While symptoms of obsessive-compulsive disorder (OCD) can begin at any age, most people will develop the condition earlier in life. Still, many wonder whether or not you can develop OCD later in life?

The simple answer is yes. However, factors include overlapping illnesses, brain structure, and thinking patterns. Throughout this article, we’ll take a deeper look at OCD’s onset in life and how it comes about.

What is OCD?

Obsessive-compulsive disorder (OCD) is a mental health condition defined by uncontrollable, reoccurring thoughts (obsessions) and/or repeated behaviors (compulsions). ¹

As a type of anxiety disorder, symptoms of OCD vary from person to person. However, they’re always marked by two categories:

1.) Obsessions

Intrusive thoughts, urges, or mental images that consistently repeat and cause anxiety. The most common symptoms include:

• Aggressive thoughts (either towards oneself or others)
• Fear of germs or contamination
• Making sure things are in symmetrical or perfect order
• Undesired forbidden or taboo thoughts (i.e. sexual obsessions)

2.) Compulsions

Repetitive behaviors that are brought about by obsessive thoughts. The most common compulsions include:

• Compulsive counting
• Ensuring things are in order and arranged
• Excessive handwashing and/or cleaning
• Repeatedly checking things (i.e. whether or not the door is locked)

Again, symptoms aren’t the same across everyone. One person with OCD may have obsessions concerning germs and contamination while another may feel more compulsions to make things look neat.

When Do OCD Symptoms Appear?

OCD can begin at almost any age, but research has found there are two distinct age ranges for OCD symptoms to appear: late in childhood to early adolescence or late teens to early 20s. ²

These age ranges are referred to as “early-onset OCD” and “late-onset OCD.” While each produces similar symptoms, scientists have discovered several differences within each category. These include: ³

Early-Onset OCD	Late-Onset OCD
Gradual appearance of symptoms	Abrupt symptom on-set (usually triggered)
Higher rates of tic disorders	Higher rates of anxiety and depression
Prevalence higher in males than females	Prevalence equal in males and females
Symptoms are more severe	Symptoms are mild to severe

Still, these two onset periods don’t answer the question, “Can you develop OCD later in life?”

It’s possible to develop the condition in later adult years, but it’s extremely uncommon. According to one study, out of 1,000 OCD patients, only five experienced their initial symptoms later in life. ⁴

Differences in OCD Onset

When it comes to what causes OCD in the brain, research has observed several differences between patients. These include:

Brain Differences

While more research is necessary, it’s believed that there are some brain differences between early-onset and late-onset OCD. Studies have revealed that those with late-onset OCD tend to have different neuropsychological deficits in comparison to early-onset. ⁵ However, we still don’t know why this is nor how much of an impact this has on treatment.

Comorbid Conditions

People who develop OCD tend to also struggle with other mental health conditions. However, the condition that one struggles with varies depending on the onset. ⁶

For example, those with late-onset OCD tend to also struggle with attention-deficit/hyperactivity disorder (ADHD), an anxiety disorder, major depressive disorder, or oppositional defiant disorder.

On the other hand, those with early-onset OCD tend to also struggle with an OCD subtype known as tic-related OCD. ⁷

These findings aren’t relevant for every specific case. For example, there is a chance someone with childhood anxiety can develop an early onset of OCD. Furthermore, someone with late-onset OCD may be diagnosed with tic-related OCD.

Gender Differences

Males have consistently proven to be more vulnerable to early-onset OCD compared to females. ⁸ However, the gender imbalance finds stability with late-onset OCD as most research reports no differences.

Symptom Development

The way symptoms develop in someone with OCD differs from early-onset to late-onset. Those with early-onset OCD tend to see symptoms gradually appear over a while.

On the other hand, those with late-onset OCD will likely experience sudden symptoms. While it isn’t always the case, these symptoms are usually triggered by a traumatic event, such as the loss of a job or the death of a loved one. ⁹

Symptoms Severity

Those with early-onset OCD tend to have more severe symptoms than those with late-onset OCD. Due to the severity, early-onset OCD may be more difficult to treat than late-onset. In many cases, a child or adolescent will have to undergo a series of medications and therapies before finding the right one for them.

However, it’s worth noting that research found no difference in medication reaction for age range. That is, once the right medication was found. ¹⁰

Still, we can say that those with late-onset OCD tend to have mild symptoms and an easier time overcoming the condition. Regardless of your position, it’s important to treat OCD early as symptoms can worsen over time.

Final Word

While most people develop OCD between childhood and early 20s, the condition can develop later in life. However, since this is such a rare occurrence, there’s a chance you struggle with another mental health condition.

To better understand your position, it’s key to see a mental health professional. With an understanding of your situation, they will be able to appropriately diagnose you.

References

¹ Brock H, Rizvi A, Hany M. Obsessive-Compulsive Disorder. 2024 Feb 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31985955.

² Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M. Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Curr Neuropharmacol. 2019;17(8):710-736. doi: 10.2174/1570159X16666180813155017. PMID: 30101713; PMCID: PMC7059159.

³ Burchi E, Pallanti S. Diagnostic Issues in Early-Onset Obsessive-Compulsive Disorder and their Treatment Implications. Curr Neuropharmacol. 2019;17(8):672-680. doi: 10.2174/1570159X16666180426151746. PMID: 29701156; PMCID: PMC7059152.

⁴ Weiss AP, Jenike MA. Late-onset obsessive-compulsive disorder: a case series. J Neuropsychiatry Clin Neurosci. 2000 Spring;12(2):265-8. doi: 10.1176/jnp.12.2.265. PMID: 11001607.

⁵ Suhas S, Rao NP. Neurocognitive deficits in obsessive-compulsive disorder: A selective review. Indian J Psychiatry. 2019 Jan;61(Suppl 1):S30-S36. doi: 10.4103/psychiatry.IndianJPsychiatry_517_18. PMID: 30745674; PMCID: PMC6343403.

⁶ Westwell-Roper C, Stewart SE. Challenges in the diagnosis and treatment of pediatric obsessive-compulsive disorder. Indian J Psychiatry. 2019 Jan;61(Suppl 1):S119-S130. doi: 10.4103/psychiatry.IndianJPsychiatry_524_18. PMID: 30745685; PMCID: PMC6343419.

⁷ Conelea CA, Walther MR, Freeman JB, Garcia AM, Sapyta J, Khanna M, Franklin M. Tic-related obsessive-compulsive disorder (OCD): phenomenology and treatment outcome in the Pediatric OCD Treatment Study II. J Am Acad Child Adolesc Psychiatry. 2014 Dec;53(12):1308-16. doi: 10.1016/j.jaac.2014.09.014. Epub 2014 Oct 2. PMID: 25457929; PMCID: PMC4254546.

⁸ Mathes BM, Morabito DM, Schmidt NB. Epidemiological and Clinical Gender Differences in OCD. Curr Psychiatry Rep. 2019 Apr 23;21(5):36. doi: 10.1007/s11920-019-1015-2. PMID: 31016410.

⁹ Nazeer A, Latif F, Mondal A, Azeem MW, Greydanus DE. Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management. Transl Pediatr. 2020 Feb;9(Suppl 1):S76-S93. doi: 10.21037/tp.2019.10.02. PMID: 32206586; PMCID: PMC7082239.

¹⁰ Nakatani E, Krebs G, Micali N, Turner C, Heyman I, Mataix-Cols D. Children with very early onset obsessive-compulsive disorder: clinical features and treatment outcome. J Child Psychol Psychiatry. 2011 Dec;52(12):1261-8. doi: 10.1111/j.1469-7610.2011.02434.x. Epub 2011 Jul 5. PMID: 21726224.