What is it like to experience OCD as a kid?
In this video, kids with OCD talk about different thoughts, compulsions, and rituals that they experience.
This video is courtesy of UNSTUCK: An OCD kids movie.
Obsessive compulsive disorder (OCD) is a mental health condition involving the brain and behavior that often begins during childhood. OCD often causes significant distress in those affected. OCD involves both obsessions and compulsions . that take up a lot of time and get in the way of important activities, such as school, family life, extracurricular activities, developing friendships, and self-care.
Obsessions are intrusive and unwanted thoughts, images, or urges that occur over and over again and feel outside of the child’s control. These obsessions are unpleasant for the child and typically cause a lot of worry, anxiety, and distress.
Common obsessions may include:
- Worrying about germs, getting sick, or dying
- Extreme fears about bad things happening or doing something wrong
- Feeling that things have to be “just right"
- Disturbing and unwanted thoughts or images about hurting others
- Disturbing and unwanted thoughts or images of a sexual nature
Compulsions (also referred to as rituals) are behaviors the child feels he or she “must do” with the intention of getting rid of the upsetting feelings and anxiety caused by the obsessions. A child may also believe that engaging in these compulsions will somehow prevent bad things from happening .
Common compulsions may involve:
- Excessive checking (e.g., re-checking that the door is locked, that the oven is off)
- Excessive washing and/or cleaning
- Repeating actions until they are “just right” or starting things over again
- Ordering or arranging things in a specific way
- Mental compulsions (e.g., excessive praying, mental reviewing)
- Frequent confessing or apologizing
- Saying lucky words or numbers
- Excessive reassurance seeking (e.g., "Are you sure I’m going to be okay?”)
In general, OCD is diagnosed when these obsessions and compulsions become so time-consuming that they negatively interfere with the child’s daily life. In most cases, the obsessions and compulsions become gradually more severe over time until they get to this point.
In rare cases, symptoms may develop seemingly “overnight” with a rapid change in behavior and mood, and sudden appearance of severe anxiety. Sometimes this happens due to an infection, such as strep throat, that causes the child’s immune system to attack the brain instead of the infection. This is called Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). When OCD onsets suddenly and dramatically without any evidence of an immune infection; this is called Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) . Learn more about PANDAS/PANS.
How is OCD different from other childhood routines?
It is common for children to become fascinated with certain things, and to have routines around meals, bedtime, etc. However, OCD is different from these preoccupations and routines. The difference here is that OCD is not something a kid or teen can simply “snap out of.” The obsessions they suffer from and the compulsions they use to try to get rid of their bad feelings are often not easy to control. Compulsions or rituals may become too frequent and/or too intense or upsetting for the child, and may begin to get in the way of their daily life.
It is important to remember that OCD is not a result of something that the child, parent, or others did wrong. There is no “cure” for OCD, but OCD is very treatable – especially with a type of therapy called exposure and response prevention (ERP) and medication. Your child or teen’s future success does not have to be limited by OCD!
-  American Psychiatric Association (2012). Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association. ↩
-  Pittenger, C. (Ed.). (2017). Obsessive-compulsive disorder: phenomenology, pathophysiology, and treatment. Oxford University Press. ↩
-  Murphy, T. K., Patel, P. D., McGuire, J. F., Kennel, A., Mutch, P. J., Parker-Athill, E. C., ... & Dadlani, G. H. (2015). Characterization of the pediatric acute-onset neuropsychiatric syndrome phenotype. Journal of child and adolescent psychopharmacology, 25(1), 14-25. ↩