Signs and Symptoms of Teen OCD

Obsessive-compulsive disorder, usually abbreviated as OCD, is a mental health condition that often begins during adolescence. Many people don’t understand that OCD has to do with mental health and instead think that people who keep their houses very clean or keep detailed lists have OCD. While neatness and time organization can, at times, be taken too far, being picky about how clean a bathroom is or how scheduled one’s calendar is does not mean that the person is suffering from obsessive-compulsive disorder. Read on to find out what OCD is, how it often manifests in teenagers, and what you can do about it if you think that your teen might be struggling with this condition.

What Is OCD?

OCD affects 1 to 2 percent of the population, so chances are good that you know at least one person with the condition. In order to be diagnosed with OCD, there must be two parts present: The first is obsessive thoughts and the second is compulsive behaviors. If a person has only obsessive thoughts or only compulsive behaviors they likely need mental health treatment, but they would normally not qualify for a diagnosis of obsessive-compulsive disorder.

What Is OCD Not?

As previously mentioned, being a “clean freak” is not the same thing as having OCD. Neither is getting up to check that the door is locked after you go to bed or always checking that the coffee pot has been turned off before you leave the house. Some people ask a lot of questions and want tasks clarified before they begin; this is not OCD. Being detail-oriented is part of someone’s personality and does not mean that they have a mental health condition. Those are just some of the misconceptions people have about what it means to have OCD.

Different Types of Obsessions and Compulsions

Obsessions, or obsessive thoughts, are unwanted and intrusive thoughts that plague those with obsessive-compulsive disorder. The thoughts usually cause distress and they can be scary or disturbing. There are several different types of obsessions. The compulsions, or compulsive behaviors, are the behaviors and rituals that follow the thoughts. The person cannot control the behaviors; they might be able to stave them off temporarily, but the urge to follow through with the behavior will grow and grow until the individual gives in and performs whatever the behavior is. Then they will feel relief for a short time until the urge grows again. Here are some of the categories that someone’s OCD symptoms might fall under.

Dirt and Germs

Your teen might worry excessively about whether something is clean. This is one of the most widely-known manifestations of OCD. You might picture someone worried about shaking someone’s hand because they are concerned about the germs that might be transmitted. Or the person might think that if they eat at a restaurant, they will die from an illness caused by unsanitary food preparation. The behavior might be washing their hands until they are raw and chapped or even bleeding. They might refuse to go to restaurants or question the waitstaff at length about how the kitchen is sanitized. They might carry their own sanitizer and scrub down the table.


Health anxiety can be a form of an obsessive-compulsive disorder. Your teen might worry that every pang, twitch, or sneeze is indicative of a serious health problem. Search engines and the internet have made it easy for people to look up mild symptoms and read about the various rare and severe complications that could theoretically happen. For example, your teen might worry excessively about whether their mild stomach bug could actually be E. Coli poisoning or that their cold could turn into severe pneumonia. The associated compulsive behaviors might include constant Google searches for their symptoms or wanting to go to the doctor for every small sign of illness. They might also ask family, friends, and strangers for their opinions on whether a symptom is serious enough to warrant immediate medical attention.


Some teens, whether or not they have been brought up in a particular religion, might develop intrusive thoughts about going to hell, going to the wrong church, or missing church. They might worry that everything they do is a sin or an affront to God or another deity. Compulsive behaviors might include wanting to go to their house of worship at all costs and not wanting to miss services even if they are very ill or traveling. They might be concerned that they have said a prayer incorrectly and repeat it over and over again in an effort to get it right. They might talk excessively about their beliefs at inappropriate times, even to the detriment of relationships and after being asked to stop.

Symmetry and Rituals

Another well-known form of OCD has to do with symmetry, order, and rituals. An individual might think that something terrible will happen to themselves or someone they know if they do not go through an elaborate ritual or keep things in a certain order. The ritual might not make logical sense to a bystander. For example, your teen might need to walk up the stairs a certain way and go back to start again if they didn’t do it “perfectly.” Or if the table is not set precisely, they might take all of the dishes and the centerpiece off to start from scratch. A teen with OCD might get very upset if you move something in their bedroom because they feel that it wasn’t put back correctly.

Treatment for OCD

If you are worried about your teen’s mental health, treatment is available and can make a difference. Talk to his or her primary care physician and ask for a referral to a mental health specialist who has experience treating obsessive-compulsive behavior in teenagers. Treatments can include both therapy and medications. A type of desensitizing training called ERP is also effective for many individuals for OCD. Most people who are treated notice a reduction in their symptoms, so don’t hesitate to get help for your teen.

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