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Signs of OCD in Young Adults: Answers to Your Top 4 Questions

Est. reading time: 7 mins
Posted Under: Treatment Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW


OCD – which stands for obsessive-compulsive disorder – is colloquially used to describe someone who is extremely organized or has very particular habits. As clinicians, we know it’s so much more than that. As Robert L. Johnson, MC, MCAP, LPC, Director of The Dorm D.C., explains, “OCD is not a personality quirk or general anxiety (something we all experience in some capacity). It’s not a joke for those individuals who have it.”

Despite this common societal misunderstanding, there are notable signs of OCD in young adults that can be treated successfully. In today’s blog post, let’s dive into the top four questions surrounding this mental health condition and its symptoms.

Key Article Takeaways: 

OCD is a rare and treatable mental health disorder. Symptoms fall into two buckets: obsessions and compulsions.

Obsessions describe the presence of unwanted thoughts, ideas, or physical sensations, even if those sensations are only perceived. To avoid the negative impacts of these obsessions, individuals feel driven to complete behaviors repetitively — these are called compulsions.

Effective therapies include Exposure Response Prevention (ERP), Cognitive Behavioral Therapy (CBT), Group Therapy, and Mindfulness practices. 

1. What is OCD?

Obsessive Compulsive Disorder, or OCD, is a mental health disorder marked by recurring patterns that interrupt a person’s daily life, including thought and behavioral patterns. It is not common, with only two to three percent of the population experiencing this diagnosis. According to the American Psychiatric Association, OCD’s symptoms fall into two buckets: obsessions and compulsions. 

Obsessions describe the presence of unwanted thoughts, ideas, or physical sensations, even if those sensations are only perceived. 

“For instance, someone may have obsessive thoughts about accidents, car crashes, or hitting a pothole, which leads them not to drive,” Robert explains.

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To avoid the negative impacts of these obsessions, individuals feel driven to complete behaviors in a repetitive manner — these are called compulsions. Examples include repeated handwashing, checking, praying, or reciting words or phrases. The compulsion’s role is to help neutralize and provide relief from the obsession. 

The cycle of obsessions to compulsions can hinder an individual’s ability to complete regular daily activities like bathing, eating, sleeping, and socializing. They can also interfere with the ability to perform at work or school and negatively impact family and social relationships. 

“An individual with OCD who notices something is disorganized experiences significant anxiety and impairment until they act on their compulsion and ‘fix’ what is out of order,” says therapist Gil Weiss, LMSW, CASAC. “For example, if they left the house without ‘tidying up,’ they may obsess about the mess throughout the day due to the lack of relief they feel from not acting on the compulsion.” 

2. What are the signs of OCD in young adults?

Some of the signs of OCD in young adults, by themselves, are quite normal in the human experience, like intrusive thoughts or distressing ideas. However, most people cope internally with the discomfort of these thoughts or ideas and then move on. For those who have OCD, the thoughts are persistent and continue unless a compulsion is engaged.

When receiving a diagnosis of OCD from a credentialed mental health professional, an individual must report that their obsessive thoughts and compulsions take more than an hour of their time each day and cause significant emotional distress. A diagnosis also requires that their obsessions or compulsions make it hard for them to attend school or work and socialize with friends and family.

“Typically, we see compulsive behaviors before the obsessive thoughts are revealed. You may see a teen or young adult repeatedly wash their hands, avoid stepping on cracks, or tap their hands or feet in a certain rhythm,” Robert shares. “It usually takes a professional to identify these patterns and diagnose them because we’re trained to recognize the specific behaviors.”

Signs of Obsessive Symptoms

When engaging in obsessive thinking, most people with OCD understand that their thoughts and fears aren’t realistic. However, they still become distressed about their presence. These obsessive thoughts are recurrent and often depict images that elicit anxiety, fear, or disgust. 

Examples of obsessive symptoms include:

  • Fear that touching an object or a person will lead to contamination or physical illness
  • Intrusive images of a sexual nature
  • Intrusive images of violence
  • Ideas about hurting the self or others
  • Excessive worry about death, dying, or pain
  • Fear that they’ll lose something, like an object
  • Preoccupation with order or symmetry
  • Preoccupation with certain numbers

Signs of Compulsive Symptoms

Individuals, then, turn to their compulsions. Often, these behaviors only temporarily reduce their distress. They must be completed several times or for a long period to continually give them comfort. Compulsions may logically connect to an obsession or appear completely random. These behaviors not only take up a lot of the person’s time, but they also serve as a distraction from school or work. Additionally, they may cause social anxiety if an individual completing a compulsion is surrounded by other people.

Examples of compulsive symptoms include:

  • Ordering objects in a certain way and not being able to move on until all objects are arranged
  • Cleaning surroundings, hands, or the body through ritualized scrubbing, wiping, hand washing, etc.
  • Repeated checking of the time
  • Repeated checking of locks, light switches, doors, etc.
  • Hand gestures or body movements, like shaking of the hands
  • Avoidance of certain numbers, colors, or patterns
  • Avoidance of certain places or people, including types of people
  • Asking others for assurance or approval

3. When do OCD symptoms usually begin?

The Mayo Clinic reports that people with signs of OCD tend to show symptoms when they’re in their teenage or young adult years. OCD often first presents during high school or college, which can have a huge impact on a young person’s academic and social life. 

OCD might also show up later in life after a traumatic event or during a period of significant grief. Others find themselves facing OCD symptoms after giving birth. Many risk factors may increase someone’s chances of developing OCD, including family history or the presence of other mental health conditions. 

Co-occurring Disorders

OCD often accompanies anxiety disorders and substance use disorders. In fact, anxiety, which tends to increase during the formative years of high school and college, is the main driver of OCD. The individual, then, feels helpless as they believe that these thoughts won’t subside, which leads to depression. As a result, they isolate themselves because they’re so embarrassed or ashamed, leading to agoraphobia, an anxiety disorder that causes symptoms of fear and prompts avoidance behaviors. From there, they may adopt thoughts of suicidal ideation in an effort to end their frustrations, Robert explains. 

In the same way that acting on a compulsion provides relief to someone with OCD, substance use may also be used to self-medicate and bring comfort. 

“Using any variety of anti-anxiety drugs, benzodiazepines, or alcohol may lead an individual to believe that they are managing their OCD symptoms, but in reality, they may be exacerbating them and leading to a dependence,” Gil explains. “Using drugs recreationally to treat OCD symptoms seems effective, but it doesn’t help an individual develop actual, long-lasting coping skills.”

4. Treating signs of OCD in young adults – what are the best options?

While OCD is considered a lifelong mental health condition, many treatment options can help people reduce the negative impact of their symptoms. 

Below, we outline the research-backed therapies that our team employs to treat young adults with ODC at The Dorm.

Exposure Response Prevention (ERP)

The first and most common treatment method for signs of OCD in young adults is exposure response prevention (ERP) notes Chief Clinical Officer Amanda Fialk, PhD, LCSW, LICSW. ERP is considered the gold standard for OCD treatment, with 63-83% of patients benefiting from treatment. The goal of ERP is to help a client respond to their triggers rather than react to them – instead of engaging in compulsive behaviors after a trigger whenever they are exposed, they learn to tolerate the underlying anxiety which is essential for sustained recovery. 

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a practical and goal-oriented psychotherapy treatment focused on helping clients change and reformulate thinking patterns that are disrupting their quality of life. Developed by Aaron Beck, the CBT cognitive model is founded on the principle that people’s thoughts and feelings are not determined by a situation, but by their interpretation and assumptions about that situation. CBT seeks to modify dysfunctional beliefs, stop the resulting negative thoughts and behaviors, and replace them with more productive behavioral patterns.

Wrap-Around Care

As Gil explains, the most effective treatment for OCD will be made up of several types of therapy alongside a supportive psychiatrist, coach, and group therapy support network.

“Working with a licensed psychiatrist to manage medication, along with behavioral therapy has proven to be the most effective treatment,” shares Gil. “CBT helps clients evaluate how their thoughts are connected to their behaviors and supports individuals as they challenge the thoughts that lead to unhealthy behaviors. Additionally, ERP within CBT gradually exposes an individual to a trigger and helps them resist the urge to act on it, easing the fear or anxiety associated with the trigger over time.”

Additionally, as he notes, medication can be an important part of treatment. For instance, the Substance Abuse and Mental Health Services Administration (SAMHSA) shares that many people benefit from taking selective serotonin reuptake inhibitor (SSRI) medications prescribed by a psychiatrist to help them manage their obsessions and/or compulsions

Group Therapy & Community Support

Last but not least, a supportive community is so important for young adults seeking sustained recovery from symptoms of OCD. 

At The Dorm, for example, we offer clients a weekly schedule of group therapy options that can help them connect with others who are going through similar experiences. Urge Surfing is a great option for to individuals struggling to manage their urges. Gil explains, “Urge Surfing gives clients the space to share their struggles with controlling their urges and offers them coping skills shared by group members and the facilitator.” 

Additionally, in a skill-building groups like mindfulness, meditation, or CBT, clients can benefit from practicing the skills they’re learning in therapy with the support of their community and a licensed therapist.

“In group therapy, clients first realize they’re not alone,” Robert explains. “Their compulsions may be different than other group members, but many times, the obsessive thoughts are relatable to each other, allowing them to release some shame and stigma surrounding what they’re going through.”

For young adults struggling with OCD, The Dorm offers evidence-based approaches, wraparound services, and community-building opportunities. Reach out to us today to learn more about our services.

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