Help with a teenager with possible OCD
October 19, 2023 5:09 AM   Subscribe

My son (15, based in the UK) has been given an informal diagnosis of OCD. What should our next steps be?

Background: he gets very obsessive about his health. He has repeatedly got very agitated about having severe health conditions (there is literally nothing wrong with him at all). When this happens he'll spiral and demand to see a GP (e.g. he'll convince himself swollen glands indicate cancer; that a rash and tiredness indicate leukemia; that he has a weak grip and is developing MND; bruises and sore throats take on great significance etc), often getting worse and worse until we make an appointment (e.g. refusing to get out of bed and go to school).

Things tend to get worse when he's under stress/unhappy. Often when this occurs he will lie in bed and express no hope for the future/no point doing anything as he will be dead soon due to [rare cancer]. He has GCSEs coming up this year.

We have paid for him to see a therapist. This may/may not help (he says it has, although he's not hugely communicative about this. He's also been in a good state the late few months, although even today I have had to field questions like "do bruises get bigger"). After 4-5 sessions she has said she believes he has OCD (although stresses she is not qualified to give a formal diagnosis).

What should we do with this information? My belief/understanding is that the NHS (probably nationally, certainly where we live) will be unlikely to help him. Waiting lists for child mental health are incredibly long, and for a condition like OCD I don't believe they will even see him. If we see the GP, they may/may not refer him, but even if they do, I suspect we'd be looking at 18+ months before anyone sees him.

Do we just carry on with him seeing his therapist (which I'll be honest, isn't cheap)? Is there anything else useful we can do in the interim?

Ideally am looking for: resources or solutions that have been useful to others in this situation, and any information on whether the NHS is likely to be of any use in this situation, and how to navigate it if we go down this route.
posted by anonymous to Health & Fitness (6 answers total)
The charity OCD UK has a section on their website with advice for young people, which might be helpful.

It's also possible that a GP might be willing to prescribe first-line OCD medication like an SSRI (if this is a palatable option for you and your kid) without needing to refer your kid to mental health services, though I don't know for sure what the prescribing guidelines are for under-18s. Given that a GP appointment is a lot easier to access in a short timeframe than a referral to children's mental health services, it's probably worth making an appointment at least to have a chat with them about what options are available in your area, as this will vary based on where you live. There might be options you're unaware of, either for fast-tracked care or something like a referral partnership with a private service.

As someone who only identified their own neurodivergence as an adult (I don't have a diagnosis, largely because of the state of the NHS, and there's no support for adults anyway), a huge amount of the benefit of even informal or self-diagnosis for me was being able to understand my challenges through the lens of that condition and to seek out resources on what other people with similar challenges do to help themselves. This is perhaps more applicable for something like autism, where there's no obvious medication or medical treatment - my understanding is that OCD often responds well to medication, but there's no harm in you and your son exploring the social media landscape around OCD and experimenting with tips that other people with that diagnosis find helpful.
posted by terretu at 6:00 AM on October 19, 2023 [2 favorites]

Some common antidepressants such as Prozac are usually the first line medication for ocd, it might be worth talking to the GP if they would be willing to prescribe.

Is important to be very specific about the school refusal piece of it as well to everyone you talk to as for children this is an huge indicator of severity.
posted by AlexiaSky at 6:03 AM on October 19, 2023 [4 favorites]

My sister, my niece and my step-father all have OCD to varying degrees. Escitalopram, sold under the brand names Lexapro and Cipralex, was life-changing for my sister. The combination of Lexapro and therapist allowed her to get through her exams and function in adulthood. She was not medicated as a teenager and I cannot emphasise enough how our entire family regrets that. Those years were so much harder for her than they needed to be and that very profound struggle still impacts her and our family relationships today.
posted by DarlingBri at 6:36 AM on October 19, 2023 [7 favorites]

Just to cosign AlexiaSky. It's possible your GP can prescribe your child medication without needing to refer him onwards.

Source: I presented to my (NHS) GP with anxiety/depression and they prescribed me an anti-anxiety medication without referring me onto a specialist.
posted by unicorn chaser at 6:49 AM on October 19, 2023 [1 favorite]

OCD benefits greatly from ERP (exposure and response prevention) and CBT (cognitive behavioral therapy) with a therapist who has expertise with these methods and treating OCD. Can you find a different therapist who has expertise with these methods? Also, as indicated above, Prozac is a very common first line treatment for OCD, but depending on how severe it is, this may not be the correct drug especially at the beginning of treatment. So make sure to talk about this with the GP if you plan to see them and ask for medication.
posted by twelve cent archie at 8:28 AM on October 19, 2023 [2 favorites]

Your son's anxiety sounds exactly the same as mine. I've been on escitalopram 10mg for 8 years now and it was a life changer. I still have health anxiety/ocd at times of great stress but the duration is always much briefer than pre-medication.
posted by thereader at 10:42 PM on October 20, 2023

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