OCD: for young people

This webpage looks at some of the reasons why obsessions become compulsions and offers advice.


This is information, not advice. Please read our disclaimer.

The word ‘obsessive’ gets used commonly. This can mean different things to different people. Obsessive compulsive disorder (OCD) is a type of anxiety disorder. In this condition, the person suffers from obsessions and/or compulsions that affects their everyday life, like going to school on time, finishing homework or being out with friends.

What are the symptoms?

An obsession is a thought, image or urge that keeps coming into your mind even though you may not want it to.

An obsession can be annoying, unpleasant or distressing and you may want it to go away.

An example of an obsession is the thought that your hands are dirty even though they are not. Different people have different obsessions.

Here are some examples:

  • fears about dirt and spreading disease
  • worrying about harm happening to you or someone else
  • fearing that something ‘bad’ may happen
  • worrying about things being tidy
  • worrying about having an illness.

Having an obsession often leads to anxiety or feeling uncomfortable and you may then have the urge to ‘put it right’. This is where compulsions come in.

Compulsions are things you feel you need to do usually to control your ‘obsessions’, even though you may not want to. You might even try to stop doing them, but this might not be possible.

Often, a compulsion means doing something again and again, as a ‘ritual’. By doing the compulsion you feel you can prevent or reduce your anxiety about what you fear may happen if you don’t do it. For example, turning the light on and off 20 times because you worry something bad may happen if you don’t.

Different people have different compulsions. Some examples include:

  • washing
  • checking
  • thinking certain thoughts
  • touching
  • ordering/arranging things or lining things up
  • counting.

Individuals who have these problems often try to avoid any situation that might set off obsessive thoughts (e.g. not using hands to open doors).

When obsessions and compulsions take up a lot of your time, interfere with your life and cause you distress, it becomes obsessive-compulsive disorder (OCD).

OCD is common and can affect people of all ages irrespective of their class, religion or gender.


There are many factors that affect whether OCD develops:

  • Genes – OCD is a complex disorder. Studies have shown that there are different genetic risk factors involved in whether someone develops OCD. People who have a relative with OCD are more likely to develop OCD than people who don’t.
  • Stress – Stressful life events bring it on in about one or two out of every three cases.
  • Life changes – Times where someone suddenly has to take on more responsibility – for example, puberty, moving house, or changing school.
  • Brain changes – We don't know if it’s a cause, or the result of OCD - but if you have the symptoms for more than a short time, researchers think that there may be changes in how a chemical called serotonin (also known as 5HT) works in the brain.
  • Personality – If you are a neat, meticulous, methodical person with high standards you may be more likely to develop OCD. These qualities are normally helpful, but can slip into OCD if they become too extreme.
  • Ways of thinking – Nearly all of us have odd or distressing thoughts or pictures in our minds at times like "what if I stepped out in front of that car?" Most of us quickly dismiss these ideas and get on with our lives. But, if you have particularly high standards of morality and responsibility, you may feel that it's terrible to even have these thoughts. So, you are more likely to watch out for them coming back – which makes it more likely that they will.

There are psychological treatments and medications available to treat OCD.

One of the helpful psychological or talking treatments for OCD is cognitive behavioural therapy (CBT) that includes exposure and response prevention (ERP).

CBT is a psychological approach that is effective in treating young people with OCD (see our factsheet on OCD).

In OCD people often think that by avoiding a certain situation or doing the ritual/compulsion helps to keep the worry (obsession) away or come true. However, this does not help the worry to go away.

In the treatment for OCD, the therapist would help you to understand this reality and also teach you ways to face the worry rather than running away from it. Eventually this helps to get rid of your obsessions and the compulsions.

In ERP the therapist helps you to facing the things that you fear and that you have been avoiding. They then help you to stop responding in your usual way (like not letting you wash hands when you worry it is dirty).

To help you fight OCD, you will be taught a wide range of skills to manage the anxiety that OCD creates. This helps you to learn strategies to control the OCD rather than it controlling you.

Sometimes therapist may suggest someone in your family to be involved during the therapy.

When OCD is severe or you struggle to do the psychological treatment, you may need medication. This is usually given to help along with you trying the CBT. Medication can help you get the most out of the psychological treatment.

It is important to seek help early and remember that having OCD does not mean you are ‘mad’ and ‘losing control’.

If you are worried about yourself, you should talk to someone you trust such as your parents or carers, or a teacher. A lot of adults with OCD never got any help for their problems when younger, and now wish they had.

Your GP or school nurse can give you advice and help you get specialist help from the child and adolescent mental health service (CAMHS). They will talk with you in order to understand the difficulties you are experiencing.

It can be hard or embarrassing to discuss the details of their obsessions or compulsions. But giving as much detail as possible will help the therapist or psychiatrist to give you the right treatment.

If your life has become severely affected by OCD, you may also need help from other professionals for example, teachers to help you get back to ordinary life at school or college.


"It started without me really noticing it. I got anxious about someone in my family dying – so I began to tap three times, when I got worried, for good luck and that would calm me down. Then I had to do it before I could go to sleep at night –not once but 3 x 3.

When I watched the programme on TV about those germs in hospital it began to get worse. I couldn’t tell my Mum or Dad about it because it sounded so silly.

I had to wash my hands all the time because I thought I would pass on an infection and someone would die. It was mainly at home, but then I began to worry that I would catch something at school.

I made my Mum wash my school uniform every day. She tried to say no, but I would get so worked up that she would give in. It came to a head when I couldn’t get to school on time because I was spending hours in the bathroom in the morning.

I had to wash my hair three times as well as going through washing in a set order. If I was interrupted because someone needed the bathroom, I had to start again.

Mum got me some help. I didn’t want to be seen as some psycho person, but Dr Roberts was really nice and understood why I was so worked up about everything. That was when I was 14. Now I am 18. It was hard work doing the therapy.

It is called CBT. You have to try and work out why you are so anxious and try and control it. Now I am at college and doing a course that I like. I still do some counting, but I can keep it under control."

Epic friends - Mental health problems are common. This website is all about helping you to help your friends who might be struggling emotionally.

OCD Action - National charity for people with OCD.

OCD Youth - A website written by and for young people with OCD, giving information on the disorder and its treatments.

OCD UK - OCD-UK is the charity dedicated to improving the mental health and well-being of almost one million people in the UK whose lives are affected by Obsessive-Compulsive Disorder.

YoungMinds have also developed HeadMeds which gives young people in England general information about medication. HeadMeds does not give you medical advice. Please talk to your Doctor or anyone else who is supporting you about your own situation because everyone is different.

Further reading

NICE guidance written for patients and carers, CG31, Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder (2005).


Naomi Fineberg and Angus Brown (2011). Pharmacotherapy for obsessive–compulsive disorder, Advances in Psychiatric Treatment, 17:419-434.

David Veale, (2007). Cognitive–behavioural therapy for obsessive–compulsive disorder, Advances in Psychiatric Treatment, 13:438-446.

National Institute for Healtth and Clinical Excellence: CG31, Core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder, 2005.


Revised by the Royal College of Psychiatrists’ Child and Family Public Engagement Editorial Board (CAFPEB).

With grateful thanks to Dr Bruce Clark,  Dr Shobha Puttuswamiah, Dr Virginia Davies, Dr Vasu Balaguru, and Thomas Kennedy..

This resource reflects the best possible evidence at the time of writing.

About this information

This information reflects the best available evidence at the time of writing. This mental health information for young people was written in 2015 and parts of it were updated in 2022.


© November 2015 Royal College of Psychiatrists