Need help now? Call our 24/7 confidential hotline (844) 229-6013

Obsessive-Compulsive Disorder in Teens

Obsessive-compulsive disorder brings recurrent, pervasive thoughts that trigger unwanted behaviors in sufferers. Sometimes, teens battling this disorder turn to substance abuse to mask the pain it causes, but only end up exacerbating their OCD. If your teen is struggling with addiction and OCD, professional treatment may be necessary.


11 min read

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is a mental illness marked by the presence of pervasive, unpleasant thoughts and subsequent behaviors that are caused by these thoughts. The behaviors — which vary from person to person — can temporarily fend off the unwanted thoughts. Having the thoughts and then engaging in the behaviors becomes a debilitating and vicious cycle, which can lead to significant problems in a teen’s everyday life.

While a person with OCD may be perfectly aware that their fears are not based in reality, they may still not be able to shake the persistent, intrusive thoughts. Remember not to place any blame on your child for their behaviors, because OCD is a disorder they cannot control.

OCD usually begins before age 25, and it often ravages teenagers. In fact, about one in 200 adolescents suffers from OCD — with prevalence split equally between the sexes.

When Was OCD Discovered?

While people have struggled this disorder for quite some time, professionals’ views on OCD have changed over the years. English scholar Robert Burton mentioned OCD sufferers in his renowned 1621 medical textbook, Anatomy of Melancholy: “If he be in a silent auditory, as at a sermon, he is afraid he shall speak aloud and unaware, something indecent, unfit to be said.” Originally considered an anxiety disorder, OCD is now classified as a singular issue.

Obsessions vs. Compulsions

As you might imagine, the term “obsessive-compulsive disorder” is derived from OCD sufferers’ cycles of obsessions and compulsions:

    • Obsessions – A teen suffering from OCD is completely consumed by their distressing thoughts, which are known as “obsessions” in this context. Obsessions often include irrational fears such as germaphobia, an unfounded fear that a loved one will be killed, or an unhealthy preoccupation with a certain number.
    • Compulsions – Due to the extreme anxiety caused by obsessions, a teen with OCD feels compelled to perform a behavior in order to alleviate that anxiety. The behaviors — known as “compulsions” — that result from these thoughts serve to briefly relieve the obsessions, but the obsessive thoughts always return. A few common examples of compulsions are excessive counting, unnecessary organizing of items and non-stop checking (for example, a teen girl who suffers from OCD might feel she is unable to leave the house unless she checks several dozen times that she locked the front door). Compulsions eat up a lot of time, and can prevent your teen from living a healthy, productive life.

For example, a child who suffers from OCD may be intensely afraid of germs. Consequently, they might engage in compulsive hand washing. In this case, the fear of germs is the obsession — which causes them stress — and the hand washing is the compulsion — which relieves his stress.

Types of OCD

washing hands

There are thousands of subtypes that fall under the OCD umbrella. A few of the most prevalent are as follows:

    • Checking – characterized by feeling compelled to repeatedly ensure that an appliance has been turned off, or a door has been locked, despite having already checked it many times
    • Hoarding – characterized by being afraid to throw anything away, and collecting an unusual amount of belongings or even animals
    • Cleaning or Washing – characterized by an intense fear of contamination (the cleaning subtype refers to a fear of environmental contamination, and the washing subtype refers to that of bodily contamination)
    • Repeating – characterized by feeling compelled to repeat certain actions a highly specific number of times (e.g. your teen may need to turn off a light switch exactly 33 times)
    • Orderliness – characterized by feeling compelled to arrange items into a certain order, or needing things to be “just right”
    • Sexual – characterized by experiencing unwanted thoughts pertaining to sex, or to one’s sexual orientation
    • Religious – characterized by a fear of offending a deity, and feeling guilt about any actions that one may perceive as wrong or sinful


What Causes OCD?

distressed teenaged girl

Right on par with many mental illnesses, the causes of OCD are complicated and not entirely understood. However, mental health professionals have gained some headway in understanding what’s behind this disorder.

Environmental factors such as disease can play a role in OCD development. Specifically, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep (PANDAS) is a sudden-onset form of OCD that follows a bodily infection. This troubling occurrence most often impacts children ages 3–14. For example, a youngster will seem well-adjusted one week, then — almost overnight — begin to exhibit severe OCD symptoms, such as obsessive hand washing.

Significant amounts of research have been poured into PANDAS, and have shown that this OCD subtype is associated with not only strep throat, but also Lyme disease, mono, mycoplasma and certain strains of the flu. If you notice acute OCD symptoms in your teen, consult your family’s doctor, who will inspect your child for signs of these illnesses.

Another theory about the causation of OCD has to do with each sufferer’s unique biological makeup. Of course, everyone has different brain chemistry. Research indicates that some people are more predisposed to developing OCD, due to serotonin imbalance in the brain.

Research points to genetics as a factor in OCD, as the disorder does appear to run in families. For reasons yet unknown, adolescent-onset OCD seems to be more genetically based than adult-onset OCD.

Additionally, OCD can be triggered by a stressful life event such as the death of a loved one or a bad car accident. If your teen is especially sensitive to stress, the risk of developing OCD is increased.

OCD and Addiction

teen with head in hands in front of boxes

The anxiety caused by OCD can either precipitate drug or alcohol addiction or exacerbate an existing addiction. OCD is often a co-occurring mental disorder — more than one-quarter of sufferers who seek treatment also have a simultaneous drug problem. In fact, researchers have found that the parts of the brain associated with substance addiction are also associated with OCD.

Teens with OCD are especially vulnerable to substance abuse, since they may lack many of the coping skills that adults have had time to develop. For example, if your teen is experiencing extreme distress over their OCD symptoms, taking drugs may help them to experience temporary relief through being high.

OCD and Alcohol

Because alcohol is a depressant — which means it slows down the body’s central nervous system — it can serve to “take the edge off” or lessen the intensity of OCD symptoms. Alcohol abuse rates are higher in teens with OCD than those in the general population. Teens begin to abuse alcohol to counter their OCD issues.

Antidepressants and OCD

It is widely recognized by clinicians that antidepressant medications can enhance the effectiveness of OCD treatment. These medications are designed to boost mood by rearranging brain chemistry. There are many antidepressants available, but doctors find the ones that work particularly well for teens with OCD are selective serotonin reuptake inhibitors (SSRIs), which impact a brain chemical called serotonin. This is because a brain that is impacted by OCD often has abnormal serotonin levels. Medication can help to even out those levels.

Following treatment with SSRIs, between 40–60% of teens experience at least partial improvement in their OCD symptoms. Your teen may or may not benefit from medicinal intervention. Only a medical professional can determine the appropriateness of medication for treating your teen’s OCD.

OCD Symptoms in Teens

teen girl obsessing over fingernails

If your teen has OCD, the symptoms are experienced constantly and with great intensity. A few of the most common OCD signs are as follows:

    • Fear that one’s body or environment is contaminated by germs
    • Preoccupation with counting
    • An intense need to have items in an exact order
    • Excessive checking
    • A need to perform actions a certain number of times
    • Consistent thoughts about yelling swear words or otherwise acting inappropriately
    • Imagining hurting others or oneself
    • Unwanted thoughts or mental pictures pertaining to sex
    • Avoiding certain numbers that create a negative feeling in the sufferer


Effects of OCD

Obsessive-compulsive disorder can wreak havoc on every aspect of a teen’s life, from school to work to home to social situations.

Mental Effects of OCD

Compulsions can be all-consuming, leaving little room for anything else in your teen’s mind and schedule. Your teen may withdraw socially, in order to practice their compulsions in private. They might not have time to engage in important activities such as schoolwork. Due to the negative impact that OCD has on a sufferer’s life, depression and self-hatred can ensue, provoking a host of new problems, including substance abuse.

Physical Effects of OCD

It is no secret that when drugs or alcohol are abused, the body is harmed. Here are a few issues that can crop up when these substances are abused:

    • Liver damage
    • Skin problems
    • Changes in appetite and/or weight
    • Autoimmune diseases such as HIV/AIDS
    • High blood pressure
    • Heart failure
    • Raised risk for some cancers
    • Seizures


Although this disorder can have a detrimental impact on your teen’s mind and body, a diagnosis of OCD is not insurmountable. The brilliant 19th-century innovator Nikola Tesla suffered from OCD, yet prevailed in spite of the disorder. However, it is crucial to obtain high-quality OCD treatment if your teen is to move forward in a healthy fashion.

Does My Child Need Treatment?

All disorders and addictions can be overcome, but most require some form of professional treatment. If your child exhibits symptoms of any mental illness or substance addiction, do not wait to get help. Reach out immediately to your child’s primary care physician, who can assess the situation and determine whether a disorder or addiction is present. You can also contact our treatment advisors at, who offer free, confidential guidance for parents who are concerned about their children’s substance abuse habits.

Residential treatment is often an effective option for co-occurring disorders because it provides an around-the-clock, immersive therapeutic experience. If the doctor sees that your child’s addiction is mild, they may recommend outpatient rehab instead.

However, without treatment, mild addiction can quickly devolve into a more serious problem. Reach out to today, and we can answer any addiction or rehab questions you might have. We can offer as much or as little assistance as you’d like, and there are no costs or obligations — just care and help. Don’t delay — your child needs you now more than ever.


Questions? We have answers.

Our recovery advisors have more information about mental health and addiction, and rehab options.


Is your child struggling with addiction?

Call us to speak confidentially with a recovery advisor today.

Get Help Now (844) 229-6013