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Anxiety and seeking professional help


bluedarling
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My 11yo is having multiple anxiety related issues.  She experienced her first bad incident this week (there were mild issues previously), and I have questions.  I have reduced her school load to see if that helps relieve any stress.

1)  Should I wait to have her evaluated? (My husband is for giving her a chance to listen to our words this week, and see if it helps, but my heart is breaking and want to address it every way I can!)

2)  If we have her evaluated, do we need a gifted specialist?  (At least one of the worries she confided was a typical gifted worry, but our small town is unlikely to have anyone with this specialization...though its only 45 min. to the city.  There are counselors here who list anxiety disorders as their specialty, just not gifted specifically.)

3) What is usually done to help with this?  Talk therapy or drugs?  Any words of wisdom from those experienced with this?

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I can't imagine that "listening to our words" could help with clinical anxiety.

 

No, I don't think you need a gifted specialist to evaluate for anxiety. I don't know what your options are; anxiety is a medical diagnosis, our insurance paid the majority of the cost of evaluation by a neuropsychologist.

 

Cognitive behavioral therapy is likely your first line of attack, medication may be necessary as well. Start with a full medical workup though, including vitamin D levels (low D3 can contribute to anxiety), thyroid, etc.

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I can't imagine that "listening to our words" could help with clinical anxiety.

 

No, I don't think you need a gifted specialist to evaluate for anxiety. I don't know what your options are; anxiety is a medical diagnosis, our insurance paid the majority of the cost of evaluation by a neuropsychologist.

 

Cognitive behavioral therapy is likely your first line of attack, medication may be necessary as well. Start with a full medical workup though, including vitamin D levels (low D3 can contribute to anxiety), thyroid, etc.

 

Thank you.  So perhaps I should start with our naturopath?  Low D3 and thyroid issues are in our family, and the naturopath treats those.  That's even easier than finding a psychologist!!  Wishing I had asked last week, since I was there and she could have gone with me!   Its possible she may even be able to refer us to someone for therapy.  I'll give that a go!

 

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Agreeing with maize. Both myself and DD (age 6) have had pretty major anxiety issues. I first took her for a psych consult at age 4, received a diagnosis, and the psych was able to give me enough info that I was able to manage at home. A different set of anxiety-related issues surfaced around age 5.5, and the same psych referred us to a therapist in her practice. We lucked out; though the therapist was pretty thrown by DD's giftedness and how that contributed, she was very experienced with children and anxiety, and willing to self-educate. And she fairly instinctively understood how one was impacting the other, anyway.

 

I would call possible therapists who work with children/adolescents and anxiety, and state that one of the anxieties may be centering around her giftedness. Get a feel for reactions.

 

Outside of a medical workup, talk therapy is the first line. If talk therapy is unsuccessful or has limited success, then meds are usually discussed. At my daughter's age, we didn't even consider meds.

 

Definitely find out what insurance covers. Ours covered an eval appointment with a psychologist, but would not have covered anything involving psych testing. But the therapy was decently covered even out of network.

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My dd12 was diagnosed with anxiety by her pediatrician 5 years ago. I would say her giftedness is relevant to her her anxiety in some ways: She experiences a lot of sensory issues common in gifted children, and her pediatrician said she does not diagnose sensory processing issues as such, but would treat anxiety stemming from her sensory issues. Also, due to her giftedness, dd can concoct quite elaborate worries, and construct very compelling arguments for her point of view.

 

In our experience, you should start to look for someone to evaluate her asap, partly because there are often long waiting lists for new patient evaluations and consultations. We often have to accept being seen by trainees, who can see her anxiety and giftedness, but are not yet specialists in either, yet. We saw several more experienced specialists for consultations that led nowhere, because she didn't fit their expected profiles.  She didn't have full neuro-psych testing until last year, at age 11. That was requested by someone we saw after several years of treatment for anxiety, when she was showing early signs of an eating disorder.

 

Most likely treatment will include CBT. Medication is less likely at the beginning of treatment, unless doctors determine that the anxiety is debilitating, or CBT isn't helping.

 

 

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My 12yo had serious anxiety issues. She's been on a low dose of medication for a few months now and it's been a miracle worker. I regret not treating her sooner. She is much happier! Her twin is not treated as her anxiety was not nearly as bad, but the one has had such an improvement that I'm considering seeking treatment for the other. 

 

We don't do CBT although it was recommended. The only availability for the only doctor we could see was right in the middle of school and we live far enough away that it would have disrupted the whole day. The psych agreed that because her anxiety was triggered by school stress, missing school to see a therapist would cause more harm than good. I was disappointed at first because we thought CBT would be the best treatment, but it turns out that a tiny bit of meds is all she needed. 

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While waiting for an appointment, you might be able to show your daughter how to do guided meditation or yoga. My son was diagonoised with anxiety (he is older), and we were told the best way to help besides therapy and medication is to make sure that healthy habits are in place - good nutritiion, good sleep habits, exercise, etc.. We were also told that he should look at ways to eliminate his stressors by sticking to a routine. It was kind of linked to a bucket mentality - if all the little stressors fill your bucket then you will already start out with too much stress so there is no way you can handle the stressful stuff in life. So for him it is little stuff like fill up your tank on your way home from work instead of on the way to work so you won't stress about being late, do your laundry always on the same day so you do not run out of clothes....

 

It is hard to watch your child suffer; I wish you and your daughter all the best. 

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Thank you.  Every response has been helpful.  I started to explain the exact concerns, but erased it due to privacy concerns.  One of the mild issues was early signs of eating disorder, so that response resonates!  If that was enough to warrant a full neuro-psych, and that was one of my milder concerns, then perhaps we are more in need of help than I realized!   I have identified 5 concerns, which I will take to the doctor this week.

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I have an anxiety disorder, and my oldest also shows signs of it. Agreeing with the others re seeing a psych for an eval. One experienced with gifted kids is a plus, but not required. Along with CBT and meds, if appropriate, another thing that I would suggest is finding a course in mindfulness meditation. I thought it was a bunch of woo when my shrink suggested it to me (a decade ago), but the science actually backs up its ability to alter the brain in positive ways. 

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With sudden onset/sudden worsening you may also want to investigate the possibility of PANDAS/PANS. OCD type symptoms are a particular hallmark; when one of mine started manifesting early symptoms of an eating disorder it was due to OCD-type intrusive thoughts/compulsions.

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Thank you.  So perhaps I should start with our naturopath?  Low D3 and thyroid issues are in our family, and the naturopath treats those.  

If you are open to this, definitely pursue it.  Some medications can be hard to get off of, and if you're having a nutritional issue, the medication isn't going to fix it.

 

If she has low D3, you might consider going gluten-free.  My son and I have been doing this because he has a condition which indicates low Vitamin A, plus he was diagnosed with low Vitamin D two years ago.    While his condition hasn't fully cleared up, we're seeing improvement where nothing else worked before  Sometimes there can be intestinal issues even without a positive celiac marker test.   Also, modern wheat can increase appetite, so if she's overeating or binge eating, could be the wheat.    

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If you are open to this, definitely pursue it. Some medications can be hard to get off of, and if you're having a nutritional issue, the medication isn't going to fix it.

 

If she has low D3, you might consider going gluten-free. My son and I have been doing this because he has a condition which indicates low Vitamin A, plus he was diagnosed with low Vitamin D two years ago. While his condition hasn't fully cleared up, we're seeing improvement where nothing else worked before Sometimes there can be intestinal issues even without a positive celiac marker test. Also, modern wheat can increase appetite, so if she's overeating or binge eating, could be the wheat.

While a gluten free diet does seem to help some people with psychological issues such as anxiety, I would be very hesitant to cut out a major food category if there is any hint of anorexic type behaviors.

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If you are open to this, definitely pursue it.  Some medications can be hard to get off of, and if you're having a nutritional issue, the medication isn't going to fix it.

 

If she has low D3, you might consider going gluten-free.  My son and I have been doing this because he has a condition which indicates low Vitamin A, plus he was diagnosed with low Vitamin D two years ago.    While his condition hasn't fully cleared up, we're seeing improvement where nothing else worked before  Sometimes there can be intestinal issues even without a positive celiac marker test.   Also, modern wheat can increase appetite, so if she's overeating or binge eating, could be the wheat.    

 

I am gluten free due to non-celiac gluten sensitivity (my symptoms matched celiac.)  All of my kids did a 6 month trial gluten free, and none of them could notice any difference, so I allowed them all back on gluten.  My 11yo was my only child without issues that could have been linked to gluten (adhd, aspergers, etc.)   Going back to gluten-free would be a battle I don't want to try again without good reason, but I will keep it in mind! 

 

She is not overweight, does not overeat or binge eat...just worries a lot that she is fat when she is far from it!  She hasn't turned down sweets, yet, so I hadn't worried too much, but was keeping an eye on it. She expresses wanting to be anorexically thin like a friend, repeatedly. She talked about it so much a friend's parent expressed concern to me.  But again, this is her milder issue at the moment!  I'll mention it when I mention the main concern, though.

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A weight obsession can be due to OCD--my dd was only 8 when she asked me one day "mom, why can't I stop worrying about weight?"

 

She wasn't choosing to think about it, the worries were just constantly intruding in her mind and were affecting her behavior.

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I am gluten free due to non-celiac gluten sensitivity (my symptoms matched celiac.)  All of my kids did a 6 month trial gluten free, and none of them could notice any difference, so I allowed them all back on gluten.  My 11yo was my only child without issues that could have been linked to gluten (adhd, aspergers, etc.)   Going back to gluten-free would be a battle I don't want to try again without good reason, but I will keep it in mind!

 

Yeah  It's tough!    I tried it for a week with my other kids and gave up after one of them looked like he was going to live on beef jerky and rice cakes alone (I figured it was better for him to live on hamburgers and pizza which is what he had been doing).  

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Mine has anxiety and OCD stuff going on. It manifested young, so psych stuff was pointed and milder. However, it is still there. He sees a psych sporatically when he feels he needs it. We talk him down a lot. It is still showing up and flaring at various moments. I was warned that hormones can cause flares. I am definitely not a psychiatrist, so who knows about your Dd. I say this for you to try and look back over time and see if there has been any past history which could have had anxiety. It can help you and the psych possibly figure out either a trigger or why it is flaring right now.

 

But get her help. By the time parents know, it is usually much worse than we think.

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