OCD Facts: What Is OCD
What Is OCD?
OCD is an anxiety disorder which, like all anxiety disorders, has a neurobiological basis. This brain illness affects how children (and adults) think. It is characterized by obsessions and compulsions that take up a considerable amount of time (more than 1 hour a day). Obsessions and compulsions create distress in the lives of individuals to the point that they interfere with daily functioning, schoolwork, and/or relationships.
OCD is not something children or adolescents choose to have. When OCD is untreated, young people frequently do not have any control over how it affects them or how they react to it, much as children with untreated asthma cannot control an asthma attack. OCD is not a behavioral choice. Although children sometimes are able to suppress or hide their symptoms at school or substitute mental rituals for overt rituals (e.g., mentally repeating a specific number pattern may take the place of hand washing), suppressing symptoms may come at a great cost. In school, these students may work diligently and expend an enormous amount of energy -- even to the point of becoming extremely fatigued -- just to "keep it together;" so much so, in fact, that school personnel may be surprised to learn that they have OCD. Moreover, once they arrive home after school, they sometimes engage in a frenzy of ritualizing, even having to "make up" rituals that weren't performed at school.
Read the clinical definition of OCD.
OCD appears about equally in boys and girls. While the disorder often appears in adolescence or early adult years, the onset of OCD frequently occurs during childhood. Although uncommon, it has been diagnosed as early as two years of age. Mental health professionals report that, when symptoms begin in childhood, they may appear earlier in boys than in girls. While the onset of OCD in boys is reportedly seen most often between 5 and 8 years of age and girls are somewhat more likely to develop OCD in adolescence, the prevalence tends to equalize during adolescence. Onset also frequently occurs during college years.
How to Recognize the Symptoms of OCD in Children and Teens
OCD is diagnosed when obsessions and compulsions are time consuming, cause significant distress and interfere with daily functioning in school, social activities, family relationships or normal routines.
Neither parents nor children cause the characteristic symptoms of childhood OCD: “bad thoughts” or overwhelming fears, worries and rituals. Inside the brain of a child or teen with OCD, the fears or worries get “stuck” -- so the young person can’t stop thinking about them. They may also experience sensations, feelings or urges that prompt them to perform compulsions.
Some children have likened OCD thoughts to having a monster locked inside their heads. It’s always there, and it’s always active, making bad thoughts happen. Older children and adolescents compare the thoughts or fears with “noise” inside their heads -- a repeating mantra of nagging thoughts that are stronger than outside stimuli. Students with OCD frequently are unable to pay attention in class because their attention is riveted on these obsessive thoughts.
The obsessions, sensations, feelings, and urges associated with OCD may lead to great distress. And although they may be hidden for a time, they may become apparent as the compulsions take more and more time out of the child’s life.
In many cases, the obsessions and compulsions "shift" from one focus to another. In fact, it is the rule, rather than the exception, that obsessions and compulsions change over time. Thus, a child may engage in cleaning rituals but then switch to checking rituals. In addition, many children have multiple obsessions and compulsions at any given point -- they may be washing and checking, for example. Moreover, OCD symptoms can wax and wane over time. In other words, symptoms get worse or better, frequently for no apparent reason.
Because children and teens are in school for such a large amount of time each day, school personnel are in an excellent position to observe behavior and recognize symptoms. This can be an important step in helping the student get the help he or she needs. If the student is already in a treatment program, school personnel play an important role in the student’s recovery process.
Learn more about OCD symptoms.