Dd has developed OCD and she isn't coping with my dog.

[Ddandmydog]

I have a large breed 3yo dog.

The last year has seen dd develop a, quite severe, disability, which has changed our whole lives.

Alongside this she has developed OCD and she really isn't coping with the dog at all.

She's back on the waiting list for help again, this will likely take 6-8 months.

She is also autistic.

The OCD means that she cannot stand the dog being near her due to the drool, she can't tolerate the sound of her eating, she can't abide any dog hair near her, she has to wash everything the dog has touched.

I don't know what to do, I'm trying to separate them as much as possible, and I make sure her environment is as clean as possible, and I do everything I can to try and mitigate the stress for dd, but I'm struggling to cope to be honest.

Is there anyone out there with a child with OCD and a dog? Any words of advice please?

As the parent of a child with severe misophonia and ocd, I can assure you these are not 'whims'. They are debilitating neurological conditions which are extremely distressing for the person experiencing them.

It sounds very tough OP. I don't have any advice except to hope that posters remember you are doing your best here and don't need their judgement.

Yes, of course the dog is better off. She went to live with my mum and loved it. But dogs are dirty, to say otherwise is just silly. You can definetly smell if someone’s got a dog 🤢

Thank you for all the advice.

Her vitamin D and B12 is low actually, and she is on supplements for both. That's actually really interesting.

It's hard to differentiate between the OCD and autism. I really try and minimise things that impact her anyway.

My dog isn't fed near her, dd has her routine of the time she sits in the living room and I have a cover for the couch and the dog isn't in the living room at those times. I have a good routine of walking, bathing and cleaning up after the dog to minimise the impact on DD. Her room is where she has always spent most of her time anyway, all of her hobby stuff is in there so she has always spent hours in there drawing or reading, and it's a comfortable space for her so she doesn't feel confined to there, its her preferred space to be.

I can't just get rid of my dog without trying everything, dd and I have adored her for 3 years, I got her with the full expectation of committing to her for her whole lifetime, it's not so easy to just say "well dd is struggling with something that could be short term, fuck it, I'll just rehome my dog". Dd still loves the dog as well.

Dd isn't dictating anything either, nor is her medical condition a whim.

I should be getting that book today so I'm going to have a read of it.

I've sort of hit the ground running with 3 massive diagnosis for dd in the last year or so and I'm just trying to learn everything and do my best for everyone as I go.

Thanks for all the advice, it's much appreciated.

Get rid of the dog.

Hi - I would say the reaction to the dog is OCD if it is new, and she has previously got on well with dogs. I'm autistic and have OCD (very well managed following therapy) and can't cope with dogs generally due to the sensory impact for me - my autistic son loves dogs and his sensory needs are fulfilled by them. So it's really a case of - is this new and unexplained, and then it's probably OCD.
While your daughter is not accessing appropriate therapy you will have to balance not accommodating OCD with her safer and other priorities. Within therapy you could expect to work on anxiety and exposure following a kind of what's easiest tackle list. But without that safety net keeping her safe is number one (my child would literally jump out the moving car if I didn't do XYZ, so I did XYZ usually) and then other things like sleep, hygiene etc.

Please do reach out to experts through charity and verified literature if you can. Avoid some elements of the internet. Please know that my child was very very ill and now is well. It's possible no matter where you are on the journey.

Ddandmydog,

Forgive this very long post (if it will let me post!) but I try to put info here that might help you or others, as you get to grips with OCD in your family.

I sincerely empathise with you and your daughter. I'm sorry to read in your initial post that your daughter developed a severe disability which has changed your lives. It's interesting that you say OCD manifested alongside this.

While OCD and OCD-Related conditions generally seem to have a genetic component, with structural changes in areas of the brain seen in fMRI studies of people with OCD and OCD-R sufferers, and in their first-degree relatives who themselves do not present symptoms, there can be other causes:

-OCD can develop in response to a stressful event (a new and severe disability onset could be a trigger in this respect)

-OCD can be induced by certain medications/withdrawal from medications.
Some medications, especially neuromodulating drugs (e.g. anti-psychotics, anti-epileptics, stimulants like ritalin, etc.) can cause OCD symptoms in people who had not previously experienced these.

-OCD symptoms can onset after streptococcal infection (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS))

OCD can present in various ways; in milder or more severe forms of those types, and symptom development/severity can change over time, and be gradual or rapid onset.

Therefore, may I suggest the following: Keep an OCD /health status diary for your daughter and in it:

(1) Construct a timeline of onset
-Which came first - the disabilty or the OCD? [or did they co-occur?]
-What age was your daughter at time of onset of OCD?
-What age was your daughter at time of main disability onset/diagnosis?
-Did your daughter have strep-infection before onset of OCD?
-Did the OCD symptoms develop gradually over time, or were they very sudden onset?
-Have symptoms increased in severity or are they stable over time? (ie. do you notice an increase of washing, avoidance, crying, distress, complaints in time since onset or steady-state).

(2) List 'contamination triggers' and when they occur (date and time) and under which conditions
e.g, after eating certain foods, after taking medication, stressed going to school, while bored, watching tv, after spending time on her phone/ laptop/ ipad, etc. -so you can see if a pattern of onset and temporal occurrence is evident.

You mention other people touching her, cannot have different types of food touching on a plate, requires individual toothpaste tube, dog: sound of eating, contact with fur /drool, is there anything else? -add to list and note date/time and circumstances of occurrence.

(3) Medications:
-Is your daughter on medications for her disabilty?
-Did the OCD manifest after starting medication?
-List all the medications and vitamin supplements your daughter is on - their name/brand, exact dose, frequency (eg.daily / three times a week, etc.), start dates (if known or to nearest month/year)
-check if her symptoms increase or worsen after taking any given medication (eg. worse within an hour, a day, etc.)

It is worth reviewing your daughter's medication (if on any) with your GP/specialist to see if any of her medications might be implicated in development/worsening of OCD symptoms, or if the dose of meds may be adjusted to see if symptoms abate. Drug-induced OCD can also occur after cessation of certain medications, as a withdrawal response.

(4) Talk to your daughter about what she feels about her triggers:
-is it a physical sensation of touch she detests (like a sensory processing issue when someone touches her, certain fabrics, the feeling of dog fur/drool on skin)
-or is it a fear of contamination by unwanted touch of an object/uncleanliness?
-or is it a fear about something else/someone else and 'avoidance = prevention' of harm to them/herself in her mind? (e.g. "if I avoid touching this, no-one in my family will come to harm")
-Does she have 'rituals' - you mention washing anything the dog has touched, does she have others? (counting, touching something repeatedly)
-Does she have other related symptoms such as physical or verbal tics? hair pulling/skin picking/nail biting, hoarding, tourettes, etc.?
-Misophonia is sometimes associated with OCD/OCD-R conditions, it may be a spectrum condition but it isn't always present and it can alleviate.

You don't say how old she is, but if she can articulate what she specifically feels and the reasons for avoidance of things, note that in the diary, it helps to understand what the trigger is and why it triggers her and what she thinks about it (even if it is/seems irrational).

Try to tell her that the OCD is like a 'false friend' - the things it makes her do are not her fault. It makes her brain over-react to normal things. You and she knows she loves the dog. So when her brain tells her to avoid, it is just 'silly ocd' - a glitch in the brain that can be helped in different ways that you can try together.(it's important to encourage and not discourage hope - to help prepare her for engage with any future treatment you seek).

(5) Engage early with Exposure & Response Prevention (ERP) training:
This is a specialised form of Cognitive Behavioural Therapy that is first-line non-pharmacological treatment for OCD and has very good response rates in both adults and children. Some info here:

What is ERP: iocdf.org/about-ocd/treatment/erp/?_ga=2.134861426.2033691826.1726058603-1810442600.1726058603

https://kids.iocdf.org/professionals/mh/about-erp-for-pediatric-ocd/

Questions that parents might ask a therapist for EPR: https://kids.iocdf.org/for-parents/how-do-i-find-the-right-therapist/

Try to seek the advice of a therapist with specialty in ERP for Paediatric OCD to help introduce exposure and avoidance of compulsive-responses.
This leaflet is more geared towards adult ERP therapy for OCD but I put it here for some general information for you and anyone interested, and for the address at the bottom, to whom you could write for advice on ERP for Paediatric OCD, if you're in UK. They might be able to point you to some.
https://www.elft.nhs.uk/sites/default/files/2022-05/exposure-and-response-prevention.pdf

(6) The Dog
Your dog is going to be your best friend and ally for you and your daughter in helping her manage down the OCD symptoms through ERP.

Especially as you say: "She loves the dog as well, they were inseperable until recently, so I think dd would be devastated if she wasn't around any more, even with her struggling just now."

Therefore it appears that the OCD aversion to the sound and hair/drool of the dog is a very recent development, and the love your daughter has for her dog is going to be of great help in switching from aversion to acceptace and overcoming the compulsion to avoid her, if you can engage with ERP to help this.

While minimizing stressful situations (e.g. feeding dog in another room, keeping bedroom free of dog, etc.), it is important NOT to reaffirm OCD triggers with full avoidance - this compounds them. Getting rid of your much-loved dog is not the solution to OCD and your daughter does, as you rightly and intuitively say, need to learn strategies to deal with things and not have additional distress, burden of guilt and stress that would arise from getting rid of her beloved pet. It is important to note that the dog is not the only trigger. There are several.
Seek ERP help for dealing with this from a practiced therapist. In the meantime, get a book on it or have a look at online articles about it.

(7) Diet
I think food -relationship to development/exacerbation of OCD symptoms is something under investigation but not conclusive at the moment. However, foods that cause release of inflammatory agents in the body, or could result in dysbiosis, eg.overgrowth or imbalance of bacteria in the gut, may alter neurotransmitter synthesis, which in turn affects the brain and its structural development/activity/connectivity, might be involved at some level in symptom severity, even if not causal in condition development.

e.g. reducing sugar in diet might help decrease inflammatory agents in the body. With her doctor/specialist, perhaps review her dietary intake and see if you can reduce intake of overly sugary foods/ high GI foods and incorporate more whole-foods, omega 3 fats, vitamins B,C,D,E and Zinc, as they seem to be helpful in managing inflammatino as well as supporting neurotransmitter production. Also note in your diary, if her symptoms present or worsen after eating any particular foods.

(8) Vitamins
That is good that your daughter is on Vit D and B12 if she has been observed to be low in these vitamins. It's worth having her vitamin levels repeat tested when she has blood tests for her underlying conditions, and also asking her GP/specialist if she can receive elevated doses of Vit B12 and Vit D3 (if medically safe to do so) for a couple of months to see if symptoms of OCD decrease. (Vit B can also be given as an injection). The OTC supplements one takes daily take a while to work and might need higher levels over the recommended daily amount.

You could show the doc the meta-analysis paper I linked in my first reply to you above - there is good evidence for the role of Vit B (B12,B6 and other B vits) in regulating the levels of Homocysteine in the body. Elevated Homocysteine has implications for impaired production of neurostransmitters affecting the brain, involved in OCD and OCD-R.

Again, in the diary, note the doses and dates of consumption of the vitamins and note if the symptoms of OCD lessen over time.

(9) General reference info:

Contamination OCD:
Contamination OCD is a type of OCD which can present multiple triggers as an obsessive fear-aversion over-reaction and compulsions to avoid or mitigate those triggers. Triggers can change over time. It can take multiple forms per this overview:
https://www.psychologytoday.com/us/blog/understanding-the-anxious-mind/202201/understanding-contamination-ocd-in-all-its-forms

OCD treatments overview:
This is a 2023 scientific review of current treatment modalities for OCD - pharmacological, non-pharmacological (such as ERP/CBT) and brain stimulation. I put it here for info for anyone interested.

"Therapies for obsessive-compulsive disorder: Current state of the art and perspectives for approaching treatment-resistant patients"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978117/

These are the papers I linked previously. I am putting them here again so everything is in one place:

Serum Vitamins and Homocysteine Levels in Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis (2021).
(see Introduction and scroll down for Discussion section)
https://karger.com/nps/article/80/6/502/825491/Serum-Vitamins-and-Homocysteine-Levels-in

N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review" (2015)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423164/

And:
Dietary quality and nutrient intake in adults with obsessive–compulsive disorder (2021)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612013/

Try not to panic! You're doing very well with all that you are doing for your daughter, your dog,and reading up on OCD. Engage with OCD organisations, especially those for paediatric OCD, for advice on therapists for ERP and access to research.

Also, in all of the scientific papers, there is a correspondence address for the first author/multiple authors. Sometimes emailing them directly can open a gateway to further information or advice if clinical studies are ongoing/recruiting as that can be a pathway to treatment also.

Medicine is moving forward all the time and the day will come when these conditions can be managed well. The Vitamins B,C,D,E supplmentation and managing homocysteine levels is an interesting strategy.

Good wishes to you, to your daughter and dog!

I'm not OCD but I can't bare being in a home with a dog. It's the smell. The sounds. The licking.

I think it's grossly unfair to a child with autism to have to deal with this because they do have additional sensory issues.

That may well then trigger OCD but imagine being extra sensitive to a dog. People saying that you get used to it, really don't get It if you have sensory sensitivity.

It'd be torture.

This isn't simply a case of OCD and it needs to be seen like that.

I'd get rid of the dog. It's unfair on the child to keep. Then focus on the OCD.

@RedToothBrush this isn't true of all autistic people and the dog is not a new addition whereas the ocd is.

People aren't 'OCD', they have OCD. It's not an identity first , positive condition unlike for eg autistic people.

@Rhetorica thank you so much, your post is so helpful.

Her autism was diagnosed at 12, then at 13 she was diagnosed with epilepsy, her autism diagnosis came after some work on her anxiety, I didn't even recognise that dd was autistic, she is just dd and, what I now know to be, her autistic traits, were just sweet little personality traits that we work around. I had no idea that she was struggling so much.

The mediaction she is on is for her epilepsy, although things keep changing as we are working to find the right combination at the moment.

Dd wanted the dog, I havent inflicted an unwanted dog on her, it's her favourite breed and they were absolutely inseperable, it really helped her with getting the confidence to go outside, even now with her OCD she takes photos of the dog, is always asking me for videos to be taken when we are out walking etc.

I'm not going simply get rid of the dog, it's just not that easy. Imagine if I find the right treatment for her OCD in 3 months and the dog has been given away. Dd would be devastated. She loves the dog, but she's just struggling with certain aspects of it right now, she's also struggling with certain aspects of school that I'm working around, and things with her siblings that I'm working around as well.

Thanks for all the help, it's been really valuable. I've got a day set aside for reading all the links and that book today so will hopefully have a bit more of an understanding of what I'm doing soon.

Ddandmydog,

Thanks for your reply - glad if you found the info useful.

I am so sorry that your little girl is having such health issues with epilepsy and OCD, that's a lot to cope with for her on top of her autism, as well as for you and other family members.

Firstly, know that you are doing everything right: getting information, making things as calm for her as possible but not allowing irrational OCD compulsions and obsessions to dictate what happens in your family and to your pet whom she loves.

From what you initially described, it's clear that she has multiple OCD triggers and these are quite new and more recent in onset than pre-existing issues. That is important for developing a timeline of when different disorders manifested. e.g. first autism diagnosed, then epilepsy, then OCD (note the dates of onset when you started noticing symptoms of each, or dates of diagnosis by doctors).

So what can you do practically?

(1) Start the health diary now - having a complete diary of triggers, food, life events, illness onset (epilepsy, ocd and diagnosis of autism) and details of dates and doses of medication, and any life circumstances/events helps a lot to identify patterns, worsenings, lessenings of symptoms and give the doctors 'real world' info of how she is managing on a day to day basis.

(2) Discuss with her doctors whether they think the OCD might be co-occuring with epilepsy as a latent-onset systemic condition, or whether it could be drug-induced by her anti-epileptic medications.

OCD can occur in some patients as a co-morbid condition with epilepsy, especially temporal lobe epilepsy, but it's not entirely clear why. In both conditions, there seems to be a link to dysregulation of glutamate - an amino acid that acts as a neurotransmitter, exciting nerve cells to fire impulses and transmit signals.

But drugs for epilepsy can also be implicated in the onset of OCD, e.g. there have been case reports of onset of OCD with Levetiracetam, Lamotrigine, (as opposed to carbamazepine); while other anti-epileptic drugs, e.g.topiramate can apparently alleviate symptoms of obsessive compulsivity (info from research studies).

So have a chat with the doctors to find out whether any medications she is on for epilepsy could be linked to onset of symptoms of OCD and whether doses can be adjusted, or meds changed, to see if these symptoms dissipate.

(3) Vitamins B,C,D,E and N-Acetyl-Cysteine
As mentioned in my previous post, check with her doctors whether she can take increased doses of these, especially the B vitamins, without any cross-reaction with existing medication or risk of worsening of other symptoms (e.g. of epilepsy), to see if any changes - i.e. down-regulation of OCD symptoms.
This is worth trying as it's something you can do at home (after ok from doctor and discussion of doses) to see if there is a change and vitamins are relatively inexpensive. NAC can also be tried as it's over the counter but check with doctor first.

You mentioned she was low on Vit B and D when previously tested and is now on supplements. That is good. If possible to have homocysteine levels checked next time her doc orders blood tests, that would be interesting. Vitamin B is essential for regulation of homocysteine in the body. Too low Vit B (esp B12 I think) results in too-high levels of homocysteine and elevated homocysteine and low Vit B can have neurotransmitter synthesis and involvement in neuro-psychiatric conditions.

(4) Mediterranean diet, nutritious and with fibre, if ok for her to take. I know getting children to eat well can be hard at the best of times, so if she prefers things that have more refined carbs, like pasta, you can cook it, cool it down to cold and reheat it. This changes the conformation of starch and makes it "resistent starch" which is better for your body.

(5) Keep things as normal as possible for yourself, your family, your pet and most especially your daughter. You will have to feel your way through this as it's a balance between trying to reduce stress on her but not compound OCD compulsions by giving them too much rule. ERP is the go-to for managing these and it works well for many folks with OCD as they learn to retrain the brain to reduce anxiety about certain obsessions and that the compulsive actions do not bring relief, and ways to manage that down by gentle exposure

Lastly, I don't want to bombard you with research papers but I link this as it's a nice article, well written, about relatively recent research from Cambridge on OCD and link to Glutamate (excitatory neurotransmitter) and GABA (dampening neurotransmitter) and the lack of balance of these in OCD patients.

www.cam.ac.uk/research/news/chemical-imbalance-in-the-forebrain-underpins-compulsive-behaviour-and-ocd-study-finds

And just to applaud you again on all that you're doing for your daughter, your family members (and dog!). Look after yourself too. It is exhausting managing these conditions for both sufferer and carer, I know. Take each day as it comes but if you can try the vitamins, it's really worth doing, if medically safe to do so, but must be consistent, daily, for at least a month or perhaps two to build up levels. Every person is different so responses to things will be different, but worth a try!

Good wishes again.

Did you miss the part where OP says her daughter and the dog were inseparable until recently?

Is rhetorica an AI bot? The answers are so weird

I’m a CBT therapist and I would say don’t get rid of the dog as it’s highly unlikely to solve the problem. OCD is an anxiety-based disorder and the rituals/compulsions are usually a response to anxiety being felt in someone’s life. It’s highly likely that the focus would just shift elsewhere if the dog was rehomed - it’s treating the symptom, not the problem