OCD and the Teenage Brain


by patrisyu freedigitalphotos.net


This post first appeared on my blog in December 2013……

“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 returned to college after a nine week stay in the program.

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  written about how 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 much advice, but I do find it somewhat 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? Exposure and response prevention (ERP) therapy should do the trick.

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