How to support a family member with OCD

Reassurance seeking is a very common compulsion amongst OCD sufferers. Photo / Getty Images

In the wake of World Mental Health Day, a mother and daughter explain the heartache caused by obsessive compulsive disorder

My teenage daughter Hattie had been expressing ‘’bad thoughts” for a while. To begin with, I just thought she was a worrier. When we noticed she washed her hands a lot, the family laughed. I am ashamed to tell you, we might even have said, “Hat, you’re a little bit OCD!”

But, as we came to realise, there’s no such thing as being “a bit OCD”. OCD is not just about straightening pictures on a wall or being pedantic about tidiness, but a serious mental health condition. We soon stopped laughing.

Hat was 21 when she was diagnosed in late 2018; severe OCD and major depression, the psychiatrist said. She seemed withdrawn; she had just returned from a placement year as part of her degree in Hispanic Studies at Warwick University. Hat slept long hours, her appetite was poor, there was something wrong, which I couldn’t grasp and which made me feel uneasy.

And then one day, suddenly, Hat’s “off” mood became a crisis. We were by the sea, on holiday in Montenegro, and she convinced herself that she had witnessed somebody drowning. She saw bubbles rising to the surface of the water in a bay. Of course she hadn’t – nobody had drowned, the bubbles were from a diver. I knew that: I had seen him.

But Hat wouldn’t accept what I told her, She couldn’t let it go. She asked me over and over if I was sure nobody had drowned. We had to check and recheck the bay. She didn’t hear reason. I would learn later that OCD does just that: intrusive thoughts become so persistent that they unpick reality and fray it as disturbing fiction. Hat sought my reassurance and I kept giving it. At the time, I didn’t know that doing this is like pouring fuel on a tinder box of skewed thoughts.

The diagnosis felt like a gut-punch. Had I done something as a mother to cause this? Had I failed to do something to stop it happening? I felt both guilt and fear – guilt because, as parents, we shape our children. If my daughter struggled with mental illness, had I damaged her in her early years?

I felt fear because I had witnessed mental illness up close before; My mother suffered horrible, recurring, treatment-resistant depression. It meant she was sometimes unable to function for months at a time. It meant visiting her in hospital where she had electric shock therapy. When my father died young, it was up to me to manhandle my mother into trains and get her to her psychiatrists’ appointments.

But any self-indulgence turned into fierce, furious determination: Hat’s life will not, I told myself (and her), be derailed by mental illness like her grandmother’s. We were lucky to have health insurance, so Hat was able to see a doctor without waiting months. Fortunately, this was before Covid, so there still were places on therapists’ lists.

But Hattie was especially unlucky as the pandemic arrived two years later. Covid presented a kind of torture for her. It held her hostage at home: even after the lockdowns eased, she was often too afraid to leave her flat in case she came into contact with the virus and gave it to somebody else. OCD is driven by a totally irrational, oversized sense of responsibility. Eventually, she was forced to give up her job in the pub as she was obsessed with making sure she’d washed glasses thoroughly enough.

But with the right antidepressant medication and cognitive behavioural therapy, Hat began to understand her thinking was part of a disorder and was not reflective of her as a person. She began to understand her illness and understand how she should respond to intrusive thoughts: not respond at all.

Some time after her diagnosis, Hattie drew a cartoon to raise awareness of mental health at university. OCD featured as a green monster which, as the redheaded girl in her illustrations learned to live with, even smile at, grew smaller and smaller. It’s our way of dragging the bogeyman out from under a bed.

I will always be sad that Hattie has had to cope with this, but I am immensely proud of how she is learning to do exactly that: manage her OCD with grace and courage. There is a pragmatism about how she deals with it; I know this, because she needs me less.

Hattie Rowan, 26, works as communications officer for a charity. She says:

The best thing my family did when my world collapsed was to take me seriously. They couldn’t understand why I was in so much pain (my thoughts and fears were nonsensical to anyone but myself) but they could see I was, and that was enough.

Mum spent hours researching the best support, took me to the doctor, and held my hand in the waiting room. She told me it was OK to take antidepressants, reminded me about appointments, and found me a new therapist when I moved cities. She took proactive, efficient steps, which is exactly what I needed.

While mental illness is taken seriously at home, my family is never afraid to inject much-needed humour into the situation. They weren’t afraid to make a joke about my irrational fear of poisoning a homeless man with an almond croissant, or how much soap I got through in a week.

They didn’t joke to diminish my illness – I received nothing but love and acknowledgment – but to diminish the worries themselves; in the same way the wizards of Hogwarts use the “riddikulus” spell to turn their phobias into something comical. Jokes don’t diminish a worry if it’s bad enough, but humour means there is always open communication at home so I didn’t feel I had to hide anything or be ashamed of having a mental illness.

Sadly, I think there is one area of OCD parents trip up on: reassurance seeking. I have asked my mum countless questions in the hope of relieving an OCD worry: “Am I a bad person?” “Will that homeless man be OK?” “I touched that postbox, do you think I’ll give someone Covid?” Guess how many times she’s managed to reassure me? Not once.

Reassurance seeking is a very common compulsion amongst OCD sufferers and gaining “reassurance” does not help to lessen anxiety. Unfortunately, my family were almost a crutch to this compulsion, helping me to limp around in endless loops. But how can you resist comforting someone you love when they’re clearly beside themselves? I still don’t have a perfect solution. Perhaps parents could employ my sister’s tactic – she still slaps me any time I ask for reassurance.

Since my mum and I learnt more about reassurance seeking, my family has tried to engage with it less (me with the compulsion, and my family with my incessant “what if” questions). I now tell others close to me that they too must try to resist, so I don’t find a new crutch outside my family.

Instead, I have worked on alternatives to seeking reassurance. Sometimes it helps if I can just tell Mum I’m having a bad day. Sometimes it helps to ask the people around me to distract me. Sometimes it helps to remember my therapist’s sage advice: “Remember all the times you thought a worry would never pass, and it always did?” Sometimes nothing helps and I just have to wait it out.

But it always helps to know that my family believes my pain, they see me and they are there for me.