How Can I Tell If My Teen Has OCD?

Between one and 200 (about 1-2%) American teens suffer from OCD.

A teen, who lines up their sneakers in a row, checks and re-checks doors, windows, facets, the oven, etc., to make sure they are turned off, and/or folds t-shirts in a particular way may be suffering from obsessive-compulsive disorder (OCD).

Perhaps, this teen is just trying to keep his or her belongings neat and organized, but, what if something more is at play – something like OCD?

If a teen’s behaviors are repetitive and compulsive, and if they prevent him or her from performing tasks, completing homework assignments, paying attention in class, or interacting with peers, it may be time to seek OCD treatment for him or her.

But how can you tell if a teen is just “quirky” or if he or she has a diagnosable mental health condition, like OCD?

Well, the first step is to get a better understanding of OCD. According to the American Psychiatric Association (APA), OCD involves intrusive, repetitive, and involuntary obsessions (i.e., thoughts, urges, fears, doubts, mental images, etc.) that not only cause distress or anxiety but also compel the individual to perform certain actions or engage in specific behaviors to get relief from his or her obsessions.

The truth is it is hard enough being a teenager without OCD, add on OCD, and the perfect storm can develop – unless OCD treatment is sought. If you are trying to understand how OCD affects teens, you have come to the right place. This article can provide you with a glimpse into the life of a teen with OCD.

What Causes OCD in a Teen?

Similar to other mental health conditions, the cause of OCD in teens varies from person to person.

Listed below are risk factors that can predispose a teen to OCD:

Genetics and Environment

According to researchers, OCD is genetic. What does that mean? It means that the teen has a family history of OCD, anxiety, or another mental health condition – a history that predisposes him or her to OCD. Although researchers believe that OCD has a genetic/biological component, the exact gene remains unidentified. Still, the general consensus, is that OCD is familial.

A teen’s environment also appears to be a contributor to OCD symptoms. This is where the nature vs. nurture debate comes into play. Some experts believe that obsessions and compulsions are “learned behaviors.” In other words, teens learn from their parents and/or other adults in their environment how to think and behave, which suggests that some teens develop OCD after adopting their parents’ behavioral patterns.

Trauma and Stress

Trauma and stress, specifically, stressful events, may be risk factors for OCD in teens. Teens, who have been abandoned, neglected, or abused are especially prone to develop a comorbid post-traumatic stress disorder (PTSD) and OCD condition. However, critics argue that PTSD is often mistaken for OCD and while trauma and stress can trigger OCD symptoms, these negative emotions are linked to past events, and situations, while OCD focuses on future doubts, fears, and uncertainties – and a desire to reduce or stop them.

What Are Some Common OCD Symptoms in Teens?

OCD is an anxiety condition characterized by non-stop, unwelcomed obsessions and compulsions. The purpose of compulsions is to ease the stress and anxiety triggered by the obsessions. OCD symptoms usually present during childhood or adolescence with the most common onset occurring at the age of 10. Some people with OCD may experience a reduction in symptoms as they age, while others may experience chronic or worsening symptoms that persist into adulthood.

It is important to recognize OCD in teens because it can significantly reduce their quality of life. More specifically, OCD can cause problems in romantic relationships, friendships, and/or at school, home, or even at work. And, if OCD is left untreated, it could lead to anxiety, depression, and/or substance abuse (drug and/or alcohol addictions).

OCD can also disrupt sleep. Teens are notorious for erratic sleep patterns – i.e., going to bed late, sleeping late, napping during the day, and/or awakening too early, however, for some teens this could signal OCD. Intrusive thoughts and repetitive behaviors can cause sleep disorders, like insomnia, in teens with OCD. These thoughts and behaviors tend to appear to worsen at night. If a specific bedtime routine is disrupted, the action or behavior must be performed again until the routine is completed.

According to experts, teens with OCD can spend 30 extra minutes settling in for bed. A lack of sleep has been linked to poor school performance, mood swings, irritability, aggression, relationship conflicts, anxiety, depression, chronic stress, physical ailments, viruses and infections, high blood pressure, mental confusion, etc. Also, insomnia can impair the therapy process, making it less effective.

Note: Sometimes, when teens are struggling with an anxiety condition, they turn to drugs and/or alcohol as a “coping mechanism.” Teens, who are grappling with mental health issues are likely to feel isolated from other, stigmatized, labeled, ostracized, misunderstood, and/or overwhelmed. To “escape” these negative feelings, teens with OCD may turn to alcohol and/or drugs for relief.

My Teenage Daughter Has OCD and Is Being Bullied – What Should I Do?

Unfortunately, some teens with OCD are psychologically, mentally, socially, and/or physically bullied. This can be extremely upsetting for both the parents and the teen. And, in some cases, bullying triggers depression, self-harm, and/or suicidal ideation.

If you become aware that your teenage daughter is being bullied at school, work, or in the community, consult the appropriate professionals – the police, school administration (i.e., teachers, principal, social worker, guidance counselor, etc.), HR at your daughter’s job, s counselor or therapist, etc.

Your daughter must learn healthy coping skills and strategies to help her deal with the bully. It is also imperative that she learn how to be more assertive towards the bully. The thing your daughter needs most right now is to feel safe and supported, so she can stand up for herself.

You may want to also consider enrolling her in individual therapy, so she can improve her social skills, and build or rebuild her self-esteem and self-confidence – while also managing her OCD symptoms.

What Are the Most Common Obsessions and Compulsions Found in Teens?

Obsessions

Listed below are the most common OCD obsessions found in teens:

• Fear of dirt, bacteria, and/or germs
• Fear of being “contaminated”
• A need for order and accuracy
• A “fixation” with religious tenets
• A preoccupation with bodily fluids
• An excessive preoccupation with “lucky” and “unlucky” numbers
• Sexual, violent, and/or aggressive thoughts or urges
• Fear of harming oneself or someone else
• A fear of becoming ill (i.e., Covid-19)
• A “fixation” with household items (i.e., knives, spoons, forks, vases, bowls, pots, pans, etc.)
• A “fixation” with sex or porn
• Violent thoughts or urges
• Constantly using profanity, being sacrilegious, and/or adopting a “swearing habit”
• A fear of upsetting or offending other people
• Fear of disappointing friends, loved ones, co-workers, etc., by being “imperfect” in academics, sports, music, and/or art
• Existential fears

Listed below are the most common compulsions found in teens:

• Excessively grooming or performing grooming rituals (i.e., repeatedly washing one’s hands even after he or she knows they are clean, showering, or brushing one’s teeth multiple times a day
• Checking and re-checking things (i.e., going in and out of one’s home a specific number of times, making sure the stove is off, the windows are closed and the door is locked multiple times, repeatedly making sure homework assignments are complete, using a pattern to walk through one’s home or in public spaces, reading and re-reading books, articles, blogs, magazines, notes, texts, etc., excessively erasing mistakes even after the person can no longer see them, and/or writing and rewriting things numerous times)
• Avoiding uncomfortable situations, activities, or people and/or trying to avoid or prevent one’s fears, worries, etc. (i.e., avoiding doing homework assignments for fear of making a mistake)
• Constantly seeking reassurance (i.e., seeking validation from friends and family that nothing bad will happen to them if he or she does not perform a ritual or routine)
• Obsessively trying to protect oneself or others from contact with “contaminated” people or objects
• Feeling the need to continuously touch certain people or objects
• Taking steps to prevent oneself from harming yourself and/or others
• Categorizing or arranging objects
• Performing counting rituals
• Hoarding or excessively collecting items – even if they hold little-to-no value
• Excessively cleaning one’s body, room, desk, bathroom, etc.

What Tests Are Used to Diagnosis OCD in Teens?

Surprisingly, there is a variety of “unofficial” online OCD assessments that can help teens and their parents identify if they could be struggling with OCD. These assessments may include Impulse Therapy Online OCD Test, the Child, and Adolescent OCD Test, 3-Minute Obsessive-Compulsive Disorder (OCD) Test, etc.). While completing these assessments will not yield an “official” OCD diagnosis, they may still highlight a need to investigate further. To receive the most effective OCD treatment, it is important that a mental health professional properly evaluate and diagnose OCD teens.

How is OCD Treated in Teens?

The truth is there is no magic cure for OCD in teens.

Although OCD can be very restrictive, however, there are treatments available that can improve OCD symptoms, making them more manageable.

The most common OCD treatments for teens involve a combination of medication (i.e., SSRIs), cognitive-behavioral therapy (CBT), exposure and response prevention (ERP) therapy, and acceptance and commitment therapy (ACT), along with hypnotherapy/hypnosis, lifestyle changes (i.e., a healthy diet, plenty of exercise, stress-management techniques, a strong support system, yoga, etc.) and self-help tools, like Impulse Therapy, an online OCD treatment program.

Antidepressants, like SSRIs, can also be used to treat OCD in teens. SSRIs boost the amount of serotonin in the body. Low levels of serotonin can trigger depression, anxiety, and/or OCD symptoms in teens.

Cognitive-behavioral therapy (CBT) is also commonly used to treat OCD symptoms in teens. CBT can teach teens how to change the way they think (obsessive thoughts), which in turn, can change their behaviors (reduce or eliminate their OCD symptoms).

Exposure and response prevention (ERP) therapy is the most common and effective treatment for OCD in teens. This therapy approach involves slowly exposing the teen to the things he or she is fearful of, so he or she learns healthy coping skills and strategies that will help him or her better manage his or her OCD symptoms.

Acceptance and commitment therapy (ACT) is a type of behavioral therapy that provides teens with OCD with a “compass” that allows them to start making strides towards being the people they want to be. According to acceptance and commitment therapists, it is not the intrusive or upsetting thoughts, feelings, mental images, fears, doubts, or urges that are causing the problem.

Rather, the real problem is an inability to properly process and accept these feelings and commit to making the necessary changes to reduce the symptoms or improve the situation. ACT can help teens with OCD recognize how the condition is affecting their lives, make positive changes and commit to the therapy process.

And, although self-help tools are considered a conventional OCD treatment for teens, studies suggest that they are beneficial for people, struggling with OCD. Other self-help tools involve online OCD treatment programs, OCD books, forums, articles, websites, and support groups.

If

OCD in teens is left untreated it could lead to the following consequences:

• Self-isolating and emotional detaching from friends, family, and activities that used to bring them joy
• Performing poorly in school or at work
• Becoming addicted to drugs and/or alcohol
• Developing an eating disorder or other mental health condition (i.e., anxiety, depression, etc.)
• Experiencing relationship problems
• Self-injuring themselves, and/or having suicidal thoughts

Note: OCD does typically arise overnight, except in cases of PANDAS. Also, keep in mind that it may take months before you see a noticeable difference in OCD symptoms.

Can Neurofeedback Help My Teen’s OCD Symptoms?

Neurofeedback may also calm OCD obsessions and compulsions by quieting your teen’s nervous system. When the nervous system is “calmed” or “relaxed,” he or she enters a parasympathetic state, where he or she can think more clearly, and cope with the OCD symptoms in a healthier way. Thus, neurofeedback affects your brain, specifically, how your teen thinks. Your teen’s thoughts affect his or her behavior, so in theory, neurofeedback can alter his or her OCD thoughts (obsessions), which in turn, can change his or her behavior (compulsions).

Brain-based interventions, like neurofeedback, may be beneficial for teens with OCD because they help them more accurately process stimuli. What does that mean? It means your teen will have fewer obsessions, compulsions, mood swings, confrontations, panic attacks, intrusive thoughts, worries, doubts, urges, and/or mental images. And, more time to think rationally, interact with others in positive ways, and think more clearly, so your teen does not get stuck in an endless OCD cycle.

My Teenage Son Is Struggling with OCD – How Can I Help Him?

There are several ways you can help your teen cope with his OCD symptoms, such as:

• Pay Attention

  The best thing you can do if you suspect that your teen is struggling with OCD is to learn about and look for signs of the condition. For instance, if your teen suddenly changes his routines or spends long amounts of time on one or more tasks, becomes “fixated” on certain topics, ideas, trends, beliefs, etc., and/or experiences obsession and compulsions that are negatively affecting their lives – in a variety of settings, he may have OCD.

• Talk to Your Teen

  If you think your teen is struggling with OCD, you must talk to him about it. The key to making this tip work is keeping an open mind and open heart. Listen to your teen and validate his feelings without interrupting or dismissing his fears, doubts, feelings, etc.

  Let your teen tell you how he is feeling and what he is going through and make sure he or she knows you will always be there for him. Your teen needs to feel safe and supported by you and other loved ones. So, listen to your teen and follow his lead by securing the appropriate resources for him.

• Seek Treatment

  If you are unsure how to approach your teen’s OCD symptoms, seek OCD help for him. A multi-treatment approach is usually the go-to treatment for OCD in teens. A therapist can help your teen process his feelings, get to the root of the OCD symptoms, and develop healthier coping skills and strategies to combat the obsessions and compulsions.

What Should I Do If My Teen Refuses to Seek OCD Treatment?

Teens can be stubborn – really stubborn and deviant, especially towards things they do not want to do like seeking OCD treatment. It is not uncommon for a teen to refuse to go from an evaluation and it is equally common for a teen to refuse to take his or her medications and/or attend therapy sessions – without being pushed to do so.

The teen years can be turbulent – even without OCD symptoms, however, adding OCD into the mix can be confusing, anxiety-provoking, and scary. As a result, many teens with undiagnosed OCD, do not receive the OCD support they need to improve their quality of life. Some teens with OCD worry about how others will perceive them once an “official” OCD diagnosis has been rendered.

Others worry about how the medications (i.e., Luvox, Paxil, Zoloft, Celexa, Lexapro, or Prozac) will affect them at school, work, and in their relationships and personal lives. Your teen may also be reluctant about seeking OCD treatment because he or she simply does not understand the gravity of his or her condition.

The best thing you can do to help your teen feel more comfortable about seeking OCD help is to find a therapist, who has experience with motivational interviewing (MI). Motivational interviewing (MI) is designed to encourage or “motivate” your teen to take steps to change or reduce his or her fear of OCD and OCD treatments. MI techniques can also help your teen become more aware of how the OCD symptoms are impacting his or her life – and the lives of his or her friends and loved ones.

Note: Do not try to force your teen to seek treatment because it will backfire, causing him or her to dig his or her heels in even further. Rather, try to be a constant stream of support for when your teen is ready and willing to take the next step. Constant nagging, pleading, belittling, confrontations, and criticizing will only make the situation worse.