mark Myers Expert Answer to: I have a son who had selective mutism from 6-8 years. He is now 16 and has been diagnosed with OCD.

Answer by Mark Myers:

Selective Mutism, as you may well know, is predominately found in children. However, some adults do experience it as well. This disorder is characterized by  a person persistently failing to speak in select settings, which continues for more than 1 month. These individuals do talk to other people, usually family members.

The diagnosis of Selective Mutism, does fall under the anxiety disorder spectrum. This spectrum would also include OCD. In fact, it is not unusual for OCD, or other types of anxiety disorders to coexist with Selective Mutism. It also does put a person at greater risk to develop other anxiety disorders later in life.

Without having met your son, I can speak in general about what may be going on. The obstinance in childhood you were talking about could have been a way for him to cope with uncomfortable or anxiety provoking situations. It would be informative to see when the behavior would present itself. A stressful situations such as exams that are currently going on, intensify symptoms. The behavior could be indicative of OCD and his inability to cope with stress.

I would strongly suggest having your son see a therapist and psychiatrist to address the symptoms. In most cases, both treatment modalities are needed.

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I don't know why but I can't tolerate anyone touching me

Answer by Mark Myers:

Obsessive Compulsive Disorder (OCD) is a disorder that could manifest itself in different ways and to different degrees. There are also disorders that may fall under the same spectrum but present themselves differently. Usually, but not always, OCD is accompanied by avoidant behavior and/or compulsive rituals. These compulsions or rituals usually create some disturbance in life areas.

From the information you provided it is difficult to determine a diagnosis. More information is needed. If this is a relatively new issue, further examination would be warranted. If certain behaviors coexist with this (such as binging with food, purging food, obsession with weight) then we might be looking at an eating disorder. If you are focussing on real or perceived body defects and repeated checking of body parts, then we might be looking at a diagnosis of Body Dysmorphic Disorder,. If these concerns have been around awhile, involve other sensory issues such as sensitivity to touch, taste, and/or sound, we might be looking at Sensory Integration Disorder.

Once more details are obtained, the diagnosis and treatment approach could be pursued. Usually a Cognitive Behavioral Approach and/or medication would be pursued. Depending on the diagnosis and severity of the symptoms, how long these symptoms have been going on, and your motivation, results may take awhile. I would suggest talking to a professional and going further into detail with him/her. From there a treatment direction could be determined.

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What are the most effective treatments for OCD?

Obsessive Compulsive Disorder(OCD), like many mental health afflictions, has different degrees of severity. Some individuals afflicted with this disorder, are able to maintain normal levels of functioning. This would include being successful at work, have few conflicts at home due to the disorder, and enjoy a good standing in the community. Few, if any people may suspect that person having OCD. Other individuals, due to the disorder, may not be able to leave their homes or function in any structured environment.

The severity of the disorder will dictate course of treatment. Medication, in most cases, would be the starting point. Since this is a very complex disorder, it is recommended you seek out a psychiatrist for medication management as opposed to a Primary care Physician. This is a diagnosis that falls under a speciality and should be addressed by someone who specializes in this.

Talk therapy is also recommended. During therapy, the patient is encouraged to desensitize themselves to the ritual or thought that is creating the challenge. The continued exposure to the stimuli eventually will eventually lessen the urge to continue with the thought or ritual. Stress management, relaxation techniques, and challenging thoughts and beliefs that contribute to the disorder should be utilized in talk therapy. Cognitive Behavioral Therapy has been found to be effective with this disorder, in addressing faulty thoughts and beliefs that accompany this disorder.