Some kids like to wash their hands, but Sarah does it too much. She wants to stop, but her hands just don't feel clean enough and she can't make herself turn off the water. Sometimes she scrubs her hands until they are red and raw. After eating, she feels she has to wash again.

Because she spends so much time washing, Sarah has to rush to get to school on time. At school, she tries not to touch doorknobs or handrails, worrying that if she does she may catch a serious disease. Sometimes, Sarah gets behind in her classwork because she feels that she needs to keep checking it over and over.

During a quiz or test Sarah checks and rechecks every answer and erases anything that isn't perfectly straight or neat. Sometimes she erases so hard it tears the paper, but she can't help it. Sarah gets a bad feeling that if everything isn't exactly right, something terrible may happen. All this worrying, checking, and fixing takes so long that Sarah hardly ever finishes the test before time is up. So even though she knows the work, she often gets an incomplete or even fails.

Sarah tries so hard to hide her habits. She worries that she might be going crazy or that people would think she's weird if they knew what she was doing. Sarah knows that the time she spends washing and checking could be spent having fun with friends or doing her schoolwork, but she can't seem to stop herself. That's because Sarah has obsessive-compulsive disorder (OCD).

What is OCD?
OCD is a type of anxiety (say: ang-zye-uh-tee) that happens when there is a problem with the way the brain deals with normal worrying and doubts. Kids with OCD worry a lot. And they feel afraid about bad things that could possibly happen.

Like Sarah, some kids with OCD are afraid of getting dirty or catching germs. Others always worry that their parents will get sick or hurt. Others worry that something bad might happen to them. Some kids feel that they have to say things a certain number of times, ask questions over and over again, or keep things super-clean as a way to keep bad things from happening.

Some kids even worry about thinking bad thoughts. They sort of believe that thinking bad things could make them come true.

People with OCD worry so much that they can spend many hours, or even the whole day, worrying about things and trying to make sure the bad things they worry about don't happen.

Normal Worry or OCD?
Of course, it's normal to worry now and then. Everyone does. Kids may worry about getting lost or that something will happen to their parents. They may sometimes feel afraid that they will get sick or hurt. It's normal for kids to worry once in awhile about burglars, fires, or earthquakes. Sometimes, worrying can help kids learn how to be safe and careful. Normal worries come and go without causing too much of a problem.

But OCD is much more than normal worry. Instead, the worry is really intense and it can happen over and over again. With OCD, the brain replays the worry thoughts and if nothing is done, the worry feeling can get worse and worse.

These frequent worry thoughts are called obsessions (say: ahb-seh-shunz), and the behaviors people do to try to make the worry thoughts go away are called compulsions (say: kum-pul-shunz).

What Are Obsessions?
A kid who has OCD might have obsessions about illness or injury or dying. And these obsessive worries just don't quit. The brain keeps repeating them instead of moving on to something else. It can be a lot like that awful song you hear that gets stuck in your head. No matter how much you don't want to hear it, your brain just keeps playing it back.

Having upsetting thoughts that you can't get rid of can feel terrible and scary. And having so many worry thoughts can make it hard to concentrate on anything else. OCD can take the fun out of almost anything.

With OCD, someone may have obsessions about:

• germs or dirt
• illness or injury (involving the person or someone else)
• coming across unlucky numbers or words
• things being even or straight
• things being perfect or just right in a certain way
• making mistakes or not being sure
• doing or thinking something bad

What Are Compulsions?
Compulsions are the behaviors, or actions, that someone with OCD does to try to shut down the worry thoughts. Another name for compulsions is rituals. By doing compulsions, people with OCD hope to keep bad things they worry about from happening. They believe that doing a certain ritual will make the bad feeling go away and, for a while, it often does. They feel scared that if they don't do the ritual something bad will happen.

Of course, plenty of people who don't have OCD have rituals or actions that are important to them. Maybe you tap your pencil three times before starting a tough test or sing a certain song just before diving off the high dive. Perhaps you have a lucky number or even a lucky pair of socks. But OCD compulsions are much more than doing something just for luck.

Kids with OCD feel they have to do certain things over and over to feel protected from unlucky events. Kids with OCD don't really want to be doing rituals. But when you have OCD, performing the rituals seems like that's the only way to feel safe from bad things happening.

And the more kids with OCD do these rituals, the more they feel like they have to do them. Kids with OCD can end up spending so much time on rituals that they have little time left for the things they really do want to do. Here are some OCD compulsions:

• lots of hand washing or showering (doing this way more than usual or having a hard time stopping)
• counting (like having to count 25 white cars before going into school)
• touching (like touching every single fence post between home and the bus stop)
• checking things over and over (such as doors, locks, or stoves)
• doing things a certain number of times (like having to try on five dresses before leaving your room)
• arranging things in a very particular or neat way
• asking the same question over and over
• tying and retying shoes over and over until they feel just right

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