What is it? 

Obsessive-Compulsive Disorder (OCD) is a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviours (compulsions) that they feel the urge to repeat over and over.

What are the symptoms of OCD?

Children with OCD ­have obsessions which are unwanted thoughts that make them worry and become very anxious. To control these anxious thoughts, they develop rules for themselves which can also be described as compulsions. Children can have obsessions, compulsions or both. 

Common obsessions may involve:

• Excessive worrying about germs or dirt 
• Extreme fears about bad things happening like getting sick or dying
• Extreme fears about doing something wrong
• Excessive attention to detail
• Disturbing and unwanted thoughts about violence or self-harm

Common compulsions may involve:

• Excessive checking and rechecking (e.g. checking to make sure that their snack is in their lunchbox) 
• Excessive washing and/or cleaning
• Hoarding
• Repeating actions like counting and recounting a lot
• Preoccupation with organization, symmetry, or accuracy
• Mental compulsions (e.g. excessive reviewing)
• Repeating sounds or words said by oneself or by others
• Excessive reassurance seeking

When is it time to seek professional help? 

OCD usually begins in children before the age of 10. It may be time to seek professional help when obsessions and compulsions become more intense and frequent, affecting the day-to-day functioning of the child.

What can be done? 

There are two main treatments that can help manage and reduce the symptoms of children with OCD. These treatments may also be used with other therapies or medications when concurrent neurodevelopmental challenges contribute to OCD. 

Exposure and Response Prevention (ERP)

ERP is a type of Cognitive Behavioural Therapy (CBT). It helps children with OCD gradually face their fears and worries without turning to their usual compulsive behaviours. The first step in ERP is to help children try to understand OCD using metaphors, age-appropriate resources and play therapy.  

Serotonin Reuptake Inhibitors (SRIs)

SRIs are a type of medication that helps to reduce the severity of OCD symptoms by altering the balance of chemicals in the child’s brain. It is recommended that SRIs be used along with ERP when a child has severe symptoms.

What makes some children more vulnerable to OCD? 

Genetic factors: family history of mental health challenges and brain-based disorders especially if the child has a first-degree relationship with a family member with OCD (e.g. parent, child or sibling). The risk is higher if the first-degree relative developed OCD as a child or teen.

Environmental factors such as adverse childhood experiences or toxic stress during childhood

Brain structure and functioning: Both genetic and environmental risk factors can alter brain chemistry and development. Scientists believe that the brains of children with bipolar disorder grow and develop differently than those of other children.

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage.  

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.