What is OCD? Symptoms, Myths, and Effective Treatments Explained for Young People
August 11, 2025
What is OCD?
Obsessive-compulsive disorder (OCD) is when a child or young person has frequent thoughts that feel invasive that they struggle to ignore or reduce, and/or compulsions, which are behaviours they feel they have to do and again struggle to ignore the urge to perform. It is a very debilitating condition that can be very distressing for the person experiencing it. It can also cause a lot of shame due to the disturbing nature of the thoughts.
For example, a child or young person may have thoughts that they want to harm someone physically. They therefore will physically stay away from people, might repeat numerous behaviours such as checking they haven’t hit someone with their car when they feel a bump in the road if they are able to drive and may even self-harm to manage the thoughts.
The symptoms of OCD
There are different variations of OCD; however, there are three main symptoms that have to be present for a diagnosis of OCD:
- Obsessive thoughts
- Taking responsibility for those thoughts turning into reality
- Compulsions to manage the thoughts
Overall, you believe you are solely responsible for those thoughts coming true and therefore doing behaviours to manage those thoughts that would show you may be struggling with OCD.
Obsessional thoughts are unwelcome and disturbing thoughts or images that repeatedly appear in the mind. The person experiencing the thoughts finds them disturbing as they definitely do not want these thoughts to turn into reality. That is a key part of the OCD and a really important thing to consider, as it causes a lot of shame.
For example:
- Worries about becoming sick
- Worries about the death of loved ones
- Unwanted thoughts about harm to others
- Forbidden thoughts (e.g. thoughts about sexual acts)
- Superstitious fears (e.g. that there are bad numbers)
Compulsions are acts that the person performs as a way to manage these thoughts. They believe it may cancel out the thoughts, reduce the likelihood of the thoughts coming true or prevent the thoughts all altogether from coming true. Compulsions are both physical and mental.
For example:
- Repetitive cleaning (of themselves, others or objects)
- Checking (e.g. doors, routes that have been driven, gas taps, ovens)
- Ordering/ arranging things or routines in a specific way
- Repeating words or counting
- Avoiding (e.g. numbers, people, objects)
Common myths about OCD
It is Generalised Anxiety
OCD is a specific type of anxiety disorder. However, the obsessional thoughts can be mistaken for worrying. This is an easy mistake to make, but if you are then doing behaviours to manage those thoughts as outlined above, this may suggest it is OCD.
For example, you may worry about your family member dying, but if you are saying three prayers every night with the belief that if you do not say those prayers, a family member will die, that may indicate OCD.
There is the thought, the responsibility and the behaviour.
It is Psychosis
Determining OCD from psychosis can be very tricky. Especially if the person truly believes in their obsessive thoughts and that their behaviours are managing them. However, there are ways to tell them apart. If there is an absence of hallucinations and delusions, that may suggest it is not psychosis. Another way to tell is that the obsessional thoughts in OCD are usually the opposite of someone’s beliefs and values. For example, having thoughts that you are going to harm a loved one, due to caring deeply about that person. Whereas in psychosis, the content of grandeur will not have much relation to someone’s beliefs and values.
If I don’t have things clean or in a specific order, then I feel anxious, so I have OCD
Whilst the behaviours that come with OCD may also occur in people with anxiety, e.g. cleaning excessively or placing things in order, this does not mean someone has OCD. You have to have an intrusive and disturbing thought that the behaviours are trying to manage, such as you have to have things ordered in a certain way, otherwise your sibling will be harmed. If you are doing behaviours just because you feel less stressed when things are clean or you feel less stressed when things are colour-coded, this may be general anxiety rather than OCD.
Getting Help For Obsessive-Compulsive Disorder (OCD)
The main therapy for OCD is cognitive behavioural therapy (CBT), discussed below.
CBT is a type of therapy that focuses on how we think, feel and act, specifically about how we can get trapped in patterns of thinking, feeling and acting that worsen our mental health. There is strong research evidence to support the use of CBT for the treatment of OCD.
Within CBT, it will map out with the child or young person what the patterns that they may be trapped in are. For OCD common one, when the person completes the behaviour and the thought doesn’t come true, they believe it was the behaviour that was responsible for the fact that the thought did not occur, which reinforces it. However, they don’t attribute it to the likelihood being low in the first place.
CBT for OCD focuses on the behavioural aspect first, using an intervention called exposure and response prevention (ERP). This is where the child/young person creates a hierarchy of all the compulsive behaviours they do, ranking them from most difficult to ignore to least difficult to ignore. They will then start with the least difficult urges to ignore, and reduce the frequency of those behaviours with support from the therapist. They will break the pattern of misplaced responsibility whilst learning techniques to help manage the short-term distress.
If the CBT therapist also focuses on the thoughts, they will use a range of techniques to do so, such as thought challenging, psychoeducation and best & worst case scenario run-throughs.
Medication
Your doctor may prescribe medication for OCD alongside therapy. However, it is recommended that therapy by itself is tried first.
Medication can include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Clomipramine
Both are effective in improving OCD symptoms.
Useful resources
NHS
You can find more information about OCD on the NHS website.
MIND
Provides information about helping someone with OCD.
OCD Action
Contains information about helping someone with OCD.
OCD UK
There is more information about OCD and access to support groups.
OCD Youth
The OCD Youth website offers helpful resources and access to support groups for young people.
Introduction to Counselling and Psychotherapy
The British Association for the Counselling Professions (BACP) have a useful document on different aspects of therapy.