Taking OCD to College? Build a Support System
With students heading off to college this month, I can't help but think back to when my son Dan was a freshman, fifteen hundred miles from home. He had been diagnosed with OCD about four months before leaving for school and the therapist he'd been seeing assured us that "Dan was fine," and would need no accommodations or additional therapy while away. Fast forward seven months, and I had a son so disabled by the disorder that he couldn't even eat.
I believe what happened to Dan could have been prevented if he'd had the proper support systems in place. Ideally, parents and students can work together to begin establishing these important relationships, even before arriving on campus. In my opinion, your support system, at the very least, should include a mental health professional, appropriate school personnel, and family.
The logical place to begin your search for a mental health professional is at the counseling center on campus. A word of caution, however. Many college and university mental health centers do not staff cognitive behavioral therapists, and even if they do, the number of appointments each student is allowed per semester is often quite limited. Staff at a good college counseling center will be able to give you local referrals to area therapists who specialize in treating OCD with Exposure Response Prevention Therapy. Even if you feel that a therapist won't be necessary at school, I encourage you to at least make an initial contact with one. That way, if problems do arise, you will already have a therapist in place. If you currently have a therapist at home that you are happy with, talk with him or her about the possibility of scheduling phone (or Skype, etc) sessions with you, either on a regular basis, or as needed. The most important thing is that you have a therapist available to you. Additionally, if you are taking medication, talk with your psychiatrist at home about getting any necessary prescriptions, and what the plan will be for communicating with him or her. If you or your doctor feels it would be beneficial to have a psychiatrist closer to school, you can get referrals from your current doctor or your campus counseling center.
Next, I recommend connecting with the "appropriate school personnel," as mentioned above. Most colleges have an academic support center that assists students who are in need of accommodations. Again, a word of caution. Accommodations for obsessive-compulsive disorder can be a tricky business, as there is a fine line between helping and enabling those with OCD. Also, it is not always clear what accommodations might be helpful to each OCD sufferer. For example, the common accommodation of untimed testing may not help students with OCD, and in fact, could make matters worse. More time for testing and handing in assignments means more opportunity to ritualize, and more ritualizing may intensify the OCD.
In Dan's case, the staff at his academic support center had little to no understanding of what OCD really is, and while they seemed willing to help him, they had no idea how. A letter written by your current therapist outlining appropriate accommodations can be extremely helpful, but what might even be more important is the open-mindedness and flexibility of the college support staff. This is because the truth of the matter is that sometimes those with OCD don't even know what they need until after the fact. Though we didn't realize it when Dan started college, he, like many OCD sufferers, often had trouble with time management, the balance of details within the big picture, and over-thinking. Once this became evident, we requested regular, detailed feedback on his work (he is an artist). Another example could be a new college student who might not anticipate getting "stuck" while reading a textbook. Because the OCD sufferer's needs will likely evolve as the semester gets underway, periodic communication is essential. Again, even if you don't think accommodations are necessary, you should have them in place. Better safe than sorry. Other "appropriate school personnel" to connect with might include your Dean of Students, Academic Advisor, and teachers. Really, the more people who are aware of your OCD, the more overall support you will have.
The final support system, family, can make all the difference in the world. It is crucial to keep the lines of communication open with your parents and/or other family members who have been helpful to you in the past. Aside from regular contact with them, consider allowing (through written consent required by law) your parents access to your academic records. This will help assure them that you are on track with your classes, and also alert them early on to any potential academic issues which could be related to your OCD. If this is something you'd rather not do, talk with your family about how much you are willing to share with them. A final word of caution: While the advent of college is often associated with independence, it is a sign of maturity to ask for help when you need it, and then be willing to accept it. I was fortunate that Dan allowed me to advocate for him when necessary. I believe this is especially important when you are in a new environment where people do not know you well. If you are having problems, an advocate who knows you and understands your OCD can be invaluable.
There is no question college can be stressful, but if you have your support systems in place and address any issues (OCD related or not) sooner rather than later, chances are your experience will be positive. Here's to a great year at school!