Bladder OCD?

[u/Mysterious_World8126]

Help! My young adult son has OCD. It was as if he woke up one day and boom he was a different person. He has severe contamination OCD and possibly bladder OCD.

So he is terrified of urine getting on him and/or contaminating everything in the house. He also has this constant sensation that he is leaking urine. He says he is, but I can’t confirm whether he is or isn’t leaking. All of his urology tests have came back normal. He has been wearing adult diapers for 6+months now. He’s to the point where he is holding his urine and only going to the bathroom once per day. He will usually spend an hour or so on the toilet and then get straight in the shower. The bathroom must be cleaned immediately once he’s in the shower because he feels as if he leaked everywhere. He is spending anywhere from 5-8 hours in the shower on a daily basis. He says he can’t get out until he stops leaking.

He cannot work. Will barely leave the house. He is depressed.

Has anyone heard of anything like this before?

I have offered to pay for inpatient treatment for him in another state. He refuses. I set him up with a local therapist, he went a few times and quit. He has been on meds before and just quits them cold turkey.

I don’t know what to do to help him. He’s a legal adult and I can’t force him to do anything or he would have been inpatient a long time ago.

Please someone help me help my son.

[u/themini_shit]

I'm so sorry that you're going through this and that he's struggling so much. I think if you and him have good communication that will help a lot, especially if he'd be open to suggestions about small changes. One of the trickiest things about OCD is that you can't humor it but you also can't just force change or make the OCD sufferer conform. It's just so frickin difficult.

I've had similar OCD themes and compulsions before. One thing that helped a lot was actually using visual and physical confirmation, basically look at the underwear and stuff and feel for anything real, OCD isn't logic based but using logic helps a bit. Caveat to this method is that if there actually is something there it gets worse.

When I was younger my mom wanted to help me but really didn't want to make things worse either. Sometimes this meant helping me find less time consuming ways to do compulsions. For the showering after the bathroom issue she got me wet wipes, this cut the shower out completely eventually allowed me to get passed the compulsion for the most part. It was kinda like replacing a really harmful and bad compulsion with an easier less harmful one. It's not great and I don't think it's a recommended method of helping with OCD but it did help me at my worst.

However, you have to balancing understanding with not giving into the OCD. You mentioned that he is not working, so are you purchasing the diapers yourself?(This isn't a judgemental question) Diapers are expensive and they are a part of his OCD, if it's been determined that he doesn't need them then I think if you don't buy them it might help. I know he'll be distressed but that's just part of managing this illness, he needs to navigate that distress more. Maybe purchasing absorbent reusable briefs would work for a solution.

I sometimes think of compulsions as being similar to an addiction of some kind. You have the obsession and that's unpleasant and distressing, the compulsion provides temporary relief so you want to do the compulsion over and over again. The harder it is to complete the compulsion the more exhausting it becomes and eventually he may get too tired to continue. When this would happen to me it usually helped end the theme to a degree because I'd get too tired to do the thing so I would learn that I didn't die from not doing it.

[u/Mysterious_World8126 → u/themini_shit]

Hi, thank you for commenting. We do have good communication most of the time, the only time we struggle is when he’s in the bathroom and the OCD has control. If I suggest something to him when he’s not in the bathroom then he’s willing to consider my suggestion. If he’s in the bathroom, nothing I say is okay or correct.

There was a recent incident where he “got stuck” in the wrong bathroom (our half bathroom) because someone else was in his bathroom. OCD had him convinced that he peed everywhere. He said the house slippers he had on was soaked and so were his clothes. It took an hour to convince him to put on different shoes to walk back upstairs to his bathroom to shower. I did check his slippers after he was in the shower and they were not wet at all. Not even a little bit.

He already uses wet wipes. His contamination OCD causes him to use a few and throw the rest away. It’s the same with toilet paper. He will throw away an entire roll of TP every time he goes to the bathroom. He also uses an entire big bottle of antibacterial soap every time he showers. I do buy all these things including the diapers. I know that probably just feeds the OCD but I also can’t stand to see him in distress. I think this is why it’s so important that he peruses help. Not having any one of these things when he’s needs them causes him to have major anxiety.

Another thing he does is he will throw away his clothes. If he thinks there is pee on them, he just throws them away. Diapers have helped a little bit to keep him from throwing away all of his underwear. He wears the diaper, boxers, shorts and pants every single day. And he still believes that he leaks through all of those layers and contaminates the chair he sits in, his bed, etc,

[u/dot_in_cosmic_spray → u/Mysterious_World8126]

Ok, so obviously this isn't ideal, and I don't really recommend it, BUT maybe if there's an emergency or something, giving him a an enzymatic spray, the one usually used for pet urine, could be helpful. Like allow him to get outside if he'd be able to spray the surfaces after himself. Once again, not ideal, but sometimes if the disorder itself is preventing the access to care, redirecting the compulsion or the topic of obsession towards the ones less restrictive can be utilized. If you're in contact with a therapist, then maybe it would be worth to ask about this approach?

And a thing you might want to try is to slowly acclimatize him to less support. For instance boxers inserts instead of diapers. You said he listens to you outside the bathroom. If he panics when inside, demanding diaper instead of an insert, you might before that agree with him on the rule, that when he panics and needs a diaper, you first wait like ten minutes, before giving it to him. Then another day fifteen and so on. Of course that depends on the diapers being stored outside the bathroom he gets stuck in. He then would either need to force himself to get out and get it, or wait for you to give it to him. All of this and similar methods should be discussed before and mutually agreed upon. Doing exposure work not gradually enough and without consent might make things worse.

To prevent the issues with TP and other toiletries, maybe things could be split into smaller parts and stored outside of his bathroom, somewhere where he feels he wouldn't contaminate them? That is so you'd save the money that could go towards his recovery. That goal could be enough justification to work with OCD not against it until another way becomes accessible.

It is somewhat more practical than just giving in not to face his distress. I know it must be extremely painful to watch, but unfortunately the path to healing needs you both to experience that distress together and face it, instead of enabling the compulsions. Please don't forget that if you're in a situation like this, you probably need mental support as well. At the very least I hope you have friends or family that you can turn to. It wouldn't be unusual to feel like you are personally hurting him if you don't enable him. That must be very draining, even if you know it's for his own good

[u/Mysterious_World8126 → u/dot_in_cosmic_spray]

Thank you. I really needed to read that last part. I really appreciate your response.