At the beginning of the coronavirus pandemic in early 2020, mental health experts sounded an alarm.
They warned that the pandemic would have a significant negative impact on the mental health of everyone in the country. Adolescent mental health experts warned that it wasn’t only the pandemic itself that would have negative consequences. They worried about the impact of mitigation measures on teenagers, specifically teens diagnosed with:
Of primary concern was the impact on teenagers diagnosed with obsessive-compulsive disorder (OCD), known by mental health clinicians as teen OCD or adolescent OCD. The latest data on teen mental health before the pandemic showed an increase in rates of depression, anxiety, and suicidality. Therapists specializing in adolescent mental health predicted that the mitigation measures like shelter-in-place orders, virtual school, social distancing, and restrictions on public activities would exacerbate any existing mental health issues in teens.
Experts in teen OCD, like Elise Guthman, warned that while teens who’d already received treatment for OCD may have been prepared to handle some aspects of the pandemic, the presence and spread of the virus itself – SARS-COV2 – had the potential to worsen symptoms characteristic of OCD.
As it turns out, evidence shows the predictions about adolescent OCD were correct. Studies published in 2020 and 2021 confirm that the coronavirus pandemic did, in fact, have a negative impact on teens diagnosed with OCD.
How significant was the impact?
We’ll answer that question in a moment.
First, let’s define OCD, so we’re on the same page for the rest of this article.
What is Teen OCD?
The American Psychiatric Association (APA) defines OCD as:
…a disorder in which people have recurring, unwanted thoughts, ideas, or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.
Teen OCD is exactly what’s described above – in adolescents.
Statistics show the following facts about the prevalence and age of onset – i.e. when OCD first appears – of OCD in the U.S.:
- Around 4% of adults (8.1 million) have clinical OCD
- About 2% of children and adolescents (500,000) have clinical OCD
- OCD typically first appears during two distinct periods of development:
- Pre-adolescence (age 10-12)
- Early adulthood (age 18-20)
Experts define four types of symptoms related to OCD. People with OCD – including children and teens – experience obsessions and compulsions around:
- Contamination. A teen with OCD may experience disruptive worry and fear about germs and illness.
- Responsibility. A teen with OCD may worry their actions, or lack of action, may result in harm befalling a friend or loved one.
- Unwanted thoughts. A teen with OCD may experience repeated, stressful, and disturbing thoughts about a specific obsession.
- A teen with OCD may experience an irrepressible drive to correct things they perceive as not right or fix things the perceive as imperfect.
Researchers published the first large study about the effect of the pandemic on OCD in April 2021. The study examined 270 adults with OCD and found the pandemic led to an increase in:
- Intensity and severity of all OCD symptoms
- Contamination-related symptoms
- Responsibility-related symptoms
- Symptoms related to unwanted thoughts
- Symptoms related to symmetry
That’s what the data says about the effect of the pandemic on adults.
But what about children and teens?
The Effect of the Pandemic on Teens With OCD
We gave it away already.
The pandemic had a significant negative impact on teens with OCD.
But don’t take our word for it: let’s take a look at the evidence from two studies.
In the first, researchers in Denmark examined two groups of 14–15-year-olds diagnosed with clinical OCD. One group was currently in treatment for OCD, while the other group had previously received treatment for OCD but were not currently in treatment. The first group participated in face-to-face interviews, while the second group complete an online survey.
Here’s what they found.
Both the clinical group and the survey showed significant increases/worsening in:
- OCD symptoms
- OCD-related avoidance behavior
- Anxiety symptoms
- Depressive symptoms
However, the survey group showed greater increases/worsening across all symptoms and all metrics. Based on this data, researchers concluded:
- Early onset OCD created increased vulnerability to the effects of the pandemic
- Current enrollment at a specialized mental health facility may have a protective effect
- Knowledge that professional support was easy and available may also have a protective effect
The second study examined a group of children and adolescents diagnosed with clinical OCD. This group completed either online or telephone surveys to assess “symptom profile, symptom severity, and symptom exacerbation during the pandemic.”
Here’s what they found:
- Significant increases in contamination obsessions
- Significant increases in cleaning/washing compulsions
- Statistically significant increases in all obsessive-compulsive subscales (detailed questions that follow up on general questions)
- Subscale increases were associated with:
- Talking/searching online for information about COVID
- Duration of OCD diagnosis: the earlier the onset, the worse the symptom increase
- Diagnosis of COVID in a friend, family member, or loved one
That’s the latest data – and it contains three important things for parents of teens with OCD to understand. We’ll talk about those three things next.
How This Information Helps Parents
Two big questions loomed at the beginning of the pandemic with regards to teen mental health. The first was whether the pandemic and associated stressors would have a negative impact on teen mental health. Data from several sources confirm that it did, indeed, have a significant negative impact on teen mental health. The second question concerned what the impact would look like, positive or negative, for each type of teen and each type of mental health issue.
We’re beginning to see that level of detail now. These two studies give us our first clear and specific data on teen OCD, which parents of adolescents with OCD can us to help support their children, and clinicians at adolescent mental health centers for OCD can use to offer targeted treatment.
Here are the three things we want parents to learn from this data:
- In the first study, current participation in a treatment program for teen OCD and easy access to professional support had a protective effect, i.e. symptoms got worse, but not to the same degree as they did for teens who were not currently in treatment.
- Constant talking about or searching for COVID-related information exacerbated symptoms.
- Teens with earlier onset OCD experienced the most significant increases in OCD symptoms.
If your teen has OCD, you now know that treatment can help manage the magnitude and severity of stress-related symptoms that originate in life changes related to the coronavirus pandemic. You now also know that if your teen with OCD spends an inordinate amount of time talking about COVID or searching online for information on the pandemic, their symptoms may get worse. Finally, if your teen received an early onset-OCD diagnosis (age 8-12), they’re particularly vulnerable to an increase in symptoms related to the stress of the pandemic.
Finding Help: Resources
Taken as a whole, the message from the new data implies this: if your teen has OCD, now is the time to seek, continue, or reinitiate professional support for them.
If you need help seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.
In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness (NAMI) also provide and high-quality online resources, ready and waiting for you right now.