OCD in Young Adults: 10 Frequently Asked Questions

What Are the Primary Symptoms of OCD?

Obsessions and compulsions are the primary symptoms of OCD. Obsessions are unwanted and disturbing thoughts, images, or urges that create extreme anxiety. A young adult with OCD may obsess over things many of their peers also worry about, such as embarrassing themselves at work, failing a college exam, or being abandoned by a romantic partner or friend. 

But for young adults with OCD, the level of intensity and the frequency of the obsessive thoughts are much more extreme than normal. And even if the person knows that their fears are irrational and extreme, they are unable to stop the obsessive thinking. 

To cope with these obsessions, a person with OCD engages in compulsions, also known as OCD rituals. Compulsions are repetitive behaviors or thoughts that a person with OCD engages in, often multiple times a day, to relieve the anxiety. For example, they might count to a certain number or wash their hands repeatedly, as a way to prevent the feared outcome from occurring. People with OCD may feel brief periods of relief after performing these rituals, but they receive no pleasure from the compulsive behaviors.

In addition, people with OCD can have a tic disorder symptom. Tics are sudden, brief, repetitive movements, such as:

• Eye blinking and other eye movements
• Grimacing
• Shrugging one’s shoulders
• Jerking the head or shoulders
• Vocal tics—repetitive throat-clearing, sniffing, or grunting sounds

What are Some Examples of OCD Obsessions and Compulsions? 

Below are specific examples of OCD obsessions and compulsions.

OCD Symptoms Checklist

What Are the Four Stages of the OCD Cycle?

The four stages of the OCD cycle include:

1. Obsessions—experiencing obsessive thoughts
2. Anxiety—distress related to the obsessions
3. Compulsions—using ritualized behaviors or thoughts as a way to keep the danger at bay
4. Temporary relief, which is disturbed the next time an obsessive thought surfaces

Treatment for this disorder interrupts the OCD cycle, and helps people with OCD learn ways to prevent compulsions and decrease obsessive thoughts.

When Is OCD Typically Diagnosed?

People with OCD are most likely to be diagnosed during the late teen years. In general, OCD is diagnosed before age 19, and 25 percent of cases are diagnosed by age 14. Once a person reaches young adulthood, the risk of developing OCD decreases. 

Moreover, both males and females have an equal risk of developing OCD after they go through puberty. However, males are more likely to develop OCD during childhood.

How Many People Have OCD?

Obsessive-compulsive disorder (OCD) affects about 1 in every 50 people in the United States (2.3 percent of the population), according to the National Institute of Mental Health (NIMH). Diagnosing this disorder requires an OCD screening with a mental health professional. 

An OCD assessment includes a psychological evaluation to discuss the extent of the person’s obsessive thoughts and compulsive behaviors. In addition, a mental healthcare provider or doctor will refer to OCD criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Moreover, they will rule out any physical or medical issues that may be contributing to or causing OCD-like thoughts and behaviors. 

Are Young Adults with OCD More Likely to Have Substance Abuse Problems?

Yes, research shows that OCD and substance abuse often go together. That’s because people with OCD may use drugs or alcohol to try to calm their obsessive thoughts and cope with the anxiety and fear related to the disorder. 

According to a study published in the Journal of Anxiety Disorders, 27 percent of OCD sufferers also meet the criteria for a substance use disorder. And the risk of developing a substance use disorder is particularly high in young adults with OCD.

Furthermore, young people with OCD symptoms often have other mental health disorders, such as:

• Generalized anxiety disorder
• Depression—research shows OCD typically leads to depressive symptoms rather than the other way around
• Body dysmorphic disorder (believing one is ugly or deformed)
• Hypochondriasis (preoccupation with physical illness)
• Trichotillomania (hair pulling)
• Panic attacks
• Eating disorders, such as binge eating disorder
• Skin-picking disorder (excoriation)
• Neurological disorders, including Tourette’s syndrome

What Are the Causes of OCD?

There is no single, clear cause of OCD. However, research supported by organizations like the International OCD Foundation shows that the following factors may contribute to developing the disorder. 

Genetics

Researchers have been working to answer the question, “Is OCD genetic?” They have found that people with a parent, sibling, or child who have OCD are at a higher risk for developing it themselves. Furthermore, the risk is higher if the relative developed OCD at a young age, during childhood or adolescence. Ongoing research on families and twins continues to explore the connection between genetics and OCD. 

Brain structure

Differences in brain structure and function may be risk factors for developing OCD. Specifically, researchers have found differences in the frontal cortex and subcortical structures of the brain in people with OCD. As a result, they believe there might be a connection between OCD symptoms and abnormalities in certain areas of the brain. 

Childhood trauma

Research shows that people who have experienced trauma in childhood, specifically emotional neglect or physical, emotional, or sexual abuse, have a higher risk of developing OCD. Furthermore, a 2021 study found that people with OCD who experienced childhood trauma are more likely to have depression as well as more severe OCD symptoms. 

PANDAS infection

Children who have a streptococcal infection known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) may develop OCD or symptoms following the infection.

Is OCD the Same as Obsessive-Compulsive Personality Disorder? 

No, obsessive-compulsive personality disorder (OCPD) is a different but related condition. About 1 in 100 people in the United States have been diagnosed with obsessive-compulsive personality disorder. And men are twice as likely to be diagnosed with OCPD than women. 

The similarities between OCD and OCPD include fixation on rules, details, and moral or ethical codes, as well as hoarding behaviors and perfectionism. However, people with OCD realize that their thinking and behaviors are irrational, and they feel intense anxiety and pain due to their obsessions and behaviors. But people with OCPD typically do not think that they are acting unreasonably. They believe that their way of acting is “the right way.” 

There is no single, specific cause of OCPD. But experts theorize that causes may include having controlling or unavailable parents; growing up in a rigid, rule-bound culture or religion; and genetic factors.

What Is the Most Effective Treatment for OCD? 

Treatment modalities include both medication and therapy. Additionally, treatment must also address any additional disorders that exist, such as body dysmorphia, substance use disorder, or depression.

A number of different medications are used to treat OCD. These include:

• Serotonin reuptake inhibitors (SRIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Clomipramine (a member of an older class of “tricyclic” antidepressants)
• Antipsychotic medications

Therapeutic modalities for OCD in young adults include:

• Cognitive Behavioral Therapy (CBT) to reframe obsessive thoughts
• A type of CBT called Exposure and Response Prevention (ERP), which exposes young adults to triggering situations so they can practice healthy coping skills
• Acceptance and Commitment Therapy uses mindfulness and behavior-change strategies to increase psychological flexibility.Deep brain stimulation (DBS), in which electrodes are implanted in the brain that release impulses to help regulate brain function. 
• Another approach for improving OCD symptoms is transcranial magnetic stimulation (TMS). TMS uses magnetic fields to stimulate nerve cells in the brain.

ERP Therapy

ERP therapy is a behavioral therapy in which clients are gradually exposed to situations that trigger their anxieties and obsessive thoughts and behaviors. The idea behind ERP is that it’s impossible to remove stress and triggers from daily life. Therefore, people with OCD need support to learn healthy coping skills to use when they’re triggered instead of reverting to compulsive behaviors.

Here’s how ERP therapy works: A client with a fear of germs might be asked to touch a doorknob or other object that seems frightening to them. But instead of rushing to wash their hands afterward, an ERP therapist will help them use response prevention skills to overcome their compulsive tendencies. ERP uses a variety of response prevention techniques. For example, non-engagement response is a technique in which the client uses simple words or short phrases, like “Whatever” or “So what” to downgrade the intensity of their intrusive thoughts.

ERP therapists usually start with exposures that trigger low to moderate anxiety in a client, and then progress to work with a client’s more intense OCD obsessions and compulsions. Over time, the person with OCD experiences what’s known as habituation. Habituation in OCD refers to a reduction in the client’s distress that occurs through repeated exposure to obsessions. By using response prevention, they become able to tolerate the anxiety and discomfort, and it decreases as a result.

OCD Treatment for Young Adults at Newport Institute

Newport Institute provides specialized OCD treatment for young adults. An integrated OCD treatment plan for teens at Newport Academy includes medication management as well as a wide range of evidence-based modalities. Each client receives a tailored treatment plan for young adult OCD, designed by a team of medical and clinical experts.

Our expert clinicians use therapeutic modalities such as Exposure and Response Prevention therapy and Cognitive Behavioral Therapy to address OCD symptoms and co-occurring issues, including substance abuse, generalized anxiety disorder, social anxiety, body dysmorphia, and suicidal behavior. In addition, clients participate in somatic (body-based) and experiential therapies. These approaches—including yoga, mindfulness, movement, and creative expression—activate the parasympathetic nervous system to reduce the anxiety and obsessions associated with OCD in young adults. 

Moreover, family therapy is an essential element of our treatment, including OCD treatment. Family therapy helps repair ruptures in the family unit, so parents can better understand their grown children, and young adults can turn to their parents for support when they are struggling with OCD symptoms. 

To learn more about our young adult OCD treatment, contact us today. We provide teen mental health assessments at no charge, either in person or virtually. Here’s where to get started on the healing journey.

Frequently Asked Questions