From Childhood Bullying to Hidden Battles: Unraveling the Link Between Obsessive Compulsive Disorder (OCD) and Childhood Trauma

INTRODUCTION

Peer victimization is almost a regular occurrence during childhood and adolescence that negatively impacts young people’s social and psychological well-being. Thankfully, educators and mental health professionals have recognized the negative effects of peer victimization. Consequently, professionals and scholars have turned their attention to the growing problem of bullying in both therapeutic and educational settings.^[1,2] Self-critical attitudes increase suffering when aggressive peers’ negative criticism is internalized. This process can lead to poor self-perceptions and social scenario avoidance, which in turn can lead the child to develop social anxiety, depression symptoms and generalized anxiety.^[3,4] It makes sense that obsessions and compulsions would develop as a result of being victimized by peers. The young person may have uncontrollably obsessive and upsetting obsessions with bullying events. When a youngster identifies particular rituals as a means of regulating or avoiding triggers connected to teasing, compulsions may arise.^[5] Peer victimization and other unfavorable features of peer interactions are associated with negative results for mental health.^[6]

Social functioning is difficult for people with obsessive-compulsive disorder (OCD); these difficulties include making and keeping friends and engaging in peer activities that are acceptable for their age.^[7,8] Children’s prosocial behavior was found to decrease with more victimization.^[9] When compared to younger OCD sufferers, older OCD sufferers typically report higher degrees of social impairment.^[10] A child’s externalizing and internalizing behaviors may be observed by parents as a result of OCD symptoms, which can also cause more victimization by peers and exacerbate symptoms of despair and loneliness. When OCD youngsters stop performing compulsions, some of them get a second chance from their peers, but others still get rejected by the peers.

We have described a situation in which our patient was the target of peer bullying because of a single incident of unresponsiveness. The state of affairs was made worse by this harassment, which resulted in the emergence of OCD and attempt of suicide.

CASE REPORT

The Assam Medical College and Hospital’s Department of Psychiatry received a referral call from a private psychiatrist for a 23-year-old male who needed further consultation. His family was nuclear middle class and he had just received his engineering degree. His father was a businessman by profession, and his mother was a homemaker. He belonged to a family environment of strict parents regarding his academics. They had high hopes from him and when he would not score up to the mark, he was criticized. On further query about his family environment, he revealed his parents frequently fought, which would hamper him. He arrived with a history of depressive symptoms, frequent intrusive thoughts involving the word “psycho,” which were typical of OCD symptoms. But after looking more into his background, it became clear that he had experienced bullying in the past. His symptoms were associated with bouts of dyspnea and palpitations on and off.

The sequence of events started in the sixth grade when he passed out and a doctor determined that he had conversion disorder. After that, his mother informed the teacher about his health and he was able to take a few days off from school. However, his pals started tormenting him by calling him “psycho” once they found out about his illness. He started to feel more and more depressed in the seventh and eighth grades since he was having trouble controlling his recurring thoughts of being called “psycho” by bullies. He turned to self-harming behaviors as a coping mechanism, such as harming himself in secret places on his body to evade attention. This action gave him some momentary respite from his repetitive and intrusive thoughts. He attempted to commit suicide by jumping into a pond, but luckily, his father saved him. On asking why he would do so, he replied that he would feel lonely and misunderstood. It served as a means of dealing with his intrusive thoughts of anxiety, which he was facing as a result of bullying.

He was sent to a private psychiatrist and given a daily sertraline dosage of 50 mg. While in his twelfth year of high school, he was doing well in his studies and started dating. But after four months the relationship ended and he again attempted suicide by taking 500 mg of sertraline. After this incident, he started having new intrusive thoughts that suggested he was gay, which made him feel obligated to constantly tell himself that he was attracted to females by stating, “No, I am attracted to girls.”

DISCUSSION

An increasing amount of studies has shown links between both direct and indirect stressful and traumatic life experiences and symptoms of OCD.^[11] Often trauma and OCD are overlapped.^[12] The way that trauma was experienced—direct vs. indirect—as well as its type—interpersonal versus non-interpersonal—are crucial factors in determining how OCD symptoms could manifest. Research indicates that specific OCD symptoms, such as symmetry/ordering and obsessions/checking, may be connected to traumatic experiences in the past, such as bullying as a youngster.

Additionally, trauma might affect the obsessive behaviors that OCD sufferers exhibit. These actions might be coping strategies to establish control over one’s life or prevent reliving traumatic events. For instance, after experiencing trauma, some people may acquire compulsions to bring back a feeling of predictability and order, while others may get fixated on repetitive actions like counting in an effort to filter out intrusive memories of the horrific incident.^[13] An individual may experience uncontrollable and intrusive distressing thoughts related to specific bullying experiences. Compulsions might arise from coincidental or perceived connections between carrying out a ritual and stimuli related to teasing. Our patient serves as a case of how internalizing unfavorable peer criticism can result in the emergence of OCD.^[5]

CONCLUSION

Bullying may serve as a primary cause in the development of OCD, causing the condition to manifest. After experiencing anything unpleasant, like bullying, our patient reacted in ways that worsened his symptoms, as it was a significant stress factor. He started to analyze intrusive thoughts excessively or engage in extensive avoidance behaviors, which resulted in the development of severe OCD symptoms.