How Do I Talk to My Teen About OCD?

“My parents don’t understand. I want to deal with this myself. If they didn’t interrupt my rituals, I’d be fine.”

Teenagers are typically aware when they are doing things out of the ordinary or that other teens their age are not doing. They may be afraid to tell anyone about their elaborate showering routines, excessive checking behaviors, bizarre and unwanted thoughts about sex or violence, a need to replace a “bad” thought with a “good” one, or other common behaviors associated with pediatric OCD.

Talking to a trusted adult such as a parent, caregiver, or even a teacher can help teens identify their unwanted thoughts and behaviors as OCD and may provide some much needed relief. However, teens — in contrast to children — are also going through a phase of increased independence and may be resistant to admitting they need help.

Below are some tips and recommendations to keep in mind when talking to your teen about OCD and OCD treatment.

Do your homework and learn as much as you can about OCD.

Get to a support group for parents. Talk to other parents and families. There are also books, and other resources geared toward teens and young adults for those interested in doing their own research and learning more about OCD. Do your research and learn how to find the right therapist for your teen. Also familiarize yourself with medications used to treat OCD and how they might help reduce symptoms to a manageable level so the whole family can cope better. More information about medication is available here.

If your teen refuses to go to see a professional (with or without you), don’t forget that you can insist the teen go. This requires a serious commitment on your part to really support your teen to learn all he or she can about OCD and to seek professional advice.

Be open and let your teen know you want to talk.

Many adults with OCD can clearly trace the beginnings of their symptoms back to childhood. Recalling feelings of shame, isolation, and fear, adult sufferers say they wish someone had taken the time to sit and talk with them about their odd behavior instead of criticizing them for it. In a non-judgmental way, encourage your teen to talk about his or her “worries.”

Recognize the impact of stigma.

Societal stigma of mental illness can compound the already-existing pressure many teens face to “fit in.” A teenager with OCD may feel stuck, especially as someone who depends on adults more than other peers, and may resent it. As a result, feelings of anger and hostility may also be more prevalent than expected. Fears of being stigmatized and excessively worrying about what others think, on top of trying to keep symptoms a secret, can prevent teens from developing a positive and self-respecting identity. This is one reason why it can be critical to speak with your teen throughout the treatment process and to make sure your teen gets the help he or she needs early on.

Don’t change routines or expectations around the house.

Parents of adolescents with OCD often forget that they are still the parents and can set limits. Expectations to do household chores or participate in family activities should not be altered to accommodate the OCD, especially as teens naturally start wanting to explore boundaries and push back against expectations. If your daughter’s usual chore is to take out the garbage and she stops because of contamination fears, don’t give her an allowance anyway “because she has a problem.” If your teen generally does his own laundry but stops because he feels “he can’t,” don’t do it for him.

Be there to coach, but don’t take over tasks that your teen should do. This is easier said than done. You may argue that cleaning up the dishes is not nearly as important as getting out of the shower and getting to school on time. However, these accommodations, no matter how small, can undermine the progress being made by your teen in treatment. If he or she is not in treatment, stopping accommodations might provide some motivation for your teen to get into treatment.

Prepare yourself to impose consequences.

As you’ve probably noticed, OCD can impact everyone in the household, not just the individual with OCD. If your home life is deteriorating because OCD has been difficult to manage, you need to take action. Often, accommodations in household routines happen slowly, creeping up one change at a time, and, before long, families find themselves embroiled in a tangled mess of OCD routines and rules. For example, in a household with only one bathroom, other family members may all start skipping their morning showers because your teen with OCD occupies the bathroom for the entire morning. Or, you may find yourself buying gallons of soap and bleach to accommodate your teen’s contamination fears.

If you get to this point, it is critical that you are firm and empathic, and are consistent and follow through. You should be working with a therapist who is open to working with the entire family to teach everyone how to avoid accommodating behaviors and how to respond to your teen’s pleas for accommodations.

Continue to make school a priority.

Don’t do your teen’s homework for them. Don’t make arrangements for home-schooling if your teen argues he or she cannot leave the house due to OCD. This will only serve to reinforce his or her OCD behaviors and can negatively impact your teen’s social development. If your child’s OCD is really severe enough that he or she cannot go to school, there are residential treatment programs and even therapeutic boarding schools available. However, this is a very important decision, and should only be made together with a skilled therapist or psychiatrist with knowledge of OCD in teens.

Find a Teen OCD Support Group.

The tendency of adolescents to form closely-knit peer groups is indispensable as part of the normal developmental process. By sharing ideas with their peers, teens try out their theories and discover their strengths and weaknesses.

The peer group provides some of the comforts of family with an added sense of independence. Adolescence is also a time to think about the future —to dream about what a teen wants to do in life. This is also when teens start thinking about and exploring their sexuality — conversations they are much more likely to have with peers than with parents.

Unfortunately, many of these normal developmental processes are hindered or blocked by OCD. Adolescents with OCD often feel extremely isolated and inadequate. It is common for them to be very fearful or ashamed of their behaviors, wondering: “How will I ever be able to work?” “Who would marry me?” “Should I have kids, or will they inherit my OCD?”

Increased internal conflict and a sense of alienation, magnified with the stress of coping with their OCD symptoms, are particularly painful for adolescents when the “normal” developmental tasks are pressing. “But mom, everybody’s doing it.” But not every teen has OCD. It may be cool to get a pierced ear, but it’s not cool to have raw hands from washing or to see a therapist! Adolescents can be difficult to engage. Getting your teen to a local support group with other young OCD sufferers who understand what your teen is going through may help with this — search the Resource Directory to find support groups in your area. If there is not a teen support group in your area, there are some online groups for teens that may also help.

Engage the entire family.

Make sure your family understands how OCD can intensify normal concerns or conflicts. Family members should also know where to draw the line or give in. Family therapy can be helpful for everyone to have a place to talk about how OCD is impacting them. This may be especially supportive for siblings and for parents learning to work together better.

Remain positive.

Once recovery from the symptoms of OCD begins, it is helpful for you as a parent to remind your teen to realistic about expectations and not be too hard on him or herself. Your teen may feel that he or she has “lost” a number of teenage years because of OCD. It may take a while longer to obtain a driver’s license, a job, a peer group and close friends, or to decide on a future education or career.

This may be discouraging for the teen as they look around and see peers doing all these things they feel far from. This can evoke feelings of worthlessness or helplessness. If you can recognize this or the teen can talk about it, praise your teen for the accomplishment of overcoming the OCD.

Remind your teen, with optimism, of skills he or she has acquired, and that he or she will “catch up” with others. With patience and a positive outlook, you can assist your loved one to continue on. Supportive counseling can be beneficial for the sufferer and/or the family. Again, don’t forget about support groups!