about your child's OCD

Title......Page 2
Copyright......Page 3
Contents......Page 6
Introduction......Page 8
Part One: The Basics of OCD......Page 10
1. What is obsessive-compulsive disorder?......Page 11
2. Is OCD common, or are we just unlucky?......Page 12
3. OCD started in my son at 5 years of age. Is this unusual? What age does it usually start at? Is it only a childhood disease? Is it different in boys than in girls?......Page 13
4. Are there differences between OCD that starts in childhood and OCD that starts in adulthood and do they both ever go away?......Page 14
6. What are the costs of OCD?......Page 15
7. Is OCD hereditary? What are the chances that my child will inherit OCD if someone in the family has it already? Is it contagious? Is it more common in some groups of people than in others?......Page 16
8. What is the cause of OCD?......Page 18
Part Two: The Diagnosis......Page 26
9. What are the symptoms of OCD that I may see in my child?......Page 27
11. My daughter is always worried about numbers. Is this unusual in OCD, and what other kinds of obsessions may she have in the future?......Page 29
12. My son seems to wash his hands all the time. I guess this is a compulsion. What other kinds of compulsions might we see in him?......Page 31
13. How are obsessions and compulsions related? What do they have in common?......Page 32
14. Everybody worries sometimes. Why did the doctor say my child has a disease? What kinds of symptom patterns are we likely to see in our son that are so different from just worrying?......Page 34
17. How do psychiatrists diagnose OCD?......Page 36
18. What other mental problems are sometimes confused with OCD?......Page 38
19. What is obsessive-compulsive personality disorder? Is this different from OCD? Can my child have both?......Page 39
20. Are there brain or neurological diseases that produce OCD symptoms? Could my child have a brain tumor or cancer?......Page 40
22. Are there any other disorders that might be mistaken for OCD?......Page 42
23. What is ritual play, and is it always abnormal? What is the difference between a normal child’s ritual and that of a child with OCD?......Page 44
24. Should I be concerned about my child’s superstitions?......Page 47
25. Could some of the symptoms be so bad or difficult that they will prevent my daughter from receiving benefit from treatment?......Page 48
27. Is there a risk for suicide? What should I look for, and what should I do?......Page 49
28. I read somewhere that infections can actually cause OCD. Is this true? What is PANDAS?......Page 50
29. How is PANDAS treated? Is it really OCD, and do you treat it the same way?......Page 52
30. As a parent, what should I look for in our child? I don’t want to miss seeing or doing something that will help our child.......Page 53
31. Is OCD due to bad parenting? What should we expect as parents of a child with OCD?......Page 54
32. My son with OCD seems to act up only at home and never at school. How can this happen? If he can control himself there, why can’t he do it at home?......Page 55
33. Are there any tests for OCD? Like brain scans or blood tests?......Page 56
Part Three: The Treatment—General Concepts......Page 58
34. This has been a very difficult time with our son who appears to have OCD. My husband and I feel he needs to be seen and treated. Where do we go? What do we do now?......Page 59
35. We went to a medical center for treatment, and they have psychiatrists, psychologists, psychiatric social workers, therapists, and lots of other kinds of mental health professionals. This is very confusing. What is the difference between all of them and whom should we see first?......Page 60
36. My daughter does not have a clear diagnosis of OCD. Rather it might be another mental problem or even OCD plus another problem? Do we treat both potential problems together or one after the other? If we treat one, will it make the other worse?......Page 62
37. What kind of treatment choices do we have for our daughter’s OCD ?......Page 63
39. I assume the first visit to the psychiatrist will be important and may take a lot of time. What will the doctor do with my child on that first visit?......Page 64
40. How often should my son see the doctor?......Page 66
42. Should I get a second opinion from another psychiatrist?......Page 67
43. What is the role of family members in the treatment?......Page 68
45. Is there any special diet or exercise that I should have my child do?......Page 69
Part Four: The Treatment—Non-Drug Therapy: CBT......Page 72
46. My child’s doctor has proposed a non-drug therapy called cognitive-behavioral therapy. What is this? If OCD is a biological disorder, shouldn’t it be treated with drugs?......Page 73
47. I heard there is an alternative to CBT called exposure and response prevention. Is this better for my child? How is it different?......Page 74
48. What is the difference between the cognitive and behavioral parts of CBT? Can we do one without the other, or are they always done together?......Page 75
50. What are the advantages of CBT? Is it painful or difficult?......Page 76
51. My son was told he should not have CBT as the first treatment. Why not? Why drugs right away? Can we use CBT later, and are there times when CBT isn’t the best treatment?......Page 77
52. How do I find a behavioral therapist?......Page 78
53. How long does CBT take to work? Will I see improvement as we go along? Where should CBT be done? What else should I know about CBT?......Page 79
54. Our daughter finally has gotten better. Her symptoms are minimal now or nearly all gone. How can we prevent relapses?......Page 80
55. I’ve heard there are group treatments. I’ve also heard there are support groups. Are they useful, and do they work?......Page 81
56. What is multifamily CBT? I heard I would be a “co-therapist” for my daughter. I’m not trained at all in this, and I’m not sure I could do it. Could you explain?......Page 82
Part Five: The Treatment—Medications......Page 84
57. What drugs are used to treat OCD?......Page 85
58. How well do these selective and non-selective serotonin drugs work? What are the side effects?......Page 86
59. Wait a minute, these are antidepressant drugs. My son isn’t depressed. He has OCD. Why are antidepressants being used for OCD?......Page 88
60. What doses are used? Are they dangerous? Are they higher than doses for other problems?......Page 89
61. How quickly will the SSRI work in my son? How long should treatment be given?......Page 90
63. How will the doctor choose which medication to give my child?......Page 91
65. Will my child’s response to the medication be different from an adult’s response?......Page 93
67. What about generic drugs. Are they okay? How about drugs from Internet pharmacies?......Page 95
68. What should I do if my son’s physician wants to use a drug that is not FDA approved to treat his OCD? Should I allow this?......Page 96
69. I’ve heard these drugs can increase the risk of suicide. What must I watch for?......Page 97
70. My child is taking an SSRI. What side effects should I look for in my child, and how do I handle them?......Page 98
71. If my son is on an SSRI and we and the doctor decide to stop the medication, is there anything to watch out for? Can it just be stopped all at once, or should we gradually lower the dose?......Page 99
73. I’ve heard that if someone is taking more than one drug there can be interactions between the drugs. Is this true? What do I need to be concerned about?......Page 100
74. Does the doctor tailor the treatment to my child’s special needs, or does one treatment work for everyone?......Page 101
75. If my child is to take medications, are there questions to ask the doctor?......Page 102
76. My child has not responded well to any of the medications that usually work in OCD. Are there any other medications that can be tried?......Page 103
77. The doctor wants to give my daughter with OCD a drug used for psychotic patients. But she is not psychotic and knows what is real and what is not. Why do they want to use an antipsychotic drug?......Page 106
78. What if we can’t afford the medications? Is there any way to get help?......Page 107
79. Our daughter’s psychiatrist thinks she has another psychiatric disorder in addition to the OCD. What other conditions could she have, and how does this affect the treatment?......Page 108
80. How do you know when the acute phase of OCD is over? When does the maintenance treatment start, and what is done?......Page 110
81. When should we consider hospitalization for our child? Or an intensive OCD residential treatment center?......Page 113
82. Should I place my child with OCD in a clinical research treatment trial for a new drug?......Page 114
83. What about alternative and natural remedies? Would prayer work?......Page 115
84. I heard that new therapies are in progress for treatment-resistant OCD? Can we expect anything new and better soon?......Page 116
Part Six: The Family, School, and Siblings......Page 120
85. Should I try to get the rest of the family to help in the treatment of my child? What should I tell them?......Page 121
86. Should I tell my daughter’s school that she has OCD? Whom do I tell, and how do I do this?......Page 122
87. My child seems to be teased by the other kids and has lost his friends. Is it due to his OCD?......Page 123
88. We can live with our son’s OCD except for homework time, which is a nightmare. What can we do?......Page 124
90. I found out that my son’s school has not been responsive to his needs, and he may have to repeat his grade. What should I do?......Page 125
91. We tried a behavioral program and our daughter’s OCD actually got worse. We gave up. Any suggestions?......Page 127
92. Is my son going to be called “crazy” because he has OCD? I don’t want him to be stigmatized for the rest of his life. Should I refuse treatment and allow him to get better on his own ?......Page 128
93. My daughter’s pediatrician says her symptoms will disappear if we wait, but the psychiatrist doesn’t agree. Should we wait or should we be aggressive in starting treatment?......Page 129
95. My son seems to feel guilty and blames himself for the bad thoughts he has. Should we tell him they are not his fault? Actually, are they his fault?......Page 130
96. I disagree with my husband about giving medications to our child for her OCD. What should we do?......Page 131
98. In the area where I live, there is no behavioral therapist. What should I do?......Page 132
99. I work full time, and my child is in school. It is hard to schedule all the appointments. Do we have to miss school and work for treatment?......Page 133
100. Help! My health insurance carrier has very limited reimbursement for OCD treatment and support functions. What can I do?......Page 134
Appendix......Page 136
Glossary......Page 144
Index......Page 154