Understanding OCD in Children

Many children occasionally have thoughts that bother them, and they might feel like they have to do something about those thoughts, even if their actions don’t actually make sense. For example, they might worry about having bad luck if they don’t wear a favorite piece of clothing. For some children, the thoughts and the urges to perform certain actions persist, even if they try to ignore them or make them go away.  This could be an indication of an obsessive-compulsive disorder (OCD) in children. OFD manifests when recurring unwanted thoughts, coupled with the urge to perform specific actions or behaviors, become frequent, time-consuming (more than an hour each day), disruptive to their routine or activities, or highly distressing.  The distressing thoughts are referred to as obsessions. The behaviors or actions are called compulsions.

Having OCD means having obsessions, compulsions, or both.

Examples of obsessive or compulsive behaviors include:

• Recurring Unwanted Thoughts: having unwanted thoughts, impulses, or images that occur over and over and provoke anxiety or distress.
• Repetitive Thinking or Uttering: children may find themselves thinking about or saying something over and over (for example, counting or repeating words over and over silently or out loud)
• Repetitive Actions: carrying out an action over and over (for example, hand washing, placing things in a specific order, or checking the same things over and over, like whether a door is locked)
• Rigid Rule-Based Actions: children may perform actions over and over according to certain rules (they have established) that must be followed exactly in order to make an obsession go away.

Children engage in these behaviors with the hope or feeling that they will prevent negative outcomes or alleviate their distress or anxiety. However, the behavior is not typically tied to actual danger of something bad happening, or the behavior might become extreme, such as washing hands multiple times per hour.

It is crucial to debunk the common myth that OCD means one is really neat and orderly. While cleanliness might be involved, many times, someone with OCD becomes fixated on the specific action or behavior that must be done over and over, rather than on being clean or organized. Furthermore, obsessions and compulsions can also change over time.

In some cases, anxiety or depression and disruptive behaviors may also occur with OCD.

A multifaceted approach to treatment can significantly improve the lives of children with OCD. Behavioral therapy, particularly cognitive-behavioral therapy, helps children transform negative thoughts into more positive, effective thought patterns, leading to more adaptive behavior. 

Behavior therapy for OCD can involve gradually exposing children to their fears in a safe setting. Gradual exposure helps children realize that their fears do not really occur when they resist the behaviors or “compulsions”, gradually reducing their anxiety over time. Families and schools play an integral role in supporting children and helping children manage their stress by actively participating in therapy and learning how to respond empathetically without inadvertently reinforcing obsessions or compulsions. 

Our team is dedicated to providing specialized support for children grappling with OCD. We recognize that each child’s journey is unique and offer tailored interventions to foster lasting positive change.  If you child is exhibiting signs of OCD, we are here to guide them towards a brighter, less burdened future.