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Help in finding diagnosis!!!

Submitted by an LD OnLine user on

Hello,
I am in serious need of some answers. My daughter,now 11 and in middle school,is a straight A student,but has such severe anxiety about school she has missed over 20 days this year alone (school started in August). She has had anxiety problems for a few years now,worrying about something bad happening,her food being poisened,almost anything and everything. She started twitching (in stomach),chanting (t-h-e,t-h-e pass,pass,pass is the chant she says,and she will say it three times) to avoid something bad happening. She started on Paxil about a month and a half ago,which I thought was a miracle drug for about the first three weeks,but now the chanting and twitching is back,and she will not go to school again. She will have an all out tantrum in the floor,refuses to get dressed,and I cannot get her out the door. When this fit of rage passes,she is perfectly pleasant,very apologetic and sad that she acted that way. She is normally a very sweet,loving and smart girl,and acts very grown up for her age. I have repeatedly told her therapist and doctor all of this,and they just say it is her way of dealing with anxiety,and for school avoidance I should just force her to go to school,and every day she does not go to school she should see her therapist. Which I agree,she needs to learn this behavior of avoiding school needs to stop,and I finally got her to go today beacause I told her if she didn’t go,we were going to see her doctor. The problem I am struggling with is I feel like I’m not being heard. We are dealing with this every single day. I guess I am wanting to put a name on whatever she is experiencing so we can go forward with the correct treatment. I have a nagging feeling that is much more than just anxiety. Could you please give us your opinion on our situation. My daughter says almost everyday that she doesn’t want to feel this way anymore. I just want to see her happy and enjoying life. If this is anxiety, are there any ways of truly coping with it other than breathing exercises which is all we have been given (other than Paxil, 10mg/day) from her doctors?

Any advice will be greatly appreciated!!

Submitted by Anonymous on Tue, 11/11/2003 - 9:10 PM

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Hi, if you are concerned that the diagnosis is incorrect or incomplete (comorbid disorders are not uncommon in the mental health field), then I would suggest that you consider going to another Dr for a consultation/re-evaluation. Because your daughter is on Paxil, you will need to address that first. You mention that you don’t feel that it is working (I’m assuming she is still taking it), start documenting the time you give the Paxil, and follow with your observations (include the time). If anything happening in the home, or elsewhere, may be having an impact on her, document that also. Be as specific as possible, but leave your interpretations or feelings out of it. I know you have an opinion, but you are wanting the Dr’s impression of your observations. Not to mention, there are those Dr’s that don’t like being told by their patients what they believe is their job to determine. It would be easier to switch therapist, as they are simply providing the therapy service. I did this with my dd when our first therapist was not helping at all and like you, I felt that I wasn’t being heard. If you choose to continue with this therapist, or find a new one, put down all your concerns on paper, write down all the interventions that have been put in place and your observations of their impact, good or bad. Then pull this out when the Dr asks that all important, yet vague question of “how are things going?”. I’d also suggest that you do some more research into your child’s diagnosis and the treatment.
Good luck

Submitted by Anonymous on Tue, 11/11/2003 - 10:17 PM

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Ask your doctor about obsessive compulsive disorder. The chanting is a hint that this might be happening. In any event, it appears the Paxil isn’t working and another medication might be more effective. Also, there are some specific concerns about Paxil that has caused the FDA to issue a warning about using it in the pediatric population.

Submitted by TerryB on Tue, 11/11/2003 - 10:49 PM

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It sounds alot like OCD. I have a 4 yr old with OCD. You may want to do some serious research and see what you think. Check out heathboards.com and find the OCD message board. It is very active. Some of the folks posting are in pretty bad shape so it is a little frightening for a parent. It seems that many of the folks posting have never had the OCD diagnosed so they don’t have the tools to fight it. There are also some real veterans on the board that are helpful.

Submitted by Anonymous on Tue, 11/11/2003 - 11:03 PM

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My son was experiencing these types of behaviors and was diagnosed with OCD caused by taking stimulants for ADHD. He was first placed on Paxil which I did not give him because I was afraid of the side effcts,and after another opinion, was placed on imipramine. It was like a miracle for him. It took a couple of months because it has to build up in the bloodstream, but it WORKED!!! It took probably 6 mos. before the bad thoughts and OCD were completely gone. We homeschool ,but I have no doubt that he could not have attended school during this time. It was bad enough with me being here all the time and reassuring him that it was O.K. when he would be having all these bad thoughts. It must be very scary for anyone to have this type of problem. We gave lots and lots of hugs and kisses to reassure him he was O.K.It has been over a yr. now and he is perfectly fine as far as these OCD symptoms go. PLEASE get another opinion. Our first Dr. was highly recommended but I just felt her assessment was wrong.You duaghter needs ALL the encouragement and love you can give her right now. Please don’t let the Drs. make you feel like this is just a behavior problem and a strong hand can deal with it. I think it would be very detrimental to your sweet child. Hope this helps. Jan

Submitted by TerryB on Fri, 11/14/2003 - 10:06 PM

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Brooksmom,
How are things going?
Terry

Submitted by KarenN on Sun, 12/14/2003 - 2:47 PM

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Sorry to be a late poster but I haven’t visited this board in a while.

I recently started reading up on Tourettes Syndrome which is related (often comorvid) with OCD. The twitching in the belly could be a tic, as could the verbal chanting. Or it could all be a part of OCD.

Submitted by TerryB on Mon, 12/15/2003 - 1:58 PM

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Karen,
We see a good pediatric OCD specialist near Albany NY. Let me know if you would like her name. She could easily sort out what is what. It sounds like things haven’t been unbearable though since you haven’t been compelled to see someone about it. We really had no choice but to get some relief for our daughter and ourselves.
Terry

Submitted by Anonymous on Wed, 01/07/2004 - 5:51 AM

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OCD, Social Anxiety, Panic attacks, etc…could be many things and different types of docs will give you different types of diagnoses’.
My son has Asperger’s/ADHD/Anxiety not to mention ODD, SPD, OCD traits, panic attacks, sensory issues, etc. etc.. All different diagnoses given by different docs over the last 4 years but recently tied together by one psychiatrist. A developmental pediatrician or neuro-psychiatrist might be your best bet if you are looking for a label, but to find the best ways of coping with your daughter’s problems I feel it is best if you research different conditions and treatments yourself and see what you think fits and would work for your child the best and then go from there.
Based on my own experience, some meds can cause many new behaviors as can new stress. I constantly experience this with my son’s meds. I even started on Paxil thinking I was suffering from social anxiety and it did great for a while but after a couple months I was pretty manic and ended up being put on an mood stabilizer. Sure it relaxed me, but stopping all the meds helped the best!! Well, there is still the handy Xanax! (see child above)

Anyway, I found it helpful to come to these boards, take some of the advice and do your own searching. The internet is a wonderful tool!
Knowledge can be a powerful and lifelong guide.

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