https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/department-child-and-adolescent-mental-health-dcamh/the-tic-service/tourette-syndrome-and-ocd/
Tourette Syndrome and OCD
Many young people with Tourette syndrome (TS) also have obsessive-compulsive disorder (OCD). OCD can involve unwanted thoughts or images (obsessions) and time-consuming rituals (compulsions). This page explains OCD, the effects it might have on everyday life, and strategies to manage the condition.
What is OCD?
Many young people feel anxious about things and may develop small fixations or repetitive behaviour (doing things over and over). However, the obsessions and compulsions that happen in people with OCD are frequent and intense that they disrupt everyday life, cause distress ad take up a of time. The most common obsession in children with OCD and TS, is a ‘just right’ feeling and the most common compulsions are often to do with checking. However, sometimes that child may also have more unusual obsessions or compulsions that involve religious beliefs or sexualised or violent thoughts.
Ways of coping
OCD is not something that someone can just choose to stop. Obsessions and compulsions can be very difficult and the person experiencing them is not just being ‘difficult’ or ‘fussy’.
- Getting help from your family doctor or specialist doctor will make a big difference.
- Talk to someone if it all feels too much. This is true for your child and all family members because there will be times when it can be hard to cope.
- Your child can also use an ‘explanation card’ to help describe their OCD.
OCD treatment
The most effective form of cognitive behavioural therapy for OCD is Exposure with Response Prevention (ERP).
With ERP, a person learns skills to resist the urge to neutralize an unpleasant thought or image by doing a certain action. For example, someone who feels the need to check that a light is switched off may learn to cope with uncertainty about whether the light is on, and resists the urge to switch it off. Over time, this becomes easier and the connection between the obsession and the compulsion is reduced.
Most medicines for TS interact with chemicals in the brain. Our brains constantly have chemical messages moving around, giving instructions for our behaviour. Different chemicals are thought to be involved in tics, attention deficit hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD). The choice of medicine will depend on which condition impacts your child’s life most significantly. Some young people need more than one medicine. The medicines which help with OCD are medicines which act on a neurotransmitter called serotonin.
Obsessions and compulsions may affect schoolwork. For example, a pupil with OCD may believe they need to check, destroy written work or reread work, repeating it until they feel it is ‘perfect’. Make sure that teachers are aware of your child’s OCD so that they can be supported in school. Once treatment has started, young people may work to resist their compulsions at school and it can help that their teachers know that some of their unusual behaviours could be part of the treatment. Sometimes children with OCD, can appear to be distracted or inattentive. If this is the case for your child with OCD, it will be important to discuss this with your child’s therapist so that they can help teachers understand how best to support your child as they learn to overcome their condition.
Tic and OCD explanation card
This is a short explanation card your child can use to help explain Tourette syndrome, tics, and OCD. Feel free to personalise this card!
Where to get help
The first stop should be your family doctor (GP). They can refer your child to a specialist, if needed for diagnosis and treatment, and can also advise you about treatments available in your local area. The following organisations will also be able to offer you support:
Telephone: 0845 390 6232
Telephone: 0845 120 3778
Further reading
- Breaking Free from OCD: A CBT Guide for Young People and Their Families (2008) by Jo Derisley (Jessica Kingsley Publishers ISBN: 1 843 105 748)
- OCD - Tools to Help You Fight Back!: A CBT Workbook for Young People (2018) by Georgina Krebs and Chloë Volz Cynthia Turner
- Can I tell you about OCD? (2013) by Amita Jassi
- NICE Guidelines for assessment and treatment of OCD (2005).