Obsessive-Compulsive Disorder in Children and Teens

Obsessive-Compulsive Disorder in Children and Teens

Obsessive-compulsive disorder (OCD) often begins in childhood or the teen years. Learn more about this anxiety disorder and how to recognize it.

PJ always liked order. “He had to have everything just so,” his mom said. “All his crayons in a row, his building blocks sorted by color.” But when he was about 12, she started to get worried. “He was constantly washing his hands. And it was harder and harder to wake him up for school. Turned out he was getting up through the night to make sure all the doors and windows were locked.”

PJ has obsessive-compulsive disorder, or OCD. OCD is a serious, long-term anxiety disorder that often starts in childhood or the teen years. OCD is a combination of repeated, unwanted thoughts (obsessions) and repeated, ritual behaviors (compulsions).

  • Common obsessions include fear of harm to self or family, a need to have things lined up or orderly, fear of germs or diseases, fear of losing something valuable and a need for perfection.
  • Common compulsions include hand washing, counting, hoarding, arranging and checking things over and over.

Obsessions are not just worries about normal problems. They are recurrent and intrusive thoughts or images that caused real distress. Compulsions are done to soothe the obsessive thoughts, but the relief is only temporary. Not doing them increases anxiety. A child may throw a tantrum if a ritual is interrupted.

PJ was lucky that his mom noticed and got him diagnosed and treated. Obsessions and compulsions can become some so time-consuming and upsetting that a child may fall behind in school, lose friends and put a strain on the whole family.

What causes OCD?

OCD is a brain disorder caused by an imbalance of brain chemicals. Research has shown that there is a strong link with a chemical called serotonin. Experts aren’t sure what causes this imbalance.

OCD tends to run in families, so it may in part be inherited. OCD is not caused by stress, bad parenting or early experiences. Stress, though, may make symptoms worse.

Studies have found that OCD may start or get worse after a child has strep throat. But this is rare.

Experts estimate that about 3 out of 100 children and teens have OCD. Many children are diagnosed between ages 10 and 12, but it can occur at younger ages. Children with OCD often have other problems, too, such as a tic disorder, depression or another anxiety disorder.

How can a parent spot OCD in a child?

It may be hard to spot the signs of OCD in a child or teen. Young people may not be able to talk about how they feel or explain their actions. They may try to hide their behaviors because they are embarrassed or afraid they seem silly.

If you suspect OCD, look for these clues:

  • Red, chapped hands from repeated washing
  • A sudden increase in towels or soap used
  • More hours spent on homework
  • Holes in tests or homework from repeated erasing
  • A sudden drop in grades
  • Asking family members to repeat phrases or answer the same question
  • Constant fear that something bad will happen to a loved one
  • Extreme distress or tantrum if not allowed to complete a ritual
  • Pulling away from friends, spending more time alone

If you think your child has OCD, talk to your child’s doctor or look for a mental health professional who works with children. OCD can be treated. Treatment can ease the anxiety and help a child live a more normal life.

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