What is it?

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. Children may have an obsessive-compulsive disorder (OCD) when unwanted thoughts, and the behaviors they feel they must do because of the thoughts, happen frequently, take up a lot of time (more than an hour a day), interfere with their activities, or make them very upset. The thoughts are called obsessions. The behaviors are called compulsions.

What causes OCD in children?

We do not know what causes obsessive compulsive disorder (OCD).

We do know that it is common for children to develop OCD if family members have a history of anxiety or if children have been through a stressful or traumatic event.

In some rare instances, children develop OCD symptoms after a streptococcal infection (a bacteria that can cause throat infections).

If your child develops OCD, remember it is not your child’s fault, and it is not your fault.

What are the symptoms of OCD in a child?

Having OCD means having obsessions, compulsions, or both.

Examples of obsessive or compulsive behaviors include:

• Having unwanted thoughts, impulses, or images that occur over and over and which cause anxiety or distress.
• Having to think about or say something over and over (for example, counting, or repeating words over and over silently or out loud)
• Having to do something over and over (for example, handwashing, placing things in a specific order, or checking the same things over and over, like whether a door is locked)
• Having to do something over and over according to certain rules that must be followed exactly in order to make an obsession go away.
• Fear of contamination or dirt.
• Doubting and having difficulty tolerating uncertainty.
• Needing things orderly and symmetrical.
• Aggressive or horrific thoughts about losing control and harming yourself or others.
• Unwanted thoughts, including aggression.

Children do these behaviors because they have the feeling that the behaviors will prevent bad things from happening or will make them feel better. However, the behavior is not typically connected to actual danger of something bad happening, or the behavior is extreme, such as washing hands multiple times per hour.

Key points about OCD in children

• OCD is a type of mental health problem. A child with OCD has compulsions or obsessions that become all encompassing in their lives.
• The cause of OCD is unknown but can be linked to having family members who suffer from anxiety or depression.
• Symptoms of OCD are unwanted thoughts, aggression, need for order and repeating actions or words. It can lead to other anxieties or illnesses.
• A child can develop OCD at any age.
• A mental health evaluation is needed to diagnose the cause of OCD.
• Treatment includes behavior therapy and medicines.