Turtles All the Way Down: Inside the Mind of a Teen with OCD
Year: 2024
Based on: Turtles All the Way Down by John Green
Directed by: Hannah Marks
Starring: Isabela Merced, Cree, Felix Mallard
What does it feel like when your own thoughts will not leave you alone?
Turtles All the Way Down is a close, honest look at adolescent OCD that focuses on what it feels like from the inside. The film follows 16-year-old Aza Holmes as she navigates friendship, first love, and grief, all while living with relentless, intrusive thoughts about illness and contamination.
Rather than presenting OCD as dramatic or chaotic, the film portrays it as repetitive, circular, and exhausting. It captures something very important: sometimes the loudest suffering is invisible.
Scroll down for the PsychiaTRICs Score as our psychiatrist weighs in on what this film gets right, and where it simplifies, about adolescent OCD.
Synopsis
Aza Holmes is a thoughtful, intelligent teenager living with obsessive-compulsive disorder. When a local billionaire goes missing, Aza and her best friend Daisy see an opportunity to solve the mystery and possibly claim a reward. This brings Aza back into the orbit of Davis, a boy she once knew whose father is the missing man.
As their relationship develops, Aza’s OCD intensifies. Her intrusive fears about bacterial infection, particularly C. diff, spiral into compulsive checking, reassurance seeking, and self-injurious skin picking. The more she tries to “solve” her thoughts, the tighter they grip.
The film gently but clearly shows how OCD does not simply disappear during meaningful life moments. It intrudes into romance, friendship, and even medical encounters, reminding viewers that mental illness does not pause for plot.
Key Mental Health & Developmental Themes
Obsessive-Compulsive Disorder in Adolescence
One of the film’s greatest strengths is its fairly accurate portrayal of OCD as a disorder of doubt, not just behavior. The film shows how intrusive thoughts repeat and build on themselves. One doubt leads to another, creating a mental loop that feels difficult to interrupt. Instead of dramatizing OCD, the story focuses on how exhausting and consuming this cycle can be.
From a clinical standpoint, the film captures the core features of OCD: intrusive contamination fears, mental compulsions and rumination, reassurance seeking, and skin picking, also known as excoriation behaviors. It also shows something developmentally important, which is fluctuating insight. Aza can recognize that her fears are excessive, yet in emotionally heightened moments they feel completely real and urgent.
Importantly, OCD is portrayed as ego-dystonic. Aza knows her fears do not make logical sense, yet she cannot simply choose to stop them. That nuance matters, especially for young viewers who often feel shame about “knowing better” but still feeling unable to control their thoughts.
The Burden of Being “High-Functioning”
Aza is academically capable, socially connected, and articulate. Because of this, her suffering is easy to underestimate.
This reflects a real phenomenon in adolescent mental health. Teens with internalizing disorders are often overlooked because they are not disruptive. Anxiety disorders, particularly OCD, can remain hidden behind competence.
For parents and educators watching, the film subtly underscores that good grades do not equal emotional well-being.
Friendship and Mental Illness
Aza’s friendship with Daisy is loving but strained. Daisy grows frustrated when conversations repeatedly circle back to Aza’s obsessions.
This dynamic is deeply realistic. Adolescents are still developing emotional regulation and perspective-taking skills. Living alongside a friend’s mental illness can create compassion fatigue.
The film avoids villainizing Daisy. Instead, it shows that friendships during adolescence are complicated, especially when one friend’s inner world consumes much of the emotional space.
Romantic Relationships and OCD
Aza’s relationship with Davis is tender but complicated. OCD intrudes into moments of intimacy, particularly when contamination fears make physical closeness distressing.
This portrayal is important developmentally. Adolescence is a time of emerging sexuality and identity formation. When anxiety disorders intersect with these milestones, shame and confusion often intensify.
The film gently communicates that mental illness does not make someone unlovable, but it does require honesty and boundaries.
Parenting a Teen with OCD
Aza’s mother is observant, concerned, and proactive. She seeks therapy for Aza and attempts to understand the disorder rather than dismiss it.
From an attachment lens, this reflects emotionally attuned parenting. The film also shows parental helplessness, the painful recognition that love cannot erase intrusive thoughts.
Clinically, this is fairly accurate. Effective treatment for OCD typically involves Exposure and Response Prevention (ERP), often within cognitive behavioral therapy (CBT) frameworks, and in many moderate to severe cases, medication such as SSRIs is also part of care. While both therapy and medication are acknowledged in the film, they remain in the background. This keeps the narrative focused on Aza’s lived experience but slightly underplays the structure and intensity that effective OCD treatment can require.
PsychiaTRICs Score: Turtles All the Way Down
Themes (Mental Health): 5/5
Why? – One of the most emotionally accurate depictions of adolescent OCD in mainstream media. It captures rumination, insight, and shame without sensationalizing.
Real-Life Relevance: 5/5
Why? – Anxiety and OCD commonly emerge in adolescence. The film mirrors how intrusive thoughts infiltrate ordinary teen life.
Impact (Emotional and Artistic): 5/5
Why? – The film uses visual and sound effects to show how intrusive thoughts repeat and spiral, helping viewers understand what OCD feels like while staying realistic.
Clinical Reflection: 4/5
Why? – Accurate portrayal of symptoms and relational impact. Treatment elements are present but not deeply explored, which slightly limits its psychoeducational depth.
Final Verdict – 19/20
Turtles All the Way Down is one of the most clinically responsible portrayals of adolescent OCD in recent years. It does not reduce anxiety to a plot twist or villainize the character’s mind. Instead, it invites viewers inside the repetitive, exhausting loop of intrusive thoughts and reminds us that teens living with anxiety are not dramatic, broken, or weak. They are often thoughtful, self-aware, and quietly fighting battles no one else can see.
