Adolescence is a very important period and there are many stresses (schoolwork, friends and home life). Consequently many teenagers are reluctant to disclose that they are experiencing “weird thoughts” because they want to “fit in” and are scared of what will happen. Fearing ridicule, teenagers may hide their compulsions when in front of friends at school or at home and become mentally exhausted from the strain. This may result in being too tired to play with friends, concentrate in school and cause family conflict.
Some common obsessions experienced by children and adolescents with OCD include:
- Contamination from contact with certain people, or everyday items such as clothing, shoes, or school books
- Obsessive doubt about locking doors, windows, lights...
- Marked over-concern with the appearance of homework assignments
- Excessive worry about the arrangement of everyday objects such as shoelaces, school books, clothes or food
- Doubt over whether you have performed an action (written something on MySpace/twitter or said something to a friend that you did not)
- Fears of accidentally harming a parent, sibling or friend
- Superstitious fears that something bad will happen if a seemingly unconnected behavior is done (or not done)
Some common compulsions experienced by children and adolescents with OCD include:
- Compulsive washing, bathing, or showering
- Ritualized/repeated touching of body parts or performance of bodily movements in a specific order or symmetrical fashion
- Specific, repeated bedtime rituals that interfere with normal sleep
- Compulsive repeating of certain words or prayers to ensure that bad things don't occur
- Compulsive reassurance-seeking from parents or teachers about not having caused harm
- Avoidance of situations in which they think “something bad” might occur
Is adolescent OCD different from other forms?
The emotional and cognitive skills are still developing in the adolescent brain and, as such, teenagers with OCD may find it hard to understand their obsessions and compulsions. They may think that their fears are normal and fail to recognise that the behaviours are excessive. Adolescents with OCD may be resistant to discussing these problems because they feel frightened of the consequences. There may be a tendency to exhibit “magical thinking” or “Thought-Action Fusion” where they believe that their fears will come true if they talk about them with a therapist (or anyone). Others may deny symptoms, or want to avoid dealing with them in the hope that their OCD will just go away by itself.
Treatment for adolescent OCD
Then only well-established for treatment of adolescent OCD is exposure-based Cognitive Behavioural Therapy (CBT) with a strong emphasis on family and peer involvement. The basic principles of treatment for adolescents with OCD are the same as for adults with OCD. A specific type of CBT known as "Exposure and Response Prevention" (ERP) has been found by researchers to be the most effective treatment for OCD in adolescents. Another CBT technique that is extremely valuable in the treatment of children and adolescents with OCD is called "Cognitive Restructuring". Prior to engaging in therapy it is important that you ask your psychologist if they:
- Specialise in OCD
- Are a member of the APS College of Clinical Psychologists
- Have a PhD specializing in OCD
- Have a proven publication history researching OCD.
Important take home messages
- You are not the only one with OCD. There are 55, 500 people in Brisbane with OCD
- Talking about OCD does not make it real
- You can stop the anxiety that comes with OCD thoughts
- You are not a bad person because you have these thoughts
- The psychologist you will see works with people every day who have OCD, so nothing sounds “weird or embarrassing”.
Disclaimer: The information on this page is very general and should not be seen as diagnosis or treatment advice. You should consult a psychologist or other qualified health professional for advice on your specific problems and the best form of treatment for you.