Sometimes when people think of Obsessive Compulsive Disorder (OCD) they have a narrow view of what the condition involves. The average person may jump to the stereotypical excessive-handwashing version of OCD, or the person who obsessively checks the stove to make sure they turned off the burner. These are examples of how OCD can show up in people’s lives, but it doesn’t tell the whole story.
Anyone who has this anxiety-based condition or has a loved one with OCD can attest to the varying ways it can present itself in thought, feeling and behavior. The hallmark of an OCD diagnosis is the presence of two components; obsessive thoughts that are distressing and repetitious, and compulsive urges to engage in behavior to reduce the stress. It’s not exactly a picnic in the park for teens with this condition, but it is manageable with the right type of treatment.
OCD Treatment for Teens
Obsessive Compulsive Disorder responds well to Cognitive Behavioral Therapy (CBT) because it helps teens dissect thoughts and feelings, while identifying ways to disrupt the urge to engage in the behaviors that can take up so much time and energy. Often the key to breaking up with OCD is learning how to tolerate the strong urges to act on distressing thought without giving in.
For teens who are struggling with this, it may sound impossible; the urge to engage in certain behaviors to reduce stress is powerful, but this is the avenue toward freedom. Think of it like a workout, or a training session for your thoughts and feelings. No one starts out running a 5K on their first day out jogging or benching 300 pounds their first visit to the gym. It’s all about learning the techniques and skills that can help you become an OCD Jedi Master.
Cognitive Behavioral Therapy also helps teens sort out some of the underlying anxieties that drive OCD. Learning about triggers is a helpful way to recognize when symptoms may become more intense. Covid-19 may be a trigger for people who struggle with fears surrounding viruses or infectious illness, for example. For some this may manifest in excessive hand washing, overuse of hand sanitizer or other behaviors to reduce stress.
It is important to remember that the compulsive behaviors of OCD are well beyond the range of typical precaution. Compulsive behaviors are time-consuming and/or disruptive to daily life. CBT can help teens determine where behaviors make the leap into being excessive or disruptive and then work on building tolerance to the distressing thoughts. Teens in treatment can learn to use coping strategies to manage thoughts and urges rather than giving in to them. Medications can also be useful for teens struggling with OCD, but it is crucial to engage in the therapeutic aspect of the work to build skills for managing it. Often CBT is sufficient, and no medications are needed.
How Parents Can Help
Parents of kids with OCD are often flummoxed about how to help. The best thing a parent can do is offer empathy, support, and gentle reminders of coping skills when anxiety triggers are mounting. Remember that teens who are struggling with OCD are distressed by their thoughts and that is what drives the compulsive behaviors. It may be tempting to try to convince them that their thoughts are illogical or baseless, but this approach is likely to cause even more stress, which could increase symptoms.
Remember, your teen will build tolerance for varying thoughts and levels of distress in therapy and will learn to trust their minds with uncomfortable thoughts. Managing OCD is about learning how to keep perspective and recognize that thoughts are “only thoughts” and do not require excessive attention or action. When people with OCD learn to allow thoughts to enter and exit the mind like a passing breeze, it can alleviate a lot of stress and often symptoms begin to subside. Even when anxiety is causing some thoughts to get stuck, treatment can help teens recognize the familiar pattern and use skills learned in counseling to get through a difficult moment without giving in to a compulsive urge.
Parents can also do some research to learn more about OCD and the ways it can affect teens. There are a variety of great resources available, including the McLean Hospital site and Peace of Mind. Both sites are helpful for parents to learn more about OCD and varying treatment methods. Teens will enjoy BeyondOCD.org Just for Teens site.
Regardless of where you are on your journey with OCD, and whether you are a parent or a teen with the condition, relief is possible. When you use CBT tools and practice strategies, you can manage OCD and enjoy your life.
Starting a conversation with your teen can be challenging in the best of times, let alone if you are worried about their well-being and emotional safety. You might be seeing signs of anxiety and depression, or even worried about self-harm or other behaviors indicating they are struggling. How do you broach potentially difficult topics? There is no right answer, but here are a few ideas to spark a connection. Beneath whatever protective exterior your teen is displaying, inside they simply want to know they are loved and cared for. Simply showing an interest can have surprising results.
1. What's your favorite song right now, do you think I'd like it?
2. What is the most embarrassing thing I do?
3. If your life was a TV show, which one would it be?
4. If an alien landed in your class today, what would they be most surprised to see?
5. If you could eat only one food for the rest of your life, what would it be?
1. What would your perfect day look like?
2. What are the best parts and hardest parts of your day?
3. What did you do that you are most proud of today?
4. If you could start today all over again, is there anything you would do differently?
5. Did you see any acts of kindness today at school?
1. What is it that makes you feel sad and why?
2. What do you do when you feel sad or upset?
3. How can I best support you?
4. What do you need from me? (distraction, space, time, etc)
5. How do you soothe yourself when you're feeling scared?
1. I love you, and nothing will ever change that.
2. Even if I don't understand, know that I want to.
3. We are going to get through this together.
4. If you talk to me about what is worrying you, I will do my best to help.
5. You can talk to me, I am always here for you. You can talk to someone else, that's okay too.
While these may start a conversation, remember it's the listening to their responses that is the most important. Encourage with a "hmmm" or "tell me more" to keep the ball rolling. Your teen may not show appreciation in the moment, but they will know you are there, and care.
Talley Webb, MA, CRMC