My 20 year old son has been a worrier most of his life. Around 3 months ago we became aware he was struggling with intrusive thoughts, to the extent that he was unable to concentrate on his university studies. With the help of the Mind website, which then lead me here, we came to the conclusion he could be suffering from a form of OCD. We had a terrible few weeks trying to access any help, but to cut a long story short he was prescribed 50mg sertraline, which he was taking for around 3 weeks before he was able to get an appointment to start CBT with a private therapist. It took around 5 weeks for the medication to kick in (initially it either had no affect whatsoever or possibly made him worse..vivid nightmares etc). He was still struggling with intrusive thoughts however the medication improved his concentration to some extent and certainly helped lift his mood. After three weeks of therapy he could see this would also help him (although he struggles with some of the exercises). Around 2 weeks ago he was once again very low and thought he may need an increase in his sertraline. He spoke to the GP who didn't seem too concerned whether he went straight to 100mg or to 75mg first (we're not sure the GP really 'gets' he has OCD, she refers to low mood and anxiety). He opted to increase his dose gradually and try 75mg as an interim measure because of concerns about side effects. He is still having the odd thought that really 'sticks' (his compulsions are mainly all mental ones, and the needing to 'solve' all worries) but seems so much better on the whole. Yesterday he decided to increase to the 100mg, he had a really good day, no worries at all, but woke up this morning feeling terrible. Vivid dreams had him waking up crying in the night, went back to sleep but woke with the thought that everyone hates him, which we have put down to the dosage increase. Just to give you the complete picture he hasn't had a therapy session for over 2 weeks due to the xmas period, and his next appointment is over a week away. Apologies for the long winded post but I'm trying to seek advice on the balance between medication and therapy? Without the medication I am not sure he would deal with the ERP parts of his CBT therapy, at the same time although I want nothing more than for him to be rid of these horrible thoughts, if an increase in medication (assuming the side effects are short term and he can cope with them) removes them completely will the CBT therapy be as beneficial? I really want him to develop tools to help him through life, not just a reliance on medication. I know ultimately the decision is his, but as a young adult he does actively seek guidance, support and advice from us (and he is very much aware that without our help, he would probably still be struggling, with no understanding of his condition...he genuinely thought he was a very bad person! I'm so relieved and thankful he feels able to talk to us). As you may have gathered, I have had my own mental health issues over the years and have experience of SSRI's for depression and CBT for GAD (although from all the reading I've been doing recently I think I may fall into the category of rumination OCD!) Once again apologies for the long winded post, but any thoughts/advice/own experiences would be appreciated.