Teen with OCD?





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Discus: Parents Forum: 2004 Archive - Part 2: Teen with OCD?
By Nash (Nash) on Monday, September 27, 2004 - 05:55 pm: Edit

Do any of you have a bright teenager with OCD? My son is a senior with an 800 verbal SAT, but even the simplest of essays is painful for him to write. He used to be able to effortlessly write great essays when he was a freshman and sophomore. You can imagine how frustrated he is now. He can still take AP exams (made 5 on both AP Eng Lang and AP Euro) without any problems, but if he sits down in front of a computer to write an essay, he either experiences an excruciating writer's block, or he constantly writes and then erases his work. He can spend many hours just writing the "perfect" introduction. With much effort, he has written many beautiful essays and poetry, and he would like to attend a LAC and major in English and History. I'm obviously concerned that this writing problem could be catastrophic for him in college. Has anyone dealt with this before? Has anyone started their kids on SSRI meds for depression or OCD, and saw an improvement in this sort of thing? He sees a psychologist, but is not taking meds. Most of his classmates don't even know that he has a problem, because he hides behind a 'veneer' of great verbal and social skills. Any thoughts?

By Bookworm (Bookworm) on Monday, September 27, 2004 - 06:03 pm: Edit

Nash,
I'm not sure if your S has OCD in other realms of his life, or just facing a writing block with apllications.
If OCD in various aspects, then it makes sense to talk with psychologist about a referral to psychiatrist, to discuss pros & cons of meds. They can be quite helpful.

If S is blocked about essay, because he is trying to make it perfect, then he can be helped in many ways.

By Nash (Nash) on Monday, September 27, 2004 - 07:09 pm: Edit

Bookworm,
My son takes long, long showers, and therefore, he barely makes it to school on time. He is not a handwasher or germophobic, but he does think compulsive thoughts. For example, he sometimes thinks that if he walks around a building on the right side, instead of the left, that something awful will happen. He then goes back, and walks around the "correct" side, and this lessens the deep sense of unfocused anxiety that he feels. Things in his bedroom have to be kept in a particular place, or else he feels unsettled. He knows that these are all irrational thoughts, but he can't control them. He is fairly easily depressed, and sometimes he experiences "panic" attacks. Fortunately, he has been able to hide most of these compulsive thoughts from his classmates. His writing problem and intermittent depression are the things that stress him the most. He dates, socializes, and otherwise is enjoying his last year of high school. I guess that we may have to try OCD medication because behavioral talk therapy hasn't been very effective. Thanks...

By Robyrm (Robyrm) on Monday, September 27, 2004 - 07:17 pm: Edit

There is an excellent cognitive-behavioral therapy program for OCD described in a book by John March. This is different than regular "talk therapy" in a sense..Before you move forward with medication, you could ask if the therapist working with your son is using this sort of approach with him- it would be considered the "gold standard" approach by most, I would think. Having said this, medication for OCD in teenagers can also be quite effective and can work very quickly. If you haven't already done so, you might want to consult with a medical doctor to see what your options would be.

By Bookworm (Bookworm) on Monday, September 27, 2004 - 07:32 pm: Edit

I agree with everything Robyrm said. Just as some psychologists have far more training in this area, the same applies to psychiatrists. I would think your current psychologist would be a good source for a referral.

By Dg5052 (Dg5052) on Monday, September 27, 2004 - 08:49 pm: Edit

My 9th grade daughter was diagnosed with OCD a year ago; we started her on Zoloft and also talk therapy. She has done VERY well on the medication. Her OCD manifestations: taking long showers, arranging her desk a million times before starting homework; in her homework and in her classwork, repeated erasing and re-writing. Also, irrational thoughts about bad things happening if she does or doesn't do a particular thing. This year in 9th grade, even though the medication does her a world of good, she got a 63 on a test because she took WAY too long filling in the squares on the scantron sheet for multiple choice questions. We got a letter from the psychiatrist indicating that she needed an accommodation, and she will have extra time to complete the tests from now on.

My daughter doesn't like to talk about her OCD, but since she started with the medication, she's a different kid. I would urge anyone whose child continues to have symptoms to explore this avenue.

By Fendergirl (Fendergirl) on Monday, September 27, 2004 - 08:55 pm: Edit

My one roommate has OCD. she has about a 3.8 or so in college. i've taken classes with her and when we've had essay tests it takes her longer to write them because she has to include EVERYTHING. but other than that, shes doing fine.

By Cangel (Cangel) on Monday, September 27, 2004 - 09:17 pm: Edit

Have your child evaluated by a medical doctor! OCD symptoms may be controlled by cognitive-behavioral therapy, but kids often (usually, I think) need meds. Also, often OCD symptoms will grow progressively worse without treatment, until the child has a "breakdown", becomes locked in some repetitive behavior and truly cannot stop - this can be very scary.
OCD is a neurochemical disorder, with some good evidence that it develops after a bacterial infection (strep throat, which has long been known to cause dysfunctions in other organs, days or weeks after the sore throat is gone). Please look at medication, it really allows these kids to function their best.

By Nash (Nash) on Monday, September 27, 2004 - 09:39 pm: Edit

Thanks to everyone for the good advice. We have an appointment later this week with a psychiatrist who was recommended to us by our psychologist. Actually, we've already dealt with several "breakdowns", and they have been scary. Thanks Cangel...

By Tabby (Tabby) on Monday, September 27, 2004 - 09:53 pm: Edit

Nash, best of luck and hope all goes well. Just in case this is useful (it may not be):I had a student with PANDAS a couple of years ago, and it was traced to a strep infection...this is similar to the info in Cangel's post.
http://intramural.nimh.nih.gov/research/pdn/web.htm
PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette's Syndrome, and in whom symptoms worsen following strep. infections such as "Strep throat" and Scarlet Fever...

By Tabby (Tabby) on Monday, September 27, 2004 - 10:02 pm: Edit

Nash, it is Tabby again. It occurred to me that you might live in or near Maryland and the National Institute of Mental Health ; if so,you might want to check their site dealing with Pediatric OCD Research and the study that they are conducting: http://intramural.nimh.nih.gov/pocd/

By Nash (Nash) on Monday, September 27, 2004 - 10:33 pm: Edit

Tabby, thanks for the links!

By Justanothermom (Justanothermom) on Monday, September 27, 2004 - 11:48 pm: Edit

"Has anyone dealt with this before?"

I have. Many moons ago, while in college, I developed writer's block. Just like your son, I continued to perform very well in written tests. However, sitting to write a simple one page essay was excruciating. It took many re-writes and the anxiety was tremendous. The problem continued throughout college and graduate school. Although my experience might not parallel that of your sonís since I didnít exhibit any other OCD behavior, I can share some coping skills that saved my sanity through the years.

If I need to write something lengthy, I give myself plenty of time. I "pretend" I'm taking a test and write a first draft under timed conditions. I do not worry about grammar, perfect structure, or vocabulary. Then, I leave the draft alone for a day or two. Once I come back to it a few days later (I donít quite understand why), the words start flowing much better. I will work on it for only so long and leave the essay alone again. I repeat the process a couple of times until Iím finished. The process is tedious, but thereís very little stress because I donít expect to find the perfect words or write the perfect sentences immediately. That relieves the anxiety and the writing becomes easier. The result is never perfect, but it is good enough most of the time.

I do sympathize.

By Nash (Nash) on Tuesday, September 28, 2004 - 12:48 am: Edit

Thanks Justanothermom. I've been suggesting that my son try exactly what you did in college and grad school. It makes good sense, and I'm going to convince him to give it a try. Kids these days have grown up with computers and word processors. From grades 6-10, he was used to typing high quality stuff directly into MS Word- no need for rough drafts. When I was in college in the 70s, I preferred to write a first draft in pencil. I would make copius notes in the margins, erase, cross things out, draw lots of arrows rearranging sentences, etc. I would then tediously type the final paper with an old-fashioned typewriter. It was not particularly fun, but it seemed effective. I wonder how many kids handwrite their rough drafts these days?

By Justanothermom (Justanothermom) on Tuesday, September 28, 2004 - 09:20 am: Edit

Nash,

Your son's experience is all too familiar. From early on, I loved writing and the words seemed to flow pretty easily. Frequently, my first draft became my final draft. Why I lost that ability, I'm not quite sure. I think that it had to do more than anything with unrealistic expectations that it had to be real good real fast.

He does well in written tests, probably because, like I did, he realizes that perfection is impossible within the time constraints. Creating a similar environment for his written assignments might have the same result. It did for me. What I think is key is that he does not pressure himself to create a polished product out of his first draft.

Whether he uses Word or he writes the first draft, might not be that important. I love to use Word now because it is so much easier for editing purposes (you do bring back memories of index cards, footnotes, unintelligible writing, and typewriters!) Once he accepts that writing can be a tedious and time-consuming process, heíll be better able to cope with his assignments. As to majoring in English or History, I donít know what to say. It was a miserable experience for me when the research papers were due (history major), but it also took me a long while to figure out what my problem was and how to cope with it. He probably will do lots better than me in that regard.


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