Behavioral Health

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Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a condition that can affect people of any age — including kids and teens. It causes people to have obsessions, which are fears, doubts, and worries that take over and interrupt a person's normal thoughts and routines. 

To get relief from obsessive thoughts, people with OCD develop behaviors called rituals or compulsions. To a person with OCD, the rituals have the power to make things seem "right" or prevent the bad things they worry about.

Obsessive thoughts can be upsetting and scary. But kids and teens feel powerless to stop focusing on these thoughts, even though they want to. This can make life very stressful.

Fortunately, kids and teens with OCD can get better with the right attention and care.

Recognizing OCD

OCD can be recognized through obsessions and compulsive rituals.

Obsessions
Obsessive thoughts can cause kids and teens to feel and act irritable, upset, sad, or anxious. Kids with OCD often get obsessed with: 

  • whether something is dirty or germy
  • things being symmetrical or even 
  • things being done in set order or a specific way
  • whether they might have sinned, broken a rule, or offended someone
  • numbers, words, sounds, or colors that seem "lucky" or  "unlucky"
  • having sexual or aggressive thoughts
  • body wastes
  • illness or harm coming to them or their relatives

Kids with OCD become afraid of what might happen if something is dirty or uneven, or if they see an "unlucky" number or color. They worry that the bad things they're afraid of will come true. They may think that having bad thoughts means they are bad. Obsessions make it hard to concentrate on schoolwork or enjoy activities.

Compulsive Rituals

Kids with OCD feel compelled to do specific rituals to get relief from their obsessive thoughts. They do these rituals to "make sure" things are clean, in order, or "just right." Rituals include things like: 

  • washing and cleaning
  • repeating specific behaviors — like saying a word or phrase over and over
  • going in and out of doorways several times in a row
  • checking — like making sure an appliance is off, a door is locked, or repeatedly checking homework
  • touching or tapping a certain number of times or a set way
  • ordering or arranging objects "just so"
  • counting — like counting to a certain number, or counting over and over

Doing a ritual gives kids with OCD temporary relief from fear, worry, or bad thoughts. But the more kids do a ritual, the more they feel the urge to do it again. Eventually, the ritual doesn't bring as much relief as it once did. So a kid may do it over, then over again. This is called "getting stuck."   

A kid with OCD may get stuck hand washing for so long he can't get to bed on time. Or a kid may get stuck packing and re-packing a backpack so many times that she misses the bus. Getting stuck in a ritual can make kids (and parents) feel frustrated, upset, and exhausted. 

Kids and teens with OCD often feel embarrassed. They might be afraid they'll be teased about their rituals. They often hide rituals or do them in a way that others don't notice. Because rituals can be upsetting, kids start to avoid situations that trigger the need to do them.

OCD affects students at school. A need to erase, rewrite, or re-do work slows kids down. Some kids won't write the correct answer on a test if it uses a "bad" number or word. They would rather get a poor grade than "risk" the bad thing they imagine might happen if they break OCD's "rules."  

Some kids tell a parent what's bothering or scaring them. But other kids may keep the worries and rituals to themselves. Parents may not realize what's causing their child's difficulties.

Why Do Kids Get OCD?

Scientists don't yet know why some people get OCD. Kids may get OCD because it's in their genes or they had an infection. And, there may be differences in certain brain structures and brain activity in people with OCD. But whatever caused OCD to happen in the first place, it's not the child's fault.

People with OCD can't control their condition or get better on their own. But the right diagnosis and therapy can help them get better and get on with life.

Diagnosing OCD

OCD can get better with the right attention and care. But problems also can continue or get worse if they're not treated. If you think your child might have OCD, here's what to do.

Talk with your child about what's going on. Talk supportively, listen, and show love. Tell your child what you've noticed and that you know it's stressful for him. Say that something called OCD might be causing your child to be worrying and "fixing" things in these ways. Say that a check-up with the doctor can find out if this is what's going on. Reassure your child that this can get better and that you want to help.

Kids with OCD sometimes feel ashamed or embarrassed at first. They may try to hide a ritual or deny doing it. But it can be a relief to a kid if someone understands what's going on.

Schedule a visit to your child's pediatrician. Tell the doctor what you have noticed. Encourage your child to speak up, too. The doctor will probably examine your child and ask questions. That helps the doctor decide if the symptoms could be OCD or another health condition. The doctor may refer you to a mental health professional for more evaluation and treatment, and can help you find a therapist who specializes in treating OCD.

Getting Help

When OCD is diagnosed, it can be a relief to kids and parents. Now they can focus on getting better. 

Therapists treat OCD with cognitive behavioral therapy. During this type of talk-and-do therapy, kids and teens learn helpful new ways to think about OCD. They learn that doing rituals keeps OCD going strong, and that not doing rituals helps to weaken OCD. 

As they go through the therapy, kids and teens learn ways to face fears and resist doing rituals. Learning these skills helps reset the brain's activity to a healthier way of working. That can stop the cycle of obsessive-compulsive messages and urges. Sometimes, doctors also prescribe medicines to treat OCD. But most kids don't need medicine to get well.  

During treatment, parents will learn what they can do to help kids get better. It's not easy at first — and the treatment takes time, practice, and patience. There can be successes and setbacks along the way. But it works well for most people who stick with it. 

Many resources and support are available for parents and families dealing with OCD. Knowing that you're not alone can help you cope and give you hope and confidence.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: January 01, 2017