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Forum -> Parenting our children -> Our Challenging Children (gifted, ADHD, sensitive, defiant)
I cannot handle my daughter's anxiety disorder anymore.



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amother


 

Post Fri, Feb 22 2013, 1:57 pm
My teenage dd has a combination of hypochondria and panic disorder. She once hit her head hard and got a concussion with some dizziness symptoms, and then kept getting headaches and dizziness that were diagnosed as migraines. Over and over she got symptoms that aren't measurable, missing tons of school, and appearing at convenient times.

Then, as those abated, she got a bad asthma attack. Now she is constantly having these attacks, whenever she smells something strong (perfume, someone's hairspray when it's on their hair) or comes near one of the foods she may or may not be allergic to. (Earlier tests say yes, later ones say no.) The reactions aren't timed right or typical and her random giant asthma attacks tend to occur when she's very stressed, or if not, every four to six weeks. Her allergist and pulmonologist both agree that her symptoms are mostly anxiety.

I am tired of taking her to the emergency room. We've gotten to the point that she knows I won't take her anymore (she doesn't need it), so she has the attacks when she's at school and the always call Hatzalah when her nebulizer doesn't fix it. She has called Hatzallah on herself when she's been home on her own.

I cannot explain the stress of not knowing what's physical and what's mental. I cannot explain the horror or knowing your child is having an anxiety attack and therefore not taking the symptoms too seriously, and having school officials and even hospital doctors and nurses think you are negligent. more than once I have gone to school and told confused administrators that my white-faced, gasping daughter can just come home with me. If they have already called Hatzallah, I will let them check her and see that her oxygen is fine, so they hate me less.

She yells at me, the doctors don't know what to do, her psychiatrist and psychologist don't know what to do, and her needs are seriously stressing the family both financially, time-wise and just plain stress.

How do you manage a situation that you just can't manage, but as it is it's an untenable situation to live in?
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happybeingamom




 
 
    
 

Post Fri, Feb 22 2013, 2:08 pm
Hugs to you, your family and your DD

I think you need to find a new psychiatrist and psychologist. The ones who you are using are not able to help your DD.
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Dolly Welsh




 
 
    
 

Post Fri, Feb 22 2013, 2:34 pm
This isn't "mental". I am no medic of any kind, but it all sounds neural, and resulting from the blow to the head. The smelling phenomena too. That's neural too. You should believe your daughter.

She needs a good neurological diagnosis and proper rehabilitation excercises and maybe medication.

Your medics should be doing all that, and if they aren't, well, get others. This is not about the emergency room.

Refuah Shleima.

Hug her and specifically tell her it isn't her fault. It isn't. She may be difficult to deal, with but it isn't her fault. But you still get sympathy for the difficulties. They aren't your fault, either.

You might equip her with an oxygen-measuring thing so she can check her own oxygen.

Her symptoms are real, they may just not mean what she thinks they mean. She may be having neural problems from the original blow to the head that mimic other problems such as allergy or asthma. But they are real experiences in her nervous system.

If she can diagnose herself she won't have to call an ambulance.

She may have to just wait the neural storm out. Maybe hypnosis and biofeedback techniques can help her calm her nervous system. Or just help her during the wait.

There is no need for anxiety and anger. You can get a good diagnosis of what is wrong with her brain, and some idea of what the future holds for that, and what can be done for it. Time may fix it.

Get a neurologist.
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Barbara




 
 
    
 

Post Fri, Feb 22 2013, 2:41 pm
amother wrote:
My teenage dd has a combination of hypochondria and panic disorder. She once hit her head hard and got a concussion with some dizziness symptoms, and then kept getting headaches and dizziness that were diagnosed as migraines. Over and over she got symptoms that aren't measurable, missing tons of school, and appearing at convenient times.

Then, as those abated, she got a bad asthma attack. Now she is constantly having these attacks, whenever she smells something strong (perfume, someone's hairspray when it's on their hair) or comes near one of the foods she may or may not be allergic to. (Earlier tests say yes, later ones say no.) The reactions aren't timed right or typical and her random giant asthma attacks tend to occur when she's very stressed, or if not, every four to six weeks. Her allergist and pulmonologist both agree that her symptoms are mostly anxiety.

I am tired of taking her to the emergency room. We've gotten to the point that she knows I won't take her anymore (she doesn't need it), so she has the attacks when she's at school and the always call Hatzalah when her nebulizer doesn't fix it. She has called Hatzallah on herself when she's been home on her own.

I cannot explain the stress of not knowing what's physical and what's mental. I cannot explain the horror or knowing your child is having an anxiety attack and therefore not taking the symptoms too seriously, and having school officials and even hospital doctors and nurses think you are negligent. more than once I have gone to school and told confused administrators that my white-faced, gasping daughter can just come home with me. If they have already called Hatzallah, I will let them check her and see that her oxygen is fine, so they hate me less.

She yells at me, the doctors don't know what to do, her psychiatrist and psychologist don't know what to do, and her needs are seriously stressing the family both financially, time-wise and just plain stress.

How do you manage a situation that you just can't manage, but as it is it's an untenable situation to live in?


Are her doctors on board with not physically treating her systems? For example, while an asthma attack may be brought on my anxiety, that does not make it any less an asthma attack, or any less physically traumatic.

ETA -- I really do feel for you, and for your DD. It must be very frustrating. IMNSHO, you may need to consult additional physical and mental health professionals, since nothing has helped her so far. Also, discuss with your DD's doctors how you should respond to the physical issues, for her physical and emotional well being.


Last edited by Barbara on Fri, Feb 22 2013, 2:48 pm; edited 1 time in total
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amother


 

Post Fri, Feb 22 2013, 2:44 pm
as the mother of an anxious child, I feel your pain.

I wish I knew the answer to your question, how to handle something you cannot handle, but I am in the dark with you.


I am assuming that the anxiety existed prior to the bump on the head. I know that injuries that start off as real physical injuries morph into a 'in your head' collection of symptoms very quickly in anxious children. I do know how hard it is not to know if a physical symptom is real, needing medical intervention, or psychosomatic, needing psychological intervention. Its not easy.

What is being done abuot the anxiety now? Is she getting any sort of treatment for it?

I'm sorry you (we) are going through this. I hope you find some answers and that it gets easier soon.
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CatLady




 
 
    
 

Post Fri, Feb 22 2013, 2:46 pm
Has your DD seen a neurologist in consultation yet? As a mom, that would be what I would be asking for. Panic disorder is treatable, but the treating team should be ruling out anything else underlying. Hang in there and keep pushing for answers. ((((Hugs))))
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Dolly Welsh




 
 
    
 

Post Fri, Feb 22 2013, 2:46 pm
What you don't want is that a physical problem cause psychological problems. That's a second fight, and it needs to be fought. The blow to the head was enough; she doesn't need to feel like a weirdo on top of that.

I am proud of her attempts to get help. You are doing well too, staying calm and analyzing the situation. It's the doctors who are not getting this right.

Her allergies may be a little bit coincidental. It's mainly from the blow, perhaps.

You wouldn't want to have her take medications for allergy and even asthma that she doesn't need so get an accurate diagnosis.

But she may also have asthma from before the blow. And allergies too.

She should acquire the information and training to tell exactly what is happening to her, and what is not. This is training and an education. That way she can handle herself, function, and not incorrectly medicate herself.

She may need a medic who is a contact person to call when she is in doubt; a 24 hour nurses' hotline, or a specific nurse or a few of them, who she can always consult if she is unsure.

You don't have to play doctor.
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amother


 

Post Fri, Feb 22 2013, 2:51 pm
OP here.

We are on our third psychologist. We decided to try cognitive behavioral this time around. It's pretty new. The thing about anxiety disorders is that if you feed them, they get worse, but here it's unclear. Anxiety can actually cause a real asthma attack. And since she got diagnosed with a peanut allergy, she is constantly worried about anaphylactic shock, though the only symptoms she's ever had are the breathing issues (no swelling, etc.) We just found out about a way to check in the hospital through bloodwork if you really had an allergic reaction or not if you do it soon after, so the next time she ends up there with an allergy claim, we will do that. But even if the asthma is under control , at school, if she even mentions the possibility of anaphylaxis, they will call Hatzalah.

Dolly, she went to a top-notch pediatric neurologist when we were dealing with the headaches, and was medicated for them for quite some time. Almost a year later, we actually had to stop her meds for three days to do the allergy testing, and found that the headaches pretty much disappeared.

Also, examples of why all of us (me, her physicians, etc.) are siding with psychological:

a) For her first asthma attack that landed her in the hospital, she was doing better after a bunch of interventions, for a good hour. Then, the dr. came in and started to talk about discharge. Within five minutes she was doing worse. This repeated itself with almost all susequent hospital visits. At one point she admitted that she felt safer in the hospital, so always would rather be there.

b) When we stopped taking her to the ER because we figured out that she didn't need it to get better (we did treat her medically, but did it all at home) several times she would work herself up to the point that after three nebulizers she was lying listless on the couch, barely responding in monosyllables to questions. But when I said emphatically, "You are not going to the hospital, she sat up straight and shouted, "You are the WORST mother in the world!" and stomped upstairs. And then she was fine.

So yes, she may very well have asthma, but it's nowhere near as bad as she makes it out to be. The first symptoms of it showed up in camp when she was being bullied, and yes, she has addressed it in therapy.

We have learned the hard way that any consulting medical person will tell you to go to the ER when there is any doubt of severe asthma or anaphylaxis. She has gone several times because of this.
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amother


 

Post Fri, Feb 22 2013, 3:11 pm
Hugs to you. I also am a mother of a young adult with anxiety and depression. I am trying to figure out what is real and what is not. I am dealing with " inability to fall asleep and can't wake up on time so. Miss going to appointments and doing chores in the house". Any and all excuse for not living! The therapist she is seeing is not good. But I can't make her change to someone else.
I am also at my wits end.
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amother


 

Post Fri, Feb 22 2013, 3:21 pm
My dd has severe anxiety, headaches, sleeplessness, etc. Been to so many therapists, etc.
I can share with you what I've found most helpful, see if it's right for you. I did not take my daughter to this therapy, but I did it for myself, twice a week, and it had an impact on my dd, sort of a ripple effect.
The therapy is called ''Somatic Experience therapy''. Google it for more info. I think the website it ''traumahealing''. There's a directory of practitionerss.
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amother


 

Post Fri, Feb 22 2013, 3:28 pm
Stick with the cognitive behavioral therapy. it is the best for anxiety panic. She should see a psychiatrist as well though, as there are drugs that can help. Untreated panic disorder only gets worse.

I know this is really hard for you, but from the other side, what happens in a panic attack is terrifying. It isn't just in your head. You get strange vision/pressure in the eyes from the blood vessels changing size as you go into fight-or-flight mode. Your hear beats faster, you do start to breathe faster to bring more oxygen into your body. You start to sweat and can feel hot all over. Your muscles in your arms and legs can either hurt or go numb because of the adrenaline and cortisol flowing through them. You may get stomach/bowel issues. All of this is your body preparing to fight or flee from a threat. (E.g., if you void your bowels, you are lighter and can run faster.) The body's natural fight or flight mechanism works great to save your life if you are chas v'shalom in danger. If you are not in danger, it's a big problem. But, your daughter's body is telling her "There is a gun to your head," or "A tiger is about to eat you." And she has to sit there an act normal. And that is where the problem comes in.

The brain part is that all of the panic response bypasses most of your prefrontal cortex (the logical, thinking part of your brain). So the tools she needs to think her way through the panic attack are largely unavailable, with the amygdala (the lizard brain) doing most of the thinking. It's quicker (again, great if you really are about to be eaten by a tiger) but not as accurate or flexible, which is bad when your allergies are making your throat swell, because when you think, "Oh my gosh, am I going to stop being able to breathe?" and the whole panic response starts.

When you get frustrated, just remember that she would do anything to be rid of this. And if you could experience once, just once, sitting in a normal situation and having to act normal when multiple systems in your brain and body are telling you you are in dire peril, you would view it differently. I know it's hard. But love and understanding and "we are in this together" is the best thing you can give her. Fake it if you don't feel it. Just remind yourself, "How would I be doing if I felt unsafe, really unsafe, large parts of the time?"

Two things to try. She should have a mantra. Something to repeat over and over when the panic comes. "I am able to handle this situation until it passes." "The things my body are doing are uncomfortable but not dangerous. Something like that. Whatever works for her.

Also, write things (affirmations, etc. down on a small pad she can keep with her at all times. This helps re-engage her prefrontal cortex. Find facts about panic attacks and put one on each page. Plus things that may be personally helpful to her. "Adrenaline is reabsorbed into the body in 10 minutes. In just a few minutes I will feel better." "I have my allergy/asthma medication with me. I am able to treat my symptoms." "Take a drink of water." (The cold water will help her not feel so much like her throat is closing and is also a good distraction.) "I have made it through a panic attack before. I can do it again." "Count backwards from 300 in fives." Etc. She can flip it open when the panic hits to help her.

This book is amazing. http://www.amazon.com/Anxiety-.....48912
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amother


 

Post Fri, Feb 22 2013, 5:00 pm
amother wrote:
OP here.


Dolly, she went to a top-notch pediatric neurologist when we were dealing with the headaches, and was medicated for them for quite some time. Almost a year later, we actually had to stop her meds for three days to do the allergy testing, and found that the headaches pretty much disappeared.



Was this neurologist informed of all of her symptoms or just headaches? Might want to try again with same or another neurologist looking at the whole picture.
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Dolly Welsh




 
 
    
 

Post Mon, Feb 25 2013, 1:32 pm
Very good advice up there. Good luck.
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shnitzel




 
 
    
 

Post Mon, Feb 25 2013, 1:59 pm
Is she on any medications for anxiety? Shouldn't the first course of action be getting the anxiety under control? I would think taking something like ativan first would be a better idea than rushing her to the ER.
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spring13




 
 
    
 

Post Mon, Feb 25 2013, 2:02 pm
Can you have her therapists speak with her school? Maybe there's some kind of accepted plan for handling her behavior that you can all agree on if there's a professional opinion weighing in on her actual needs vs. anxiety.

Also, I'm no pro at this, but I wonder if something like yoga could help her learn to feel more in control of her body and her reactions to the world? Just a quick google search seemed to bring up a few proper articles about a positive connection between yoga and anxiety disorders.

http://www.health.harvard.edu/.....ssion
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amother


 

Post Mon, Feb 25 2013, 7:58 pm
OP again. Thank you for all the feedback, including the hugs. To those of you similarly afflicted, I am so sorry. Maybe we should start a support group, or at least a thread.

DD is on meds, yes, both maintenance and emergency (an ativan type med). Sometimes, if she's too far into an attack, the emergency med doesn't work. Also, while after an attack is over she may later see it was a panic attack, at the time she always believes it is severe asthma or anaphylactic shock. So she treats that first, and once you've taken an epipen (which she has to have because of her peanut allergy), you must go to the hospital, even if you didn't really need the epi. Schools get very nervous about these things. Can the psychiatrist guarantee it's all anxiety? No, so off she goes. And even if it never gets that far, she's missed an hour of class. Several times a week.

She's a hypochondriac. She always thinks things are worse than they are, and at least subconsciously wants to keep it that way. If nothing else, it means she wasn't wrong about all the fuss she's made.

I will try to Somatic Experience thing- I've heard of it. And I've suggested yoga but we can't find a class she can go to (frum ones here are during the day.)

The overall of it all is hard- what do we do, what can we do, how do I help her. But often I think the day to day is even harder. I tell myself in advance what type of approach and attitude she needs from me, but when the school calls me in the middle of my hour-long carpool and I know I can't get there for an hour so they'll send her to the hospital and my whole day is shot by the time they discharge her with printouts on asthma and anxiety, I get pretty upset. Her school is also getting annoyed, and might not take her next year.

So I'm dealing with administrators on eggshells and dealing with doctors and with her, and by the end of it all I am angry. And I tell her so. Because yes, she has a disorder, but she also makes bad choices (not complying protocols that might keep her out of the hospital, making a big deal of others needing to accommodate her allergy needs, not reliably reporting symptoms to me). And I pay the price now, and she will pay it later. But she doesn't see that. And that's when I explode.
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imasinger




 
 
    
 

Post Mon, Feb 25 2013, 8:06 pm
OP, the hardest thing about dealing with stressful children is keeping our own calm.

Is there any way you can make time for helping yourself? You'll set a great example for her. Whether it's time to do something you like, or a group just for parents like you, or something else, don't neglect yourself. Sometimes, in a family system, when one person changes, others do, too.
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granolamom




 
 
    
 

Post Mon, Feb 25 2013, 8:32 pm
just an 'out there' thought...what if you told her shes missing so much school maybe its time to consider home teaching (either homeschooled by you or maybe through your school district if she qualifies due to her medical issues) until this is sorted out?
she's got you jumping through hoops it seems.
did she always have issues with anxiety? or did it start with the bump on the head?

also I remember once reading something about breathing exercises to control asthma, buteyko or something like that.
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Peace and Happiness




 
 
    
 

Post Mon, Feb 25 2013, 11:50 pm
Hi OP,

It sounds like things have been really terrible, hugs to you.

At the same time, its great that you have her being seen by someone who is practicing from a CBT perspective. By far, CBT has the most evidence to being effective for anxiety disorders. Her symptoms sounds pretty severe however, have you thought of taking her to a clinic that can provide more intensive treatment than a psychologist in a private practice? There are several CBT-oriented clinics that might be an appropriate for her. One is the NYU Child Study Center ( http://www.aboutourkids.org/ ), the other is the Child Mind Institute (http://www.childmind.org/ ). Child Mind has an Anxiety and Mood Disorders program which is run by wonderful clinicians.

Best of luck to you and your daughter!
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amother


 

Post Tue, Feb 26 2013, 9:16 am
OP here.

DD has always been a bit anxious, and has a minor history of making up stories for attention. Her early asthma symptoms, strictly at camp, pre-date the bump on the head. We have thought about moving her closer to home for school (though it's a dubious match), but are afraid of damaging her self-esteem. Education-wise, she's doing quite well in her current school. But I imagine it will be worse if she gets kicked out... Will have to revisit.

Thank you for all the concrete advice. I am now in research mode on all these new options. A few look pretty promising.
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