What are Anxiety/OCD?

What is OCD?

Obsessive compulsive disorder (OCD) is a mental health condition that affects at least one in 200 youth. It occurs when a person is caught up in a cycle of obsessions and compulsions:

Obsessions are intrusive thoughts, images, or urges that come up over and over again and feel outside of the student’s control. These obsessions cause discomfort and distress.
Compulsions, or rituals, are behaviors a child feels they have to do to get rid of the bad feelings from the obsessions. These behaviors can be both physical and mental.

In general, OCD is diagnosed when these obsessions and compulsions become so time consuming that they negatively interfere with your life. Typically, the obsessions and compulsions become gradually more severe over time until they get to this point.

Among racial and ethnic minorities, OCD symptoms may be influenced by negative stereotypes, racism, or one’s racial identity. For example, fear of validating false racial stereotypes may contribute to OCD-related anxieties.

There are many different types of OCD. Here are a few of the most common obsessions and compulsions:

Theme	Obsessions	Compulsions
Contamination	Fear of touching or otherwise coming into contact with things you think are "contaminated," or dirty, unclean, dangerous, gross, etc. These things can include body fluids, dirt, germs/diseases, chemicals, etc.	Washing hands over and over again or doing so in a specific way Long cleaning routines in the bathroom (showering, brushing etc..) Avoiding places, or people you believe are contaminated
Perfectionism	Having really high expectations when it comes to completing an assignment or a task Wanting to know or remember things or being afraid you’ll forget something important	Re-writing or re-reading Repeating until it feels right Stepping on an even number of sidewalks
Doing Harm	Fear of doing something horrible to yourself or a loved one Being afraid something terrible is going to happen to friends, or family.	Repeating positive words a certain number of times to avoid harm from happening to a loved one or a family member. Seeking reassurance that you didn’t do something that harmed your loved ones
Intrusive Thoughts	Having unwanted harmful or forbidden thoughts come to mind	Intrusive thoughts can involve mental compulsions like doing homework and making sure it ends on a good note, or a safe number.

What is Anxiety?

As a student, you may feel worry, fear, or nervousness. This is defined as anxiety and it can happen at any time regardless of what is happening in your life. For example, toddlers are often distressed when separated from their parents, even if other family members are surrounding them. Young children may feel worried or nervous when going out in public, seeing friends, or participating in certain activities. Although fears and worries are typical in children, when these fears become persistent or extreme or interfere with school, home, or activities, the child may be diagnosed with an anxiety disorder. Anxiety can affect your behavior at school and at home, and your ability to participate in class and perform assigned tasks.

For BIPOC youth, experiences of racism and discrimination, social determinants of health, current and historical stressors, and the resulting internalized stress may contribute to increased anxiety and mental health concerns. Further, youth living within a racially oppressive context may feel as if they are constantly in a state of hypervigilance, contributing to increased anxious arousal or generalized worry, fear, or nervousness.

Click on the (+) sign next to each condition below to learn more about the various types of anxiety disorders:

Generalized Anxiety Disorder

What is it?

Generalized anxiety disorder (GAD) is characterized by extreme and constant worry — about any number of things — that lasts for at least six months and interferes with daily activities.

What does it look like?

Symptoms of GAD in children include reassurance-seeking from teachers and loved ones, difficulty concentrating in class or while doing homework, and even avoiding going to school.
Children with GAD can also be overly self-critical, leading them to avoid activities they think they may not excel at.

How common is it?

GAD is less common in younger children — from ages 4–11 years old, it occurs in less than 1% of youth.
In older children/teens, around 12–15 years old, the rate of GAD grows to 1.1%, or around one in 100 older children/teens.

How is it treated?

Cognitive behavioral therapy (CBT)
Medication

Panic Disorder

What is it?

Panic disorder is characterized by repeated feelings of severe fear that occurs randomly due to a perceived imminent danger. These intense feelings are also called panic attacks.
Panic disorder may also be accompanied by agoraphobia, which is avoiding conditions, locations, and situations that may cause one to panic.

What does it look like?

The symptoms of panic disorder are heart palpitations, sweating, trembling, shortness of breath, chest pain, dizziness, heat sensations, chills, and feelings of choking.
They may also include an extreme untriggered fear of dying, losing control, or going crazy. The person experiencing this may feel detached, or as if they are outside themselves.
Research shows that 13–14 year olds who suffer from panic attacks are two times more likely to have attempted suicide.

How common is it?

Panic disorder is not very common in children. Research shows that among 8–15 year olds only 0.4% have the disorder. But in comparing children to teens, there’s an increased rate from 0.3% in children to 0.5% in teens.
Overall, the lifetime prevalence of panic disorder is 4.7%. Twenty-five percent of those who develop a panic disorder will do so by the age of 16.
Comorbidity, or having more than one diagnosis, is very high with panic disorder. The majority of youth with panic disorder, between 50-90%, will also experience a mood or anxiety disorder.

How is it treated?

A form of cognitive behavioral therapy (CBT) called panic control treatment for adolescents (PCT).
Medication.

Separation Anxiety Disorder

What is it?

Separation anxiety disorder is the experience of great distress caused by fear of being separated from home or from a loved one.
It can also be characterized by constant worry that a loved one will be harmed or will die.

What does it look like?

Symptoms of separation anxiety disorder in children often includes throwing emotional tantrums, crying, holding on to the parent, refusing to participate in activities that involve separation, not wanting to sleep alone, and refusing to go to school.

How common is it?

Among the children that will develop this disorder, 75% will do so by age 10 and 90% by age 13.
Separation anxiety disorder is diagnosed less frequently the older youth get — 4.1% of 9–10-year-olds have it, down to 0.6% of 12-year-olds, and even lower in older adolescents.

How is it treated?

Cognitive behavioral therapy (CBT)
Parent child interaction therapy (PCIT)
Medications can be used in treatment of separation anxiety

Social Anxiety Disorder

What is it?

Social anxiety disorder is characterized by the fear and avoidance of social performance situations, lasting for at least six months.
Usually symptoms occur when the person is exposed to new or unfamiliar people or situations, and fear they might act in an embarrassing way.

What does it look like?

Social anxiety disorder may look like a fear of going to a new school, going through social situations with great distress or avoiding them altogether, fear of being embarrassed or judged, self-consciousness, avoiding eye contact, and avoiding other people.
In more severe cases, children may refuse to go to school, or get physically aggressive if forced to do so.

How common is it?

Social anxiety disorder is one of the more common anxiety disorders in youth in the USA; 5–15% of adolescents have, or have previously had, social anxiety disorder.
Although symptoms usually start around 15 years old, they have been known to occur in children as young as eight years old.

How is it treated?

Cognitive behavioral therapy (CBT)
Group therapy
Medication

Selective Mutism

What is it?

Selective mutism is when a person is unable to speak in certain social situations, lasting for at least one month, despite the fact that they are able to speak in more familiar situations.

What does it look like?

Some of the symptoms of selective mutism include inability to speak, timidity, social anxiety, struggle with speech and language, being easily frustrated, developmental delays in some children, nervousness, and fear.

How common is it?

Selective mutism occurs in 0.11–2% of children.
Selective mutism usually appears when youth are between two and four years old, but children typically don’t receive treatment until they are 6–9 years old.

How is it treated?

Cognitive behavioral therapy (CBT) and behavioral therapy are first-line treatments.
Social communication anxiety therapy
Medication

Specific Phobias

What is it?

Specific phobias are devastating individualized fears that a person experiences regarding an object or a situation that poses little to no danger. Some examples include fear of heights, airplanes, animals, blood, needles, or clowns. The individual will then avoid these situations or objects in order to not experience the immense anxiety.

What does it look like?

Symptoms of specific phobias include sweating, nausea, difficulty breathing, and feeling powerless when exposed to whatever the specific trigger might be (object or situation).
Children with specific phobias may cry, throw tantrums, and hold on to their parents when faced with their specific feared object or situation.

How common is it?

The average age of onset for specific phobias is 9–10 years old.
Specific phobias affect 5–10% of children and adolescents, according to community samples. However, research done with parents shows that this number may be higher — 17.6% of children experiencing childhood fears may fit the criteria for specific phobia.

How is it treated?

Exposure-based cognitive behavioral therapies
Medication

Post-Traumatic Stress Disorder

What is it?

Post-traumatic stress disorder (PTSD) occurs when a person has experienced, been threatened by, or has witnessed serious injury, death, or sexual violation.
The individual with PTSD will experience dreams, flashbacks, memories, and/or other physical reactions that are upsetting and unwanted for over a month after the incident.

What does it look like?

In children, some symptoms may include acting helpless, angry outbursts, or reliving/recreating the incident through play.
Other symptoms may include negative self-image or emotional state, detachment, hypervigilance, or memory and sleep troubles.

How common is it?

Studies show that about 14–43% of youth go through at least one trauma. Of those children and teens who have had a trauma, 3–15% of girls and 1–6% of boys develop PTSD.

How is it treated?

Trauma-focused cognitive behavioral therapy (TF-CBT)
Prolonged exposure therapy (PE)
Relationship-based therapy
Group therapy
Medication

What is OCD and Anxiety for BIPOC Youth?

While all students are susceptible to anxiety and/or OCD symptoms in the school setting, students from racial minority groups are also vulnerable to symptoms of racial trauma. Therefore, it’s essential to understand the signs and symptoms of racial trauma to differentiate between normal vs. abnormal behavior, particularly when considering anxiety or OCD among students of color.

Racial Trauma in BIPOC Youth

Traumatic events that occur due to experiencing racism or discrimination can profoundly impact your mental and physical well-being. Racial trauma, or race-based traumatic stress, refers to the mental and emotional impact of one’s experiences of racism and discrimination. Signs of racial trauma appear in students ranging from infancy-adulthood.

When it comes to racial trauma in a school setting, you may notice yourself experiencing some of the following signs/symptoms:

Racial trauma may contribute to you having increased physical symptoms, like headaches, stomach aches, tension in the chest, or a racing heartbeat.
You might be feeling increased negative emotions, such as depression or anxiety, within the context of discrimination.
Exposure to chronically stressful race-related conditions may make you feel detached or numb.
Racial trauma may make you feel helpless, hopeless, and worried for other students with your skin tone and/or ethnic-racial identity.
You might become preoccupied with your safety or the safety of peers/family members.
You may notice decreased academic motivation in general or have difficulty concentrating in the classroom.
Incomplete assignments or homework, although you know you are capable of doing them.
Seeking reassurance or validation from others.

How are Anxiety/OCD Treated?

The treatment for anxiety and OCD is cognitive behavioral therapy (CBT) and/or medication. For certain types of anxiety and for OCD specifically, a type of CBT called exposure and response prevention therapy is the best treatment. The exposure in ERP means exposing yourself to thoughts, images, objects, or situations that may make you anxious. The response prevention part of ERP means you make a choice to not engage in compulsive behavior. This may sound hard, but it is done with the help of a professional therapist. Click here to learn more about CBT/ERP, and click here to learn more about how to find the right therapist.

Medication can also help treat anxiety/OCD, especially if your symptoms are really severe and intense. The type of medications used for anxiety/OCD are called serotonin reuptake inhibitors (SRIs). This medication should be administered by a licensed medical mental health professional, such as a pediatrician or psychiatrist. Click here to learn more about medication for anxiety/OCD.

For BIPOC youth, experiences of discriminatory encounters may contribute to increased anxiety and mental health concerns. Racial socialization, or transmitting culture, attitudes, and values to prepare youth to cope with racial discrimination, may be an essential component of effective anxiety/OCD treatment for BIPOC youth. Click here to learn more about racial socialization, and click here to find a multicultural or racial trauma-informed therapist.

What are Anxiety/OCD?

What is OCD?

Theme

Obsessions

Compulsions

What is Anxiety?

What is OCD and Anxiety for BIPOC Youth?

Racial Trauma in BIPOC Youth

How are Anxiety/OCD Treated?