OCD-ODD

Each and everyone has their own habits and hobbies. These are the things that we do in our spare time or whenever it is convenient. But when habits and hobbies would consistently urge and totally disrupt you from your actual responsibilities, you or someone you know may have Obsessive-Compulsive Disorder.

Obsessive-Compulsive Disorder (OCD) is a long-lasting anxiety disorder characterized by persistent obsessions (involuntary thoughts/images/impulses) and compulsions (behaviours or rituals urging to be acted out). However, they become so excessive that they interfere with other daily activities.

People with OCD cannot introspectively question these actions. OCD causes the brain to get stuck on a particular thought or impulse. If you, your child, or someone you know has OCD, they may somehow feel impossible to resist and break free from it.

People with OCD often fall into one of the following categories:

1. Checkers: Repetitively checks things (i.e. door locked, oven turned off, etc.) associating them with harm/danger
2. Doubters / Sinners: Perfectionist thinking doing otherwise means trouble or punishment
3. Hoarders: Fears throwing things away thinking something bad will happen
4. Washers: Fears contamination; hand-washing/ cleaning compulsions
5. Counters / Arrangers: Obsessed with order and symmetry; Have numerous superstitions on certain numbers, colors, and arrangements

Having obsessive thoughts and performing compulsive actions does not necessarily entail OCD. People diagnosed with OCD have thoughts and behaviours that cause terrible distress, use up so much time on a specific thought or behaviour that disrupt daily productivity. Most people with OCD may have one or a combination of the following signs of OCD:

Obsessive thoughts

1. Fear of losing control
2. Fear of being contaminated
3. Fear of losing things you might need
4. Intrusive sexually explicit/ violent thoughts and images in mind
5. Order and symmetry
6. Superstitions / Excessive attention on things that are “lucky”
7. Excessive focus on moral ideas

Compulsive behaviours

1. Repetitive double-checking things (i.e. appliances, locks, plugs, appliances)
2. Counting/ Tapping and other senseless actions to reduce anxiety
3. Excessive ordering or arranging things
4. Hoarding unusable things/ “junk”
5. Spending a lot of time washing or cleaning
6. Praying excessively

As parents, we like to see our child develop a sense of respect and social responsibility towards their peers. Teachers and other authority figures share the same sentiment towards their learners and individuals.

But if a person shows a persistent pattern of defiant behaviour such as irritability, anger, hatefulness towards you or anybody in authority of the situation, they may have Oppositional Defiant Disorder (ODD).

People with ODD are openly uncooperative and hostile towards authority figures like parents, teachers, employers etc. It can even escalate quickly to tantrums and outbursts in situations that can upset them by being defensive or by saying “No!” to almost everything.

You may have been called up several times to the Principal’s or Guidance Office for your child’s behavioural problems in school only to find out that they are labelled as “attention-seekers”.

But this defiance is actually a response to bigger underlying causes. Read more below to find out about it and how we can help someone with ODD.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists down criteria for diagnosing ODD. The DSM-5 criteria for the diagnosis of ODD show a pattern of behaviour that:

A pattern of angry/ irritable mood, argumentative/defiant behaviour, or vindictiveness lasting at least 6 months as evidenced by at least four (4) symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.

Angry/Irritable Mood

1. Often loses temper
2. Is often touchy or easily annoyed
3. Is often angry and resentful

Argumentative/ Defiant Behaviour

1. Often argues with authority figures or, for children and adolescents, with adults
2. Often actively defies or refuses to comply with requests from authority figures or with rules
3. Often deliberately annoys others
4. Often blames others for his or her mistakes or misbehaviour

Vindictiveness

1. Has been spiteful or vindictive at least twice within the past 6 months

The disturbance in behaviour is associated with distress in the individual or others in his or her immediate social context (e.g. family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.

The behaviours do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.

Mild: Symptoms are confined to only one setting (e.g. at home, at school, at work, with peers).

Moderate: Some symptoms are present in at least two settings.

Severe: Some symptoms are present in three or more settings.

A child or adult left untreated or misdiagnosed with OCD and ODD can have several problems in almost all areas of their lives. The impacts, of course, will vary from one case to another depending on the severity of the symptoms, genetic composition, and existing disorders, and substance use or alcohol. The most common impacts, however, are listed below:

ODD

1. Inability to maintain one job
2. Isolation and other anti-social personality traits
3. Irresponsible
4. Substance abuse
5. Conduct disorder
6. Self-harm
7. Suicidal thoughts

OCD

1. Lack of concentration due to extreme anxiety and overwhelming urges
2. Isolation
3. Depression and low self-esteem
4. Resentment and/or anger

Aside from having similar symptoms with other disorders, it can co-exist with other chronic health conditions such as:

1. Learning difficulties
2. Depressive disorders
3. ADD/ADHD
4. Bipolar disorder
5. Anxiety disorders
6. Bipolar disorders