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 some children, the thoughts and the urges to perform certain actions persist, even if they try to ignore them or make them go away.
For example, some children might worry if they don’t wear certain clothes, eat certain food, or even sit at the exact spot in the car or in the classroom… These thoughts are called obsessions.
The repetitive behaviors (like hand washing, keeping things in order, checking something over and over) or mental acts (like counting, repeating words silently, avoiding….) are called compulsions.
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.
Having OCD means having obsessions, compulsions, or both. Examples of obsessive or compulsive behaviors include:
A common myth is that OCD means being really neat and orderly. Sometimes, OCD behaviors may involve cleaning, but many times someone with OCD is too focused on one thing that must be done over and over, rather than on being organized. Obsessions and compulsions can also change over time.
The first step is to talk with a healthcare provider to arrange an evaluation. A comprehensive evaluation by a mental health professional will determine if the anxiety or distress involves memories of a traumatic event that actually happened, or if the fears are based on other thoughts or beliefs.
The mental health professional should also determine whether someone with OCD has a current or past tic disorder. Anxiety or depression and disruptive behaviors may also occur with OCD.
Treatments can include behavior therapy. Behavior therapy, specifically Cognitive-Behavioral Therapy (CBT), helps the child change negative thoughts into more positive, effective ways of thinking, leading to more effective behavior.
Behavior therapy for OCD can involve gradually exposing children to their fears in a safe setting; this helps them learn that bad things do not really occur when they don’t do the behavior, which eventually decreases their anxiety.
Behavior therapy alone can be effective, but some children and adolescents are treated with a combination of behavior therapy and medication.
Families and schools can help children manage stress by being part of the therapy process and learning how to respond supportively without accidentally making obsessions or compulsions more likely to happen again.