OCD and Teens: What to Look For

Patients with OCD need to control their fear about unrealistic, improbable, or intrusive ideas. When OCD emerges amid adolescent uncertainty, the result can be a mental health condition that is hard to identify, and even harder to manage. Parents should be looking for signs your teens’ worry is more than just passing anxiety, and speak to a professional when the symptoms of OCD arise.

How Does OCD Affect Teenagers?

Obsessive compulsive disorder (OCD) is one of the more common mental health disorders among teens and other school-age youth, but it is not as commonly discussed as mood disorders like anxiety and depression. OCD often starts in late adolescence, but up to one quarter of cases have begun by age 14. That means that OCD is often a teenage mental illness that first needs to be addressed in high school.

OCD is related to anxiety, and patients who suffer from OCD often also experience anxiety, depression, or social phobias as well. However, the two aspects that set OCD apart from other anxiety disorders are obsessions and compulsions.

Common OCD Obsessions for Teens

The “obsessive” part of obsessive compulsive disorder involves intrusive thoughts that cause heightened anxiety or worry. Among teens, this could include:

• Worry about germs or getting sick
• Fear of dying
• Concern that something will go wrong, or bad things will happen
• Feeling that things need to be “just right”
• Thoughts or images of hurting others
• Disturbing thoughts or images about sexual behavior
• Worry over sexual orientation

Patients with OCD often struggle with being uncertain about their thoughts. The repetitive thoughts, images, and urges are unwanted and obtrusive, and can interfere with students’ ability to focus on work and school.

This is especially true for teens. As children grow up, they begin to encounter issues of sex, social status, changes to their physical body, and moral or religious questions. These new uncertainties can trigger or aggravate OCD in ways teens, their parents, and even their treatment professionals don’t expect. Your family should work with your therapist to anticipate the stressors and create strategies for dealing with obsessions when they occur.

Common School-Aged OCD Compulsions

The way an OCD patient responds to these obsessive thoughts is through ritualized compulsive behaviors. For school-aged teens, these compulsions could look like:

• Repeated arranging or ordering their desks, backpacks, lockers, or closets
• Frustration or anger when things become disorganized or routines change
• Resistance to trying new things
• Redoing or re-checking completed assignments to ensure they are done perfectly
• Repeating themselves to make sure words sound right
• Atypical sloppiness or carelessness, or incomplete homework
• Frequent toilet use or hand washing
• Refusing to touch others’ belongings or share their own
• Counting, tapping, or touching objects
• Avoiding physical contact with people or objects
• Excessive need for reassurance

Which compulsions manifest depends on the type of obsessions a teen is experiencing. The compulsions are generally based on avoiding or minimizing the unwanted thoughts.

Getting Teens to Talk About OCD

OCD can be challenging for teens and their parents. While obsessive compulsive disorder is treatable with medication and therapy, teens often refuse to go through with assessment and treatment. This could even be based on the disorder itself if the teen is afraid of the stigma associated with an OCD diagnosis. They may not even tell you about their obsessive thoughts, thinking they are a normal part of growing up.

Often, compulsions are the first sign for parents that something is wrong. You can work with a therapist experienced with teenage OCD to develop questions that will encourage them to make a change and reduce their negative feelings about treatment. However, you also need to accept that your teen may be more willing to talk to a therapist about their thoughts than they are with you.

That tendency, for teens to distance themselves from their parents, makes having other skilled adults available essential. Your teen needs to know there is someone safe to reach out and explain their feelings to. Ideally, this person will be a psychotherapist with experience working with OCD teens. Through tested therapy methodologies, that therapist will help them learn to interrupt their intrusive thoughts and reduce the need for compulsive acts, so they can live life without constant interruptions.

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David Stanislaw is a psychotherapist with over 30 years of experience. He helps children, teens and adults manage obsessive compulsive disorder, anxiety and other psychiatric issues. Contact David Stanislaw to get help for your teen today.