Obsessive-Compulsive Disorder

All kids have worries and doubts. But kids with obsessive-compulsive disorder (OCD) often can't stop worrying, no matter how much they want to. And those worries frequently compel them to behave in certain ways over and over again.

About OCD

OCD is a type of anxiety disorder. Kids with OCD become preoccupied with whether something could be harmful, dangerous, wrong, or dirty — or with thoughts about bad stuff that might happen. With OCD, upsetting or scary thoughts or images, called obsessions, pop into a person's mind and are hard to shake. Kids with OCD may also worry about things being out of "order" or not "just right." They may worry about losing "useless" items, sometimes feeling the need to collect these items.

Someone with OCD feels strong urges to do certain things repeatedly — called rituals or compulsions — in order to banish the scary thoughts, ward off something dreaded, or make extra sure that things are safe or clean or right. Children may have a difficult time explaining a reason for their rituals and say they do them "just because." But in general, by doing a ritual, someone with OCD is trying to feel absolutely certain that something bad won't happen.

Think of OCD as an "overactive alarm system." The rise in anxiety or worry is so strong that a child feels like he or she must perform the task or dwell on the thought, over and over again, to the point where it interferes with everyday life. Most kids with OCD realize that they really don't have to repeat the behaviors over and over again, but the anxiety can be so great that they feel that repetition is "required" to neutralize the uncomfortable feeling. And often the behavior does decrease the anxiety- but only temporarily. In the long run, the rituals only worsen OCD severity and prompt the obsessions to return.

Doctors and scientists don't know exactly what causes OCD, although recent research has led to a better understanding of OCD and its potential causes. Experts believe OCD is related to levels of a normal chemical in the brain called serotonin. When the proper flow of serotonin is blocked, the brain's "alarm system" overreacts and misinterprets information. Danger messages are mistakenly triggered like "false alarms." Instead of the brain filtering out these unnecessary thoughts, the mind dwells on them — and the person experiences unrealistic fear and doubt.

Genetic Link

Evidence is strong that OCD tends to run in families. Many people with OCD have one or more family members who also have it or other anxiety disorders influenced by the brain's serotonin levels. Because of this, scientists have come to believe that the tendency (or predisposition) for someone to develop the serotonin imbalance that causes OCD can be inherited through a person's genes.

Having the genetic tendency for OCD doesn't mean people will develop OCD, but it means there is a stronger chance they might. An imbalance of serotonin levels can also result in other types of anxiety or depression.

An estimated 1% of children in the United States experience OCD, which is characterized by a pattern of rituals and obsessive thinking that generally lasts more than an hour each day, causes a child distress, or interferes with daily activities. It's more prevalent than many other childhood disorders or illnesses, but kids often keep the symptoms hidden from their families, friends, and teachers because they're embarrassed by them.