What Causes OCD in Children and Teens?

Imagine your child being trapped in a cycle of thoughts and behaviors that feel impossible to escape. That's what living with OCD (obsessive compulsive disorder) is like for many children and teens. When parents come to my Ridgefield, CT clinic, I always explain that OCD often stems from a dysregulated brain. It’s not just about being overly neat or organized—OCD can be an overwhelming, relentless condition that leaves kids feeling anxious and out of control.

And as a parent, watching your child struggle with something so powerful can be heartbreaking. But the good news is that understanding the root causes of OCD and knowing the right steps to take can make all the difference. In this article, we’ll explore what causes OCD in children and teens and how you can help your child break free from its grip.

Causes of OCD in Childhood

OCD in childhood doesn’t just appear out of nowhere; it’s often the result of a mix of influences working together. From genetic risk factors and brain function to other environmental factors, stressors and neurobiological changes, multiple elements can contribute to the development of OCD. Understanding these causes helps in finding the most effective ways to support and treat children struggling with this challenging condition.

Genetics

There is evidence that pediatric OCD can run in families, suggesting a genetic component that increases susceptibility. However, genetics and family history alone don’t determine whether a child will develop OCD. If OCD runs in your family, it is best to have your child evaluated right away if there's a dramatic onset of OCD symptoms.

Brain Function and Structure

Abnormalities in brain function and structure, particularly in areas related to emotion regulation and repetitive behaviors, can contribute to OCD. Dysregulation in specific brain circuits, such as those involving the basal ganglia and the frontal cortex, has been observed.

Neurobiological Factors

Imbalances in neurotransmitters like serotonin may play a role in OCD. Disruptions in the brain’s chemical systems can affect mood and anxiety levels.

Environmental Stressors

Stressful life events, trauma, or significant changes in a child's environment (like a move, family issues, health problems, or academic pressures) can trigger or exacerbate OCD symptoms.

PANS/PANDAS

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) are conditions where infections or autoimmune responses lead to the onset of OCD or other psychiatric symptoms.

Parenting Style

While parents play not a direct cause, certain parenting styles or family dynamics may influence the development or severity of OCD symptoms. Overprotectiveness or high parental anxiety can contribute to the child’s stress and coping mechanisms.

Cognitive and Behavioral Factors

Children and adolescents with OCD often develop maladaptive thought patterns and behaviors as a way to manage their anxiety. These compulsive behaviors can become reinforced over time, perpetuating the disorder.

Obsessive Compulsive Disorder develops over time. Even when one has genetic underpinnings, our genetics don’t define us and anxiety or other clinical issues can be mitigated by lifestyle changes and learning healthy ways to cope with stress. OCD typically starts with anxiety that one engages in an action (intrusive thinking, obsessive thoughts or compulsive behavior) in order to avoid a negative result and this inadvertently negatively reinforces a behavior, which means it is more likely to occur. It is sort of like feeding a barking dog in that every time you feed into the intrusive thoughts you accidently allow them to take hold, then they are more likely to occur. Someone with OCD isn’t doing these behaviors on purpose and instead, their behaviors get reinforced at a subconscious level.

OCD and the Dysregulated Brain

Pediatric OCD and OCD in general results when there is a dysregulation of brainwave activity in specific regions and in the neural networks. With a QEEG brain map or a brain check with our staff (we work with kids in person and remotely), you are able to see the exact regions that are impacted by OCD, as well as the neural networks. With OCD, regions that process emotional information, help you regulate stress, and apply the breaks and switch gears are highly impacted.

When you look at the brain functioning of someone with OCD, a clear pattern emerges in that the region that regulates how one perceives stress is overactive, as well as their neural networks are “stuck on” in a continual looping of inner chatter. And when their central nervous system is hyper stress activated, they are too sensitive to seemingly benign stimuli and live in a constant state of activation or a fright response. That overactive brain that “can’t shut off” is something that every person with OCD reports and it is because of that overactive brainwave activity.

OCD Hijacks Your Brain Until You Treat It

Intrusive, unwanted thoughts, and compulsive behavior hijacks a person’s brain and makes the day to day very difficult. When your brain is constantly in a state of fright, it is hard to be connected, focused, and do even simple tasks if those intrusive thoughts and compulsions are intense. Many people with OCD are highly functional and go through periods of waxing and waning when the thoughts and compulsions might be less or more intense. Kids can do really well in school as they channel their energy until the stress of that hijacked brain and constant inner chatter is just too much. There are science-backed natural methods that treat OCD and extinguish OCD behaviors and it's SUPER IMPORTANT that we address intrusive thought and compulsions early with kids, so we break the subconscious habit or negative reinforcement cycle.

What is a Negative Reinforcement Cycle in OCD? 

OCD is so treatment resistant due to something called a negative reinforcement cycle and how obsessive and compulsive behavior get ingrained at a neurological level. Negative reinforcement in OCD is when you engage in an action in order to avoid a negative result. This avoidance robs the child or teen of the ability to learn that what they fear might not be quite as bad as they anticipated and actually reinforces the behavior.

In other words, it means the child will neurologically be more likely to keep repeating the behavior instead of learning a new, healthier way to tolerate and cope with the stress. It is sort of like feeding a barking dog in that every time you feed into the intrusive thoughts or compulsive rituals by avoiding, you actually allow them to take hold, then they are more likely to occur. 

This isn’t purposeful and instead occurs at a subconscious level.  It is because of this negative reinforcement cycle that OCD can be very treatment resistant and why regular talk therapy doesn’t help OCD and in fact often worsens it. You need the right treatment for OCD or it is a clinical issue that will fester for years. 

Getting Professional Help for OCD Symptoms

Pediatric OCD can look different older children than adults and is often missed. It often starts with subtle behaviors, such as a need for reassurance seeking or asking the same questions again and again, insistence on nighttime rituals, or other behaviors that the child thinks you may interpret as, ‘nerves' or worry.

Children may be less likely to communicate about their obsessions, making it harder to identify. They might experience harm-themed thoughts and behaviors more frequently than adults.

Understanding these nuances can help in recognizing OCD early on, even if the child isn't verbally expressing their distress. Keep an eye out for patterns of repetitive behaviors or extreme reactions to minor changes in routine, as these can be tell-tale signs.

OCD treated effectively often involves a combination of therapies, including cognitive-behavioral strategies, medication, and holistic approaches. The good news is that OCD behaviors can be unlearned with the right kind of therapy, ERP combined with neurofeedback. To learn more about OCD or locate resources or a healthcare provider in your area, try visiting:

• Findtreatment.gov
• American Psychological Association psychologist locator
• American Academy of Child and Adolescent Psychiatry child psychiatrist finder
• International OCD Foundation

At my Ridgefield, CT clinic, we offer a holistic approach to treating OCD that goes beyond traditional methods. In our BrainBehaviorReset program, we begin with a detailed brain map for a comprehensive evaluation and pinpoint the specific areas needing attention. A QEEG brain map can help in understanding what's happening in the brain and once your child is OCD diagnosed, a tailored treatment plan can be developed to address the child's specific needs. and craft a personalized care plan. 

Our comprehensive treatment includes Neurofeedback sessions to regulate brain activity, PEMF therapy to enhance mental health, and targeted supplementation to support overall well-being. We also integrate behavioral support, Exposure and Response Prevention (ERP) therapy to address core symptoms, and dietary recommendations to complement the treatment. This multifaceted approach ensures we address OCD from all angles, providing a path to lasting relief and improved quality of life.