Obsessive Compulsive Disorder (OCD) in Teens

The adolescent and teenage years are a challenging phase of life. During this time, it is fairly common for youth to develop certain habits and quirks in an attempt to manage the various stressors. Yet, for some, these individual “quirks” can indicate the presence of a more significant issue – obsessive-compulsive disorder. Experiencing OCD symptoms can significantly impact teenagers, making it crucial to recognize these symptoms early.

What is OCD?

OCD, or obsessive-compulsive disorder, is a mental health disorder marked by uncontrollable and recurring thoughts (obsessions) and behaviors (compulsions). Historically, OCD was classified within anxiety disorders, but its classification has evolved over time due to new research highlighting its differences from other anxiety disorders. The thoughts associated with obsessive-compulsive disorder fuel the urge to act out certain behavior(s) over and over again. OCD tends to affect all areas of a person’s life, and when it comes to adolescents and teenagers, this means school life, social life, home life, and personal life. In this guide, we will cover the signs, symptoms, causes, and treatment for OCD in teens and what you can do as a parent to help.

Obsessions

The repeated thoughts or mental images inherent to obsessive-compulsive disorder commonly surround one of the following areas:

• Germs/contamination – obsessive thoughts about being in contact with germs or contaminated with germs; can cause fear of shaking hands, using doorknobs/handles, etc.
• Order and symmetry are ongoing thoughts and ruminations about having things in a particular and precise order (e.g., putting items on the desk perfectly lined up or following an exact nighttime routine). They usually include beliefs that if a particular order is not followed, disaster will occur (e.g., he or she will fail the exam).
• Aggression or Violence – thoughts and/or mental images surrounding violent or aggressive acts toward self or others.
• Doubts—obsessive thoughts and doubts about certain acts being completed (e.g., the door being locked or the oven being turned off); doubts lead to anxiety about catastrophe (e.g., the house burning down, the home being burglarized, etc.).

Compulsions

Compulsions are excessive and persistent behaviors, rituals, or mental acts that a person with OCD feels driven to carry out in response to the obsessive thought(s). In the short term, carrying out the compulsive behavior(s) can ease the anxiety and diminish the distress. For teens and adolescents with obsessive-compulsive disorder, the compulsions can feel near impossible to avoid acting on, and the brief sense of relief reinforces the belief that the behavior is “helpful”. OCD compulsions often consist of one of the following:

• Washing – excessive and repeated cleaning and/or washing (often of the hands) in response to fear of germs or contamination.
• Arranging or ordering – this compulsion involves the urge to repeatedly place items in a particular order or symmetrical pattern. This compulsion is frequently connected to a need for control.
• Checking – compulsions of checking typically encompass making sure a certain task has been completed, such as locking the door or turning off the oven.
• Counting – many with OCD feel compelled to count in an attempt to decrease anxiety. Oftentimes, individuals with this compulsion count things such as floor tiles or engage in other compulsions a certain number of times (i.e., locking the door eight times every time).

Signs and Symptoms Your Adolescent or Teenager May Have OCD

Obsessive-compulsive disorder typically starts somewhere between the late adolescent years and early twenties. Recognizing obsessive-compulsive symptoms early is crucial to access appropriate treatment. Some early signs and symptoms of obsessive-compulsive disorder in youth include:

• Repeated, ongoing worries
• Low self-esteem
• Worries that seem unfounded or irrational
• Difficulty (or inability) to explain a particular action or compulsion (i.e., multiple hand washing)
• Disciplinary action at school (due to compulsive behavior)
• Isolation or social withdrawal from friends and family
• Trouble making and/or keeping friends
• Withdrawal from usual activities
• Becoming easily upset (showing signs of violence in extreme cases) over minor or insignificant issues
• Difficulty with spontaneity or diverting from one’s regular schedule
• Indecisiveness
• Excessive and/or repeated reassurance seeking (even once the answer or response has been given)
• Difficulty concentrating or staying on task (a symptom often mistakenly attributed to attention-deficit disorder)

Cause of OCD in Adolescents and Teenagers

The exact cause or causes of obsessive-compulsive disorder remain inconclusive.  Regardless, studies indicate certain factors make some adolescents and teenagers far more likely to develop OCD than others.

• Chemical imbalance – commonly, mental health professionals will describe the cause of obsessive-compulsive disorder in terms of biochemical imbalance. When it comes to a chemical imbalance in the brain and OCD, studies focus on the particular neurotransmitter of serotonin.  Serotonin is the primary chemical in the brain responsible for regulating sleep, memory, and anxiety.
• Genetics – genetic studies indicate the tendency towards anxiety runs in families. Thus, if a teenager’s family member suffers from an anxiety disorder, he or she is more likely to develop one as well, including obsessive-compulsive disorder.  In fact, if there is a history of OCD in a teen’s family, he or she is up to four times more likely to have it as well.
• Environmental factors – things such as stress and parenting styles have been cited as environmental factors that may contribute to the development of obsessive-compulsive disorder. Stressful or traumatic events in childhood and/or anxious personality styles modeled by parents may make it more likely a child will suffer from obsessive-compulsive disorder.

Treatment of OCD in Adolescents and Teenagers by Mental Health Professionals

Obsessive-compulsive disorder in adolescents and teens can be effectively treated with cognitive behavior therapy (CBT), cognitive behavioral therapy (CBT), and cognitive therapy. Although there is no “cure,” there are many treatment options to help your child learn to manage his or her symptoms and have an overall better quality of life. Treating OCD often involves specialized therapies like exposure and response prevention (ERP) therapy, which helps patients gradually confront their fears while learning to manage their compulsive behaviors.

Individual cognitive behavior therapy

Cognitive behavioral therapy (CBT) is a widely used treatment for obsessive-compulsive disorder in adolescents and teenagers. With the guidance of a mental health professional, CBT aims to modify unhealthy thoughts and behaviors while teaching skills to manage emotions. CBT has shown lasting results for many youth with OCD.

Likewise, Exposure and Response Prevention Therapy (ERP), a form of cognitive behavioral therapy, has been shown to provide a significant reduction in OCD symptoms for many individuals. With the support of a mental health professional, ERP therapy puts the person suffering from OCD in situations where they are exposed to their obsession(s) while at the same time being prevented from performing the compulsion(s) usually used to ease the anxiety. In short, ERP intentionally induces anxiety in a controlled way to gradually show the person with OCD that he or she can “survive” the anxiety without acting in a compulsive manner.

Family therapy

Family dynamics can have a significant impact on the treatment outcome of a youth with obsessive-compulsive disorder. Family therapy, which is often part of an OCD treatment plan, not only supports the individual with obsessive-compulsive disorder but also his or her parents and siblings. Family therapy can assist family members in better coping with and responding to the struggles of the teen or adolescent with OCD. Family therapy can also help promote understanding and empathy and support family members in learning how to set limits and boundaries.

Medication

Due to the immense stress and anxiety that can result from obsessive-compulsive disorder in adolescents and teens, sometimes medication (such as selective serotonin reuptake inhibitors) is prescribed to help manage the difficult symptoms. Medication can provide the necessary relief from the OCD symptoms needed to enable teenagers to engage in, and benefit from, other treatments, such as psychotherapy.

School support

As with most other areas of life, school, for adolescents and teenagers with OCD, is often affected by the symptoms of the disorder.  Frequently, educators will work with the child, parents, and mental health professionals to incorporate certain adaptations to assist the student in better managing the symptoms while at school.

Challenges of Having an Adolescent or Teenager Has OCD

When an adolescent or teenager has obsessive-compulsive disorder, it is not uncommon for the whole family to be affected and home life to become very stressful. Watching your child behave in seemingly strange ways can cause confusion and be frightening. Siblings of the teen with obsessive-compulsive disorder may become easily annoyed when the OCD behaviors are displayed due to a lack of understanding. The difficulties those with OCD face in accessing cognitive-behavioral therapy (CBT) must be acknowledged, as should the importance of developing innovative methods to improve access to effective treatments. Other challenges of having an adolescent or teenager with OCD include:

• Involvement in OCD behaviors – adolescents and teenagers with OCD often involve their parents in their obsessive-compulsive behaviors in various ways: asking a parent the same question over and over again, begging parents and/or siblings to help carry out an OCD ritual or insisting family members participate in the rituals as well.
• Violence/Rage – adolescents and teenagers with obsessive-compulsive disorder often become extremely angry, have outbursts, and sometimes even become violent when family members do not engage in OCD behaviors.
• Lack of communication – secrecy is common amongst adolescents and teens. Yet, if your child has obsessive-compulsive disorder and refuses to discuss his or her symptoms, it can be hugely challenging for the parents/caregivers and siblings.

Starting a Conversation about OCD

Starting a conversation about OCD can be challenging, but it’s essential to approach the topic with sensitivity and understanding. Here are some tips to help you start a conversation about OCD:

1. Choose the right time and place: Find a private and comfortable setting where your teen feels safe and relaxed. This could be during a quiet moment at home or while taking a walk together.
2. Use open-ended questions: Ask questions that encourage your teen to share their thoughts and feelings. For example, “How are you feeling lately?” or “What’s been on your mind?” can open the door to deeper conversations.
3. Listen actively: Pay attention to your teen’s words, tone, and body language. Show that you’re engaged and interested in what they’re saying by nodding, maintaining eye contact, and providing verbal affirmations.
4. Avoid judgment: Refrain from making judgments or criticisms about your teen’s thoughts or behaviors. Instead, focus on understanding and empathy. Let them know that you’re there to support them, not to judge.
5. Validate their feelings: Let your teen know that their feelings are valid and that you’re there to support them. Phrases like “I understand this must be really hard for you” can go a long way in making them feel heard and supported.

Example conversation starters:

• “Hey, I’ve noticed that you’ve been seeming a bit anxious or stressed lately. Is everything okay?”
• “I’ve heard that OCD can be really tough to deal with. Can you tell me more about what you’re experiencing?”
• “I’m here to support you, and I want to make sure you know that you can talk to me about anything.”

By approaching the conversation with care and understanding, you can help your teen feel more comfortable discussing their obsessive-compulsive disorder and seeking the support they need.

Debunking Common Myths

There are many common myths and misconceptions about OCD that can make it harder for people to understand and seek help. Here are some common myths debunked:

1. Myth: OCD is just about being neat and tidy.Reality: OCD is a complex mental health condition that involves unwanted intrusive thoughts and compulsions that can interfere with daily life. It’s not just about cleanliness or orderliness; it’s about managing overwhelming anxiety through repetitive behaviors.
2. Myth: People with OCD are just being lazy or stubborn.Reality: OCD is a serious mental health condition that requires treatment and support. People with OCD are not lazy or stubborn; they’re struggling with a condition that’s beyond their control. Their behaviors are driven by intense anxiety and the need to alleviate it.
3. Myth: OCD is rare.Reality: OCD is more common than you might think. According to the International OCD Foundation, approximately 1 in 40 adults and 1 in 100 children in the United States have OCD. It’s a prevalent anxiety disorder that affects many people.
4. Myth: OCD is just a phase.Reality: OCD is a chronic condition that requires ongoing treatment and support. While symptoms may wax and wane over time, OCD is not something that people simply “grow out of.” It requires consistent management and care.
5. Myth: OCD is a sign of weakness.Reality: OCD is a sign of strength, not weakness. People with OCD are fighting a daily battle against their symptoms, and seeking help takes courage and resilience. It’s important to recognize their strength and support them in their journey.

By debunking these common myths, we can work to reduce stigma and promote understanding and support for people with obsessive-compulsive disorder. Understanding the realities of OCD can help create a more compassionate and informed environment for those affected by this mental illness.

Supporting Your Adolescent or Teenager with OCD

Living with a teenager with obsessive-compulsive disorder can be hugely distressing, but there are things you can do to help support your child and in turn, manage the impact his or her disorder has on the rest of the family.

• Educate yourself – do the research and learn as much as you can about obsessive-compulsive disorder. Familiarize yourself with symptoms, treatment approaches, and ways to support your child.
• Talk to your teen – be open and let your teen know you want to talk. Encourage your child to discuss his or her challenges, worries, etc. Important to remember is that you although you cannot force your teen to open up, you can let him or her know you are there when he or she is ready to talk.
• Take care of yourself – having an adolescent or teenager with obsessive-compulsive disorder is bound to take a toll on your own mental health and well-being. There will be times when you likely feel frustrated, angry, overwhelmed, and/or helpless. Thus, it is vital you care for yourself. This may include identifying a support group and/or individual psychotherapist, reaching out to friends and family, incorporating self-care and ways to manage your stress, and getting adequate rest.
• Model a healthy, balanced lifestyle – adolescents and teenagers learn from their parents. Developing and demonstrating a healthy lifestyle (in terms of sleeping, nourishing the body, socializing, self-care, etc.) can help encourage your child to do the same.
• Don’t blame or shame your teen – it can be extremely frustrating to have a child with obsessive-compulsive disorder. Yet many of the difficult behaviors he or she may be displaying are likely not intentional, and thus, it is not helpful to yell, punish, or blame your child.
• Help your teen seek treatment and continue to encourage him or her to follow through with the treatment plan and recommended services.

Polaris Teen Center offers residential treatment for mental health disorders, including OCD. For more information on our youth programs, or to speak with an admissions specialist, call 1-844-699-5615 today.

Polaris Teen Center

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Polaris Teen Center is a residential treatment facility for teens and adolescents suffering from severe mental health disorders. Our highly accredited facility is fully licensed and certified in Trauma Informed Care and is a part of the Behavioral Health Association of Providers (formerly AATA).

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