OCD and other "Accessories"

My brother was a “difficult” child, and when he was around 6, he was diagnosed with Tourette’s, Obsessive compulsive disorder (OCD), and Attention-Deficit Hyperactivity Disorder (ADHD). A lot of people take pity on my brother when I tell them this. They imagine him as an odd, scared little boy, but this couldn’t be farther from the truth. As a sophomore in high school, he received 1st team all-state in baseball and maintained a 4.0 GPA. He is 6’2, 195 lbs. of humor and baseball knowledge. His disorders mean our sibling dynamic has always been a little different, but it feels normal to me. Sometimes I don’t realize how much it affects me until my parents point it out.

Tourette’s is often comorbidly (simultaneously) diagnosed with ADHD, and about 30% are diagnosed with OCD, (Lombroso and Scahill). Obsessive Compulsive Disorder is a disorder with two main components: obsessions and compulsions. Obsessions are brought on by anxiety, and compulsions are performed in order to reduce the anxiety. People with OCD feel like they have little control over their obsessions and compulsions. Some treatments for OCD include cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and acceptance and commitment (ACT).

CBT identifies the beliefs that bring on anxiety and tries to correct this thinking by

exposing them to their fears and then helping them re-think these fears. ERP is a type of exposure therapy that exposes the person to their obsessions and works to prevent the response (aka their compulsions). ACT encourages acceptance of the obsessions as a way to remove the power from them.

OCD puts a strain on relationships, including family relations. Siblings of children who have OCD show higher levels of anxiety and depression, exhibit more rivalries, and are exposed to the increased accommodations their sibling receives. Therapy and treatment are not only beneficial for the patient, but also their family, as it can reduce the burden of accommodating the affected member of the family.

 

Stigma vs. Sister

Like all mental disorders, stigma clouds people's mind when discussing OCD. People who live with OCD often feel shame or guilt for their obsessions and compulsions, and the stigma does not help. Every time I tell someone about my brother’s diagnosis, I feel the need to tell them of all the great things he has done. I think this is a way to prove that he is still “normal”. This is a result of the stigma around mental disorders. If people did not create a negative image of my brother in their mind when I told them, I wouldn’t feel the need to combat it with positive things. To help limit this stigma, it is important to discuss these disorders openly and without judgement. One way my family tries to remove the stigma is to openly discuss and explain OCD to our community. We also talk about it often in our household and make sure to not treat it like a taboo topic.

Separating the Sibling from the Disorder

Sibling relationships are already unique. Sibling relationships when someone has OCD (and accessories) is ten times more unique. Researchers suggest families adjust their expectations for family members, but this can be difficult for siblings to do. When I was younger, I was jealous of the attention and emphasis my parents put on my brother. I have found it important to separate the disorder from my brother, and not view him only as his OCD. When he did something that annoyed me, I would ask if it was his OCD or Tourette’s. If it was not, I allowed myself to be upset, and maybe start an argument for fun (like normal siblings). If it was, I remind myself that he is probably as frustrated about it as me, and instead of getting mad at him, I will let him know it bothered me and then move on. As an older sister, I have always felt the need to take care of my brother. This has led to me unknowingly making accommodations for him. Treatment helps take this burden off of siblings because, as the compulsions lessen, the need for accommodations lessen.

Taking Time to Focus on Yourself

It can be hard to live with someone who has OCD, but it is much harder for them. That being said, it is still valid to take time to focus on yourself and “reset” after stressful days. It is not selfish to tend to yourself before you tend to others. Some things that can be helpful for reducing stress and decompressing include exercising, journaling, or setting aside time for a hobby alone. Another thing you can do if you are feeling stressed or overwhelmed is talk to your parents and let them know how you feel.

At the End of the Day

It is important to remember that every person with OCD is different, and every family is different. Figuring out what works for your sibling relationship can help manage the stress brought on by OCD. Talking to your parents and attending therapy can benefit both the sibling with OCD and the sibling without. Remember to take time for yourself in order to limit anxiety and frustrations brought on by accommodating.

 

Citations

Abramowitz JS. The Psychological Treatment of Obsessive—Compulsive

Disorder. The Canadian Journal of Psychiatry. 2006;51(7):407-416.

doi:10.1177/070674370605100702

Black, Donald W. M.D.1; Gaffney, Gary M.D.2; Schlosser, Steven M.A.T.1;

Gabel, Janelle R.N.1. The Impact of Obsessive-Compulsive Disorder on the Family: Preliminary

Findings. The Journal of Nervous & Mental Disease 186(7):p 440-442, July 1998.

Lombroso, Paul J. and Lawerence Scahill. Tourette Syndrome and Obsessive-

Compulsive Disorder. Official Journal of the Japanese Society of Child Neurology.

2008;30 (4): 231-237.

Noppen, Barbara Van, and Michele Pato. “Living with Someone Who Has OCD.

Guidelines for Family Members.” International OCD Foundation, 11 Oct. 2017,

iocdf.org/expert-opinions/expert-opinion-family-guidelines/.