Kids with obsessive compulsive disorders have certain thoughts that keep coming into their brain, even when they try to stop them, and do certain things to try to help themselves feel better when they have those thoughts. They might worry about getting sick, think there is something wrong with their body, have to do the same things over and over again, or be scared that something terrible will happen to them or their family. There are two important types of symptoms that kids will have:

Obsessions are unwanted thoughts that kids can’t get out of their heads. These could be certain images, or thinking that they have to do something, or being very worried about something bad happening.

Compulsions are the things kids do to try to manage obsessive thoughts. Some kids might wash their hands over and over because they are worried about germs. Some kids might lock and unlock the door ten times before leaving the house because they are worried about someone breaking in. Some kids might walk a certain way because they think that if they don’t, something bad will happen to them or their parents. Kids usually have a hard time stopping these behaviors, because they think that doing these things will help them feel better or keep something bad from happening, even if that’s not really true.

There are a few different diagnoses in this category. Obsessive compulsive disorder (OCD) is the most common one. Other diagnoses are body dysmorphic disorder (believing that there is something wrong with the way your body looks), hoarding disorder (keeping lots of stuff in your home and not being able to get rid of things or throw them away), trichotillomania (pulling your hair out and not being able to stop), and excoriation disorder (picking at your skin and not being able to stop, even if it hurts you).

These diagnoses can cause problems for kids at home, in school, and in their social lives. If left untreated, kids will have a hard time doing the things they are supposed to do and enjoying life, because they will spend so much of their time dealing with obsessions and compulsions. As a parent, it’s important to think about whether your child’s thinking and actions are normal for their age, and if this causes problems for them. All kids worry about things sometimes, or focus on certain things, or behave in strange ways, or do things over and over again sometimes. But if you notice your child is spending more than an hour a day doing the same types of things over and over again, or if your child seems terrified about thoughts they just can’t get out of their head, or if they are pulling their hair out or picking their skin until they bleed, these could be signs of something more serious.

Obsessions and compulsions are not caused by just one thing – there are a few factors that can mak it more likely that a child will develop this kind of disorder:

Genetics & personality: kids who worry a lot or have a lot of negative emotions (like sadness, hopelessness, and fear) might be more likely to develop these types of disorders. There are also certain things in kids’ brains that can make it more likely for them to develop these symptoms, and we know OCD and similar disorders are more common for kids who have a parent, grandparent, or sibling who also struggles with OCD.

Environment: there are some things that can happen to kids that make it more likely they’ll have OCD or a similar disorder. Kids who are hurt by others or experience something traumatic might start to develop obsessions and compulsions afterwards. If you think your child has experienced something very stressful or traumatic, it’s good to get professional help right away – early intervention can sometimes help protect kids from having these kinds of thoughts and behaviors!

Medical conditions: some kids start to have OCD symptoms after they get sick with something like strep. This is usually called PANDAS or PANS. Scientists don’t always agree on how to think about this diagnosis or the best way to help kids with this type of OCD. This is more rare than other forms of OCD, and you should always talk to your child’s doctor if you think this might apply to your child.

Scientists estimate that between 1% and 3% of kids and teenagers have OCD. These symptoms can start in childhood or adults can experience obsessive compulsive symptoms for the first time once they’re older. About 1% of kids have body dysmorphic disorder, and this gets more common as they get older (teenagers are more likely to have these symptoms compared with younger kids). There’s less research on the other disorders in this category (skin-picking, hair-pulling, and hoarding disorder) but we know that these happen in kids too.

There are a lot of things that you can do to help your child who has obsessive thoughts or compulsive behaviors – and you’re already taking a big step by learning more! Many kids & parents see a lot of improvement with the right support. Here are some treatments that scientists have found to help with obsessive and compulsive difficulties:

COGNITIVE BEHAVIORAL THERAPY

Cognitive Behavioral Therapy (CBT) is usually the best treatment for obsessive and compulsive symptoms – it teaches kids to understand how their thoughts, feelings, and actions are connected and how to make changes in their thoughts to help them feel and act differently.

An important part of CBT for these types of symptoms is exposure & response prevention (ERP). Exposure and response prevention involves working with kids to understand their obsessive thoughts and compulsive behaviors, and teaching them to respond in different ways that are more helpful for them. The first step in ERP is usually creating a list of things that make your child worry or behave in a certain way. You and your child will rank these things from the ones that bother them the least to the ones that make them very upset and scared. Your child’s therapist will usually choose some of the things that don’t bother them as much to start with, and will gently have your child think about these things more or have them do things that make them feel a little bit worried. They will also work with your child to keep them from doing the compulsive behaviors they would usually to do help feel better. This can be hard for kids and parents at first, but it teaches your child that the worry they feel doesn’t last forever, and usually it gets better and they can learn to deal with it. Once your child gets more comfortable with things that are lower on their list, their therapist will start to expose them to things that make them feel more scared, because they will have learned new skills to manage those things. When treatment is successful, your child will learn that they don’t need to use compulsive behaviors to feel better, and they can manage their fear and worry on their own.

FAMILY THERAPY

Family members of kids who have obsessive thoughts and compulsive behaviors can have a hard time knowing how to help them. For a lot of kids, the compulsive behaviors they have cause problems in their daily life, and these symptoms can make life more difficult for their families too. Family therapy helps support caregivers, siblings, and others in the home to support kids with OCD without leaning into their fears. Sometimes it can be tempting for family members to step in and try to help when kids have obsessions or compulsions, or to try to reassure them right away when they feel worried. Sometimes these things are helpful for a time, but they can also get in the way of kids learning their own skills to manage their symptoms. Family therapy helps with these skills and teaches the whole family how to care for themselves and to best support their child with OCD.

MEDICATION

Sometimes kids with obsessions and compulsions can get better with medication. Usually medication helps the most when kids take medication and do therapy at the same time. Medication won’t totally stop your child’s obsessive thoughts or compulsive behaviors, but it helps make them less strong so that your child can work on them in therapy.

Usually doctors recommend medications called SSRI’s (selective serotonin reuptake inhibitors) for OCD. These medications make serotonin (a chemical that sends messages in the brain) more available. Serotonin has a lot to do with how people feel and how they manage their feelings, so having the right level of serotonin in your brain can help you feel your best.