Specialties & Conditions Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder (OCD)
What is OCD?
Obsessive-compulsive disorder (OCD) is a mental health condition with two main parts: obsessions and compulsions. Obsessions are distressing, unwanted thoughts or images that repeatedly enter a person's mind. Compulsions are actions people do to temporarily relieve the distress caused by these thoughts. OCD can significantly interfere with daily life.
OCD often begins in pre-adolescence or young adulthood. The obsessions cause extreme distress and anxiety, and the compulsions temporarily relieve these feelings but do not provide lasting relief because the unwanted thoughts keep returning. OCD can also affect families, as children may involve parents or siblings in their compulsive behaviors. Since stopping these behaviors can cause anxiety, families might support them to reduce distress.
Common obsessions might include:
- Worrying about germs or health
- Feeling that things have to be perfect or just right
- Images or thoughts about hurting others
- Fears of bad things happening or of doing something wrong
Common compulsions could include:
- Cleaning or washing excessively or in specific ways
- Ordering or arranging things so everything is just right
- Doing things (that may feel odd or silly) over and over
- Specific rituals, routines, or superstitious behaviors before going to bed or leaving the house
- Use of special numbers or words, such as always having to read a paragraph three times or getting up from a seat twice before finally sitting down
- Asking parents or teachers for reassurance excessively
What Causes OCD?
Like many mental disorders, there is no single cause of OCD. Children who develop OCD often have family members with OCD or anxiety disorders, putting them at some risk biologically. Environmental stressors and personality characteristics can also contribute.
What are Signs & Symptoms of OCD?
Every person’s OCD looks different. However, people with OCD will experience both obsessions and compulsions. There are some obsessions and compulsions that are common or shared between people with OCD (see above for examples), though OCD can “latch onto” anything that may really scare or disgust a person.
Other signs may include:
- Involvement of family members in rituals
- Asking the same questions over and over again
- Sensory sensitivity
- Avoidance of specific situations
How is OCD Diagnosed?
OCD is diagnosed through meeting with a mental health provider (for example, a psychiatrist, psychologist, social worker, or other therapist) and answering questions about symptoms, behaviors, and the impact those have on someone’s life.
It is often helpful for mental health providers to use written questionnaires to help with diagnosis. For example, the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) is a common tool used to help understand symptoms and severity in OCD.
How is OCD Treated?
There isn't a cure for OCD, but treatments can help children and families cope better with intrusive thoughts and behaviors. OCD is usually treated with a combination of cognitive behavioral therapy (CBT) and medication. For milder cases, CBT alone may be enough. Research shows that medication alone typically isn't enough to fully improve OCD in children, but it can be very helpful when combined with CBT.
Medications
Common medications for OCD include selective serotonin reuptake inhibitors (SSRIs) like Prozac or Zoloft, which are also used to treat depression and anxiety. Higher doses of these medications are often needed for OCD. Sometimes, an additional medication, such as an atypical antipsychotic like Abilify, may be used alongside an SSRI.
Therapy
The specific type of CBT designed for OCD is called exposure and response prevention (ERP). In ERP, patients learn about the OCD cycle and how compulsions only temporarily relieve distressing thoughts. They are gradually exposed to their fears and taught to resist compulsions, helping their brains learn to cope without them. The goal is to improve symptoms so that daily activities like eating, using the bathroom, showering, going to school, and being around others can be done without significant issues.
What are the Long-Term Effects of OCD?
OCD can be effectively treated with the methods mentioned, and the consequences are much worse if it is left untreated. Compulsions can take up more and more time and affect school attendance and performance, daily activities, family and social relationships, and even family finances if they require specific objects or cleaners.
Additionally, untreated OCD can cause distress that puts young people at risk for other mental health issues like depression, suicidal thoughts, and self-harm.
Make an Appointment
If you are looking for care related to OCD, call 1.800.543.7362 (1.800.KIDS DOC®) and ask for Psychiatry. Be sure to mention that you have concerns about OCD when you are completing the diagnostic screening over the phone.
Resources & Support
Refer to the following recommended resources for more information on OCD.
- The International OCD Foundation
- Learn more about OCD, find out how you can attend national meetings and workshops for people and families with lived experience with OCD, and find providers in your area.
- Books and media for parents, kids, and families
- What to do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCD by Dawn Huebner, Ph.D.
- Freeing your Child from Obsessive-Compulsive Disorder by Tamar E Chansky, Ph.D.
- Breaking Free of Child Anxiety and OCD by Eli R. Lebowitz, Ph.D. (Supportive Parenting for Anxious Childhood Emotions workbook)
- UNSTUCK: An OCD Kids Movie