OCD Children Live in a World Apart

Welcome to a five-part series on children and obsessive-compulsive disorder. Learn how common this debilitating disorder is, what the causes may be, why children aren't getting the help they need and what you can do to help. Part one explores the basics of the condition.

It's torture...

With every step that needs to be counted over and over and over.

With every light switch that needs to be checked and checked and checked.

With every speck of dirt that needs to be scrubbed off again and again and again.

Life is excruciating for people with obsessive-compulsive disorder (OCD), particularly children. With OCD, the mind becomes a broken record, hiccupping on the same thought. For a child, it can bring shame and depression and ruin their lives when not treated early.

"The big danger of not catching it is that kids lose a great deal of their energy fighting the disorder and then they start falling behind in school and their relationships suffer," says Susan E. Swedo, M.D., chief of the Pediatric and Developmental Neuropsychiatry Branch of the National Institute of Mental Health.

"Our studies show that kids get depressed after the onset because it's very demoralizing," she says.

If the disorder goes on for too long, kids may slide into a downward spiral of drug abuse and other serious problems.

OCD is a chronic, often debilitating mental disorder, causing intensely recurrent, unwanted thoughts (obsessions) usually coupled with uncontrollable, repetitive behaviors (compulsions). Typical behaviors include hand washing, counting, checking, hoarding or cleaning. They are performed with the hope of preventing obsessive thoughts or of making them go away. However, these rituals provide only temporary relief and not doing them only increases anxiety. Sometimes OCD can co-exist with motor tics or Tourette's syndrome.

"OCD is pretty common in kids," Swedo says. "One in every 200 children and teens has OCD. OCD is one of the few psychiatric disorders that we actually know how many kids have it."

Left untreated, obsessions and the need to carry out rituals can consume a life.

"Some people become hidden in their homes. They might become pack rats and hoard newspapers," says Mark Wellek, M.D., describing a worse case scenario. Wellek, past president of the American Society for Adolescent Psychiatry, adds, "That could be an end result if not treated."

Often, OCD begins in childhood and adolescence. Some experts estimate that more than half of adult OCD sufferers had symptoms before they were 15. About 1 million children and teens deal with OCD every day. In comparison, 1.6 million children and teens cope with Attention-Deficit/Hyperactivity Disorder, which also is a troublesome neurological disorder.

At least 3 million Americans have OCD today. And many experts estimate that the severity of their symptoms may have been lessened if the OCD was caught earlier in life, says David Fassler, M.D., a child and adolescent psychiatrist and clinical associate professor of psychiatry at the University of Vermont College of Medicine and a spokesman for the American Psychiatric Association.

"Many people don't get treatment as children because it isn't always recognized as a disorder. People might assume that it's just a personality quirk," Fassler says.

Fassler notes that many who were diagnosed as adults probably first experienced problems as children.

"The good news is that we can help most children who suffer from OCD and other anxiety disorders," he says. "But treatment is most effective when it begins early and is individualized to the needs of the child and family."

The next article in this five-part series discusses the causes of childhood-onset OCD.

Sources:

Centers for Disease Control and Prevention

The American Society for Adolescent Psychiatry

Anxiety Disorders Association of America

The National Institute of Mental Health

The National Alliance for the Mentally Ill

The American Academy of Child and Adolescent Psychiatry

The American Academy of Pediatrics

The American Academy of Family Physicians

The Obsessive Compulsive Foundation

The Madison Institute of Medicine

This article was reviewed and updated June 2007.