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How to Spot OCD Symptoms in Teens

Most kids with OCD go into adulthood without a diagnosis. This means years of feeling different. Years of feeling ashamed. And years of little to no support. If parents and therapists can learn how to spot OCD symptoms in teens, we could help them save years of unnecessary pain and suffering.

OCD requires a very specific therapeutic approach called Exposure Response Prevention (ERP). If a teen’s OCD symptoms are missed, they are also missing the help they so desperately need and deserve.

Sadly teens with OCD who go undiagnosed have a higher likelihood of suffering from depression and ongoing symptoms.

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So what are the signs of OCD in teens?

It’s not always an easy thing to detect. Teens with OCD have had years to develop compulsions. Many of them have gotten very good at the art of hiding these behaviors.

Let’s start with what OCD is and what it isn’t.

OCD is not about being a “neat freak.” Many extremely messy teens are silently suffering from OCD. OCD is not about being obsessed with organizing. Many disorganized teens can still have OCD.

OCD is about having an intrusive thought, feeling, image or song stuck in one’s head and the need to do or avoid something to get some brief relief. The problem is, the more you do or avoid, the bigger the OCD grows.

OCD has many sub-types.

OCD isn’t just about germs. In fact, many people with OCD don’t worry about germs. There are many different “sub-types” or themes around OCD.

-Some teens worry they are a bad person.
-Some teens don’t feel right and have to do things over and over again.
-Some teens worry about getting sick.
-Some teens worry about throwing up.
-Some teens worry about having things balanced.
-Some teens worry about getting poisoned.
-Some teens feel a strong disgust around certain things or people.
-Some teens feel discomfort if they don’t do the things OCD wants them to do.
-Some teens feel like something bad will happen if they don’t do compulsions.
-Some teens feel they will be responsible for bad things happening.

The list can go on and on. The common denominator though is this: They all have an intrusive thought, feeling, image or song in their head and they all do compulsions to get some relief.

So how can you tell if your teen has OCD?

When in doubt, go see an OCD therapist to get a proper assessment. You can visit the International OCD Foundation’s therapist directory to see if there is anyone in your area. It is always good to be proactive and get professional help. This list below is just for information and is not designed to replace the guidance of a qualified OCD therapist. I strongly suggest parents take their teens to get an evaluation. It can’t hurt and it can only help.

I will highlight some of the most common behaviors I see in teens with OCD. This is not a comprehensive list. Behaviors I list below are just possible red flags. If you see some of the behaviors I talk about, it doesn’t mean a teen has OCD, but rather it is a possible red flag to explore further.

Teens with OCD do not have all of these behaviors, in fact most will only have a few. This list is to give you a broad understanding of the many ways OCD can manifest in teens.

Observe their behavior

OCD compulsions will often appear bizarre or non-sensical to the observer. If a teen is doing things that don’t seem to make sense or are repetitive in nature, explore this with them. Remember though, teens have often hidden these behaviors for years. They might feel embarrassed and may explain away their actions.

Some common OCD behaviors can include things like:

-Over washing or showering
-Not allowing others to touch their things
-Meltdown when someone sits on their bed or enters their room
-Won’t use or touch certain things in the house
-Avoids certain objects, places or people
-Repeats behaviors over and over
-Checks things over and over
-Washes things down
-Touches things with elbows or uses their clothes
-Has to touch things with both sides of their body to make it even
-Has bodily gestures, blinking or movements (sometimes they can seem like tics)
-Has to do things in odd or even numbers
-Over wipes in the bathroom and/or uses an excessive amount of toilet paper
-Turns things on and off multiple times
-Opens and closes doors, drawers or containers multiple times
-Writes and re-writes or reads and re-reads things

Pay attention to their questions

Interactions with parents can often be compulsions in disguise. OCD will want a teen to ask for reassurance. They will want to confess behaviors and thoughts. They will ask you to repeat things or say things in certain ways.

Here are just a few examples of how this can show up:

-Will ask if something is safe to eat or touch
-Will ask if what they did was “bad”
-Will confess that they had a “bad” thought
-Will ask someone to repeat what they said even though they heard it the first time
-Will often say “I think” “Maybe” or “I guess” after they answer
-Will often ask you to make a choice for them
-Will ask you to respond in a very specific way
-Will ask the same question over and over, even after you’ve answered it
-Will try to get your approval for things that don’t warrant permission
-Will tell you their actions or behaviors when it isn’t necessary
-Will ask you if they are okay or have a temperature

Watch their routines

Compulsions are often disguised as “habits.” Habits are preferential behaviors, but they are not necessary. When a teen has a habit, they enjoy doing things in a certain way, but can be flexible. When a habit is really a compulsion in disguise, the teen will panic if you try to get them to veer away from doing it.

Here are some examples:

-Has to walk in certain ways or patterns around the house
-Will only use certain cups, plates or towels
-Will do things in a very particular order
-Will get upset if their routine is disrupted and will have to start all over again

Ask them these questions

Don’t be afraid to ask your teen questions about their behavior. You don’t want to do it in an accusatory tone or you’ll most likely shut them down. I would recommend starting off your question with something like…

“I noticed you have to only use this plate, what’s the worst part about using our plates?”

“I noticed you won’t touch the doorknob with your hands. What does your anxiety say would happen if you did?”

It can also help to show them a teen Youtube video on OCD. Often when kids see that they are not alone, they are more likely to open up.

This is a Youtube video I would recommend starting with:

What to do next if you suspect your teen has OCD.

Getting help right away is so key to a positive long-term prognosis. I would strongly encourage you to seek out a therapist who specializes in OCD. Most general therapists will not have the expertise to diagnose or treat teen’s with OCD.

A great starting point is checking out the International OCD Foundation’s directory. Anyone can join the IOCDF directory, so this is just a good place to begin. You’ll still want to do your homework to make sure it is a good OCD therapist.

If you can’t find an OCD therapist in your area, you can look into teletherapy. NOCD provides child and teen OCD teletherapy across the United States. You can click here to learn more.

For step-by-step guidance on how to help your teen with their OCD, you can take my on-demand, online class, How to Crush Your Child’s OCD. In that class I teach parents how to spot OCD signs, what role they play in helping their child and how to do ERP (Exposure Response Prevention) at home. To learn more click here.

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