT) and certain types of medication have been shown to be helpful in the treatment of anxiety disorders.

 

Panic Disorder

Panic disorder is different from the normal fear and anxiety reactions to stressful events. Panic disorder is a serious condition that strikes without reason or warning. Symptoms of panic disorder include sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening. Over time, a person with panic disorder develops a constant fear of having another panic attack, which can affect daily functioning and general quality of life.

Panic disorder often occurs along with other serious conditions, such as depression, alcoholism, or drug abuse.

What Are the Symptoms of Panic Disorder?

Symptoms of a panic attack, which often come on quickly and last about 10 minutes, include:

  • Difficulty breathing
  • Pounding heart or chest pain
  • Intense feeling of dread
  • Shortness of breath
  • Sensation of choking or smothering
  • Dizziness or feeling faint
  • Trembling or shaking
  • Sweating
  • Nausea or stomachache
  • Tingling or numbness in the fingers and toes
  • Chills or hot flashes
  • A fear that you are losing control or are about to die

Beyond the panic attacks themselves, a key symptom of panic disorder is the persistent fear of having future panic attacks. The fear of these attacks can cause the person to avoid places and situations where an attack has occurred or where they believe an attack may occur.