New Delhi: Covid–19, which started towards the end of 2019, completely changed the lives of people in multiple ways. Besides claiming millions of lives, the pandemic also presented a huge challenge to public health. Besides everything, the mental health of people was also affected heavily. One of the issues under mental health is obsessive-compulsive disorder (OCD). People with OCD have recurring, unwanted thoughts, ideas, or sensations, and to avoid these, they feel driven to do something repetitively.
According to a study published in the journal, BMC Psychiatry, in 2020, which assessed the experience of children and young people with the condition during the pandemic, they experienced their OCD, anxiety, and depressive symptoms worsen during the pandemic.
Speaking to ABP Live, some psychologists who deal with youngsters and children with OCD explained in depth what causes it, how it gets triggered, what is the treatment available, and how anxiety contributes to intensifying the impact of the disorder. While there is no data available in the public domain to ascertain exactly how many children were affected by OCD during the pandemic, all the psychologists from different Indian cities ABP Live spoke to said they started to get more such cases after the pandemic.
How Covid-19 Triggered Anxiety In Children?
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According to Dr. Teena Augustine Joseph, counselor, and mental health advocate working as the head of training and development at Vandrevala Foundation which has its headquarters in Mumbai, Maharashtra, said: “Post pandemic, we have seen a lot of children suffering from anxiety. It can be genuine because the pandemic has opened windows to many anxiety behaviours in people. A lot of people have come forward to say this.“
She added: “I think the concept of hygiene has gone higher after the pandemic and people are now conscious about how they conduct themselves. It is seen in the way people control their children from a small age. People often don’t let their children go out in the open. There is a fear of the unknown which has started in the pandemic.”
Dr Teena said now even the schools have started to follow rigorous hygiene norms. “It started with wearing masks, washing hands. Now we have started fearing everything that could cause some sort of danger, and this behaviour has started to become an obsessive thought in children.”
She said parents also have a role in this increase in anxiety in children. “I think to some extent it is also the parents. Maybe it can also be a part of modernisation that we fear the unknown.” Elaborating on how social media also contributed to increased anxiety and the fear of the unknown, Dr. Teena said that youngsters often get unsolicited advice on social media, which makes them believe in things in a certain way.
“Social media gives children a lot of unsolicited advice about what is dangerous around us. From everything that you eat or even picking up a fruit from the floor and eating it without washing causes a lot of anxiety in children. Not letting yourself experience certain experiences is the start of it.”
Child psychologist and behaviour therapist Dr. Aruna Agarwal said that in the two years of the pandemic, the children were not much exposed to things so the language did not develop in them and the children also went through the pressure of performance. “There is a pressure of performance like the academic performance of the child because for two years they were just exposed to the screens so the language didn’t develop.”
She said there are a lot of cases where the child is not socially getting connected with people and they do not like being with other children. Talking about the parents‘ conduct, she said: “The parents have also been under a lot of pressure in their own lives due to their work or due to their child not performing well. Because of what happened in two years, the children were all by themselves in the house, enclosed in small nuclear families.”
Dr Aruna added: “Now when they are going out of this, they have to go outside and deal with other children in the schools or other public spaces. They’re not able to deal with it because they have to share their things. The children have not learned these skills, which we normally learn either in the joint family system.”
Recalling the pre-pandemic time, she said: “Before the pandemic, children were going to schools, they were going to other places... It was naturally coming. We never realised how it can affect us in a very adverse way.” Dr. Aruna, who also runs a playschool in Mumbai’s Powai, said she is getting two or three such cases where speech is not developed in the child. “To the little ones who were born during the pandemic, their language did not develop. So I am getting, almost every day, two to three cases where their speech is not developed.”
They will definitely have a lot of anxiety. Because they cannot speak and then they start showing tantrums. So initially all that looks like the pattern. What I’m saying is that there is a pattern, but then it is not a pattern because the child is not able to speak. He will start throwing things,” she added.
Basic Symptoms Of OCD In Children
Dr. Teena said if children become very rigid and feel the need to arrange certain things in a certain way, that’s a symptom of OCD. “Sometimes rigidity in thought patterns. Children are quite often very rigid about certain things. For instance, they might want to keep their water bottle in a certain order or in a certain direction and if someone turns it the child gets upset. For such children, things should be arranged in a certain order,” she told ABP Live.
But Certain Repeat Actions Don’t Always Mean OCD
It is pertinent to note that the visibility of basic symptoms doesn’t always mean OCD. “The challenge is that if a person is particular about something we start calling it OCD. This word has become so popular that people have started using it without understanding that there are some traits to qualify. Just because someone is particular about arranging certain things doesn’t mean it’s OCD,” said Dr Teena.
“All of us might have certain obsessions in our minds. We have compulsive behavior that we cannot avoid. The crucial thing is that if we are not performing certain actions or behaving in a certain way is it causing anxiety or not.“
Impact Of OCD
What happens if OCD is left untreated?
According to educator, counsellor, and family therapist Archana Singhal, untreated OCD can lead to longer-term social and psychological problems in children and adults. “If left untreated, OCD can lead to a range of longer-term social and psychological problems in children and adults. This can lead to depression and other mental health conditions, eating disorders when OCD rituals include eating or selective eating, long-term under-performance at school and social isolation, inability to hold regular employment, and a general inability to reach their potential,” she told ABP Live.
Elaborating on the impact of OCD, Dr. Aruna said there are certain patterns that we see in children, and if they are not tackled properly these behaviours later on affect the life of the child in adulthood.
“There are certain patterns that we see in our children and what happens over a period of time is if they are not tackled properly then these behaviours later on affect the life of the child who gets into adulthood and then it starts affecting the family. So these patterns if not taken care of at the initial years and we are not able to do the early intervention then it affects the later stage of life,” Dr Aruna told ABP Live.
“There is a problem later on which can be that they are not able to have good social connections. They see our relationships affect many people.” She added: “You see that they are not able to stick to certain relationships for a longer duration. They start feeling anxious about it and they start feeling lonely. So it’s a repercussion which can affect the life of a person.”
According to Archana Singhal, “Both adult- and childhood-onset OCD were once thought to be a rare condition affecting less than 1 in 1,000 individuals; however, advances in diagnosis and treatment have led to increased identification of the disorder.” She added: “The condition can leave some sufferers unable to eat, leave the house or in other ways go about their daily lives, often becoming isolated and depressed as a result.
Almost 90% of children and adults with OCD have problems at school, at home, socially, or at work, with difficulties doing homework, concentrating, memorising, and retaining important information or an inability in paying attention. When children experience this from childhood, they grow up as individuals with lower self-esteem, say experts.
What Age Group Does OCD Affect The Most?
According to Dr Teena, OCD becomes visible in childhood and it is often ignored initially. “It becomes visible in childhood and often people ignore it. As the person grows and this rigidity doesn’t stop. This behavior carries into your adolescence and then into your adulthood also.”
Is OCD Hereditary?
According to Archana Singhal, it is unclear if OCD is hereditary, but “it’s believed that a combination of genes inherited from parents having OCD along with environmental factors plays an important role in OCD”.
“Since OCD is thought to be caused by a combination of genetics and external factors, an individual’s vulnerability to it is dependent on the versions of the genes they inherit from parents and in what combination,” she said. “From there, the environment has an incredibly strong influence on whether or not the genetic vulnerability will express itself as OCD.” Dr. Aruna said there is still research going on to understand whether OCD can be passed on from one generation to another or not. She also said it can be passed on genetically but if one person gets it treated then it can change the whole system.
“Sometimes we pass on our own anxiety to our children. So in that particular case, if you see it can be genetically passed on. There are chances. Yes, it comes from you know, our genes also, but it can be treated. It is not that generation after generation. If one person treats it then and changes the entire whole system working on themselves,” she said.
How OCD Affects Family Life Of Children When They Become Adults
Senior psychotherapist and founder of Able Mind in Bengaluru, Karnataka, Rohini Rajeev said OCD can have a significant impact on the family life of the affected individual. According to her, there are several ways in which OCD can impact family dynamics. For example, she said, family members may be expected to take part in the rituals of OCD sufferers.
“The person often has specific rituals they feel they need to perform to alleviate anxiety or prevent harm from happening. These rituals may involve family members and the person may become upset or anxious if their family members don’t participate. Another way family life can be impacted is that the routine of family members may be disrupted by the person’s OCD symptoms, as they may need extra time to perform rituals or complete compulsive behaviors. There is a possibility of emotional strain on family members.”
Rohini Rajeev added: “Family members may feel helpless or frustrated by their inability to alleviate their loved one’s OCD symptoms. There can be social isolation: OCD can cause social isolation, as the person may avoid social situations or public places due to their anxiety or fear of contamination. This can limit the family’s ability to engage in social activities together, and lead to feelings of loneliness and isolation.”
Ways To Treat OCD
When it comes to the treatment of OCD, Dr. Aruna said, the first thing that is required is acceptance. She also said there are many evidence-based practices to treat OCD. “To deal with stress, we have to first accept the situation. Yes, there is a problem and we need to do something about it. And now, with a lot of evidence-based practices, we can definitely do a lot to deal with this. There are people who go for psychiatric treatment,” Dr. Aruna told ABP Live.
“So being a psychologist and a behaviour therapist, I do not recommend medicines. That is only for a higher intensity. These things definitely impact others. So for me, I always suggest therapies and evidence-based therapies. You should just not go for any kind of therapies that are not evidence-based,“ she added.
According to Rohini Rajeev, the support of the family is very important, and in order to gain control over OCD, mental health professionals can help the family to manage the effects of OCD on the family’s life.
“It is important for family members to be supportive and understanding of their loved one’s OCD, while also seeking professional assistance and support for themselves if necessary. A mental health professional can help the family develop coping strategies and provide support to manage the effects of OCD on the family’s life.“
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