Understanding the Symptoms of OCD


Obsessive-compulsive disorder (OCD) is a mental health condition that affects young people in varying ways. It often features distressing, obsessive and intrusive thoughts and repetitive, compulsive physical or mental acts.

OCD is an anxiety disorder that affects around 2% of the population, with people most often showing signs by adolescence.

Elements of Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) generally features a predictable pattern of behaviour with four elements: obsession, anxiety, compulsion, and temporary relief. However, the obsession and the compulsion or compulsive behaviours are the most obvious and powerful, although they are often all connected.

  1. Obsession – the person experiences an unwanted and distressing thought, image or urge entering their mind.
  2. Anxiety – the obsession provokes an intense feeling of anxiety or distress.
  3. Compulsion – in order to control obsessions and anxiety, young people with OCD will often turn to certain compulsive behaviours, routines or rituals to provide relief from the anxiety they are feeling. This can vary widely from person to person but is generally a repetitive behaviour or mental act that an individual feels driven to perform, often as a response to the obsessive thought.
  4. Temporary relief – performing a compulsive behaviour often relieves the anxiety for a short period of time. However, the obsession and anxiety will soon return, and the cycle begins again.

It’s possible to only have obsessive thoughts without the other elements or only have compulsions without other elements, but most people with obsessive-compulsive disorder experience both.

Obsessive Thoughts

Most young people will have unpleasant or unwanted thoughts that cause stress, anxiety or worry at some point. For some, this could be thinking that they forgot to turn the cooker off or lock the door of the house when they left. It may even be a sudden violent image or offensive thought. These often subside quickly, but for those that have OCD, this obsessive persistent thought or mental image can have a profound impact on their thinking and their lives.

This thought or image can be so intrusive that it interrupts other thoughts at work, while driving or performing other important tasks, and takes over everything else. It can become very challenging to focus on other daily activities in general.

Common Obsessive Thoughts

Some common obsessions or obsessive thoughts include:

  • Fear of losing control and deliberately harming yourself or other people.
  • Intense worry or fear of being contaminated by germs, dirt or illness, or contaminating others.
  • Intense stress when objects aren’t placed in order or aren’t facing a certain way.
  • Offensive mental images such as images of driving your car into a crowd of people.
  • Sudden unwelcome violent thoughts.
  • Thoughts about shouting obscenities or acting inappropriately in public.
  • Unpleasant sexual images.
  • Unwanted sexual thoughts or images of inappropriate activities which you fear you may act on.
  • Strong religious or superstitious beliefs.

Compulsive Behaviors

Compulsive behaviours, or OCD compulsions, are behaviours or actions people engage in for reassurance; repeating words in their head, checking doors are locked, arranging, hoarding and other repetitive behaviors are all common compulsive behaviours. However, not all compulsive behaviours are obvious to other people, and people may develop very specific behaviors to deal with their own obsessions and the anxiety that accompanies them. Behaviours that are visible are ‘overt’ whereas those that cannot be seen are ‘overt’.

Compulsive behaviour compulsions often start as a way of trying to prevent and reduce anxiety caused by obsessive thoughts. For example, those who frequently experience intense anxiety linked to an intrusive thought about doing someone harm in public may avoid social situations when they can and go shopping at quiet times of the day. In addition, a person who experiences significant distress caused by fear of infection or contamination may engage in excessive cleaning and hand washing.

People often feel that they have to complete a particular pattern of behaviour in order to avoid the anxiety caused when an unpleasant thought or urge repeatedly enters their minds.

What Causes OCD?

Doctors do not yet know for certain what causes obsessive-compulsive disorder (OCD), although it is thought that there are certain factors or events that may increase a person’s chances of developing the condition. Genetic, neurological, behavioral, cognitive, and environmental factors may all contribute, with some events being linked to the onset of OCD or an episode, such as:

  • Significant life changes such as moving, getting married or divorced, or starting a new school, or job-related problems.
  • The death of a loved one or other emotional trauma.
  • History of abuse, often in childhood.
  • Illness.
  • Low levels of serotonin, a natural substance in the brain that maintains mental balance.
  • Overactivity in certain areas of the brain.
  • Problems with an important relationship.

OCD symptoms often appear in childhood or early adulthood and although you can’t prevent OCD, early diagnosis and effective treatments can help you reduce OCD symptoms and the effect it has on your life.

Genetic Causes

OCD appears to run in families, suggesting there may be a genetic link that is passed down. More research is being done into the significance of family history.

Imaging studies show there are characteristic differences in the brain function of individuals with OCD. Genes have an effect on the way that the brain responds to dopamine and serotonin – important neurotransmitters that affect mood regulation – behavior, and learning. It is thought that these may play a role in causing obsessive-compulsive disorder (OCD).

Environmental Causes

It is thought that extremely stressful life events may trigger obsessive-compulsive disorder in young people with a predisposition to OCD.

There appears to be a pattern with individuals reporting that the symptoms of OCD appear within 6 months of stressful events, including:

  • childbirth, especially with complications during pregnancy or delivery.
  • severe conflict.
  • a serious or life-threatening illness.
  • a traumatic brain injury.

All of these events are generally also associated with post-traumatic stress disorder (PTSD), and there are theories within the medical community that OCD may be linked to trauma.

This said, not all young people with obsessive-compulsive disorder (OCD) report having lived through such an event or trauma, meaning there could be a number of causes.

OCD and Mental health

Obsessive-compulsive disorder is often trivialised by society and misunderstood as a disorder that causes people to be neat and tidy or enjoy keeping things clean. However, it is in fact much more complex and impactful on daily life. Repetitive behaviours such as hand washing can be time-consuming and frustrating. OCD obsessions can cause debilitatingly intense anxiety and avoiding situations that trigger obsessive thoughts can leave young people feeling isolated and alone.

Obsessive-compulsive disorder is often linked to other mental health problems or mental disorders including anxiety, severe depression and substance abuse. Alcohol or drug use may help young people who feel upset or feel anxious to ‘self-medicate’ for symptoms of OCD and attempt to alleviate the fear of their own thoughts.

Developing OCD can be personally distressing and disabling, as well as devastating to relationships, school or work success, and general life satisfaction. Young people with OCD and severe depression may experience suicidal thoughts that they fear acting on.

Treatment for OCD

Fortunately, there are medications and therapies to treat OCD. Medications prescribed for young people with OCD are often antidepressant medications including selective serotonin reuptake inhibitors (SSRI).

Exposure and response prevention therapy (ERP) and cognitive-behavioural therapy (CBT) are two forms of therapy that have shown success in treating OCD and helping alleviate the symptoms.

At The Wave, we understand how isolating and distressing OCD can be, especially as it often affects young people at such an important, formative time when they want to focus on enjoying life without having to deal with obsessive, intrusive thoughts.

We offer programmes that treat OCD in addition to co-occurring mental illnesses that may have developed as a result of OCD or at the same time.

Contact The Wave today for more information about our nurturing programmes for teenagers and young people.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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