By Owen Kelly, Ph.D.
Question: How Do I Cope With a Teenager with OCD?
Teenagers can be a challenge at the best of times. However, when your teenage son or daughter has OCD, it can present additional challenges. Parents often ask, how do I help my teenage son/daughter with OCD?
Teenagers with OCD may have a number of problems that can make treatment of symptomsdifficult.
Your Teen Refuses to be Assessed and/or Treated for OCD: Teenagers often refuse to go for assessment and treatment for OCD. This is often related to the stigma of being diagnosed with a mental illness. They may also worry about falling behind in school or have concerns about the side effects of OCD medications. In addition, like many people with OCD, your teen may have poor insight into the nature and severity of their symptoms and may not see the need to seek treatment.
How to Cope: Try to find a therapist who is skilled inmotivational interviewing techniques. These are designed to help enhance motivation for change and reduce negative feelings towards treatment through education. These techniques may also help your teen gain insight into the impact of their symptoms.
Above all, it is important to remember that forcing someone to change simply does not work. Just being there as a source of support for when they do decide to seek treatment is often the best option -- constant nagging and confrontation often makes the situation worse.
You Have Become Involved in Your Teen's Compulsions: Many teenagers with OCD have managed to get their parents involved in their compulsions. This could involve things like helping with a cleaning ritual, agreeing to arrange items in the house a certain way, or providing excessive reassurance (e.g., telling your teen over and over again that their hands or clean or that nothing bad will happen). This can cause burnout and frustration as parents grow tired of participating in rituals and/or continually providing reassurance for the same problems.
How to Cope: Ideally, you should have no involvement in your child's compulsions nor should you continue to provide reassurance once you have given initial feedback to your child. Participating in compulsions only reinforces their importance -- likewise, providing excessive reassurance validates the worries that accompany OCD. Many parents go along with their teen's compulsions so that teen will not feel distressed. However, it is important to realize that in the long run, this does much more harm than good.
It can often be helpful to work with a mental health professional to identify problematic OCD behaviors. Moreover, involving family members in treatment can be helpful.
Your Teen Becomes Enraged/Violent When Prevented From Participating in an OCD Ritual: Many pleasant, otherwise well-adjusted teens with OCD become very angry when prevented from carrying out an OCD ritual. In some cases, this can lead to physical confrontations between the parent and teen or destruction of property.
How to Cope: It is important to remember that in the vast majority of cases, this anger is driven by fear, anxiety and frustration, rather than aggression. Your teen is simply feeling overwhelmed and has run out of coping resources. It can often be helpful to engage an objective third-party, such as an OCD therapist, who can work with your teen in a non-judgmental environment to explore the nature of their obsessions and compulsions. The therapist can then work with your teen to put coping strategies in place and work to reduce the frequency of compulsions.
If you are tackling this alone, your best strategy may be to simply walk away until you and your teen have calmed down. You can then discuss the matter rationally.
Your Teen Will Not Discuss Their OCD Symptoms With You: Teenagers are often reluctant to share details of their life with their parents at the best of times, and this secrecy can be even worse in teens with OCD. Symptoms of OCD can be embarrassing, particularly with respect to obsessions related to sexuality, which could involve parents, siblings, pets or other inappropriate figures.
How to Cope: You may have to accept that your teen will not be willing to share the nature of their symptoms with you. Respecting their privacy and providing a supportive, non-judgmental environment should they decide to open up is often the most helpful strategy in these circumstances. You may suggest that if they are not comfortable speaking with you, you will help them find a therapist they are comfortable with.
Although your teen may be willing to discuss their symptoms with their OCD therapist, keep in mind that in most cases the therapist is bound to maintain your child's confidentiality and will not share details with you unless they have their permission. This can be very frustrating for parents, but it is important to respect your child's right to privacy.
Your Teen is Using Drugs to Cope With Their OCD Symptoms: It is not uncommon for teens to use drugs and alcohol to cope with symptoms of OCD -- particularly if their OCD symptoms are accompanied by depression.
How to Cope: In these circumstances, it is advisable to seek professional assistance, as this can be a complex problem that requires the experience of trained mental health professionals. Your family doctor is often a good starting point to identify resources. It can be frustrating for your child to reject such assistance, but unless they are a danger to themselves or someone else, they cannot be forced into treatment. Setting firm boundaries at home (e.g., not allowing drugs/drug use in the house) and managing your own stress levels are paramount in these instances.
My Teen is Being Bullied at School Because of Their OCD: Unfortunately, some teens with OCD are subjected to psychological and/or physical bullying. This can be extremely stressful for both parents and the affected teen, and can lead to depression. Of course, depression increases the risk of self-harm behaviors, including suicide.
How to Cope: If you become aware of bullying, it is essential to engage the appropriate professionals at your teen's school, including the school principal, guidance counselor, and your child's teacher. While your teen needs to be taught assertiveness skills for dealing with such situations, they also need to feel safe and confront such problems in a supportive environment. Individual therapy can helpful for focusing on building self-esteem, working on social skills, and of course, managing OCD symptoms.