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 illness marked by uncontrollable and recurring thoughts (obsessions) and behaviors (compulsions). The thoughts associated with obsessive-compulsive disorder feel 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, as well as 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:

• 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).
• Thoughts and/or mental images surrounding violent or aggressive acts toward self or others.
• Obsessive thoughts and doubts about certain acts being completed (i.e. – the door is locked or the oven is turned off); doubts lead to anxiety about catastrophe (i.e. – house burning down, 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).

OCD Symptoms in Teens

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)

OCD Causes in Teens

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 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, OCD was historically classified as an anxiety disorder but has since been reclassified in DSM-5 due to key differences compared to other anxiety disorders. 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.

OCD Treatment for Teens

Obsessive-compulsive disorder in adolescents and teens can be effectively treated with specialized therapy, particularly Exposure and Response Prevention (ERP) therapy, to treat OCD. 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.

Individual OCD Therapy for Teens

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

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 with teen 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.

Supporting Your Adolescent or Teenager with OCD

Living with a teenager with obsessive-compulsive disorder can be challenging, but there are things you can do to help support your child and 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. It is important to remember that 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.