Subtle Signs of OCD in a Young Child

Sometimes you can’t tell from the way a child looks or acts that they have OCD.

Posted Dec 17, 2013

My particular variant of OCD is characterized by repetitive intrusive thoughts, without visible compulsions.  In other words—you can’t tell from the way I look or act that I’ve got OCD. I share my personal experience to inform parents and care givers that in young children, OCD may manifest itself in behaviors more subtle than the more recognizable hand-washing and checking.

When I was young, even though you couldn’t “see” my OCD, I’m told that you could tell I was a little different. My grandmother told me right after she read my memoir, Triggered:

“We always knew something was a little off!” 

The signs were subtle, but they were there. 

For example: when I was a kid, I loved dinosaurs. Now, I’m 26 years old and I still love dinosaurs, so let me clarify this:  when I was a little kid I was OBSESSED with dinosaurs. 

I couldn’t stop thinking about them and I wouldn’t stop talking about them.  As I understand it, such preoccupations aren’t unusual among young gentlemen of a certain age—anyone who has seen the twelve sequels to The Land Before Time knows what I’m talking about. But my enthusiasm was way beyond anything typical.

I saw dinosaurs everywhere, in clouds and trees, in bits of trash. My mother tells me when I was 3 and in nursery school, I would line up plastic dinosaur figures in order of their evolutionary period—Triassic, Jurassic, and Cretaceous, and within each of those, I’d line them up from earliest to latest.  Then, I’d get extremely upset if other kids moved them out of order, or had the herbivores eating the carnivores, or had dinosaurs of different periods interacting with each other.

I loved dinosaurs because they were huge and powerful but they were also classifiable, and I could master them and control them in my mind. So here I was, at age 3, and already displaying some rigidity in my thinking.  

My obsession with dinosaurs became the model for a recurring pattern of behavior as I grew.  Every year or two, I would find some new subject and devote myself to its study, things like:

-  those floppy Beanie Babies that I adored and then remorselessly shoved into my closet; or

-  the 150 species of Pokemon characters—between trading cards and plush toys and bootleg keychains they sold at the convenience store, I’m pretty sure I did actually “catch ‘em all”;  and

-  though I flirted with Star Wars, ultimately I preferred robotic Transformers. I collected the videos, toys, and chintzy fast-food promotional giveaways that didn’t “transform” so much as “hinge” or “sit immobile”—but that was never the point. 

It was the collection in my head that mattered. It was like having a wonderful toy box in my mind, full of objects that I could take out and play with whenever I was bored or sad or hurt.

When I was about 5 or 6, I was referred for psychological evaluation and intelligence testing, mostly because I was kind of antisocial and was already reading at the 8th- grade level.  My teacher wanted to get a handle on what was going on. 

Unfortunately, I tested quite high on the intelligence scale, which led to a lot of “Occam’s razor” parenting and teaching and therapy—as in, the simplest solution must be the correct one. In other words, the fact that that I’d scored so well was used by adults as an explanation for my “daydreaming,” my “boredom” and my “worrying.” 

“Oh,” they figured, “He’s so smart, he’s just inventing his own imaginative world…” This may sound familiar. There’s a fine line between “eccentric” and “mentally ill,” and sadly, as far as appropriate treatment was concerned, I fell on the wrong side of it.

During these years, I exhibited a couple of other recurring problems that, in combination with the obsessing, might have been indicators of a developing mental disorder. In particular, I suffered from severely low self-esteem and what we now know was scrupulosity—a kind of OCD characterized by guilt and religious obsessions.

My struggle with low self-esteem was apparent in my interactions with my peers. I may have been part of the mix in kindergarten, when the only prerequisites for popularity were having an inclusive birthday party and a convincing fake belch, but after that I often found myself alone.

As the disorder began to develop in elementary school, I experienced greater difficulty allowing myself to make friends. The OCD could pick out a comment I overheard or even just a hostile impression from someone, and then use it to convince me that others disliked me. If I didn’t have proof that I was loved, then I must be hated. 

I was so terrified of social rejection, of the scorn and mockery of my peers, that I began a preemptive campaign of self-criticism to protect myself from their judgment. So if I told a joke, then I carefully pre-scripted it and rehearsed it countless times in my head before I could take a chance repeating it out loud. 

It should come as no surprise that I’m told, by those who knew me, that I was a quiet child.

And then, there was my scrupulosity.

A significant barrier to my socializing was that I lived beneath a dangling sword of soul-obliterating guilt.  Anything that I did, or saw, that was even slightly objectionable, would trouble my soul until I confessed it to a proper authority.  I couldn’t even hear a classmate cuss without feeling the overwhelming urge to cleanse my tainted thoughts. (And, these were not mind-blowing swears, either. Even a meager “shut up” would be enough to upset me.) 

I would convey to a teacher or parent my daily confession of entirely-forgivable sins, and would be absolved me with a murmur of “that’s dumb” or “don’t worry about it.” But, unfortunately, my worries couldn’t be so easily dismissed. 

Now certainly, not every child who has an overactive imagination, who is abnormally fascinated with collections of things like dinosaurs, Beanie Babies, and Pokémon, or who exhibits anxiety, low self-esteem, or all-consuming guilt suffers from OCD. But, a thorough evaluation at that time for the spectrum of anxiety disorders might have revealed that we had been dealing with the individual symptoms, but not with the disease.  In third grade I suffered my first full-blown bout with intrusive thoughts OCD. 

You may be interested in my column, "Caring for a Child with a Mental Illness"

Copyright, Fletcher Wortmann, 2013.  Author of Triggered:  A Memoir of Obsessive-Compulsive Disorder (St. Martin’s Press), named one of Booklist’s “Top 10 Science & Health Books of 2012.”

Read my Psychology Today blog:  Triggered

Image:  http://en.wikipedia.org/wiki/Manipulative