OCD in Children

According to the dictionary, obsessive-compulsive disorder, or OCD, is “a psychoneurotic disorder in which the patient is troubled with obsessions or compulsions or both and suffers extreme anxiety or depression through failure to control the obsessive thoughts or to stop performing the compelling acts.” This disorder is seen in as many as one in two hundred children. Studies have shown that OCD is a brain disorder that tends to run in families. This does not mean, however, that if a parent suffers from OCD, that the child definitely will. Children that have no family history sometimes suffer from the disorder as well which points to environmental influence playing a strong role. Recent studies have also demonstrated that OCD may either begin or worsen after a streptococcal bacterial infection.

OCD is characterized by intense obsessions and/or compulsions that occur often enough to interfere in daily life. An obsession is a recurrent and persistent thought, impulse, or mental image that is completely unwanted and causes tremendous anxiety or distress and are often unrealistic and irrational. A compulsion is a repetitive behavior or a ritual like excessive hand washing, hoarding, or checking something over and over. In OCD, these obsessions and compulsions cause significant anxiety to the child and drastically interfere with their daily routine.

The obsessive thoughts will often vary according to the age of the child. A younger child may begin to have persistent thoughts or fears that harm will come to himself or a family member, for example, by an intruder who manages to enter the home through an unlocked door or window. The obsession will cause the child to compulsively check the locks on doors and windows after his parents are asleep. They may fear that they accidentally unlocked a door or window when they were checking the locks and feel the need to check them all repeatedly. An older child may become fearful of becoming ill with germs or contaminated food.

To combat these fears, the child may develop certain rituals. The fear and the compulsion may become linked as in “I fear [this] will happen if I stop checking or hand washing so I can’t stop even though it doesn’t make any sense.” Children that suffer from Obsessive Compulsive Disorder often feel shame and embarrassment or worry that it means that they are crazy. They may be hesitant to talk about how they are feeling or their behavior. Good communication between the parents and child will help them understand the problem as well as gain support.

OCD is a sort of “overactive alarm system.” The anxiety the child feels is so strong that he feels that he has no choice but to perform the task or dwell on that thought, over and over, no matter what the effect on their daily life is. Most children who suffer from OCD do realize that they don’t actually HAVE to keep repeating the action or thought but the anxiety becomes so great that they can’t help themselves. The anxiety is often decreased by the action, but only temporarily. Long term, the rituals only worsen the Obsessive Compulsive Disorder and make the obsessions more likely to return.