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Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is an anxiety disorder consisting of recurring and unwanted obsessive thoughts and/or repetitive and compulsive actions and behaviours.

OCD can vary in its severity and impact and can sometimes result in very high levels of anxiety and distress. OCD can also take up a considerable amount of time and attention for both the sufferer and their family and friends.

We all have anxious thoughts and they can influence our behaviour in a helpful way. For example, the thought: “Did I leave the front door open?” might lead us to go back and check, and prevent the house from being burgled.

It’s also normal to have certain routines, for example, a bedtime routine consisting of having a bath, reading a book, and ending with a milky drink.

However, if these thoughts and behaviours become obsessive (recurring), they can lead someone to engage in unhelpful behaviours (for example, repeatedly checking the door), which can interfere with their daily functioning, such as frequently being late for work or school.

OCD is when a person carries out compulsions to reduce their anxiety and obsessive thoughts, as this reinforces their belief that their worrying thoughts might be true. They never get the opportunity to learn that their anxiety will gradually go away without performing their compulsions.

Some of the most common signs to look out for are:

  • Particular and repetitive behaviours (for example, tidying a room in a certain way or recurrent lining up of certain items)
  • Repetitive hand washing
  • Prolonged showering/bathing
  • Excessive worry about handwriting and/or neatness of handwriting
  • Excessive worry about possible harm coming to loved ones
  • Repeated checking of things (for example, door locks, windows, taps, gas hobs)
  • Repeated counting and distress when interrupted
  • Excessive worry about illness or disease
  • Hoarding items and/or refusing to discard seemingly useless items
  • Gain an understanding of what maintains the OCD. What are the obsessive thoughts and what does your child or young person do to reduce their anxiety?
  • Encourage them to keep a thought and behaviour diary. This is a useful way of identifying how thoughts and beliefs are triggering and fuelling their OCD and can help spot thinking errors; are they overestimating the chances of something bad happening or assuming that they can’t cope with it?
  • Challenge the negative thoughts and beliefs that keep the child or young person’s OCD going. This can be achieved by asking ‘What is the evidence for and against the anxious thoughts? ‘Are the thoughts realistic? Is there another way of looking at this?
  • Help to replace negative thoughts with more realistic/alternative thoughts. It’s helpful to write a child or young person’s realistic thoughts and use this list to support them when they’re feeling anxious
  • Encourage them to face their fears without giving in to their compulsions. This will provide them with evidence that their fears won’t come true and they’ll learn to cope with the uncomfortable feelings of anxiety. It's best to start with the least anxiety-provoking first
  • Try not to reassure your child or young person about their worries; educate your family about how reassurance keeps OCD going and won’t aid the recovery process
  • Introduce daily calming routines or relaxation (reading, exercise, listening to music) as OCD symptoms tend to increase when young people are under stress
  • Support your child or young person to think of options and try not to solve problems for them when they arise
  • Praise your child or young person for their efforts and encourage them to praise themselves

Many children and young people with OCD can feel embarrassed and ashamed of their thoughts and behaviours. Some might not even know that what they’re experiencing is OCD. This can make it really hard for them to talk to other people about how they feel and ask for help.

When children and young people do manage to talk about how they feel, they often feel much better.

If you’ve tried to support the child or young person by using the techniques on this page and they’re still having difficulties, there’s lots of support available in your area. You can find information about what your local area offers in the ‘Local Offer.

If the symptoms of OCD are interfering significantly with their day to day life and/or you are concerned that they may be at risk of harm, for example by not eating or by harming themselves, talk to your GP or another health professional about what other support is available or refer your child into our services.

You can find additional support online by visiting:

Books that might help include:

  • Talking back to OCD, John March & Christine Benton, 2007.
  • Cognitive Behaviour Therapy with Children & Young People edited by Polly Waite & Tim Williams, 2009.
  • Free From OCD: A Workbook for Teens with Obsessive-Compulsive Disorder Timothy Sisemore, 2010.
  • Touch and Go Joe: An Adolescent’s Experience of OCD Joe Wells, March 2006
  • Breaking Free from OCD: A CBT guide for Young People and Their Families Jo Derisley, Isobel Heyman, Sarah Robinson & Cynthia Turner, May 2008.