Obsessive-Compulsive Disorder (OCD) is a mental health condition that affects people of every age. Those who develop it young may have heard that it will get easier and may even go away completely when they get older. But is there any truth to this claim?

Identifying OCD in Children

Between 0.25% and 4% of children will develop OCD.^[1] The average onset is around ten years old, although children can be any age when they receive a diagnosis. The obsessions and compulsions of children with OCD are vastly different from what adults experience. For example, common childhood obsessions can include:

• Disturbing, intrusive thoughts
• Worrying about bad things happening or doing something wrong
• Worrying about getting sick
• Needing things to be exactly right

Compulsions are often related to obsessions, and in children can include:

• Elaborate routines that must be repeated every night
• Repeatedly checking things, such as confirming that homework is done, the lights are off, and the doors are locked
• Repeating words to themselves
• Excessively showering or brushing their teeth

The symptoms of OCD are hard for children to deal with. Their rituals may give them some relief, but they take up a lot of time and energy, and children can struggle to focus on or enjoy anything else. They may struggle with anxiety, frustration, and sadness and need constant reassurance from others that they are okay.

Children may also try to keep their obsessions, compulsions, and emotions from their parents out of fear, confusion, or shame. They might have had their symptoms for a while before their parents notice it.

The Causes of OCD

There is no exact cause of OCD, although researchers think that there are multiple factors that may play a role:

• Trauma – some studies have uncovered a link between early childhood trauma and symptoms of OCD.^[2]
• Genetics – there is evidence that certain genes may signal greater vulnerability to OCD. OCD also runs in families, and having a close family member with the condition can raise a child’s risk of developing it.
• Brain differences – it has been found that those with OCD have differences in the frontal cortex and other areas of the brain.^[3]
• Stress – stress from home, school, and illness may trigger symptoms of OCD in children.

There is also sudden onset OC, which is known as PANDAS. This is triggered by an infection that attacks the child’s basal ganglia, the part of the brain that affects thoughts, feelings, and movement. This  rare illness can be treated effectively with medication, although some of the symptoms of OCD may linger.

Does OCD go Away?

In a word, no. Childhood OCD will not go away on its own, although symptoms may improve with treatment and age. Symptoms may even worsen in times of high stress for the child, such as a divorce or when taking exams, but ongoing treatment and learning healthy ways to manage the disorder can reduce this risk.

Early intervention is also essential to managing childhood OCD. The earlier OCD is caught and diagnosed, the better the child will respond to treatment, and the risk of OCD worsening is reduced.

There are several ways to treat OCD:

• Cognitive-Behavioral Therapy (CBT) – OCD in children is often treated by a form of CBT called Exposure and Response Prevention (ERP). This exposes children to their anxieties, such as germs, and prevents them from using their usual rituals to ease their anxiety. This shows children that there is nothing to fear from their anxieties. The involvement of parents in this form of therapy is a strong indicator of success.^[4]
• Medication – severe OCD can be alleviated by medicines called Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs can help reduce anxiety but are used cautiously, especially in young children.
• Family Therapy – parents play a vital role in helping their child combat mental health conditions such as OCD. Family therapy can help educate the entire family on how best to work together to make life easier for the child with OCD.

Parenting a child with OCD can be challenging, but with education and treatment, it is possible for children with this condition to live happy lives.

Co-Occurring Disorders

OCD can sometimes be mistaken for several other disorders. It can also co-exist with them, making an accurate diagnosis more difficult. These disorders include:

• Anxiety, such as social anxiety and generalized anxiety
• Attention Deficit/Hyperactivity Disorder (ADHD)
• Autism

If you are unsure whether your child has received the right diagnosis, contact their healthcare provider for a second opinion. They may be struggling with another condition besides OCD or have another condition co-occurring with it that requires separate treatment.

Coping With OCD: Parents and Children

When learning to manage childhood OCD, it can be a long road for both the child and the parent. However, there are effective ways to cope:

• Talk about it – as a parent, you do not have to deal with childhood OCD alone. Involving other family members can build a strong support network for you and your child.
• Find support – community pages that share tips and stories about parenting children with OCD can be great sources of support and information.
• Get involved – being involved with all aspects of your child’s therapy can greatly enhance the success rate of treatment. Your child will feel supported and know that you understand more about how they are feeling.
• Be patient – treating and managing OCD is a long process, so be patient with both yourself and your child. This might get difficult for both of you, so include plans that will help you to relax and unwind.
• Be supportive – try to attend all of your child’s therapy appointments and praise their effort to overcome their compulsions. If they ever slip up, don’t get angry – encourage them to try new techniques that they learned in therapy and remind them not to give up.
• Get some exercise – there is a growing body of evidence suggesting that exercise can help to reduce the intensity and frequency of symptoms. Find an activity that you and your child can do together, such as dance classes or walking, or find something that they might be able to do alone.
• Brush up on relaxation techniques – stress and worry can trigger OCD symptoms to come back or intensify. Learning to relax and manage stress can help reduce this risk, so try breathing techniques or meditations with your child.

However, simply coping with OCD may not be enough. Do not hesitate to reach out for professional help for both you and your child.  Treatment for OCD can reduce the symptoms and increase your child’s mental resilience.

Conclusion

Although childhood OCD will not disappear completely, it can improve with early intervention and management. Exposure and Response Prevention (ERP) Therapy is a key tool that helps children see that nothing bad will happen if they do not complete their intricate rituals. Professionals can also prescribe medication as necessary to help children manage symptoms of anxiety that often come hand-in-hand with OCD.

If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates – call 800-335-0316 or email info@heatherhayes.com today.

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Sources:

^[1] Krebs G, Heyman I. Obsessive-compulsive disorder in children and adolescents. Arch Dis Child. 2015;100(5):495-9. doi:10.1136/archdischild-2014-306934

^[2] Barzilay R, Patrick A, Calkins ME, Moore TM, Gur RC, Gur RE. Association between early‐life trauma and obsessive compulsive symptoms in community youth. Depress Anxiety. 2019;36(7):586-595. doi:10.1002/da.22907

^[3] Sinopoli VM, Burton CL, Kronenberg S, Arnold PD. A review of the role of serotonin system genes in obsessive-compulsive disorder. Neurosci Biobehav Rev. 2017;80:372‐381. doi:10.1016/j.neubiorev.2017.05.029

^[4] Walczak M, Esbjorn BH, Breinholst S, Reinholdt-Dunne ML. Parental involvement in cognitive behavior therapy for children with anxiety disorders: 3-year follow up. Child Psychiatry Hum Dev. 2017;45(3):444-454. doi:10.1007/s10578-016-0671-2