Obsessive - Compulsive Disorder 

People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. OCD is often a chronic, relapsing illness. Fortunately, through research supported by the National Institute of Mental Health (NIMH) and by industry, effective treatments have been developed to help people with OCD.

How Common Is OCD?

• About 2.3% of the U.S. population ages 18 to 54 - approximately 3.3 million Americans - has OCD in a given year.
• OCD affects men and women equally.
• OCD typically begins during adolescence or early childhood; at least one-third of the cases of adult OCD began in childhood.
• OCD cost the U.S. $8.4 billion in 1990 in social and economic losses, nearly 6% of the total mental health bill of $148 billion.

What Causes OCD?

There is growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. OCD is not caused by family problems or attitudes learned in childhood, such as an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the striatum. This is graphic evidence that both psychotherapy and medication affect the brain.

What Treatments Are Available for OCD?

Treatments for OCD have been developed through research supported by the NIMH and other research institutions. These treatments, which combine medications and behavioral therapy (a specific type of psychotherapy), are often effective. Several medications have been proven effective in helping people with OCD: clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine. If one drug is not effective, others should be tried. A number of other medications are currently being studied. A type of behavioral therapy known as "exposure and response prevention" is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts, and then is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety.

For a complete discussion on the treatment of OCD in kids and teens, please go to Summary of the  Practice Parameters for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder by the American Academy of Child and Adolescent Psychiatry.

Can People With OCD Also Have Other Illnesses?

OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit hyperactivity disorder, or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat. Symptoms of OCD can also coexist and may even be part of a spectrum of other brain disorders, such as Tourette's syndrome. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD.  Compulsive hair pulling is known as trichotillomania.  

Publication No. OM-99 4154 (Revised)
Printed September 1999

Things Parents Can Do To Help Their OCD Child

Childhood OCD can be a truly debilitating disability, not just a minor problem or personality quirk. Children with OCD experience extreme anxiety, embarrassment, sometimes even harassment, because of this disorder. Their OCD symptoms often prevent them from building good relationships, from achieving their best in school, and from having a normal childhood. The effects of this disruption can be painful and lifelong.

The good news is that OCD is very treatable. With prompt, consistent intervention, most young people with OCD can wrest back control of their lives. Obsessive-Compulsive Disorder helps parents:

• Secure an accurate and complete diagnosis
• Live with OCD in the family: using effective parenting techniques, building support systems, and handling difficult issues
• Understand medical interventions
• Explore therapeutic and other interventions, such as cognitive therapy and vitamins or supplements
• Get care with an existing health plan, even with no coverage of "mental disorders"
• Navigate the special education system
• Find resources

Two books that can be extremely helpful to parents are reviewed below.  By clicking on the title you can learn more about the book or purchase it from Amazon.com.

Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents   

If you're a parent of one of the more than one million children in this country with obsessive-compulsive disorder, you know how confusing, even frightening, the symptoms of OCD can be. You're terrified of losing your child and angry about the havoc this disorder has wreaked in your family. More than anything, you want to be able to unlock the secrets of OCD, understand the cause of your child's bizarre symptoms, and help your child break free of these disruptive, relentless thoughts and actions.

In her landmark book, Freeing Your Child from Obsessive-Compulsive Disorder, Dr. Tamar E. Chansky creates a clear road map to understanding and overcoming OCD based on her successful practice treating hundreds of children and teenagers with this disorder. In Part I, Dr. Chansky "cracks the code" of the peculiar rules and customs of OCD -- the handwashing, tapping, counting, and so forth. She explains how OCD is diagnosed, how to find the right therapist partner, and how to tailor treatment options to your child's needs. You'll learn how powerful behavioral modification can be and when medication can help. In Part II, you'll learn how not to be pulled in by your child's debilitating rituals at home or at school, how to talk to your child about the "brain tricks" OCD causes, and how to create an effective OCD battle plan that will empower your child to "boss back" the OCD monster. You'll also learn how to cope in moments of crisis.

Part III offers specific advice for how to help your child handle the most common manifestations of OCD such as fears of contamination, checking, getting things "just right," intrusive thoughts, and more. Part IV is an indispensable guide to additional resources, including books, videos, organizations, and websites.

Obsessive-Compulsive Disorder : Help for Children and Adolescents (Patient-Centered Guides)

The author, Mitzi Waltz,  presents a superior guide on this complex neurological illness, with thorough and thoughtful attention to every subtopic imaginable: causes; consequences; diagnosis (including rare conditions and related disorders); therapeutic, medical, and alternative intervention; insurance issues; schooling; and transitions. Each chapter reads easily as it unravels the intricacies associated with OCD, but never sacrifices detail. Most helpful are Waltz's comprehensive list of medications (including generic names, side effects, known interaction hazards, and special tips), her critical chapter on the turbulent school years, and the resource section that includes the Children's Yale-Brown Obsessive Compulsive Scale for assessing symptoms. Herself the mother of two children diagnosed with OCD, Waltz speaks candidly, empowering parents to make critical choices for their child's treatment and to employ successful coping skills for daily living. Her opinions--and those quoted from parents traveling the same road--offer additional, firsthand knowledge that smartly supports each topic. 

Additional Resources

National DMDA (National Depressive and Manic-Depressive Association)

NAMI (National Alliance for the Mentally Ill)

Obsessive Compulsive Disorder In Children: The Silent Tragedy from NAMI

Obsessive-Compulsive Foundation

The Anxiety Disorders Education Program, National Institute of Mental Health
6001 Executive Blvd.
Room 8184, MSC 9663
Bethesda, MD 20892-9663   Or call 1-888-826-9438 (toll free)