Written by Dr. Paul Kelly, C.Psych. May 10, 2025
OCD in College?
Discover why symptoms often begin or worsen at college.
Learn about key factors of OCD.
When should students seek help?
Read here to learn more.
Table of Contents
- Maya’s Story: OCD in College
- Why Do OCD Symptoms Often Start in College?
- 3 Kinds of OCD Symptoms and 2 College Stories
- When Should College Students Seek Help?
- Key Takeaways for Students and Families
- Personal Note and Recommended Research
Maya’s Story: OCD in College
Maya was always a perfectionist. She liked things tidy. She laid her clothes out a certain way. But her fussiness was a quirk not a problem. Everything changed when she left home for university in Toronto.
Moving into residence was a tough transition for her. Maya was away from her family for the first time. She felt pressure to make new friends. School assignment was more demanding than high school. She started to worry about germs in the shared bathrooms.
At first, she washed her hands a little more than usual. Soon, she was washing dozens of times a day. She started to check her door lock over and over when she left her dorm room. Small assignments took hours to complete because she kept redoing them. She couldn’t stop checking or washing.
Her rituals left her exhausted and isolated. She felt embarrassed. She tried to hide her compulsive behaviours from the girls on her floor. She knew her fears were over the top, but she couldn’t stop. Fortunately she talked to her parents and they helped her to find an OCD therapist.
Why Do OCD Symptoms Often Start in College?
Maya’s story is not unusual. It is very common for people to develop OCD symptoms in their early adult years. There are two patterns: Some people develop OCD out of the blue.
For them, the symptoms start when they go to college or university. Other people had some OCD tendencies or symptoms to begin with. In their case, their symptoms got a lot worse when they left home for college.
Three factors make the college years a high-risk window for OCD symptoms to begin or get worse:
- Biological Factors: This includes genetic predisposition and developmental factors. OCD runs in families. If a student has a close relative with OCD, they are more at risk for developing OCD. Brain development is also a factor. Brain areas connected with decision-making, impulse control, and processing fear and anxiety are maturing and changing in the college years. This can create a risk for OCD development.
- Environmental Stress: College brings significant life changes. Students move away from home, academic pressure increases, they must make new friends and develop new routines. These stressors can trigger or intensify OCD symptoms.
- Loss of Family Accommodations: Family members may have protected or assisted students at home. When they leave home, these supports disappear. This change may cause their existing symptoms to worsen, and worse symptoms can develop.
3 Kinds of OCD Symptoms and 2 College Stories
Three kinds of symptoms show up with OCD:
- Intrusive Thoughts or Doubts: Unwanted, distressing thoughts (obsessions) begin, such as fears of contamination, making mistakes, or causing harm.
- Compulsive Behaviors: To manage the anxiety, the person starts performing rituals or mental acts (compulsions), like excessive handwashing, checking, repeating actions, or seeking reassurance.
- Increasing Interference: Over time, these thoughts and behaviors take up more time and energy, interfering with schoolwork, social life, and daily routines.
Here are the stories of two students who developed OCD symptoms after they left home and moved into dorm rooms. (As always, identifying information has been changed.)
Ethan’s Story: Constant Reassurance
Ethan was in residence in his first year. He had always been a little anxious, but his worries got out of control when he left home. Every day, Ethan was haunted by thoughts that he had done something wrong or offended someone. He could not stop or ignore these upsetting thoughts.
He started asking the guys in his dorm for reassurance to calm himself. He knocked on their doors, sometimes late at night, and asked, “Are you sure I didn’t say anything weird at dinner?” or “Do you think I upset anyone today?” At first, the other guys were patient and tried to help.
When someone was kind and reassured Ethan, he felt better for a while, but his worries always returned. He always needed more reassurance because his worries were so compelling. Over several weeks, the guys got annoyed with Ethan and started to avoid him. Some of the guys yelled at him to stop pestering them, which made his worries and obsessions even worse.
Ethan’s constant need for reassurance was a symptom of his OCD. It made college life stressful and lonely, even though he lived in a dorm. He wished he could break the cycle, but didn’t know how.
Ayesha’s Story: Constant Hand Washing
Ayesha was a first-year community college student. She had a meal plan, but the cafeteria was a problem. The prospect of touching a food tray or cutlery filled her mind with thoughts of germs and infecting her family. She was obsessed with thoughts about germs and contamination.
After she ate in the cafeteria, she had to spend hours washing her hands. She scrubbed until her skin was red and raw. Even after washing, she still felt ‘dirty,’ and the urge to clean her hands returned. She started to skip cafeteria meals to protect herself and her family.
When her friends invited her to eat with them, Ayesha made excuses. She felt embarrassed and alone. She knew her friends were eating and socializing while she sat hungry in her room. The more she avoided the cafeteria and washed her hands, the more trapped she felt by her fears.
Ayesha’s struggle is common for students with OCD, especially those with contamination worries. Her constant handwashing and fear of germs made it hard for her to enjoy campus life or care for herself.
When Should College Students Seek Help?
OCD symptoms rarely go away on their own. And they can get worse if they are not appropriately treated. Here are some signs that you or someone you care about should seek professional help:
- OCD symptoms take up more than an hour of your day.
- Your symptoms are causing a lot of anguish and distress.
- Symptoms interfere with your ability to study, work, or be with your people.
- You notice your world is shrinking, to accommodate rituals or avoid triggers.
- You cannot control the thoughts or behaviours, even though you know they’re excessive.
- You feel shame, guilt, or hopelessness about your symptoms.
- Friends or family are concerned about your behaviour.
Early Intervention is Crucial
The good news is that there are effective treatments for OCD. OCD rarely goes away on its own and can become more severe if left untreated. Evidence-based therapies are highly effective for OCD.
Find a therapist who can offer one of the proven therapies such as Exposure and Response Prevention (ERP), Cognitive Behavior Therapy (CBT), Inference-Based Therapy, Barlow’s Unified Protocol, Acceptance and Commitment Therapy, or Mindfulness-based therapy. Find a therapist who feels right for you.
They should show that they respect and care about you, and they will adapt the therapy to suit your preferences and readiness to change. Starting treatment early can improve academic success, relationships, and overall quality of life.
Key Takeaways for Students and Families
- OCD often starts or worsens during the college years due to developmental, genetic, and environmental factors.
- Early signs include persistent, distressing thoughts and time-consuming rituals that interfere with daily life.
- If symptoms are causing distress or disruption, seeking help from a mental health professional is recommended.
- Early treatment leads to better outcomes and helps students regain control over their lives.
Personal Note and Recommended Research
I still remember the first client I treated who had OCD. She had a lot of grit, and she was able to overcome very severe compulsions. She inspired me to learn as much as I could about specialized treatments to help people with OCD.
I have a lot of respect for people who have been living with OCD symptoms. They deserve expert help from well-trained therapists. That is why I have set up a special program at my Clinic.
It is important to me that you find practical and trustworthy information. That is why I personally selected and reviewed all the sources for this article. My advice is also based on my own experience helping people with OCD and my decades of supervising other therapists who provide OCD treatment.
Sulkowski, M. L., Mariaskin, A., & Storch, E. A. (2011). Obsessive-Compulsive Spectrum Disorder Symptoms in College Students. Journal of American College Health, 59(5), 342–348. https://doi.org/10.1080/07448481.2010.511365
Silverman, M. E., Nag, S., Kalishman, A., Cox, P. H., & Mitroff, S. R. (2022). Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic. Journal of American College Health, 72(5), 1466–1472. https://doi.org/10.1080/07448481.2022.2080507
Silva, A.V., de Christo, R.B., Alves-Pereira, R., et. Al. (2024) Experiential avoidance and obsessive-compulsive symptoms in university students. Neuroscience Applied, Volume 3, https://doi.org/10.1016/j.nsa.2023.103924
Centre for Addiction and Mental Health (CAMH). Website information about Obsessive-Compulsive Disorder (2024). https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/obsessive-compulsive-disorder
International OCD Foundation website. This is an excellent source of information about OCD and related disorders for clients and families. Here is the link: https://iocdf.org/
