Obsessive-compulsive disorder (OCD) is a challenge faced by many young people, and it can feel overwhelming at times. But with the right support and understanding, it’s possible to treat OCD and live a fulfilling life. This article will look at OCD, its impact, and how acceptance and commitment therapy (ACT) can support teenagers and young people when dealing with it.
What is OCD?
OCD stands for obsessive-compulsive disorder, a mental health condition that involves two main elements: obsessions and compulsions.
- Obsessions are intrusive, unwanted thoughts, images, or urges that repeatedly pop into your mind. They are distressing and feel hard to ignore. Common examples include fears of germs, worries about harming someone, worries about something terrible happening, or the need for things to be perfectly organised.
- Compulsions are behaviours or mental acts you feel compelled to perform to reduce the anxiety caused by obsessions. These might include washing your hands excessively, checking if a door is locked over and over, giving yourself reassurance or repeatedly counting in your head.
For young people, OCD can show up in many ways. They might feel like they must follow rituals to avoid bad things happening, or try to push certain thoughts away, only for them to come back stronger. It’s important to know that nobody is alone, and help is available.
If you or someone you know is struggling with symptoms of OCD, it is recommended to seek help from a mental health professional, such as a therapist or psychiatrist, who can provide a proper diagnosis and develop an appropriate treatment plan.
How does OCD affect young people?
OCD can make life tough. It can take up a lot of time and energy, interfering with school, friendships, and hobbies during a life stage that is already filled with social anxiety, uncertainty and change.
For teenagers OCD might show up in many ways including:
- Time-consuming rituals: OCD can lead to spending hours on compulsions, leaving less time for things teens enjoy or need to do, like hanging out with friends or studying.
- Stress and anxiety: Obsessions can create a cycle of intense worry, and compulsions might only provide temporary relief.
- Strained relationships: Friends and family might not always understand the struggles that a teenager with OCD is facing, leading to further feelings of isolation and leaving relationships strained or unhelpful accommodations that accidentally make the OCD worse.
- Avoidance: Young people might avoid certain places, activities, or situations because they are worried about triggering their OCD. This leads to them feeling like they are missing out on life.
- Low self-esteem: Many young people with OCD feel ashamed of their thoughts and behaviours, which can make them feel bad about themselves.
If you’re a teenager experiencing any of these challenges, remember that there’s no shame in having OCD because these intrusive thoughts are not you. Reaching out for help is a brave and important step.
What triggers OCD?
Anyone can get stuck in a loop having unwanted intrusive thoughts, and trying to fight them in ways that make them fight back and stick around longer. OCD says to someone ‘you can’t handle uncertainty or distress’ and suddenly they’re engaged in a constant cycle of trying to remove the distress entirely or be 100% certain (which is never possible). The specific content of the intrusive thoughts might change over time and might get louder when the person is stressed or struggling.
Why is ACT a good fit for young people with OCD?
The most effective treatment for OCD is called exposure and response prevention (ERP). Acceptance and commitment therapy (ACT) has been shown to be a powerful way to make ERP more palatable, compassionate and precise.
ACT is particularly helpful for teenagers and young adults because it focuses on building a life that’s meaningful, rather than just trying to “fix” problems. It’s about empowering young people to take charge of their life, even when OCD tries to pull them in different directions. Instead of focusing on getting rid of obsessions and compulsions, ACT teaches skills to handle them differently. Here’s how it works:
- Creating space for fears: ACT helps young people learn that their fears and intrusive thoughts don’t need to control them. Instead of getting caught up in compulsive behaviours to reduce anxiety, they can expose themselves to things that trigger the intrusive thoughts and choose to notice that there’s room inside them for the discomfort and uncertainty. For example, a young person with OCD might have intrusive thoughts about contamination but choose not to engage in repeated handwashing, allowing the discomfort to exist while focusing on enjoying a meal with their family.
- Helping thoughts lose their grip: Through cognitive defusion, ACT teaches young people to step back from their thoughts and recognise them as just words or mental events, rather than absolute truths. For instance, a thought like, “I need to check again, or something terrible will happen,” can be met with, “I don’t know what’s going to happen, and neither does the OCD, let’s find out” This shift helps reduce the power of the thought and allows them to focus on their chosen actions.
- Facing fears with courage: ACT incorporates values-based exposure, where young people are encouraged to approach situations that trigger their OCD while staying grounded in what matters most to them. For example, if spending time with friends is a key value, they might face the fear of attending a social event without performing mental rituals. This approach builds psychological flexibility, helping them show up for their values even in the presence of anxiety.
- Strengthening mindfulness skills: OCD often pulls young people into a loop of worries about the past or future. ACT helps them ground themselves in the present moment using mindfulness techniques, so that they can notice that OCD is trying to pull them into a tug-of-war and choose to not engage.
- Focusing on what’s important: ACT encourages young people to identify what they care about most—whether it’s relationships, hobbies, or personal growth—and use these values as a guide for their actions. By shifting focus from avoiding anxiety to pursuing meaningful goals, they can begin to take small, value-driven steps even when OCD feels overwhelming.
- Choosing meaningful actions over avoidance: Instead of being controlled by OCD’s demands, ACT helps young people make choices that align with the life they want to live. This might mean choosing to be curious and resisting the urge to perform a compulsion or staying engaged in an activity they value, even if anxiety is present. It’s about helping them build a life that’s guided by their values, not dictated by OCD’s threat of uncertainty.
ACT can help adolescents take small, meaningful steps to break free from OCD’s grip and focus on what truly makes their life special.
For more information about ACT and how it can help with OCD, check out our resources and workshops designed for young people and their support network. Managing OCD is a journey, and with patience and the right support, a life that’s guided by values and not fears is possible.
