15 year old breakdown, intrusive thoughts, OCD

[Mun2]

My DH took everyone out yesterday so I could organise some stuff. He was going to do something fun so I was surprised that my oldest Ds said that he had homework to do.

Not long after they left he came to me the kitchen and basically broke down in tears, he has been having obsessive thoughts, intrusive thoughts, they won’t leave him alone. It’s been going on for 5 months, he hasn’t been happy for one day.
He keeps seeing signs when he is outside. He is over analysing his dreams. He has bitten his nails all the way down and has been pulling out his hair. In school he can’t concentrate and writes all over his hands. He told me he wants me to take him to the Drs he needs tablets to make it stop.

I gave him a cuddle and told him it’s ok, thank you for telling me. Don’t worry. He is in bits. It started with a health anxiety, he thought he was going blind, as I found out that a family member got diagnosed with Ushers syndrome. But he said he’s not thinking about that anymore, now it’s switched onto other stuff.

I found a phone line that he is going to call later on when it opens, I’m going to speak to the GP tomorrow and we have been watching YouTube videos about OCD, intrusive thoughts etc.

How else can I help him?

I’m scared of antidepressants but not opposed to them. Surely any parent would feel anxious as to their child taking something that may have negetive effects. If the GP would’ve recommended them I would have gotten him to take them. But she didn’t.

Thank you for the link, I’m checking it out now.

@Mun2 if he has actually stopped eating altogether, you need to call 111. If he is finding it hard to eat, but is eating, I would ditch any thoughts of healthy eating and just let him eat what he is happy to eat. If that's 10 bars of chocolate, go with it.

GPs generally can't prescribe SSRIs to children without CAMHS oversight. It's against NICE guidelines. CAMHS will take a very long time unless your DS becomes so unwell that he needs a hospital admission. For context, DD3 was completely out of school, in her bedroom with the windows wide open in the middle of winter, and it did nothing for her in terms of CAMHS.

I don't know what his availability is, but Dr Channing at Alternative CAMHS has been very good for DD3 and he reviews her on Zoom. You could email him.

I think all GPS can do is refer to camhs or inpatient type care. I have taken my daughter a few times whilst on the camhs waiting list. You can take him to a and e to be seen by a crises team if he isn't eating or if he is in crises. You may find they just do you another camhs referral but you will the likely to be seen within a week, but then potentially just be put back on another waiting list

@Mun2Hi OP,
Really sorry to hear your son is going through such a tough time with ocd. I have been there (and sadly continue to be there). I couldn’t read and run - I don’t have any strong advice necessarily however when I was his age I too had an obsession about going to hell. I’m not religious in the slightest but my entire being was consumed with thoughts of going to hell and it did take a long time for it to subside. Sadly this only left me to go on to the next ocd theme and I’ve spent the best part of 15 years in this never ending looping cycle of ‘what if’ scenarios.

If you and your son do feel comfortable, antidepressants or even a slightly stronger medication such as quetiapine may help even if temporarily. (He may be a little young for quetiapine but thought it was worth mentioning). I personally found antidepressants were unsuitable but that was mainly due to gastrointestinal upset they caused me and I too have major health anxiety so this just didn’t work with me physically as well as mentally.

I just wanted to reply as I had never even heard of the ‘hell theme’ within ocd when I was first diagnosed - I spent so many years thinking it was just something strange I became fixated on. It was only 5 years ago when my therapist told me it had been ocd all along and I then identified a string of triggers and other themes that I’d experienced. I know how utterly lonely it feels to be stuck in a particularly strong ocd theme and you are doing the perfect thing by getting him immediate help. All the best x

I am just here to show solidarity. My 12yo has had severe OCD for well over two years. He is not able to attend school or to learn at home as OCD takes up all of his thoughts. It’s a tricky condition in that it can change form or the person can have more than one type of OCD going on. My son’s is mainly contamination based, but he also has counting rituals and reassurance seeking behaviour. CAMHS have been about as much use as a chocolate fire guard. To be honest though, most of the work to help the child get better is carried out at home, by the parents. I had OCD myself as a teenager and, although I do still have some issues, it has mostly been background noise. Anti depressants can only be prescribed by a psychiatrist and they aren’t a miracle cure. They are a means to help the child engage with therapy. My son is on a very high dose of Fluoxetine, but I think it probably needs to be higher unfortunately. I could write volumes about how this illness has invaded all our lives, but I am ever hopeful that we’ll get through this eventually. Wishing you all the best

Hi OP my DD has OCD and severe anxiety, she has been housebound for 3 years due to it. She had to leave school half way through her last year and never returned.

CAMHs were useless, she was passed about, cancelled appts, new people etc she became so disillusioned with the whole mental healthcare system it took another 18 months to get her to see a GP. She’s on sertraline but I don’t think it helps, has had psychology and physiatrist input but it hasn’t helped so far. I’ve joined OCD Action UK which has been great for info and support. There’s specialist support groups for under 18s and parents.

The type of OCD you are describing @Mun2 is called "moral and religious OCD". It can change and probably will, the illness just spirals and develops. He will need medication, it might give some relief from the awful things in his mind. It's a dreadful illness with seemingly sudden onset, and escalates quickly as you have seen OP.

CAMHS/GPs etc (and certainly not 111) can rarely deal with OCD and I am amazed you think he can go to school like this. My DD was diagnosed with OCD when she was 16, but by then she'd spent many periods housebound, for years. She's nearly 22 now and still having treatment after years on various waiting lists. I did pay for a private diagnosis and then used that to get CAMHS to refer her to a specialist tier 4 service in London. CAMHS like to go all round the houses to avoid referrals due to cost so children with OCD often suffer for years if the psychiatrist thinks the parents don't know what to do. Many parents have no choice but to pay for a private diagnosis.

I am battle weary after 7 years now, but in the parent support groups there are many parents like yourself @Mun2 just horrified that their child is suffering like this, whilst quite determined that they'll be much better in a few weeks. We all believe that in the beginning I'm sorry to say.

Please do approach one of these organisations tomorrow - they specialist in OCD, and you need specialist advice now:

https://www.ocduk.org

https://ocdaction.org.uk

Helpline: 0300 636 5478

@Mun2

Breaking free of childhood anxiety and OCD by Lebowitz will teach you how to help him.

The most important thing to remember is to try not to offer reassurance unless he's really distressed.

Challenge your OCD by Amita Jassi is what is used by the Maudsley hospital who are experts in childhood OCD. It will help you and your son to understand how OCD works and how to fight it.

But, he really needs to be on medication to properly fight it. CAMHS are the ones that can prescribe.

Call the CAMHS crisis line and/or take him to A and E. You are going to have to be pushy to get any kind of help. You have to the one who shouts the loudest to get that help.

OCD Action have an advice line and I found them really helpful.

Cross posted with @sweetkitty - whenever this comes up sadly you find a little group of parents coming forward on various board on MN saying yes, this is us too. Its a lonely illness to be a carer to - most people don't want to know or don't believe what's wrong.

personally I wouldn’t go straight to meds without even trying CBT/therapy.
your area will have a local nhs talking therapies service but the min age is 16 and there will be wait lists.
look on the BABCP register for private CBT therapists, anyone trained in this will be able to work with OCD no problem.

@Mun2 my child had low level OCD for around 3 years before having a full.on breakdown at the age of 12. They couldn't go to school for 6 months.

However, once the initial 6 weeks were over and they were put on medication, we dangled carrots to get them.out the door. Such as a trip to McDonald's or a hot chocolate. Just for their own mental health. We were led by them on how long they could manage but we all think that it was the right thing to do.

2 rounds of CAMHS treatment failed. Then we pushed for The Maudsley. They have been outstanding! My child still has OCD but it is currently under control and they are getting better every day. It's taken 4.5 years after the breakdown to get there.

https://www.madeofmillions.com/articles/intrusive-thoughts-pure-o-dr-steven-phillipson-ph-d/amp Helped me. There’s a series of videos

This is spot on!

My child is on 200mg of sertraline. It's been life changing. I took was nervous about medication but it was the right decision.

Thank you everyone for your help.

I contacted someone on the Psychology Today website and they are going to see him on Saturday.

A nurse from camhs contacted me around 5 and filled out more of the referral from the GP she said someone should phone 1-2 weeks.
I am pushing him to go to school even if he struggles a bit because I don’t want him to give into his fear and end up house bound.

He spoke to his friends and they were understanding and he said that he didn’t realise he had such good friends before, even the teachers are being really nice and it’s a strict Academy school, normally if they see you out of class you get shouted at. I’m also telling him to go to school as half term is coming up so he only has 2 days left now. I also want the school to see how he is so that if he does get worse and can’t go to school they will have seen that he tried to go to school.

It’s sad to read that it’s so long lasting for some children, even with medication.

I'm going to say something that no one so far has mentioned...check your son for Vitamin D deficiency. You can get a blood test organised at the GP or buy one of those instant pinprick vitamin D tests from the pharmacy
My son during COVID winter 20/21 spiralled down spent all day in his room doing online uni and socialising only online developed intrusive thoughts by summer. He stopped going for walks or meeting people which made things worse, vitamin D wise. I organised a private person centred therapist he had twelve zoom /phone sessions and topped up his vitamin D (he had a bad patch of deficiency at 17 too). The intrusive thoughts went without GP or medication (except Vitamin D) but therapy was incredibly important - she taught him techniques for dealing with the intrusive thoughts. He is now 25 and I would say they haven't come back despite a few ups and downs

Check out the Facebook support group called Parenting Mental Health, it’s amazing, and you will be able to talk to people with experience who’ve come out the other side and can help guide you both through this. Wishing your son a speedy recovery xx

The GP did request that he does a blood test as he hasn’t been eating that much. I wonder if he is deficient in something. He has a blood test next week.

As a 30 year old who has had OCD since I was 16 you're doing all the right things! Your DS is very lucky to have you.

I just want to offer a reassuring perspective. My OCD wasn't diagnosed until I was really struggling while at uni at 20. I then did have a rough few years - but exacerbated by being severely depressed having to drop out of uni etc,. I was on clomipramine as I found the other SSRIs didn't do much for me, but Clomipramine was literally an OCD off switch. I found CBT really useful but so hard, you really do have to persevere and stick at it (I did go private due to wait lists).

But now, at 30, I haven't taken any meds for years (not that there's any shame in it!). I no longer really class myself as having active OCD, but I am prone to health anxiety & some flare ups at stressful times. I do have long-term weekly counselling, but that doesn't center around OCD it's more for my stubborn perfectionism & some trauma.

But I can hold down a full-time job, went back and finished uni etc., have lovely friends, active social life - just a completely normal life! And my OCD was classed as very severe by my psychiatrist, so there is always hope!! I'm sure with having such a supportive family, your son will manage it very well. X

Thank you for sharing. That gives me a lot of hope.

This is a great resource for intrusive thoughts https://www.voicecollective.co.uk

Also, if your son really can't cope with school, please don't force him.

My child ended up rocking back and forth in front of classmates and recalls people staring as they did it.

I agree with this. It is a really difficult decision to make, to keep your child home from school. My son was still in primary school when things escalated. The school was utterly fantastic. He was allowed to arrive late to avoid the playground crowds. No assembly. No group activities. No PE, which had previously been his favourite part of school, but became a minefield as he was terrified of touching shared equipment and inadvertently clashing with people. Homework was sent home digitally etc. BUT eventually it all got too much for him. I remember cajoling him into school, then sitting outside crying, wondering if I had done the right thing. I started to realise that I was sending my son into his worst nightmare every day and therapy had not given him the tools to cope. So he stayed home and the relief was immense, both for him and me. Of course I worry about his education, but he’s a bright boy and some day he’ll be ready to re engage. He has missed the whole of what would been his first year in secondary school, but has a statement in place for his return. It’s a horrible illness, but very much sufferer led when it comes to recovery.

I totally feel for your son, the fact he has managed to open up to you and ask for help is amazing. I suffered in teenage years but kept it quiet until I had my first child and I was so ill with OCD. I got diagnosed at 19 and I am now 40. I still take an SSRI, and I have done CBT. I have tried to come off the medication in the past but it caused a severe relapse. I accept medication is a part of my life probably for the rest of it but the fact im able to parent and hold down a job wouldn't be possible without it. OCD is like being tortured by your own mind and for a teenager its very scary. I just want to say you are doing all the right things- listening to him, advocating for him to achieve support and just being there. In time he will find his own coping mechanisms, its different for everyone. The most important thing is he has a great support system.

Vitamin D is not something you get through food, unless it is highly highly fortified and a complete food (baby formula). We get enough vitamin D through sunshine April to sept or through supplements. It regulates all our systems including immune. B vitamins are also important for mental health

But B vitamins you can usually improve through dietary means, unlike vitamin D.