Obsessive Compulsive Disorder in Adolescents
Obsessive-compulsive disorder or OCD starts from adolescence onwards. OCD is a feeling of strong obsessions and compulsions which result in intense discomfort and affects daily functioning.
Obsessions are thoughts which are persistent and recurrent. They even include unwanted images and impulses which lead to distress and anxiety.
These feelings and thoughts are usually irrational or unrealistic. Compulsions are repetitive rituals or behavior such as checking something again & again or mental acts such as counting. These obsessions & compulsions cause intense distress and anxiety and can interfere with the daily activities, relationships, social activities, and academic functioning.
The person with OCD thinks that he has no control over his actions. OCDs are relapsing and chronic illness.
The thoughts change as the adolescent grows. Younger children suffering from OCD often have thoughts of harm befalling on them and their family such as a thief getting into the house through an unlocked door. This will make the children recheck the door and windows, again and again, fearing that they might have left the door unlocked accidentally.
Teenagers suffering from OCD fear that they might get fall sick due to germs, contaminated food, and AIDS. The adolescent develops certain rituals, such as washing hands innumerable times, in order to get over the fear.
These rituals help them to think that they have overcome the problem for the time being and give them temporary relief. If they do not perform these rituals, they become more and more anxious.
OCD is a sign of brain circuitry’s unusual functioning and it involves the striatum part of the brain.
The brain activity patterns of such people differ from normal people and people with other mental disorders. Researchers have concluded that OCD is usually a family problem and is a disorder of the brain.
Streptococcal bacterial infection can create or worsen the condition of OCD. Adolescents with no family history of OCD can also develop it. Most of the adolescents feel embarrassed to talk about their OCD.
They think that people will label them as crazy and this will make them feel ashamed. This will make it difficult for the parents to talk to their children about their OCD, in order to solve them.
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Parents need to develop good communication skills for this purpose. Parent’s support is also very important to the adolescent. Cooperation is extremely important along with treatment because if the problem is not treated the adolescent will grow into a disturbed adult.
Most of the adolescents with OCD can receive effective treatment.
The treatment can include psychotherapy and intake of medications such as fluoxetine, clomipramine, fluvoxamine, paroxetine, sertraline, and other serotonin reuptake inhibitors.
When OCD is caused due to streptococcal infection, the adolescent can be administered with antibiotics to kill the bacterium which is causing it. Exposure and response prevention behavioral therapy are very useful in solving OCD.
In this therapy, the adolescent is wontedly exposed to his/her fears which give him/her obsessive thought. After that, he/she is trained to avoid these thoughts and the rituals which he/she carries out to tackle the anxiety.
An adolescent having OCD can also have depression, substance abuse, attention deficit hyperactivity disorder, eating disorders, and other types of anxiety disorders. When a person with OCD and other mental illness, is treated, OCD becomes more difficult to treat and even diagnose.
Depression in Adolescents
Depression in adolescents is a disorder which occurs due to persistent sadness, loss of interest, loss of self-worth and discouragement.
Depression is normally a temporary reaction towards situations of stress. Depression is a normal part of the maturation process of adolescents. It is even induced due to the production of sex hormones. Adolescent females are depressed twice more than adolescent boys according to a study.
Adolescent behavior is normally marked with good and bad moods. The transition from a good mood to a bad mood and vice-versa can take minutes, hours and even days.
That is the reason why true depression is very difficult to find out. Depression in adolescents can be caused due to bad school performance, break up with boyfriend or girlfriend, and failing relations with friends and family.
These causes can lead to persistent depression. Other serious causes are a chronic illness, obesity, child abuse, stressful lifestyle, poor social skills, unstable caregiving and depression in family history.
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Symptoms of depression in adolescents are eating disorders, weight change, irritable mood, excessive sleeping in the daytime, excessive temper, criminal behavior, memory loss, fatigue, self preoccupation, sadness, difficulty in concentrating, worthlessness feelings, loss of interest, self hatred, obsession with death and thought & attempts of suicides.
When these symptoms are being noticed for more than two weeks, it is important to get treatment for the adolescent. Depression not only affects interpersonal relationships but school performance as well.
Depressed adolescents are more prone to take onto drugs and alcohol as an attempt to overcome their depression. Such problems require intensive treatment.
The doctor will take a blood test and perform a physical examination to determine the cause of depression.
The adolescent can also be tested for substance abuse such as smoking, heavy alcohol consumption, marijuana smoking, and usage of other drugs. After the physical examination, psychiatric evaluation is also done to understand the cause of sadness, loss of interest and irritability.
Depression can also lead to the development of other psychiatric disorders such as schizophrenia, mania, and anxiety.
It is also important to determine whether the adolescent poses a risk for himself/herself and others. Family and school personnel can provide valuable information about the adolescent to the doctor.
Treatment for depression for an adolescent is similar to the treatment of depression for adults.
Along with the treatment, the adolescent is given antidepressant medication and psychotherapy. Antidepressant medications include tricyclics, Prozac, selective serotonin reuptake inhibitors or SSRI.
Some of the medicines increase the risk, so it is a good idea that parents discuss the possible risks with the doctor. Only some of the antidepressant medications are meant for children and adolescents. Adolescents with severe depression need to be hospitalized as they are more prone to kill themselves.
Family and school support are necessary to tackle the depression of the adolescent.
Parents can get their children admitted to emotional growth schools, boot camps or wilderness programs, to solve the behavioral problems. These programs consist of non-medical staff and confrontational therapies.
But care must be taken as some of the programs can in turn harm children who are depressed and sensitive. Adolescents, who get caught due to the criminal offense, should be taken special care of by their parents.
It is best that the child face the consequences and learn a lesson from it. Depressed adolescents respond well to treatment if they are treated comprehensively and early. More than half of the adults are known to have depression when they were in their teens.