How Do I Know if My Teenager Has OCD?

Have you noticed your teenager counting things, repeating rituals or lining up objects? Perhaps you've noticed an increased obsession with cleanliness or orderliness? If your teen is acting in an unusual or highly anxious way, it's natural to be concerned.

According to Swinburne University, around 3% of Australians experience Obsessive Compulsive Disorder (OCD) in their lifetime.

Living with OCD is a lot more than being clean and tidy and is not a trivial matter; it's a complex mental health condition which causes intense distress and seriously impacts a person's quality of life. Chronic OCD in teenagers can affect relationships, school, sport, part-time work, family dynamics, and socialising with peers.

What is OCD?

OCD is widely misunderstood and misdiagnosed, with around 60% of people reporting symptoms before the age of 20. It can take many years before someone gets the right treatment, so understanding more about OCD and its symptoms is an important step towards getting your teen assessed.

OCD is an Anxiety Disorder that's caused by hereditary transmission of a gene that leads to biological changes in the brain. Rarely, medical conditions like autoimmune disease and infection can be sources. Its onset can sometimes be triggered by a traumatic or stressful life event, but OCD often builds momentum in childhood, culminating in a tsunami of overwhelming intensity and high anxiety in adolescence.

Over-sensitive brain circuitry, caused by the biological changes in the brain, makes people with OCD extremely sensitive to perceived external and internal threats (unwanted thoughts and feelings) - even if the threat has passed or isn't real or rational. While many people experience worrying, unwanted thoughts and feelings from time to time, they arise, then pass. However, people living with OCD become ‘stuck’ in these unwanted thoughts, which leads to high anxiety. This is the ‘obsessive’ part of OCD. A person living with OCD also experiences compulsions, and intense apprehensions.

Obsessions
Repeated and persistent intrusive thoughts, images, and impulses which induce distress and feelings of guilt and fear.

Compulsions
Urges or impulses to carry out certain rituals or behaviours in an attempt to neutralise the obsession and alleviate anxiety.

Apprehensions
A sense of fear or dread that something terrible will happen to you or others if you don’t carry out the compulsive rituals to neutralise obsessions.

The types of obsessions and compulsions are different for each person, but these are the common ones:

• Contamination - with urges to clean and avoid germs, diseases, bodily fluids, and perceived harmful substances like toxins.

• Order and symmetry - leading to organising, repeating, and hoarding.
• Doubt - leading to constant checking and reassurance-seeking.
• Superstition - giving rise to urges to count, tap and touch.
• Fear of danger and aggression - leading to mental rituals, constant safety-checking, and even self-harm.
• Morality and doing the right thing - causing strict rule-following, urges to confess, extreme fear of making mistakes, and reassurance-seeking.

Even though the ritual (compulsion) provides only fleeting relief (from the physical and mental distress of the obsession) there's still the strongest urge to act and keep acting. This compulsive, continuous cycle takes up a lot of time and effort, making daily life a struggle, and only exacerbates anxiety. A person with OCD may not want or need to carry out the ritual (of counting, repeating, checking, cleaning, confessing, ordering and so on) but feel they have to 'just in case' and as a way of feeling like they can gain some sense of control.

Does my teen have OCD?

The symptoms of OCD can be crippling and cause substantial disruption to everyday life. Some OCD symptoms might not be obvious to you as a parent or carer. If they are, it can be hard to understand why your teen thinks and acts the way they do. To help you better understand and spot some of the signs and symptoms of OCD, here are some examples that may indicate your teen has OCD.

Helping your teen

As a first step, register with MindSkiller for specialist-grade education and helpful advice about OCD. The OCD eLEARNING Unit includes a symptom checklist and a Personalised Management Plan with links to Help-Providers and Services you can access. MindSkiller’s OCD eLEARNING Unit also gives family members the confidence to provide support for their teens and each other while navigating OCD. You should also talk to your GP about OCD and get a referral for a mental-health professional if necessary.

Uspace, St Vincent's Private Hospital's young adult mental health unit in Darlinghurst, offers a gold-standard (best available) OCD Program for inpatients which includes Cognitive Behaviour Therapy with Exposure and Response Prevention (gradual exposure to obsessions until they are no longer seen as a threat). There are also some exciting and innovative OCD-specific interventions on the horizon at Uspace, including: Transcranial Magnetic Stimulation (TMS), a safe and mild form of brain stimulation using magnetic fields; and Virtual Reality Exposure Therapy (VRET), incorporating the immersive capabilities of VR with exposure therapy and mindfulness.

Early intervention, education and treatment improves long-term outcomes. With love, support and the right help - as well as empowering your teen with self-help coping methods - recovery is possible.