How can you recognise obsessions in teenagers? What lies behind handwashing, checking and intrusive thoughts, and how families can support a young person.
You notice that your fifteen-year-old daughter's hands are red and cracked in the middle of winter. When she gets off the school bus she heads straight for the bathroom, and when she comes out the tap is still running. Or your son checks the door lock three times and the cooker knobs four times before going to bed at night; even when you tell him, "I've already turned it off", he cannot settle. Obsessions in teenagers often begin quietly like this, disguised as an everyday habit. The young person knows that what they are doing looks odd, so they hide it. The family, meanwhile, first interprets it as "being fussy", "being scatterbrained" or "just a teenage phase". In this article I explain how obsessive thoughts and repetitive behaviours show up in young people, what feeds them, what helps at home and what makes the problem bigger, and how this is worked on in therapy.
What Are Obsessions in Teenagers, and How Do They Differ from Ordinary Tidiness?
An obsession is a thought, image or urge that keeps coming back into a person's mind against their will and causes distress. To reduce the distress this thought creates, the person feels a need to do something: wash, check, count, arrange things in a particular order, or silently repeat a prayer or a phrase. These behaviours are called compulsions. A compulsion brings brief relief, but that relief paves the way for the thought to return more strongly next time.
Not every kind of tidiness is an obsession. If a young person who likes keeping their room neat and lines up their pens by colour enjoys doing so, and feels only mildly annoyed and moves on when the arrangement is disturbed, this is a personality trait. The deciding factors are these:
- Time: Do the rituals take up a significant part of the day? Forty minutes in the bathroom, an hour spent rubbing out and rewriting the same sentence in homework, and so on.
- Distress: Does the young person dislike these thoughts and want to be rid of them?
- Interference: Are there losses such as being late for school, being unable to meet friends or being unable to study?
- Flexibility: If a ritual is interrupted, does it lead to intense anxiety, anger or a crying fit?
If you answer "yes" to several of these four questions, it is worth looking at the matter more closely. If you are curious about the adult picture, the article what is OCD offers a general framework; in young people, however, some differences stand out.
What Do the Signs of Obsessions in Teenagers Look Like?
In young people, obsessions cluster around themes similar to those in adults, but they are coloured by the particular worries of adolescence.
Contamination and cleaning
Fear of germs, illness and dirt is the most familiar theme. A young person may be unable to use the toilets at school, touch door handles only with the end of their sleeve, avoid buying anything from the school canteen, or change all their clothes as soon as they get home. In some young people the fear is less about germs and more about a feeling of "disgust"; after touching something, they feel "contaminated".
Checking and doubt
The door, the cooker, the plug socket, the school bag, the homework diary... The question "What if I forgot?" never goes quiet. In a young person preparing for an exam, this may appear as reading the same paragraph over and over, checking the answers marked on a test again and again, or being unable to let go of the optical answer sheet. From the outside this looks like a careful student, but it is in fact a cycle of doubt that eats up time.
Thoughts about harm and responsibility
Some young people have images come into their mind of harming someone they love, causing an accident, or the idea that "if I think something bad, it will happen". For example, to neutralise the thought "Something will happen to Mum on her way to work", a young person switches the light on and off a certain number of times. These thoughts make young people deeply ashamed; this is often the least talked-about type of obsession. There is an important point to know here: such thoughts do not reveal a hidden wish. On the contrary, the person is so disturbed precisely because they are afraid of that thought.
Religious and moral worries
Endless doubt about whether ablution, prayer or a supplication has been performed "correctly" is known in everyday Turkish as vesvese. A young person may start an act of worship over again many times, or constantly feel guilty for having thought something wrong. The problem here is not the faith itself but the way doubt takes the person captive.
Symmetry, counting and the feeling of "just right"
Objects having to be lined up, doing something an even number of times, handwriting having to look flawless... The young person often does not talk about a fear at all; they simply say it "doesn't feel right". The behaviour continues until that feeling passes.
Invisible, mental rituals
Not every compulsion can be seen from the outside. Some young people carry out their rituals entirely in their heads: silently repeating a "good" sentence after a bad thought, counting up to a certain number, or replaying a memory from start to finish in the "right" way. While these young people appear to be sitting quietly at the table or studying, they may in fact be putting in exhausting inner overtime. Absent-mindedness, difficulty concentrating in lessons, suddenly freezing or breaking off mid-conversation are sometimes the only outward traces of these mental rituals. That is why, with a young person who says, "There's nothing wrong with me, my head is just full", it is valuable to ask, with non-judgemental curiosity, what is filling it.
Reassurance seeking is also very common in young people: "I washed my hands, didn't I?", "Nothing bad will happen, will it?", "Did you lock the door, are you sure?" When the same questions are asked dozens of times a day, the family too becomes part of the ritual.
Why Do Obsessive Thoughts Develop in Young People?
Obsessions do not have a single cause. Biological predisposition, learning and life circumstances play a part together.
- Family predisposition: The risk may be higher in young people with a family history of anxiety disorders or obsessions. This does not mean it is inevitable.
- Developmental stage: Obsessive symptoms often become noticeable at the end of childhood and during the teenage years. In this period, when the brain is rapidly reorganising and the sense of responsibility and self-awareness are growing, the question "What if it happens because of me?" can weigh more heavily.
- Periods of stress: Events such as the LGS or YKS year (Turkey's national high-school and university entrance exams), moving house, a parent falling ill or the loss of a loved one can trigger an existing predisposition. The heightened emphasis on hygiene during the pandemic also fed washing rituals in some young people.
- Giving thoughts excessive meaning: A person with obsessions concludes, "If I thought this, it must be important and I must do something." Yet everyone has odd, disturbing thoughts come into their mind from time to time; the difference lies in how one responds to them.
- Perfectionism and intolerance of uncertainty: Young people who struggle to tolerate making mistakes or "not being sure" may be more prone to checking behaviours.
Very rarely, in some children and young people, obsessive symptoms are seen to start suddenly and severely after an infection. If symptoms appeared within a week and worsened rapidly, be sure to tell your child's paediatrician and a child and adolescent psychiatrist.
The Marks Obsessions Leave at Home and at School
Let us say a fourteen-year-old tears a page out of their homework book and rewrites it because they feel the letters are not "neat". One piece of homework stretches from dinner until midnight. The next day they get up short of sleep, miss the school bus, and argue with their father on the way as he drives them in. The problem is not one piece of homework; it is a cycle that sets the routine of the entire household.
Over time, obsessions also narrow a young person's social life. They cannot stay over at a friend's house, because they will not be able to carry out their rituals there. They do not join the school trip. They avoid using the changing room after PE. In a crowded flat, the bathroom being occupied for an hour leads to fights with siblings, and delays during exam periods lead to a drop in school performance.
Most young people hide their symptoms for months, even years. The fear that "they'll think I'm going mad", shame and the feeling of being alone are the main reasons. In Turkey, the stigma surrounding mental health also prolongs this silence; families wary of the label "the child who sees a psychologist" may prefer to ignore the symptoms. Yet obsessions noticed early are generally easier to address than entrenched rituals.
What Can You Do as a Family?
Parents' instinctive reactions usually go to one of two extremes: either they join in with the rituals to ease the young person's anxiety, or they apply pressure by saying, "Don't be silly, just stop it." Both approaches are understandable, but both feed the cycle.
When working with obsessions, the aim is not to make the young person's anxiety disappear at once, but to experience together that anxiety can ease even without the ritual.
Separate the problem from the young person. Saying "This obsession is giving you a hard time again" instead of "You're so weird" brings the young person to your side rather than setting them against you. Some families even give the obsession a name; a young person might call it "the bully in my head". This kind of language reduces shame.
Gradually reduce reassurance. Answering "Did I wash my hands?" with "Yes, you did" every time brings relief in the moment, but makes the question permanent. Rather than stopping abruptly, reduce it by agreement with the young person: "I'll answer this question once, and after that we'll try waiting together." It is healthier to make this plan with a specialist if possible.
Notice when you join in with rituals. Checking the door on their behalf, washing their clothes separately, insisting that everyone wash their hands on coming in... Over time, the family's accommodation of the ritual becomes a house rule. List these and consider which one you could start stepping back from.
Do not punish or mock. Obsessive behaviour is not a stubbornness the young person has chosen. Do not allow siblings to tease them with remarks like "clean freak" either.
Communicate with the school. Sharing this with the school counsellor can help secure temporary flexibility over homework deadlines or exams. When you do so, get the young person's consent; respecting their privacy protects trust.
Watch your own anxiety. A young person's anxiety is fed by their parent's anxiety. When you are able to stay calm, you show them through your behaviour that it is possible to tolerate uncertainty.
When Should You Seek Professional Support?
If any of the following apply, it is advisable to see a clinical psychologist or a child and adolescent psychiatrist:
- The rituals take more than an hour a day, or the time is steadily increasing
- The young person is struggling to go to school, study or see their friends
- There are wounds on the hands or skin problems caused by excessive washing
- The obsessions are affecting eating or sleep
- The young person is noticeably unhappy or hopeless, or says things like "I don't want to live like this"
If thoughts of self-harm or ending their life are present, do not wait; in an emergency, call 112 (emergency services).
Remember, the signs listed here do not on their own amount to a diagnosis. Obsessive symptoms may occur alongside anxiety disorders, tic disorders, attention deficit or eating difficulties; an assessment by a specialist is needed for an accurate picture.
How Are Obsessions in Teenagers Addressed in Therapy?
The most researched approach for obsessive symptoms in young people is cognitive behavioural therapy (CBT). At its heart lies a method called exposure and response prevention. The young person faces anxiety-provoking situations in small, controlled steps, and tries not to carry out the ritual while doing so. For example, first touching a door handle and waiting five minutes without washing their hands, then gradually extending that time. A difficulty ladder prepared together with the young person starts from the easiest rung; no step is ever forced on them.
This work may look challenging at first glance. But when the young person experiences for the first time that anxiety eases on its own after a while even when the ritual is not carried out, this experience gives them a confidence that no words could. Small experiments are carried out at home between sessions, and at the next meeting what was hard and what was easier than expected are discussed together.
Psychoeducation is another important part of therapy. As the young person learns what the thoughts coming into their mind are and why compulsions keep anxiety going, they begin to be able to say, "I'm not broken; this is a cycle." The meaning given to thoughts, the belief in excessive responsibility and the need for certainty are also the focus of cognitive work.
Family involvement is especially valuable when working with young people. Parents review their habits of giving reassurance and joining in with rituals, and set up the plan to be applied at home together with the therapist. If symptoms are severe, or progress is limited despite therapy, an assessment by a psychiatrist can support the process. You can find more information about work with young people on the adolescent counselling page; if you are curious about the similar picture in adults, you can also take a look at the article on obsessive thoughts.
Frequently Asked Questions
Will my teenager's obsessions go away on their own?
Some mild, short-lived rituals may ease once a stressful period has passed. However, obsessions that have lasted for months and take up more and more space often do not disappear by themselves; on the contrary, rituals grow stronger the more they are repeated. Support started early helps prevent the symptoms from settling into daily life.
Are obsessions in teenagers the same thing as OCD?
Not every obsessive thought means obsessive-compulsive disorder. A diagnosis is made through specialist assessment, by looking at how much time the thoughts and rituals take, how much distress they cause and how far they restrict life. That is why it is healthier to have a consultation than to reach conclusions with online tests.
What can I do if my teenager does not want to go to therapy?
Many young people resist at first because they are embarrassed or afraid of being labelled "mad". Explaining that this is not a weakness but a cycle the brain has learnt through anxiety, and making the decision together, can open the door. During this time, parents seeking counselling on their own is also a good start for changing the cycle at home.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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