OCD Teenagers: 7 Surprising Tips To Manage OCD

Introduction

OCD is a mental health disorder in which a person either experiences repetitive, recurrent thoughts, ideas, or images that elevate their anxiety; they may in engage in compulsive covert or overt behaviors to manage the anxiety they are experiencing or to avoid anticipated anxiety; or both. 

OCD in Teenagers

OCD has an estimated prevalence of 0.25%–4% among children and adolescents (Flament et al, 1988). Genetics explain 45%- 65% of the variance of OCD in children, making it a primarily hereditary condition (van Grootheest et al., 2005). Neuroimaging studies show increased activity in the lateral and medial orbitofrontal cortex in both- children and adults with OCD (Pauls et al., 2014). Delays in diagnosing OCD in adolescents may reflect embarrassment and attempts to hide symptoms, poor insight, and difficulty in differentiating actual symptoms from normative rituals during the period of growth (Evans et al., 1997).

Symptoms of OCD in Teenagers

Teenage can be a difficult phase in a person’s life. With fluctuating hormones and situational factors, the symptoms of OCD can, at times, heighten. These symptoms may also go unnoticed or be mistaken for typical teenage tantrums or mood- swings. Some signs of OCD in teenagers include excessive worrying or thinking about something despite exercising efforts to stop thinking about it (obsessions) and/ or having ritualistic behaviors that one has to do to prevent something bad from happening or to reduce the anxiety already being experienced. These ritualistic behaviors include:

• Compulsive, repetitive checking
• Spending a long time grooming, which includes cleaning- hands, body, hair, etc.
• Counting continuously in their head.
• Wearing certain colors or adhering to certain numbers.
• Plucking hair or pricking one’s skin
• Hoarding or collecting unnecessary things.

Some obsessions in teens include:

• Excessive preoccupation with contamination or germs
• Need for symmetry, order, or precision, e.g., being precise on scoring a certain position academically
• Preoccupation with body waste, which can also include period blood.
• Fear of illness or harm to oneself or others
• Sexual or aggressive thoughts
• Religious obsessions

Impact of OCD on Teenagers

While adolescence has its challenges, teenagers suffering from OCD have more trials to face. Some of these challenges include

1. Low self-esteem: obsessions for symmetry and perfection can cause heightened focus on one’s body features which may be seen as flawed. This focus on flaws can cause unappreciation and disgust to one’s appearance which can result in low self-esteem.
2. Physiological ailments: repetitive thoughts of engagement with perfection can lead to teenagers taking up crash diet courses to look a certain way, which in turn can cause ailments in their bodies. These ailments can include being anaemic, dysregulation in menstruation, etc.
3. Identity crises: obsessions related to sexual themes can have a severe impact on teens. Recurrent, socially discouraged thoughts or images can question their identity and who they are as people.
4. Difficulty in time management: excessive time spent on compulsive behaviors, such as washing, counting, etc. to neutralize the anxiety experienced leads to poor time management which affects their academic performance and can also cause interpersonal conflicts.

Effective Treatment Options for OCD in Teenagers 

Treatment options for OCD in teenagers include psychotherapy and pharmacotherapy.

• Psychotherapy: Counseling for OCD involves more than just talking therapy treating OCD. Cognitive Behavior Therapy (CBT) has often been useful in treating OC symptoms. Exposure and Response Prevention (ERP) is a form of CBT devised primarily to treat phobias and OCD. CBT focuses on restructuring faulty cognitive beliefs and ideas while replacing faulty behaviors with productive ones. In ERP, the patient is exposed to the stimuli causing anxiety (obsession), e.g., exposing the patient to dirt, followed by enduring the anxiety with the newly learned productive behavior and replacing the previously performed compulsive behavior. Systematic desensitization can also be used when multiple OC symptoms are present. In this, a hierarchy of anxiety-eliciting obsessions is created, and ERP is done in ascending order of the list.
• Pharmacotherapy: Since OCD is primarily a genetic disorder (van Grootheest et al., 2005), certain medicines can help tackle its symptoms. Mostly, antidepressants such as Fluoxetine, Fluvoxamine, and Clomipramine are prescribed. However, the medication should be taken as advised by a qualified Psychiatrist. 

7 Surprising Tips to Manage OCD in Teenagers 

Some tips to manage OCD in teenagers include:

1. Psychoeducation: Understanding that the ego-dystonic thoughts that one is experiencing don’t define them but are a symptom of the disorder they are going through.
2. Acceptance and distress tolerance: Anxiety, like any other emotion, is transient. The more they try to fight it, the longer it stays.  Accepting the anxious state and tolerating it until it passes away can be more beneficial than trying to repress it by performing compulsive behavior.
3. Identify your cognitive distortion: Practicing the revelations in therapy about one’s faulty beliefs and cognitive distortions, such as ‘all or none thinking,’ and identifying when they can help one develop tolerance.
4. Inhibit reassurance: The need to confess or talk it out to feel reassured can often lead to new compulsivity. Instead, try tolerance using other effective measures.
5. Mindfulness: Being mindful and nonjudgmental towards obsessions can help them pass early. 
6. Seek help: If your thoughts are hampering your daily life activities and relationships, seek help from a mental health expert for proper treatment.
7. Be compliant: OCD is a biological condition that requires treatment. Be complaint about the medicine prescribed or activities discussed in therapy.

Conclusion

OCD is a hereditary psychopathological condition in which a person experiences repetitive, ego-dystonic thought and/ or engages in compulsive activities for neutralization. Up to 40 % of teenagers experience OCD, and 0.25–4% among children and adolescents (Flament et al., 1988). OCD in teens can impact their self-esteem and identity while also making them vulnerable to many physiological disturbances. Seeking professional help, being compliant with the treatment, and practicing distress tolerance, mindfulness, and acceptance are effective ways to manage the symptoms.

References

Flament, M. F., Whitaker, A., Rapoport, J. L., Davies, M., Berg, C. Z., Kalikow, K., … & Shaffer, D. (1988). Obsessive-compulsive disorder in adolescence: an epidemiological study. Journal of the American Academy of Child & Adolescent Psychiatry, 27(6), 764–771.

Van Grootheest, D. S., Cath, D. C., Beekman, A. T., & Boomsma, D. I. (2005). Twin studies on obsessive-compulsive disorder: a review. Twin Research and Human Genetics, 8(5), 450-458.

Pauls, D. L., Abramovitch, A., Rauch, S. L., & Geller, D. A. (2014). Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nature Reviews Neuroscience, 15(6), 410-424.

Evans, D. W., Leckman, J. F., Carter, A., Reznick, J. S., Henshaw, D., King, R. A., & Pauls, D. (1997). Ritual, habit, and perfectionism: The prevalence and development of compulsive-like behavior in normal young children. Child development, 58-68.