Adolescents often have routines that they don’t like to break. When does a love of routines cross the line into obsessive-compulsive disorder, commonly abbreviated as OCD? The teen years are a common time for mental health issues such as OCD to become apparent, so it is helpful for parents to know the signs and symptoms of obsessive thoughts and compulsive behaviors. This can enable you to get your teen the help he or she needs. Read on to learn more about the symptoms of OCD in teens and what you can do to help.

What Is OCD?

OCD stands for obsessive-compulsive disorder. The disorder is made up of two separate issues:

The obsessive part of the disorder means that the individual will have obsessive and intrusive thoughts. While many people think that most OCD has to do with cleaning or cleanliness, that is just one example. The thoughts often revolve around safety. For example, a teen might worry that someone will break into their home or that their family members will be killed. These thoughts happen over and over again and cause the second part of the disorder.

The second part is compulsive behavior. In an effort to stop the obsessive thoughts from becoming a reality, the person feels as though they must follow through on a particular behavior. Going through the behavior (which could be checking the door to be sure it is locked, washing their hands, saying a certain phrase, or just about anything else) makes them feel as though they or their family is safe, but this relief only lasts a few seconds or a few minutes. Then they must go through the behavior again.

As time goes on, the obsessive thoughts and compulsive behaviors often get worse and begin to negatively affect the person’s life.

How Does OCD Manifest in Teenagers?

Obsessive-compulsive disorder can manifest in a wide variety of ways. A teen will often feel extreme anxiety when they are being plagued by their obsessive thoughts and might also feel anxious as they go through the motions of their compulsive behaviors.

Some of the ways that OCD can present in teenagers include:

• Cleaning or contamination symptoms. The adolescent might feel that they are at risk of getting themselves or someone else seriously ill if they don’t wash their hands constantly, disinfect the bathroom floor, scrub silverware a certain number of times, and so on. Someone who is naturally neat and clean or who is sanitizing the home because an illness recently went through the family is not suffering from OCD. The condition is irrational and not based on normal cleanliness or extra efforts made on a short-term basis for a specific reason.
• Hoarding symptoms. Your teen might feel as though they can’t get rid of certain items that are generally characterized as trash because something bad might happen. For example, your teen might safe food wrappers because they are terrified of eating outdated food and they need to keep checking the packaging of what they ate to assure themselves that they haven’t eaten anything that they perceive as unsafe.
• Ordering or repeating symptoms. Some teens will decide that tasks or rituals need to be done in a certain order and that doing them out of order will cause death, illness, or another tragedy. Symptoms of this type of OCD include counting rituals, needing to touch the wall a certain number of times, needing to clear their throat three times before speaking, etc. They also might repeat phrases over and over again.
• Health symptoms. People with health anxiety often fall under the OCD umbrella. With easy access to health information (some of it accurate and some of it not accurate), it is becoming more common for people with health anxiety to get into the ritual of having to check their symptoms over and over again. For example, if a teen with health-related OCD believes that their heart skipped a beat (which is common and usually not of concern), they might look up information about the phenomenon over and over again and check their pulse repeatedly over the course of a few minutes or a few hours.

There are other ways that OCD can present, as well; these are just a few examples. Also, other types of anxiety or being on the autism spectrum can cause OCD-like symptoms. If you suspect that your teen has obsessive-compulsive disorder, it is important to take them to the doctor for an evaluation.

What Are the Treatments for Symptoms of OCD?

Obsessive-compulsive disorder can be difficult to treat, but it often involves both therapy and medication. With adolescents, sometimes therapy is tried first without medication since the medications used do have some potential side effects and risks for young people. With that being said, it is important to discuss your concerns with your child’s doctor and to take their advice under heavy consideration. Not treating the symptoms of OCD properly can lead to more mental health issues such as anxiety and depression, and these could ultimately lead to suicidal ideation.

The medications used are often SSRIs, which are a type of antidepressant. Some of the brands that might be effective include Zoloft, Paxil, Prozac, and Celexa. These are just examples; your teen’s doctor will have more information on the best medication for your specific circumstances.

One of the most effective types of therapy for teens with OCD is a kind of cognitive behavioral therapy called exposure and response prevention, or ERP. It is a form of desensitization therapy where the individual is asked to think about their obsessive thoughts and to choose not to do the compulsive action. It can be quite effective over time.

If you think that your teenager has obsessive-compulsive disorder, his or her pediatrician or family doctor can perform an evaluation to see whether a referral to a mental health specialist is appropriate. From there, a therapist or psychiatrist can work with your teen to help him or her get the condition under control so it stops impacting his or her life.