OCD just appeared with my Autistic stepson

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Greetings All. I'm Brand new to this so please forgive Me not knowing the ins and outs of this world. I have done a good deal of research on Autism in the last year and in November Married my wonderful wife. We both have 2 children and merging the families is going very smoothly. My step son ( 21 ) was diagnos with autism over 10 years ago. I went into this marriage knowing full well that He would most likely live with us possibly forever. He and I have really connected well as have all 4 kids. Slowly but surely he started having OCD issues to the point now he can't function. He washes his hands over and over. And basically needs constant attention. He is now on Meds for it ( 4 weeks now ) and so far no improvement. We had to take him out of college for now where he was on the Deans list. My wife has become his slave in a way. Certain times of the evening he gets in a cycle where we can't use either of the bathrooms as he needs them both. I'm struggling with how to help. Obviously as newlyweds not being able to have a life is a stress All on its own but since He has never had this happen I Fear that I'm to blame as Me Marrying his Mom obviously was a big change in his life and the dynamics of home life for him. Part of Me feels if I leave it may help them both. But the thought of leaving Someone I love kills Me not to mention how can I leave Her while she is going through all this with him and barely able to go to work or sleep etc. I realize I'm rambling now. And once again I apologize if I've said anything wrong on a first timer.

Is he going to graduate from college pretty soon? Is he perhaps a senior?

Just shooting out the idea that maybe he's afraid he'll graduate and be expected to become more independent or even live on his own. If he has that fear, he might be having meltdowns because he knows he's not equipped to handle living on his own. If my theory is right, you might want to have your wife and you sit down to talk with him and explain that you love him, and want him to continue to live with you when he graduates.

Just my two cents.

I truly appreciate the response.. We made it clear to all the kids especially Him that we were selling our 2 homes to buy a bigger one so everyone would have their own room. This was during our engagement and made a point of involving him in the house shopping process. He is a senior in college so Yes there is a chance he is realizing that he will be expected to do something out in the world. I just can't shake the feeling I caused the disturbance in his world. My therapist ( who has treated him since age 10 ) told me that even a positive change is a change and could have caused it. It kills me to think the poor kid started to meltdown only 2 months after our Marriage.

Hello, how are things now?

I suffer from obsessive behavour, mine is to do with contamination from other people. It's very like OCD but without the compulsive element. Until my diagnoses for autism, I thought that was the main player in my issues. Since my diagnosis, I have stopped trying to cure my obsessive behavour, and concentrated (largely due to what I have learnt on WP) on prioritising my anxiety. As I am coping better with my anxiety, my obsessive behavour has become easier to cope with. It's the crutch that basically forces me to control my environment, rather than the problem.

Trying to predict what set off your step-son's OCD is pointless, also you leaving would mean another change for him so might defeat the purpose of what was intended.

https://www.gq.com/story/buried-alive-solitary-confinement

... Jose Flores (11 years in solitary): You get a lot of OCD in the SHU (Secure Housing Unit). I've got blisters from wringing out towels and laundry. But I mean, that's normal...

All the symptoms of autism are identical to the effects of extended "solitary confinement," in the sense that the adults around autistic children don't know how to communicate with these children. Hence these children effectively grow up in solitary confinement.

Wanting to get rid of OCD is wanting to reach the Hallelujah mountain peaks (as in the "Avatar" movie). Floating mountain peaks only exist in movies. In the real world, mountains must have a body and a foundation. What I mean is, there is no shortcut. OCD should be the least of your worries. The white elephant in the room is your stepson's underdevelopment. He has been in solitary confinement his entire life. That, is the problem that needs to be addressed.

You didn't cause this. OCD, like many mental health problems, has a tendency to first show up in young adulthood - between the ages of 17 and 21. Autistic kids are more prone to OCD than normal. Your step-son is completely typical in this.

It was just bad luck that the wedding came at the same time. I'm sure that the blending of families did cause some stress. No matter how good you were about it, that's just expected. Moving homes is stressful for everyone. Blending families is stressful for everyone. But that didn't cause the OCD. OCD is caused by a neurological differences that tips off a chemical change. Keeping stress low can help treat it, but again... you didn't cause this.

Medication is very helpful for OCD. Talk i is also important. Continuing to work through the stress of the changes he's facing will help because it will support him in engaging with the treatment for OCD. A lot of us autsitic folk do very well with understanding, intellectually, the cause of our mental health challenges, but with the internet, that's very available to him if he wants it.

Your job is just to support him right now. Someday, you might be able to play the role of the person who gives tough-love, but its my opinion that you can't do that on the basis of your step-motherhood. You need to wait until you two have a bond with each other that goes beyond what you share with your wife.

oh i don't see all ^ this,
ignoring (a bit) might be better then focus upon, i'd say; you'd better work upfront, eg in broading challenges and responsabilities, instead of hanging onto mopping behind
sometimes, there might be a (parental) need for distraction, that enables staying stuck in a bad place for all

always have high expectations for your children, even if it's not selfevident

Have you considered the possibility of PANDAS?

Your step son would take a blood test to check the level of antibodies to strep. Now, some doctors are skeptical about the whole thing and so far mainly only children and teenagers have been studied. But if you check any standard medical reference about rheumatic heart fever, it certainly can affect people in their 20s and 30s. And PANDAS is very similar to Sydenham chorea which has been known about since like the 1700s, so I don’t understand the skepticism, but it’s definitely out there. What’s known so far about both is that in some people, your body’s own antibodies to the common strep infection inappropriately attack and inflame the brain’s basal ganglia. Ouch! No fun at all, but treatable and manageable with prophylactic antibiotics, just like with rheumatic heart (in which the body’s antibodies inappropriately attack the heart valves).

And for this, a regular doctor like a pediatrician (even for someone 21), family practitioner, or internist, may be a better place to start than a psychiatrist.

I've struggled with OCD beginning age 16, worries about both germs and chemicals, and what I've heard called responsibility OCD.

One thing which belatedly helped was learning just a little bit of zen. And then, if I can wind to the place where it's okay to do the health precaution but it's also okay not to do it, that's actually a pretty good place to be.

I don't know, however, how much this can be successful taught, coached, or (?) required of someone else.