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OCD nation: Children as young as eight have been diagnosed with the disorder


SGMCF328
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Informative article on OCD. I always thought OCD refers to those who like to keep things clean and tidy, but there are so much more to it. I guess I am one of them too.

https://www.straitstimes.com/lifestyle/ocd-nation-children-as-young-as-eight-have-been-diagnosed

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SINGAPORE - Two years ago, when Vera was in her first year of junior college, she had problems taking notes.

She would rewrite them repeatedly to ensure that her handwriting was neat and "perfect", using copious amounts of correction tape.

She sometimes stayed up till 2am, tearing up sheets of notes that did not meet her expectations. She found it embarrassing to study in groups as it hindered her rewriting obsession, which she wanted to keep to herself.

Now a 19-year-old university student, she says: "I was always looking at my handwriting, but I was not absorbing the information. I felt very tired doing my homework because it took so long."

"I didn't seek help immediately because the stereotype of OCD behaviour is handwashing. I was doubtful whether mine was an OCD symptom," says Vera, who declined to give her full name.

She sought professional help in her second year of junior college and has since learnt to manage her condition.

Obsessive-compulsive disorder (OCD) features obsessive and unreasonable thoughts and fears, and compulsive, repetitive behaviours.

In Singapore, which has a higher prevalence of OCD than global norms, children as young as eight have been diagnosed with the mental disorder.

DIFFICULT TO DIAGNOSE

Despite warning signs, the condition is not easy to diagnose in children and youth as they are less able to verbalise what they are going through.

Ms Haanusia Prithivi Raj, a senior clinical psychologist at the Institute of Mental Health (IMH), says OCD is usually triggered by an obsession that incites anxiety or discomfort, prompting the sufferer to engage in repetitive actions to alleviate the uncomfortable feelings.

Common obsessions include those revolving around "order or symmetry"; religious anxiety with excessive fears of offending a higher being; or worries about contamination and falling ill.

Dr Adrian Loh, a visiting consultant at IMH's department of developmental psychiatry, says the national prevalence for OCD is 4 per cent of the population, higher than global figures of 2 to 3 per cent.

From 2014 to last year, IMH's Child Guidance Clinics saw an average of about 130 children and adolescents with OCD annually.

Figures have remained consistent, with about 50 new cases each year, according to IMH.

Dr Loh says OCD can develop from the pre-school years through to adulthood, but there are two peak ages where OCD is more likely to appear.

These are "the upper primary school years, just before puberty; and the late teen years, the transition from junior college and polytechnic to university or a corporate environment".

The onset of OCD, like other psychiatric conditions, can be triggered by "excessive stress", such as the stress experienced during key transition years, says Dr Loh.

Although OCD is the third-most prevalent mental disorder in Singapore - after major depressive disorder in first place and alcohol abuse in second - the condition can be difficult to diagnose.

Dr Loh says: "What makes OCD different in children is that they frequently lack insight and awareness into the abnormal nature of their symptoms, and may be more unwilling to seek help or accept the problem.

"In some cases, all they can explain is that something just 'feels right', leading to parental frustration."

"Some sufferers who are unable to obtain relief from overwhelming anxiety (by engaging in rituals) may end up having rage attacks that can be misunderstood as misconduct. This can lead to disciplinary measures instead of taking the child to seek professional help," Dr Loh says.

EVERYTHING HAD TO BE PERFECT

At age 15, Mr Wayne Kee was taking part in the National Physical Fitness Award Scheme (Napfa) test in school when he landed "wrong" after doing the standing broad jump.

He complained that his neck felt stiff, but all scans and physical checks showed nothing was wrong.

After psychological tests, he was diagnosed with OCD and started receiving therapy.

His mother, Ms Evelyn Chng, said: "The initial difficulty was that we couldn't see physical rituals (associated with OCD). We only knew he was anxious but we couldn't understand why, because he couldn't relate what was wrong with him."

"Neither could he verbalise his thoughts to his psychologist," says Ms Chng, 49, who is married to a 51-year-old financial consultant.

They also have a 20-year-old daughter.

Ms Chng recalls a profound indecisiveness in her son at that time.

"He would call me and ask what he should eat at the school canteen. I had to reassure him that eating caifan (economy rice) or yong tau foo was the right decision," says the counsellor with Caregivers Alliance Limited.

But "the monster in his head", as she describes it, surfaced in full force a couple of years later, when he started opening and closing the fridge door, in addition to other hours-long rituals.

By age 17, OCD had taken over his life and he had to drop out of polytechnic.

Mr Kee, now 23, recalls: "I had mental rituals and a certain way of doing things which I thought was right, but it was OCD.

"I had the feeling that something would go wrong. It's like acting, every scene must be exact. If not, my life is not recorded properly and I would have to re-edit the scene and ask people to redo it."

TOLL ON THE FAMILY

Family meals were agonising, his mother recalls, because everything had to be put in its exact place. A dish of fish had to be passed to and fro, in the same direction.

Dragging Mr Kee away from performing his rituals would result in screaming or he would find a way to return later to complete his rituals.

The police were called in by neighbours several times when arguments got heated between Mr Kee and his father.

Ms Chng was caught in the middle. Sometimes, when Mr Kee engaged in rituals such as opening and closing the fridge door for hours, he got tired and asked his mother to do it for him.

His relationship with his sister deteriorated too. "It was crazy. There was shouting and screaming, fights between him and his dad and quarrels between me and my husband," says Ms Chng, who suffered two mental breakdowns.

Things got better in 2015 when Ms Chng, then working in retail, and her husband went for a workshop on OCD and started attending classes at Caregivers Alliance which they had come across at IMH.

Three years ago, she started working at Caregivers Alliance.

She learnt to be a caregiver for a person with mental illness and engaged Mr Kee in chores that he enjoyed, such as cutting and preparing vegetables with precision.

Mr Kee, too, felt the need for a change and started to commit to his treatment at IMH, which he previously felt was a waste of time and money.

This involved Exposure and Response Prevention (ERP) therapy. In ERP, the person with OCD is exposed to the source of his fear, without acting out any compulsions to ease the fear.

Mr Kee says: "I decided I wanted to start afresh. I had just turned 21 and I wanted things to improve."

Today, his condition is under control and he works as a peer support specialist at IMH, where he helps and supports clients with OCD.

He says he wants to talk about his experiences to combat the stigma associated with the illness.

"At the start, I was afraid. But I wanted to stand up because no one else would," he says.

COMMON OBSESSIONS IN OCD

Here are some common obsessions in OCD, according to Ms Haanusia Prithivi Raj, senior clinical psychologist, department of developmental psychiatry, IMH.

• Fear of contamination, such as of places deemed "dirty"; or fear of contagious diseases like Ebola or H1N1

• Intrusive aggressive thoughts, such as the fear of being harmed or of harming family or friends

• Intrusive, sexually explicit or violent thoughts or images

• Fear of losing important things

• Discomfort if things are not symmetrical or evenly numbered

• Needing to tell or confess everything

Watch our for these common compulsions, which are repetitive actions to reduce anxiety:

• Excessive washing of one's hands, body or important items like wallets

• Checking doors, locks, phones, bags

• Mental rituals such as the repetition of prayers to negate intrusive negative thoughts

• Avoiding possible OCD triggers, such as avoiding throwing things into the dustbin, suggesting the child might have intrusive thoughts about dirt

• Seeking reassurance by repeatedly asking seemingly mundane questions that the child is worried about

• Counting, tapping, repeating certain actions such as rewriting or re-reading, or doing other senseless things to reduce anxiety

 

Edited by SGMCF328
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My friend's daughter has GAD (Generalised Anxiety Disorder) at the age of 9. He first noticed her started crying excessively over incoming exams, exam scores, homework and tuition. Then he brought her to a psychiatrist who diagnosed and treated her. She is better now and completed her PSLE recently.

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"Obsessive-compulsive disorder (OCD) features obsessive and unreasonable thoughts and fears"

 

I have OCD everytime I read the story of the "condo saga" who command a $66k per month job .... :a-bang:

I fear & thoughts of our younger genertion local Uni degree (rank top 30 in the world) thats cannot even command such a high salary per month in their first 5 years ... :a-rip2:

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45 minutes ago, Weez911 said:

My friend's daughter has GAD (Generalised Anxiety Disorder) at the age of 9. He first noticed her started crying excessively over incoming exams, exam scores, homework and tuition. Then he brought her to a psychiatrist who diagnosed and treated her. She is better now and completed her PSLE recently.

meds?

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1 hour ago, Volvobrick said:

Some car owners very OCD about their cars....

 

I am one of them,  I always have the intention to keep my car clean and shining but never have the determination  to do it. I wash it once in three weeks or once  a month but still think it is not clean enough. 😄😄

Edited by Ct3833
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19 minutes ago, Ct3833 said:

I am one of them,  I always have the intention to keep my car clean and shining but never have the determination  to do it. I wash it once in three weeks or once  a month but still think it is not clean enough. 😄😄

Still better than @Jamesc who OCD with his MIL ... :slow:

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21 minutes ago, Ct3833 said:

I am one of them,  I always have the intention to keep my car clean and shining but never have the determination  to do it. I wash it once in three weeks or once  a month but still think it is not clean enough. 😄😄

You not consider OCD la, since you can tahan to wash your car once in 3 weeks to a month. Plus you have no determination to maintain it. Lol. If a person has OCD, he/she will make sure the cleaning is done very often.

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Now wonderin if I abit of ocd myself also.

I can tolerate stone chips, small scratches but cannot tahan obvious dents. Hv fixed 2 dents so far and one time reversed into blind pointed corners, end up dent on rear with dotted chipped paint, repaired & sprayed work done. I can tolerate the diff in color tone after repair.

My frens were surprised when they learnt that one can be so intolerant of dents which is probably minor or part parcel of car ownership. Thou I didnt make a big deal outta it when I spotted it myself, cos I know spending $$ can massage dent back. But many got a shock when they know my dent repair would cost $40 to $50 each time & wonder why I would bear to part $$ like this merely for a 5 min job?

If I m really ocd on this part, perhaps I must make an effort to change.

 

Edited by Unfazed
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1 hour ago, Unfazed said:

Now wonderin if I abit of ocd myself also.

I can tolerate stone chips, small scratches but cannot tahan obvious dents. Hv fixed 2 dents so far and one time reversed into blind pointed corners, end up dent on rear with dotted chipped paint, repaired & sprayed work done. I can tolerate the diff in color tone after repair.

My frens were surprised when they learnt that one can be so intolerant of dents which is probably minor or part parcel of car ownership. Thou I didnt make a big deal outta it when I spotted it myself, cos I know spending $$ can massage dent back. But many got a shock when they know my dent repair would cost $40 to $50 each time & wonder why I would bear to part $$ like this merely for a 5 min job?

If I m really ocd on this part, perhaps I must make an effort to change.

 

why need to make an effort to change unless it is causing major disturbance to your life?

Not sure if what you experience is considered OCD or not, but it doesn't sound like you need to change anything.

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https://mothership.sg/2019/10/singapore-suicide-help-please-stay/

4 mums, whose sons took their lives, start initiative to prevent youth suicides in S’pore

Focus on mental wellness is the first step.

Zhangxin Zheng | October 30, 08:12 am

Four mothers fought back tears to share their stories about losing their sons to suicide in a video.

The PleaseStay. movement is a newly launched initiative started by a group of mothers who lost their children to suicide.

Its aim is to raise awareness of youth suicide and mental wellness in Singapore.

The central message they wish to convey is to ask young persons to “Hold on to hope. No one should be lost to suicide. Your life is precious. Reach out for help.”

A coordinated & integrated approach led by a central agency needed

Please Stay. is part of the Child Bereavement Support Singapore (CBSS) which works with the Institute of Mental Health and the Ministry of Education on a national strategy on mental wellness and suicide prevention.

The movement “hopes to catalyse actions to support the development of a comprehensive national strategy on mental wellness and suicide prevention”.

The mothers said that this effort requires a coordinated and integrated approach backed by strong commitment and leadership from a central agency.

The 10-minute video was also screened at the launch event on Oct. 30.

Four mothers — Ho Geok Lan, Elaine Lek, Doreen Kho and Jenny Teo — recalled the behavioural changes they see in their sons and their reflections upon their sons’ suicide.

Ho, Lek, Kho and Teo lost their teenage sons to suicide recently, in 2018 and 2017.

Focus on children’s mental wellness

Through their stories in the video, they observed that youth suicides prevention starts with the focus on mental health.

Ho recalled that her son, Mitchell Ang who passed away at the age of 17, had some behavioural change when he was around 15.

The family thought it was due to a transition to adolescence change but little did they find out that anxiety was the cause.

Ho added that the family went to watch a motivational speaker’s talk and that her son was motivated for a while.

However, the nightmare of losing their son still occurred just as they thought things would be getting better.

Kho also recalled losing her son, Evan Low, when he was only 11.

She said that despite the tender age, Evan was already hiding his struggles from her.

Evan tried hard to cope with his depression and a new environment after returning to Singapore from Melbourne in 2016.

She added that Evan tried to share his struggles with his sister but asked her not to tell the adults.

Acknowledge your child’s pain

In the video, Lek, who lost her 18-year-old son, Zen Dylan Koh, shared that what parents need to do is to acknowledge their children’s pain.

‘To the parents out there, please don’t try to rationalise how your child feels, there are so many families that are in denial, “I think it’s all in your mind, you’ll grow out of it”…Or, “you are just seeking attention.” Just acknowledge your child’s pain, I think what they really want is acknowledgment.’

She also highlighted that parents need to stay vigilant when their child is taking prescribed antidepressants.

For the first few months, there is a high risk of suicide ideation.

While taking the medication can help one sustain through the day, the dark thoughts will come at night and make a child feel really helpless.

Parents can also show their children that seeking help is not a sign of weakness.

Ho elaborated in the video,

“You do not have to suffer in silence. Sometimes your parents may not understand the pain you’re carrying, and as parents, many a times, we are vulnerable as well. We face many problems in our lives, and sometimes we may not find the perfect solutions to it. But, believe me, as parents we love you unconditionally. We will journey with you and do all we can to bring you out of darkness.”

More empathy

The mothers also raised the need to educate parents to teach their children to be more empathetic in the video.

Peer pressure and bullying can be the trigger to suicide.

Lek shared that it was only after her son’s death that she found out that he was taunted.

Kho also recalled that she saw a Facebook message from a friend of her son which said, “I should have known when you cried when you got your results.”

While the family does not focus on the grades, Kho did not expect her son to face the pressure nevertheless.

“Even though we don’t focus on grades as a family, I think he felt the peer pressure, he felt that he didn’t do good enough…as compared to his friends. And these are things as a family, we cannot take away, we cannot shield him against. When people make fun of him, when he is bullied if he was, we would not have known and he would not have voiced out.”

The official statistics from Samaritans of Singapore (SOS) show that there were 397 reported suicides in Singapore last year.

This is a 10 per cent increase from 2017 and of which, 94 cases were youth.

Suicide is now the leading cause of death for those aged 10 to 29.

Support hotlines for those seeking help

If you or someone you know are in mental distress, here are some hotlines you can call to seek help, advice, or just have a listening ear:

Samaritans of Singapore: 1800-221-4444
Singapore Association for Mental Health: 1800-283-7019
Institute of Mental Health’s Mobile Crisis Service: 6389-2222
Care Corner Counselling Centre (Mandarin): 1800-353-5800

The videos are in the link provided above.

Edited by Weez911
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I wondered the obsession to BAN MCF members is it a known reported OCD. If it has not been reported I would like to write a peer review article on this.

Paging Undertaker.

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