What is Obsessive-Compulsive Disorder (OCD) in Kids and Teens?
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. A child with OCD can have obsessive thoughts, feelings and fears that are not wanted and/or do repeated behaviors called compulsions (also called rituals) to make those fears go away.
What are Obsessions?
Obsessions are recurring thoughts, feelings and images that can make kids feel anxious. These thoughts are not wanted, and a child typically can’t stop thinking about them. A child with OCD may realize their thoughts are not logical but still feel extremely anxious about certain things.
These fears might include obsessing over:
- If they, or someone else, will get sick, hurt or die.
- Having said a bad word, had a bad thought or made a mistake.
- Feeling they have broken a rule, done a bad thing or sinned.
- If something is clean, dirty or germy.
- If something is straight, even or placed in an exact way.
- If something is lucky or unlucky, bad or good, safe or harmful.
What are Compulsions?
Compulsions, also known as rituals, are recurring behaviors to relieve the stress and anxiety caused by obsessions. OCD causes kids to feel they must do rituals to ensure things are clean, safe, in order or just right. To kids with OCD, rituals seem to have the power to prevent bad things from happening.
Rituals include things like:
- Repeated handwashing (often 100 or more times a day).
- Often erasing things, re-writing, re-doing or re-reading.
- Hoarding objects.
- Going in and out of doorways several times in a row.
- Checking to make sure a light is off, a door is locked or checking and re-checking homework.
- Touching or tapping a certain number of times, or in a specific way.
- Following firm rules of order, such as putting on clothes in the very same order each day.
- Counting to a certain “good” number, avoiding “unlucky” numbers.
- Repeating questions or words spoken by oneself or others.
- Repeatedly using inappropriate words or making rude or obscene gestures.
How is OCD Different from Typical Childhood Routines?
As children grow, rituals and obsessions not related to OCD normally happen with a purpose and are based on age. For example, preschool age children may have routines around meals or bedtime to help provide comfort and predictability. Older kids may create group rituals as they learn to play games and sports, or develop hobbies that help them learn to socialize.
OCD is different from these typical routines. When a child has OCD, obsessive thoughts and compulsive rituals can become frequent and strong, and can interfere with daily life and development. Those with OCD cannot “snap out of” the obsessions or compulsions they suffer from. These disruptions also cause severe mental health distress and can affect how the child thinks. While adults with OCD may realize their actions are irrational, children often cannot. In most cases, the compulsions of OCD, such as excessive handwashing or checking locks on doors, can use more than one hour each day.