Anxious Child

If you notice your child engaging in distressing repetitive actions or thoughts, you might wonder if they have obsessive-compulsive disorder, or OCD. Your hunch isn’t so far fetched.

OCD in children is common. It’s a brain disorder, often inherited, that usually begins in adolescence and young adulthood. As many as 1 in 200 children and adolescents experience OCD, according to the American Academy of Child & Adolescent Psychiatry.

What Is OCD?

OCD stands for obsessive-compulsive disorder. It’s a common mental health disorder that is chronic and long-lasting. It doesn’t go away on its own.

People with OCD experience unwanted, uncontrollable, and recurring thoughts (obsessions) and behaviors (compulsions).

Obsessions include repeated and persistent thoughts, urges, or mental images that cause fear, stress, or anxiety. Compulsions include repetitive behaviors, rituals, or mental acts. If your child has OCD, they can have obsessions, compulsions, or both.

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Risk Factors for OCD

Why some children develop OCD is unclear.

OCD tends to run in families. If a parent has OCD, it increases the risk their child will develop symptoms. If a child has OCD, it increases the risk their siblings will develop it.

But just because it runs in families doesn’t mean your child will definitely develop it. Some children with OCD have no family history of the disorder.

OCD often co-occurs with Tourette Syndrome (TS) and other tic disorders. Up to 60% of TS sufferers also experience OCD symptoms, and 50% of children with OCD have had tics, according to the International OCD Foundation.

Most people with OCD are diagnosed by age 19, according to the National Institutes of Mental Health. Boys tend to develop it at an earlier age than girls do.

Symptoms of OCD in Children

Unlike everyday worries, OCD thoughts and related rituals are often irrational and unrealistic.

For example, your child might worry they, or you, will die in a car crash. To safeguard against these fears, they latch onto rituals that make sense only to them. They may insist on buckling and unbuckling their seat belt 3 times before you can pull the car out of the driveway.

Obsessive-compulsive disorder in children and teens can leave them feeling stressed, anxious, and overwhelmed. They want to stop the stressful cycle of thoughts and actions but often don’t know how. Or they feel that if they do stop, something bad will happen.

Some children may not even realize that their thoughts and behaviors are out of the ordinary.

How OCD is different from normal habits

Everybody double-checks things from time to time. But OCD thoughts and behaviors aren’t like everyday habits, like worrying about a test or checking to make sure they locked the door.

Here’s what makes them different:

  • Children and teens can’t control these thoughts and behaviors, even when they recognize that they are excessive.
  • These persistent thoughts and behaviors interfere with your child’s schoolwork, extracurricular and social activities, and daily life.
  • Children and teens with OCD will spend at least an hour of their day on these obsessions and compulsions.
  • Children and teens can only find temporary relief from their need for these behaviors and rituals.

It’s a myth that if you have OCD you’re obsessed with washing your hands. Though that is one symptom, not everyone with OCD does that.

OCD doesn’t go away on its own. OCD obsessions and compulsions can change over time. Knowing what to look for can help you get them the help they need.

Obsessions

Common symptoms of obsessions in children to watch out for include:

  • Worry that they or someone they love will get injured, get sick, or die.
  • Fear of germs, contamination, or illness.
  • Forbidden or taboo thoughts of sex, religion, or violence.
  • Aggressive thoughts toward others or self.
  • Needing to have things in a symmetrical or perfect order.

Compulsions

Common symptoms of compulsions in children to watch out for include:

  • Repeated handwashing or spending an unusual amount of time on other personal hygiene.
  • Touching, tapping, or stepping in a certain way.
  • Keeping things very neat or in a certain order.
  • Checking something over and over, like if they locked the door, or that they charged their phone.
  • Counting up to a certain number or in a certain pattern, such as by twos.
  • Repeating words, phrases, or questions silently or out loud.
  • Having trouble making choices and decisions.
  • Taking a long time to finish routine activities, such as doing homework, taking a shower, or eating.

Treatment for OCD

Treatment for OCD in children includes psychotherapy, medications, or both. Cognitive behavioral therapy and antidepressants known as serotonin reuptake inhibitors (SSRIs) are often prescribed as first-line treatment.

Support for OCD

Family support is a huge part of treatment success. If your child has OCD, it’s important to remain patient and understanding as they go through treatment. It will take time for your child to regain control over their thoughts and actions.

Children and teens with OCD often feel embarrassed and ashamed. They often avoid talking about what they are feeling. Seeing a child and adolescent psychiatrist can also help your child gain a better understanding of their OCD.

Sources

Obsessive-Compulsive Disorder in Children. Centers for Disease Control and Prevention. Link.

Obsessive-Compulsive Disorder in Children and Adolescents. American Academy of Child & Adolescent Psychiatry. Link.

Obsessive-Compulsive Disorder. National Institute of Mental Health. Link.

OCD and Tourette Syndrome: Re-examining the Relationship. International OCD Foundation. Link.

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.