What it is:
Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder that can emerge at any age in childhood, but tends to emerge in kids starting around ages 8 to 12. Kids with OCD become stuck in a cycle of obsessions and compulsions that cause a lot of distress for children and their families and can cause significant problems at home, at school, and with friends.
Obsessions are repeated and unwanted intrusive thoughts, images, or urges that cause intensely distressing feelings in kids (e.g., anxiety, fear, panic, anger/irritability). In childhood, common obsessions include worrying about contamination or germs, worrying about the safety of family or parents, worrying about hurting or offending others, or worrying about things not being perfect.
Compulsions are actions, rituals, or routines that are meant to reduce the distress caused by obsessions. In childhood, common compulsions include excessive washing or sanitizing, confessing or apologizing for mistakes, rewriting or repeating phrases, and touching or rearranging objects. While all kids have routines and quirks, compulsions are often repeated, excessive, and time-consuming, cause children a lot of distress if they can’t be completed in an exact or specific way, and interfere with the ability for children to function and live the life they want. In addition, kids with OCD will often ask parents to participate in routines, help with handwashing or cleaning, repeat certain words or phrases, or provide a lot of reassurance. For parents, not participating in these routines or rituals can lead to big escalations in anxiety or outbursts, often causing the entire family to feel stuck in the OCD cycle.
Does This Sound Familiar?
- My child gets stuck in loops, where they need to do something over and over again until they can get it exactly right.
- My child worries that “something bad” will happen to their family if they don’t perform an action, routine, or ritual.
- My child’s routines or rituals interfere with their ability to succeed at school, socialize with friends, or function at home.
- My child gets extremely anxious, distressed, or angry when I don’t participate in their routines or rituals.
- My child washes their hands to the point of redness, rawness, or dry cracking skin.
- My child needs a lot of reassurance that they are a “good” kid or that they haven’t done anything “bad.”
- My child has a particular bedtime routine which needs to be completed in the exact same way and order; otherwise, my child will restart or ask me to restart the routine (common bedtime rituals include: saying prayers in a certain way, saying goodnight or “I love you” in a certain way, pointing stuffed animals in a certain direction).
Associated Concerns:
Anxiety: Children with OCD often experience other forms of anxiety and stress, including social anxiety, generalized anxiety, panic, and specific phobias. Our OCD experts are well-equipped to treat kids with multiple forms of anxiety and understand how to teach principles and skills that target the underlying drivers of multiple forms of anxiety.
Depression: OCD can get in the way of a child's ability to engage in various activities that produce meaning and joy, including going to school, eating, sleeping, spending time with friends, and physical activity. When OCD becomes life-interfering, it often leads to depression as kids feel a loss of control.
Shame/Perfectionism: While perfectionism can be viewed as a subtype of OCD, many children with OCD can be more sensitive to easily feeling guilt and shame. This may show up as being quick to get down on themselves, easily feel others are angry and upset with them, blame themselves too harshly, and hold themselves to unreasonably high standards. This can contribute to anxiety, depression, eating concerns, and self-harm/suicidality.
Autism, ADHD: and Neurodivergence: Research suggests neurodivergent children experience higher rates of OCD. For those kids with subtler presentations of neurodivergence, often OCD may present first or be more obvious. When OCD presents alongside sensory sensitivities, broader rigidity in thinking and behavior, social challenges, and/or attention issues, assessment for neurodivergence can be very helpful.
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