What it is:
Obsessive Compulsive Disorder (OCD) in teens is categorized by a cycle of obsessions and compulsions that result in significant distress or cause life impairment. Obsessions are intrusive and unwanted thoughts, images, or urges that result in severely distressing feelings (e.g., anxiety, shame, disgust). Compulsions are behaviors that are designed to reduce the distress caused by obsessions. While most people will experience obsessions or compulsions at some point in their life, OCD interferes with teen’s ability to function and live the life they want. Common obsessions associated with OCD include contamination (e.g., dirt, germs), loss of control, unwanted sexual thoughts, perfectionism, and harm. Common compulsions include excessive checking behaviors, reassurance seeking, avoidance, counting, and washing or cleaning.
Does This Sound Familiar?
- My teen insists on doing certain routines or actions over and over to prevent “bad” things from happening.
- My adolescent goes out of their way to avoid touching certain things, waits for others to open doors, or insists that others not touch certain “clean” items in their space.
- My teen excessively washes their hands or body, uses excessive amounts of soap or toilet paper. They may demand others wash or clean things in certain ways.
- My teen insists on re-reading emails and school work for mistakes over and over and repetitively checks to make sure they turned in work. They may ask for parents to review their work or ask for reassurance about their performance.
- My youth asks you over and over if you think they are a good person, did something wrong, think this frightening outcome is likely to happen, or confesses things they did wrong.
- My adolescent worries excessively about having accidentally upset others and asks for reassurance that others are not upset with them.
- My teen insists that certain things in their space have to be arranged a certain way, touches items a certain number of times or insists on “evening out” touch on both sides of their body so it “feels right.”
Associated Concerns:
Anxiety: Teens with OCD often experience other forms of anxiety and stress, including social anxiety, generalized anxiety, panic, and specific phobias. Our OCD experts are well-equipped to treat teens with multiple forms of anxiety and understand how to teach principles and skills that target the underlying drivers of multiple forms of anxiety.
Depression: OCD can get in the way of a teen’s ability to engage in various activities that produce meaning and joy, including going to school, eating, sleeping, spending time with friends, and physical activity. When OCD becomes life-interfering, it often leads to depression as adolescents feel a loss of control.
Shame: While perfectionism can be viewed as a subtype of OCD, many teens with OCD can be more sensitive to easily feeling guilt and shame. This may show up as being quick to get down on themselves, easily feel others are angry and upset with them, blame themselves too harshly, and hold themselves to unreasonably high standards. This can contribute to anxiety, depression, eating concerns, and self-harm/suicidality.
Suicidality; self-harm: Severe OCD can make being alive quite miserable, which can lead adolescents to feel hopeless and suicidal. This, in and of itself, can also lead to self-harm. At other times, self-harm can become an OCD compulsion, as teens may have intrusive thoughts that produce shame and guilt that they then “punish” themselves for with compulsive self-harm.
Autism; ADHD, and Neurodivergence: Research suggests neurodivergent teens experience higher rates of OCD. For those adolescents with subtler presentations of neurodivergence, often OCD may present first or be more obvious. When OCD presents alongside sensory sensitivities, broader rigidity in thinking and behavior, social challenges, and/or attention issues, assessment for neurodivergence can be very helpful.
Eating disordered behavior: Many experts believe that anorexia nervosa can be conceptualized as OCD applied to the body and food. Additionally, for teens without any concerns about their body shape and size, OCD can lead to significant difficulty eating due to intrusive thoughts that food is contaminated and fears of vomiting.
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