Teen Brains and OCD

teen wih soccer ball

“But he’s only nineteen. His frontal lobe development won’t even be complete until he’s twenty-four. Of course he needs your guidance with this decision.” These are the words spoken by my son Dan’s therapist when we sought his advice. Dan had decided to leave college so he could stay “as long as possible” at the residential treatment program he was attending. Thankfully we did intervene, and Dan left the program after a nine week stay.

This was the first time I realized there is a biological reason why teens and young adults think and act the way they do, often exasperating their parents. In this easy-to-understand article, the author (who happens to be a pediatric neurologist as well as a mom) explains that the frontal lobes, the part of the brain that says: “Is this a good idea? What is the consequence of this action?” are not fully connected in teens and young adults. My guess is anyone who has parented a teenager is now nodding his or her head in agreement.

So what does this mean for teens and young adults with obsessive-compulsive disorder? Well, not only are these young people battling OCD, they are also dealing with their not yet completely developed brains. Both of these factors often involve a lack of good judgment as well as the inability to make good decisions. A double whammy. And for parents and other loved ones of teens suffering from OCD, it can also be doubly challenging. In Dan’s case, we were fortunate he was never an antagonistic teen, but I still often found myself shaking my head in disbelief: “What was he thinking?” Was it his OCD or his age that caused him to think and act a certain way? Who knows?

Decision making and impaired judgment are not the only deficits in a “young” brain. I’ve previously written about the fact that teens experience more difficulty in overcoming fear than adults and children and how this can affect their OCD, as well as their treatment success. Of course, if OCD is present and diagnosed in childhood, treatment early on can help ease the chaos of the teen years.

I don’t have any words of advice, but in a way, I do find it comforting that not everything can be blamed on OCD when dealing with teens and young adults with the disorder. Some of their baffling behavior should diminish with age.  And the rest? Hopefully, Exposure and Response Prevention therapy will do the trick.

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10 Responses to Teen Brains and OCD

  1. Lynn says:

    I wish someone could give me some advice about how to help my own 19 year old son. I can see him working on his exposures, and struggling, but any attempts to help him just get me pushed away. I end up hiding in my room because it’s so difficult to see him struggle.

    • Hi Lynn, Thanks so much for sharing. I’m wondering if you have talked to your son’s therapist about your concerns? I know every family dynamic is different, but in our case, we never worked with Dan on his exposures. We were supportive, and we tried to not enable him, but beyond that, it was really a battle between him and his OCD. I know how difficult it is to see your son struggle. Maybe this post might help a little: https://ocdtalk.wordpress.com/2013/03/04/lighten-up/. I wish you and your family all the best and hope to hear from you again.

  2. It’s hard for me to imagine getting treatment when I was a teenager. I was so secretive about my symptoms. It would have been hard for me to share the extent the symptoms were troubling me. I think it would have been hard for me to face my biggest fears, too. I would have just wanted to hide away, I think. I’m glad there are treatments–and therapists–now who know how to deal with special issues that might affect teens.

    • Thanks for sharing, Tina. My guess is it is still really difficult for most teens to undergo therapy, and we sure could use MORE properly trained therapists. I have great admiration for teens (and children, and adults) who undergo ERP therapy!

  3. Deb says:

    This article is so interesting! I see this as well. I find myself asking constantly has my son’s most recent bad judgement the result of his OCD or just 19 year old bad judgement? Or sometimes, has my son lost his mind?
    I would love to take this article further and theorize that OCD might improve (along with exposure therapy) when that frontal lobe finishes developing at age 24. Am I being wishful? Maybe there is a correlation between the age 18-19 and OCD onset or triggering. Here’s hoping that the mid twenties will knock some OCD out of my sons head. 🙂

    • Hi Deb, Thanks for commenting. I have thought the same as you, as Dan is now 24! I wonder if his more complete brain development will affect his OCD at all? Thankfully he is still doing well. It is all very interesting, as you say. I’m glad you could relate to the post.

  4. Mary Jo says:

    Do you notice a significant difference in judgment and overall brain development/maturity with your son (19 vs. 24)? My son has ASD, ADHD and OCD…he used to show a lot of wisdom, but at 19, it has dipped down.

    Looking for hope!

    • Hi Mary Jo, You will definitely find hope here! My son is now 24, and there is a world of difference between his overall maturity, etc. compared to when he was 19, which is when his OCD was severe. He lives 3,000 miles away and is supporting himself (just barely but that’s okay :)), working in his chosen field, and taking care of all the responsibilities that come with living on your own. And he’s doing it well. There is so much hope for your son! Wishing you all the best.

      • Mary Jo says:

        Thank you, Janet! I am hanging onto hope! I see glimmers of it at times…just hard to see the light at the end of the tunnel when you are so IN it. I sometimes need perspective!
        I so appreciate your kind reply. 🙂

      • You’re welcome, Mary Jo. I hope to hear from you again!

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