How OCD Affects Social Interaction

Attending school presents students with opportunities to develop not only academic skills, but also social skills.  School is a critical testing ground for social interaction capabilities that will follow a student throughout life.  For a child or adolescent who has OCD, social development is often negatively impacted because OCD symptoms present special barriers:

• A student who demonstrates compulsive behavior may be perceived as “different” or may be ridiculed and labeled as “crazy,” thereby causing embarrassment or increased stress (which can make OCD symptoms worse).
• Students who hide compulsions such as counting or praying may become agitated if interrupted during their rituals.  This agitation can result in a harsh exchange of words between students or even verbal outbursts.  It can also lead to negative labeling by peers.
• The stigma of mental illness can weigh heavily on a student who is the subject of gossip, name-calling or whispering campaigns.
• Depression is a real danger for students with OCD who may become withdrawn, feeling isolated from classmates.
• A student who has OCD may withdraw from other students who were previously friends as a way to avoid having to explain unusual behavior.  Or the child may not have enough time to interact with friends and family because obsessions and compulsions consume so much time.
• Students with OCD may believe they are the only ones on the entire planet who could possibly be experiencing such weird thoughts and the need to repeat certain actions.  They may actually believe they have gone “crazy.”
• Some students with OCD engage in compulsions that offend or bother other students, or are considered “odd.”  These actions can cause classmates to dislike the child with OCD and, depending on the students involved, can lead to bullying, shunning and even outbursts of shouting.  
• Academic failure due to OCD can cause a student to be labeled as “stupid” or “dumb,” which can affect friendships, sometimes causing friends to “drop” the student from their social set.
• Peer pressure to “fit in” may make life difficult for a student who has OCD.  Even one who successfully hides compulsions may have a very hard time fitting in, and the fear of failure can cause stress that aggravates symptoms.
• Students with OCD often spend less time participating in social activities because:
  • They may be trying to avoid contamination.  Fears of being contaminated by others, for example, may prevent them from participating in contact sports.
  • They fear that participating in extracurricular activities will cut into the time they believe is needed for their rituals.
  • They spend an extensive amount of time ritualizing outside of school and, therefore, have little, if any, time for friends, family or social activities.  This time may be devoured by performing rituals routinely carried out at home and possibly rituals they were unable to perform in school.  In addition, homework may consume a huge amount of time due to OCD symptoms.
  • They may be physically and mentally exhausted by their obsessions and compulsions and they are simply too fatigued to participate in social activities.
  • They know their OCD rituals may look peculiar to others, so they sometimes prefer to retreat from peers rather than risk social rejection, humiliation, or even bullying.

Social Skills Impaired by OCD

During their school years, children and adolescents typically build social competencies such as making and keeping friends and selecting friends based on shared interests and compatibility.  Students battling OCD, however, may fail at growing these skills because the OCD distracts them and they focus primarily on their intrusive thoughts, fears and worries.  They may also focus on their sadness, acutely aware that they are “different” and without friends.

In many cases, they are struggling not only with OCD but also other coexisting conditions which may affect their proficiency with social skills.  They may have difficulties with:

• Recognizing how others feel, uncertainty regarding how to respond to others or a frustrating inability to respond to them in any appropriate way
• Expressing their own feelings or choosing appropriate language to express themselves
• Generating ideas and/or using creative problem-solving techniques
• Figuring out how others will react to what they say or do
• Being flexible and reacting appropriately to situational changes
• Reigning in impulsivity
• Acting appropriately assertive, or being too aggressive for the situation
• Building friendships that last
• Feeling comfortable in the context of peers, teachers, and others.  They may fear embarrassment in social situations (e.g., social phobia), worry about symptoms that are evident to others (e.g., tics in Tourette Syndrome), fear humiliation because of a perceived or real imperfection in their appearance (e.g., Body Dysmorphic Disorder, skin picking, nail biting, Trichotillomania), etc.

Surviving Peer Pressure

If the onset of OCD is in the “tween” or teen years, it can be particularly difficult for the student.  Adolescence is a time when peer pressure is undoubtedly at its height and puberty is capable of wreaking havoc on tender emotions -- even in completely healthy students.

Educators who recognize the particular vulnerability of the student with OCD during these years can make a significant difference in how the student reacts to the onslaught of peer pressure.  The first step is recognizing OCD symptoms when they appear in school.  After that, helping the student learn and execute strategies to manage his or her OCD is essential. 

Bullying and Students with OCD

Bullying has become an increasingly disturbing concern in our schools.  School personnel must be particularly attentive to ensure that a student with OCD is not the target of bullies.  Anecdotal records have indicated that students with OCD may be at higher risk for bullying than “normal” students, for several reasons.  First, when OCD rituals are obvious to others, they may make the student with OCD look different, if not “strange.”   Second, because children and adolescents with OCD often have a reduced network of friends, they may not have the physical and emotional support necessary to ward off bullying.  Third, students with OCD frequently have coexisting conditions that may pose social difficulties over and above those associated with OCD.  When a child with OCD also has Tourette Syndrome, for example, there is an increased risk for being teased and bullied because of the tics.

A research study conducted on peer victimization among students with OCD supports bullying concerns.  Researchers found that, of a group of 8-17 year old students with OCD, one quarter were found to be experiencing peer victimization significantly more than “normal” peers and even more than peers with Type I diabetes.  Because children with Type l diabetes may have different eating habits, (e.g., they can't eat candy, sweets) and sometimes need injections or special medication, they may appear different from other children, possibly increasing the potential for teasing.  In this study, it was also found that more severe OCD symptoms led to more victimization, leading to higher levels of depression, loneliness, and externalizing problems among students with OCD.

This information underscores the importance of school personnel being attentive to peer teasing and bullying in children and adolescents with OCD.

Learn more about how to manage OCD in a classroom setting.

Learn more about social development support for children who have OCD.

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