Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. If your child or teen has OCD, they have repeated, upsetting thoughts. They do the same thing over and over again to make the thoughts go away. They feel like they cannot control these thoughts or actions.
The upsetting thoughts and images are called "obsessions." Examples include a fear of germs, a fear of being hurt, a fear of hurting others, and disturbing religious or sexual thoughts.
The actions they take over and over again to make the thoughts go away are called "compulsions." Examples of these repeated actions include counting, cleaning, and checking on things.
Children with OCD may have just obsessions or just compulsions, but most often they have both. Many children with OCD know that their thoughts and actions are not normal. They may try to hide their problem from family and friends.
The cause of OCD is not known. Children who have been diagnosed with Tourette's syndrome are more likely to develop OCD. Some studies show that parts of the brain work differently in people with OCD. OCD may develop or get worse after a strep infection. Children may show signs of OCD as early as the preschool years, but it is most commonly diagnosed when children are between the ages of 10 and 15.
OCD symptoms often increase and reduce without apparent reason. Sometimes they will disappear and not return. Often symptoms will happen only in certain places, for example, at home but not at school. They may also happen at a specific time, for example at bedtime or when children are getting ready for school.
The kinds of obsessions and compulsions children have depend on their age. The obsessions and compulsions may change as the child gets older. Children with OCD may:
Along with the main symptoms, children with OCD may:
Children with OCD may be successful in school, but they may have trouble completing homework and papers as they focus on getting things perfect.
Children with OCD often involve family members in their rituals. For instance, they may insist that their laundry be washed multiple times, demand that parents check their homework repeatedly, or become outraged if household items are in disarray.
The children often feel helpless over not being able to stop their obsessive or compulsive behavior. When they try to stop their obsessions or compulsions, they may stop for several hours or even a few days, but it takes great effort.
If your child's rituals are very time consuming, cause a lot of distress, and interfere with daily life, your child may have OCD. Your child's healthcare provider or a mental health therapist will ask about the child's symptoms, medical and family history, and any medicines the child is taking. Your child may have some lab tests to rule out medical problems.
Along with OCD, children and teens may have other problems or disorders as well, such as:
Treatment for OCD often combines both therapy and medicine.
There are several behavioral treatments that help teach children to control or stop their obsessive acts. Behavioral therapies help children stop doing the ritual without feeling anxiety about not doing it. Exposure and response prevention therapy has provided relief for many children with OCD, but it takes time and much of the work is done as homework. For example, if children wash their hands all the time because they are afraid of being dirty, the therapist might have the child touch something dirty. Then the two of them might stand at the sink without washing hands until the anxiety goes away. Children learn ways to control their body's response to anxiety, like breathing exercises. If they practice faithfully at home, gradually they find that obsessive thoughts don't make them as anxious, and that they can skip compulsive behaviors for longer periods of time.
Cognitive behavior therapy (CBT) helps children learn about what thoughts go with their urges to act or think and how to control them. CBT also teaches specific skills for managing anxiety about symptoms.
If a child has severe symptoms, both behavioral therapy and medicine may be best. Several types of medicines can help treat OCD. Your child’s healthcare provider will work with you and your child to carefully select the best one for your child.
Family therapy may also be helpful. Family therapy treats the whole family rather than just the child. Children often feel very supported when parents and siblings attend therapy with them and work as a group.
It is important to have an experienced professional working with you and your child. The mental health professional treating your child may recommend continuing treatment after your child no longer has symptoms. Since OCD often comes and goes without a clear reason for stopping and starting, continued treatment is sometimes a way to prevent symptoms.
Children may always have this disorder, but treatment can help them recognize and manage the symptoms. OCD may last for weeks or months and then disappear or reduce dramatically. However, children who have had it once are at greater risk for future OCD. It may reappear during the adult years.
It is very important to help your child feel supported.
When OCD symptoms seriously interfere with school, socializing with friends, or daily activities, your child needs help. If OCD symptoms happen more than a few times in a week, get professional help. The symptoms may not go away or may get worse without professional help.
Get emergency care if your child or teenager has ideas of suicide, harming him or herself, or harming others.
For more information and support resources check:
Web site: http://www.ocfoundation.org
(Note there are local chapters of the OC Foundation in many cities)
National Institute of Mental Health
Telephone: 866-615-NIMH (6464)
Web site: http://www.nimh.nih.gov
Mental Health America (formerly the National Mental Health Alliance)
Telephone: 800-969-NMHA (6642)
Web site: http://www.nmha.org