Obsessive-Compulsive Disorder (OCD)

Overview

What Is Obsessive-Compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) causes upsetting thoughts called obsessions. It also causes the urge to do behaviors called compulsions (also called rituals). Kids and teens with OCD get stuck in a stressful cycle of these thoughts, anxiety, and rituals.

If you think your child has OCD, start with a visit to your child's doctor or mental health provider. They can check for OCD or for other problems that could be the cause of your child's symptoms.

Top Things to Know

• Obsessive-compulsive disorder (OCD) is a brain condition that causes kids and teens to have upsetting thoughts (obsessions) and feel the need to repeat behaviors or rituals (compulsions).
• Kids with OCD may have strong worries, feel anxious or irritated, and spend a lot of time doing rituals to try to feel better or prevent something bad from happening.
• Cognitive behavioral therapy and sometimes medicine can help treat OCD. Support from parents and caregivers is also an important.
• OCD can sometimes be hard to spot because kids may hide their thoughts and rituals, or the behaviors may be mistaken for habits or personality traits.

Signs & Symptoms

What Are the Signs & Symptoms of OCD?

Here are some of the most common signs parents and caregivers may notice.

Obsessions

These are stressful thoughts that come to mind over and over. A child with OCD doesn't want to think about these things. But they feel they can't stop.

Parents may notice obsessions as intense fears or worries. Kids with OCD may feel unusually upset about:

• germs, dirt, illness, injury, or harm
• whether someone could get sick, hurt, or die
• things that seem wrong, or out of place
• whether bad thoughts might come true
• things that are not straight, even, or arranged "just right"

Compulsions (Rituals)

These are behaviors a child will do, trying to feel better. To the child, rituals seem like the way to stop thoughts and relieve fears. They seem like a way to keep bad things from happening.

Parents may notice that kids:

• touch, tap, or step in unusual ways
• arrange things over and over
• repeat words, phrases, or questions
• have many doubts and trouble making choices
• wash or clean more than needed
• take a long time to do things — like get dressed, shower, eat, do homework

Kids may involve parents in rituals. And at first, parents may not realize that something is a ritual. For example, a child with OCD might ask for reassurance over and over. Or a child may insist a parent say or do something a set number of times, or in a set way.

Kids and teens with OCD can have obsessions, compulsions, or both.

Feelings

OCD symptoms are hard on kids. Rituals may seem to give them some relief at first. But rituals multiply. They start to take more time and energy. Kids have little left for things they enjoy. OCD thoughts, feelings, and rituals become a stressful cycle. This can make it hard to focus in school, have fun with friends, get to sleep, or relax.

Kids may seem:

• anxious, worried
• frustrated, irritable
• sad, tired
• upset when they can't do a ritual
• to need constant reassurance from a parent that things are OK

Some kids, especially young children, may not be able to let parents know about the thoughts, fears, and behaviors OCD causes. They may feel confused or ashamed about their fear and keep it to themselves. They may try to hide rituals they do. Some kids may have OCD symptoms for a while before their parents realize it.

Diagnosis

How Is OCD Diagnosed?

If you think your child might have OCD, make an appointment with your child’s doctor. The doctor will want to make sure that there’s not a medical illness that could be causing your child’s symptoms. Once a medical cause is ruled out, you may need a child psychiatrist or psychologist. Your child's doctor can help you find the right person.

To diagnose OCD, your child’s psychiatrist will spend time talking with you and your child, using a questionnaire that tracks symptoms. The psychiatrist will explain the treatment plan if your child is diagnosed with OCD, and your child will retake the questionnaire throughout treatment to see if the treatment is helping.

Treatment & Care

How Is OCD Treated?

Treatment for OCD can include therapy, medicines, or a combination of the two.

Cognitive behavioral therapy (CBT) is one type of treatment for OCD. In therapy, kids learn coping and calming skills for anxiety. They learn how to safely face fears without doing rituals.

Along with therapy, doctors may give medicines to some kids to reduce symptoms. For kids who need medicines, doctors give SSRIs (selective serotonin reuptake inhibitors). These include fluoxetine, fluvoxamine, sertraline, and paroxetine. There is one non-SSRI medicine called clomipramine that’s also been shown to be effective in helping kids with OCD. Kids who are prescribed these medicines should have regular checkups to monitor possible side effects.

Treatment works best when a parent or caregiver goes to therapy with their child. That way, they can learn how to coach their child through OCD symptoms, help their child practice skills they learn in therapy, and offer daily support.

How Can I Help My Child?

Here's ways to help support your child with OCD:

• Take part in your child's therapy. Part of treatment is coaching parents on how to respond to their child's OCD symptoms. Learn all you can about ways you can help. Learn how to support your child's progress without giving in to rituals.
• Be patient. Overcoming OCD is a process. There will be many therapy visits. Be sure to go to them all. Help your child practice the things the therapist shows you. Praise your child's effort. Show how proud you feel. Remind them that OCD is not their fault.
• Get support, and give it. There are lots of resources and support for families dealing with OCD. The International OCD Foundation is a good place to start. Knowing that you're not alone can help you cope. Sharing success stories with other parents can give you hope and confidence.