OCD: More Than A Quirk

You’ve probably encountered someone in your life and have written off their quirky behaviors to OCD. Perhaps this friend was overly neat and organized. Maybe they were excessively clean and were taken to be a germophobe. Possibly, this person just seemed uptight and needed to learn to relax. Or, so you thought.

In reality, OCD is far more than a quirky behavior. Obsessive compulsive disorder (OCD) is defined as anxiety that presents itself with recurring thoughts and behaviors. These thoughts, easily considered obsessions, make the afflicted person want to do something repeatedly. These behaviors can then wreak havoc in the person’s ability to carry on with daily activities. Even a task as simple as flipping on a light switch, or washing hands, can easily become out of control.

Obsessions and compulsions common for those with OCD

Those with OCD commonly experience both compulsive behaviors as well as obsessive thoughts. These obsessions are simply thoughts that recur and persist, and are hard to push away. Those with OCD might comment that they struggle to “get out of their head,” or to move on to a new thought. They might even dwell on a thought that for most others, would simply be fleeting or forgotten as quickly as it came on. And perhaps even more frustrating is that the person with OCD understands that the behavior and thoughts are unreasonable and unjustified.  But, they simply can’t get the ideas or notions out of their head.

Compulsive behaviors are also quite common for those with OCD. These repetitive acts are difficult to control, and are sometimes without purpose. For example, someone with OCD might flip a light switch on with their left hand, and then feel obligated, or that it is compulsory, to do that same action with the other hand. In other cases, they might feel the need to flip the light switch on and off multiple times, for no clear reason.

Typical compulsory activities for those with OCD include:

• Obsessive cleaning – Those with OCD feel that the obsessive cleaning will help to remove or rid the area of germs or debris that can cause illness. Though this might actually seem like a wise activity, for the person with OCD, the cleaning takes on an entirely new meaning. Those with OCD might spend minutes upon minutes (or hour upon hour) cleaning the same thing over and over.
• Repetition – For some with OCD, they might find it comforting to participate in a repetitive behavior (such as the flipping on or off of the light switch). These repetitive behaviors could including repeating a certain word, name, or phrase over and over. And though the person with OCD knows that that the repetition will not keep them from harm (and they know that the behavior is unusual), the fear of what will happen if they stop is often all-consuming.
• Double-checking and confirming – Those with OCD often feel the need to check and recheck things over and over. This might mean double, triple, and quadruple-checking that the door is locked, or checking dozens of times to make sure that the stove isn’t on. Whatever it is that needs to be checked, the person will check multiple times, even if they weren’t recently using that item.
• Organizing – For those who suffer from OCD, they might feel a compulsory need to organize things. This will likely mean that cabinets will have glassware perfectly aligned, or that books will be alphabetized and aligned perfectly by the spine. Even items such as household towels will be hung in such a way as to define perfection.
• Mental compulsions – Similar to the repetition mentioned above, in some cases those with OCD will suffer from intrusive thoughts. This might entail the need to pray repeatedly or to mutter a phrase over and over as a way of reducing anxiety or preventing something bad from happening.

The causes of OCD

Often times, parents will worry that they did something to cause the OCD in their child. However, this is an unfounded belief and fear, as OCD is not directly caused by a parent’s style of parenting or a lack of control (or even a need for control). This said stressful events can be a trigger for OCD. Typical examples of these triggers include:

• The loss of a family member or other loved one
• The birth of a sibling
• The divorce of parents
• The start of a new year at school
• The relocation or move to a new home or community
• A family vacation or travel to a place away from home
• Other illnesses

Stressful events can exacerbate OCD behaviors. And, the higher the stress, the more difficult it will be for the teen to keep their OCD under control.

Recognizing the signs and symptoms of OCD

Though most teens and youth have feelings of fear or anxiety, those with OCD can’t control their thoughts like others often can. Those worries and concerns often overpower their ability to complete standard tasks. For parents wondering if their teen might be suffering from OCD, it is critical that they be on the lookout for the following signs and symptoms.

• Unusual fear of germs and dirt
• An extreme inability to remain in an unclean area (or enter the area in the first place)
• A fear of becoming contaminated
• An extreme need for order, symmetry, or precisions

• Religious obsessions
• Preoccupation with bodily waste
• The presence of lucky or unlucky numbers associated with decision-making around those numbers (complete avoidance of unlucky numbers or only being able to move forward when a lucky number is present)
• Sexually aggressive thoughts
• Irrational fear of illness, injury, or other harm happening to oneself or loved ones
• An intense preoccupation or fixation with household items
• Intrusive sounds or words

Parents may find it difficult to witness the above behaviors or concerns as many of these take place in private. The key to remember with OCD is that those with the affliction know that their behaviors are extreme, odd, or unwarranted. They simply can’t figure out how to turn off the thoughts or how to change the behaviors.

Teens and youth often exhibit the following behaviors.

• Grooming rituals that include hand washing, showering, and teeth brushing
• Repetitive rituals that include entering and exiting doorways or needing to move through spaces in a particular way
• Repetitive rituals that include rereading, erasing, and rewriting to the degree that work does not get completed in a reasonable amount of time
• Rituals that involve repeatedly checking to see if an appliance has been turned off or a door has been locked
• Repeated checking of homework to the degree that homework is turned in late or the teen loses sleep due to the amount of time taken to complete one certain piece of homework
• Rituals to decontaminate after exposure to a certain person or object
• Rituals that involve touching
• Rituals to prevent harming self or others
• Ordering or arranging objects
• Rituals that involve obsessive or repeated counting
• Hoarding and collecting of items that have no apparent value and can’t be determined to have any sentimental value
• Cleaning rituals related to the home or possessions

Treatment for OCD

Though there is no official cure for obsessive compulsive behavior, there are a variety of effective treatments. In most cases, cognitive-behavioral therapy (CBT) and medicines can be highly effective in managing the symptoms of OCD. Many experts feel that CBT is the treatment of choice for teenagers who suffer from OCD.

Through the use of CBT, teens and youth are trained to learn and understand that they are in charge of their behaviors, and not the OCD. Through this course of treatment, experts work with the teen to teach them to do the opposite of what they might have a compulsory nature to do. This might mean facing their fears in slow and deliberate steps without reverting to the ritualistic behavior that they would normally turn to. Through the use of exposure and response prevention, the teen starts to identify that their fears will not come to life if they do not participate in a certain ritual. This helps to make scary feelings dissipate, or in the least, tolerable.

Medications are also often prescribed to help treat OCD. The drawback to the use of these antidepressants is that the behaviors will often recur if the child stops taking the medications. Therefore, the use of these selective serotonin reuptake inhibitors (SSRI’s) should be limited, and many physicians will only take this route in combination with a CBT approach. Further, the use of medicines to treat OCD should only come into the equation when OCD symptoms are at the moderate to severe level.

There really is no perfect medicine to treat OCD, particularly because OCD manifests a bit differently in everyone, and everyone responds to medications differently as well. Your teen’s physician will determine which medicine to try and for how long before moving onto other solutions. In most cases, a doctor will wait at least ten to 12 weeks to see if a medication is working or changing behaviors before moving on to another option.

How parents of a teen dealing with OCD can cope

Teenagers of all types can be a challenge, but it can be especially difficult for parents who have a teen suffering from OCD. In many cases, teenagers will push back on the idea of getting treatment for their OCD. They may fear that a behavior change will be expected, and they will worry about the ramifications of changing their ritualistic behavior. The teen may also be afraid of being given a label, or by being diagnosed with a mental illness.

Parents need to understand that with OCD, typical talk therapy is not going to be effective. For example, spending time exploring issues about self-esteem, family dynamics, or peer pressures, though they might be helpful for other concerns that the teen might have, will not n33wwq4ily solve for their OCD related challenges.

However, teens experiencing OCD do need to receive treatment before their affliction becomes worse. OCD can be quite debilitating and can have negative consequences on the teen’s ability to function main stream. Thus, parents are encouraged to identify a therapist who is trained and skilled in the science of motivational interviewing. This technique was developed to help teens enhance their motivations and conversely reduce their poor or negative feelings towards education and treatment of the illness.

ERP, otherwise known as exposure and response prevention, is designed to lead to a habitual behavior that will replace the previously ritualistic behavior. The teen will learn that when they participate in a certain act, whether it be one time or repeatedly, that nothing bad will happen to them. This allows the teen to develop a level of tolerance so that their anxiety can start to dissipate. In certain cases, those feelings of anxiety disappear altogether. In most cases, teens will undergo a course of treatment over a period of ten to 15 weeks. And, parents should not expect to see improvement right away. Behavioral changes, if any, will start to present themselves several weeks into the process. For teens that do not start to show improvement by the end of the 15-week period, the therapist will begin to explore other avenues that might be more effective, or that might need to be added to an ongoing stream of ERP related support.

When proper treatment is received and in a timely manner, many teens will experience a significant and dramatic improvement in their OCD symptoms and behaviors. Proper diagnosis is critical to ensuring success and will provide your teen with the highest likelihood that they will be able to develop coping skills to help them move forward effectively.

Parents and teens both need to understand that even though television and the theater often treat OCD as a joke or a laughing matter, that OCD is real and it is serious when left untreated. Nearly six million Americans are suffering from OCD, which is nearly three percent of the U.S. population. And statistically, OCD impacts roughly one in every 100 children.

If your teen is struggling with OCD and they’re having trouble managing their disorder, you have options. Hillcrest – and our trained staff – can help. Reach out today in order to find out how we can help your teen develop solid coping mechanisms to manage their compulsions and start to move forward on the road to recovery!