Anxiety

[nature girl]

So I know anxiety can go hand in hand with ADHD. I hadn't seen much anxiety in Anna before recently (just minor things, like being scared of the dark.) She does have minor OCD tendencies that seem related though, like she's upset if things like our nightly rituals of story/backrub/lullaby/hug are disrupted, and she needs to be the one to turn off the light before bed, if one of us does it she freaks out until we turn the light back on so that she can turn it off.

 

Recently it seems to be getting worse. She doesn't want to walk down the hall alone, because she says it's spooky. She said tonight that she heard scary noises in the kitchen, and ran to be with me. And then tonight we were looking up at the stars, I told her I was making a wish that both our dreams would come true, and she freaked and hid under the table. I asked what was going on, and she finally said she'd had a dream last night about turning into an ogre, and she was scared now that it was going to come true. It almost seems like she's half-joking when she acts like this (where the few OCD-tendencies she seems more panicked), so I'm not sure whether she actually believes something scary is going to happen, only half-believes it, or knows it's not true but has a panicked feeling anyway and wants comforting.

 

Regardless, I assume this is anxiety, and it really worries me because if it gets much worse it may be incapacitating. Have any of you been through anything similar with your kids? Other than reassurance, are there any non-drug ways to help a child through it?

[PeterPan]

Maybe view it as a multi-pronged thing?  You can try some therapies that tackle the ADHD and anxiety *and* try techniques for rigidity *and* get some counseling *and* try nutritional things...

 

On the nutritional (my fav), make sure she's getting calcium and magnesium.  I make sure my ds' milk substitute has calcium added as well as giving him calcium.  Oatmeal for breakfast, believe it or not, can calm anxiety, as can split pea soup, calcium-rich foods (brocolli, sunflower seeds) and fish like halibut, which happens to be sort of natural prozac.  :)  Trader Joes sells a really yummy frozen battered halibut.  You could try it on her and see what happens.  Try having her eat a cup of the split pea soup daily and have oatmeal daily for breakfast.  That way you're using the nutrition throughout the day to push the effect.  It can be helpful.

 

On the counseling, we haven't done it, but it exists.  CBT I think.  I will say, as a christian, I'd be getting in there with some peaceful thoughts about God watching us and taking care of us, singing hymns that are peaceful, etc.  I think imagination is good during the day, but I'd tamp down those ogres at night, oy.  

 

For the rigidity, oh vey.  In our house pretty much anything he does can become a pattern he gets stuck on.  I try to rotate things to prevent meltdowns.  If he wants to get stuck, I go back to the social story mantra (We can do it multiple ways.  We can do it this way and that way.  Yesterday we did it one way.  Let's try another today.  We like to try new ways.)  In our house it's extremely dangerous to get patterns we aren't willing to live with.  Maybe start the discussion with her, introduce the idea of flexibility and that you might be trying to do things multiple ways.  Elicit suggestions from her on multiple (even silly) ways you could do things.  Like ok, we turn it off with the magic wand tonight, whoever holds the magic wand gets to turn it off.  Shake things up.  

 

On the therapies, neurofeedback can help.  You keep mentioning not wanting meds, well neurofeedback can tackle the ADHD *and* the anxiety.  Zengar is what we're doing.

[OneStepAtATime]

I have kids that sometimes experience extreme anxiety but it isn't constant or chronic.  I have a friend with a child that exhibited anxiety and OCD tendencies  starting in about 4th grade that ramped up over time until they were really extreme (as in debilitating and she is now frequently not even functional, but they have finally gotten professional help and things are improving, slowly).  Because it didn't happen overnight, they didn't immediately realize how serious things were becoming.   Whatever you decide to do, I urge you to stay on top of it and if your mommy instincts say this is really off, get help.  Don't wait.  

 

:grouphug:  :grouphug:  :grouphug:

[sbgrace]

I have a child with anxiety (OCD and general anxiety) that drastically ramped up around age 8.  It quickly become incapacitating yes. He wasn't eating (losing weight drastically) or sleeping much at all  because of death related OCD stuff. A friend of mine has a son who also became incapacitated with OCD. I have other friends whose kids anxiety didn't take over though, including some who had bursts of anxiety at certain times that, in retrospect, seemed to be age related.

 

Dawn Huebner has some really good books written to kids (though the parent would need to read/help) to try to teach cognitive behavioral techniques. She has What To Do When you Worry Too Much (anxiety) and What to Do When Your Brain Gets Stuck (OCD). Both are available on amazon. The friend with the severely affected son did find these techniques helpful with her son, though he had to get some supplement help first to be able to work on the issues.

 

If you might want try supplements, her son takes N-acetyl Cysteine (studies show it might help OCD) at 1200 mg 2 x per day or maybe she does 900 mg 3 x per day now that I think of it. Both doses have been used in pediatric OCD studies--a current one with the 900 mg 3 x a day kids dosing: https://clinicaltrials.gov/ct2/show/NCT01172275He also takes inositol, though I don't know the amount she uses for that one. Both together take the intensity down enough to be able to use the cognitive techniques. He was very severe.

 

My son was helped with just the NAC (he takes 1200 mg twice a day) and probiotic (culturelle twice a day). My son also takes l-theanine sometimes, which has an immediate calming effect for him. We actually use it to calm ADHD stuff, but I've seen it used with anxiety generally and it's safe. I haven't needed to work with him otherwise. But if I did I would need professional help I think.

 

 

If needed, cognitive behavioral therapy is by far the best approach for anxiety therapy. The OCD Foundation online https://iocdf.org/find-help/has lists of providers who do CBT therapy for OCD. Finding someone who specializes in that area would be very important if this is OCD. OCD has very specific and different treatment from other anxiety disorders. You want an expert in it who works with pediatric patients.
 

 

 

 

 

[Lecka]

http://www.amazon.com/What-When-You-Worry-Much/dp/1591473144/ref=sr_1_2?ie=UTF8&qid=1441889124&sr=8-2&keywords=when+my+worries+get+too+big

 

http://www.amazon.com/Growing-Up-Brave-Strategies-Overcome/dp/0316125601/ref=sr_1_1?ie=UTF8&qid=1441889169&sr=8-1&keywords=growing+up+brave

 

I've heard both of these books are good.

 

I think at her age -- depending on how often this is happening, and how upset she gets, these sound to me like things 6-year-olds say.  They are getting older and noticing more, but they are still little kids. 

 

But if you feel like, it is a concern, then don't get blown off.  There are kids who are having levels of anxiety that are within an age-appropriate level, and there are kids who are not.  I am just saying "maybe it is in the age-appropriate range."

 

 

 

[Lecka]

http://www.amazon.com/What-When-You-Worry-Much/dp/1591473144/ref=sr_1_2?ie=UTF8&qid=1441889124&sr=8-2&keywords=when+my+worries+get+too+big

 

http://www.amazon.com/Growing-Up-Brave-Strategies-Overcome/dp/0316125601/ref=sr_1_1?ie=UTF8&qid=1441889169&sr=8-1&keywords=growing+up+brave

 

I've heard both of these books are good.

 

I think at her age -- depending on how often this is happening, and how upset she gets, these sound to me like things 6-year-olds say.  They are getting older and noticing more, but they are still little kids. 

 

But if you feel like, it is a concern, then don't get blown off.  There are kids who are having levels of anxiety that are within an age-appropriate level, and there are kids who are not.  I am just saying "maybe it is in the age-appropriate range."

 

There is a lot that is not medical.  I don't necessarily know what it is.

 

My older son had anxiety when he was 7, but I talked to a counselor about it, I did not research it myself, other than looking enough to see that she seemed like she was recommending good things for us.  It ended up being something that did not last too long for him, but I watch for it to possibly come back when he is older.

 

 

 

 

[nature girl]

Thanks so much for your suggestions. I've just put the linked books on hold! Ahhh, more fun reading...

 

I've thought of trying L-theanine for the ADHD, and it's interesting to hear it might help with anxiety, so I'll add it to our slew of supplements...along with some halibut. Interesting! (We do a Ca/Mg supplement since she's dairy-free, and I know the Mg is supposed to be calming but I haven't noticed it helping much.)

 

OhE, I love your ideas for helping with the rigidity! I'm going to try those tonight! Thinking about it, she's started to add more and more to her bedtime routine in order to calm down, including of all things a youtube video with a funny cat that we watched near bedtime a couple of weeks ago, which she's now been asking for every night. I'd thought it was just a way to delay bedtime, but I'm realizing it's slowly turned into more. I'll start working with her on flexibility, I do think mixing things up could be a great technique.

 

I think at her age -- depending on how often this is happening, and how upset she gets, these sound to me like things 6-year-olds say.  They are getting older and noticing more, but they are still little kids. 

 

I did wonder whether it might be normal, which is part of the reason I brought it up. Till this point I'd thought the fears weren't all that unusual and I'd thought age would help her get past them, but seeing her under the table last night, and the fact that it's been getting worse, made me start worrying that this may be turning into something we need to work on.

 

I know CBT is strongly suggested for ADHD in general, and I'd been planning to start at some point, but maybe we do really need to start sooner rather than later. (More money. Sigh. I know money shouldn't even be a consideration, but we don't have great insurance, and all this is really adding up. If we have to decide, it might be that CBT is more important than OT for now. Or maybe if they start zones/engine now in OT, that might begin touching the issues in a similar way to therapy.) Is it possible to learn CBT methods from a book and start therapy at home, or is a therapist necessary? Since the Huebner book discusses CBT techniques, I'll definitely start there.

[Lecka]

The therapist is not necessary, if you go through the book  and see that it is all you need.  

 

If you go through the book, and you see "oh, we need more help than this," then you can go to the next step of seeing a therapist.

 

I do think you are fine to read the book, though, as a starting point.  I have heard really good things about it.

 

Of course -- if you are very concerned, don't wait around.  But if you just know you need something -- I think starting with the book is a good idea.  

 

I have heard of it going both ways.  I have heard of some kids where they get the book and then the parents feel like they have got what they need.  I have heard of other kids (much fewer) who have a higher level of anxiety and need to see a counselor and also who need medication.  It just depends.  Definitely a lot of kids do not need the higher level of intervention, though.  The same as with any intervention -- a lot of kids will get what they need from the lower level, and a few will need more.  

 

 

 

 

[Tiramisu]

http://www.amazon.com/What-When-You-Worry-Much/dp/1591473144/ref=sr_1_2?ie=UTF8&qid=1441889124&sr=8-2&keywords=when+my+worries+get+too+big

 

http://www.amazon.com/Growing-Up-Brave-Strategies-Overcome/dp/0316125601/ref=sr_1_1?ie=UTF8&qid=1441889169&sr=8-1&keywords=growing+up+brave

 

I've heard both of these books are good.

 

I think at her age -- depending on how often this is happening, and how upset she gets, these sound to me like things 6-year-olds say.  They are getting older and noticing more, but they are still little kids. 

 

But if you feel like, it is a concern, then don't get blown off.  There are kids who are having levels of anxiety that are within an age-appropriate level, and there are kids who are not.  I am just saying "maybe it is in the age-appropriate range."

 

There is a lot that is not medical.  I don't necessarily know what it is.

 

My older son had anxiety when he was 7, but I talked to a counselor about it, I did not research it myself, other than looking enough to see that she seemed like she was recommending good things for us.  It ended up being something that did not last too long for him, but I watch for it to possibly come back when he is older.

 

I agree that things like this are common at this age but that those with ADHD or similar things going on will deal with anxiety more and can see a progression of things from this age onward.  In our experience, there is often a trigger which precipitates a bad period. With your recent concerns, Anna's mom, maybe Anna is picking up on it. Kids like this are so sensitive to slight changes in our moods and stress levels. I've definitely seen ups and downs over time. We go through bad periods and then it gets better and it doesn't interfere with life too much. My youngest is the most obviously OCD and she has a lot of the behaviors you describe. She has a thing about going around and shutting doors and checking locks, especially at night. Certain things have to be in certain places, and unless we keep a strict bedtime routine it can really affect her functioning.

 

ETA: Strict, in this situation, means a book, cuddle, and back rub. Our own special needs version of "strict". LOL

[camino]

My son (9) has been diagnosed with severe ADHD and generalized anxiety. At its worst, it was a huge struggle to get him to leave the house. At a more functional but high state, it reminds me of how you describe your child.

 

I agree with so many of the comments above and I just want to add to a couple made by OhElizabeth. Rigidity definitely goes hand-in-hand with anxiety. I think it is extremely common for children who feel out-of-control to try to exert control over their environment; and for children who feel unstable to try to make their environment stable and predictable. In our experience, the lack of flexibility was a more serious sign of my child's anxiety than specific fears (the dark and so on). My son's anxiety has fluctuated a lot in the last few years and his rigidity has been intimately aligned. When the anxiety is low, the rigidity disappears. In other words, I think, the you are right to see her bedtime habits as signs of anxiety, to take them seriously, and to try to address the underlying anxiety.

 

I also wanted to address a small point you made, that your daughter seems like she is half-joking. When my son's anxiety is extreme, he is unable to think of anything else and is overcome by it. But otherwise, he is a lot like our daughter. I think the half-joking is their way of showing that they are aware that they are different, that they are embarrassed, they know what they are feeling isn't "normal." But I don't think--even though in the moment sometimes I am tricked by it--that it means they are making up their feelings or just trying to get attention or not really upset. I have learned to always take my son's anxiety seriously, even when it seems most absurd or misplaced to me. I have to remind myself that he isn't making it up--why would he??! it is no fun for him!--and I am better able to support him when he knows I believe him. 

 

We have taken pretty much every approach that exists to address my child's anxiety. There was a time when he needed to be medicated. I am thrilled that that time is over but I don't regret it. We probably waited too long because of my reluctance to resort to medication ... my son had gone from highly anxious but functional to practically opting out of childhood, unable to participate in school, activities, sports, social experiences, etc. We saw a wonderful therapist for years and that was enormously helpful. In the last year my son has made enormous strides in every imaginable way. My family, neighbors, friends remark on it every time they see us. I can proudly say that he has become a polite, compassionate, bright and curious boy--of course he will always be intense and somewhat anxious as well. He has never been more social nor more successful at sports activities. I attribute this change primarily to homeschooling, which addresses the ADHD and intellectual needs much better than school ever did (we never medicated for the ADHD). And the good feelings and success have led to more good things. But we have also been doing nutritional supplements forever, as well as neurofeedback for a year now. It is hard to parse the results, but since things have never been better, I am pretty happy with these interventions and think they are worth exploring.

 

 

[kbutton]

I would encourage you to seek some professional advice on prioritizing CBT vs. OT. Sensory issues and anxiety are kind of like two sides of a coin. In fact, OT could be putting her over the edge right now, but in a way that helps in the long run. When we did the brushing protocol for my son (every two hours for x number of days), he flaked out for about 70% of that time period. He was on high alert, cranky, weapy, the whole nine yards, and then he suddenly was not, and we were able to finish the protocol and see lasting results (greatly reduced sensory defensiveness).

 

You've gotten great advice, but I thought I'd just throw that out there too.

 

I also suggest a big-gun probiotic. We've liked the ones from Renew Life. They have a kids chewable version with many strains and a high count.  You might find out just how much magnesium you can give her. I've hear it said that you'll get the runs if you have too much, and that's the only reason to stop dosing, but I don't know if that's valid. You can use epsom salts in her bath besides going the oral route. I've read that our bodies blow through magnesium like crazy when we are stressed. I get low-anxiety if I have not been eating well and supplementing, or if I have to take a steroid or antibiotic--all of those things do things to our guts, and I have had to be GF for several years. I didn't get tested for celiac since I found out by accident and haven't been willing to eat gluten to get the test done. I am not the only family member with gluten issues, and there have been others with suggestive but not totally conclusive bloodwork. Anxiety is one possible manifestation of celiac, and while it's not commonly talked about, I have met a celiac for whom that is the primary problem. 

[Guest]

Renew Life's chewable probiotic (it's the refrigerator kind) is the one we use and I would not change it. I have seen the difference it has made in my youngest. Keep in mind that the bottle says that it has come in contact with soy and milk during fermentation, so if there is a soy or milk allergy it is not recommended.

 

We are not dealing with ADHD and any signs of anxiety I see in my two boys is sensory related so I don't have any advice to offer. I do seem to remember reading though, when I was reading about ADHD, that it's a good idea to stop screen time a few hours before bedtime, regardless of the content. Just thought I would mention it and you can look into it a bit further. I would also monitor the content of the stories you read together just before bed.

[summerreading]

Hi, I'm just going to guess you are on the same side of the world as me and you are heading into fall and winter. I have an anxiety disorder that will morph into depression if I don't take care of it. Starting this time of year I need to add in a light therapy box in the morning. It is just a bright light (needs to be 10,000 lux) that you sit in front of for 15-30 minutes in the morning. The extra light helps your mood. You might want to consider adding this into her routine with anything else you are doing. It really helps me. The change in seasons and the declining light might be ramping up her anxiety.

[PeterPan]

Camino, that's cool to hear how well your ds is doing with your mix of interventions!  How many sessions of neurofeedback has he had and with what system?

[Storygirl]

DS11 had counseling for anxiety. We did not try medications; our pediatrician thought we might be headed that way, but DS's anxiety did not progress to that kind of critical level. We focused on learning calming techniques. We learned some from the pediatrician, some from the psychologist, and some from the OT.

 

Our pediatrician recommended a book called Sitting Still Like a Frog (sorry, can't make a link, but it is easy to find on amazon), which comes with a CD. The CD is actually the most useful part. It is a mindfulness/yoga thing. Don't let that put you off if yoga is not your thing. (We are Christians and did not find anything in the book that concerned us spiritually.) The CD has a calm lady's voice talking the participant through various deep breathing and calming exercises. They vary in length from just a couple of minutes to ten or fifteen minutes, and each one is slightly different. So you can choose which one or ones you like. My husband used to play portions of it for all of our kids at bedtime, and they all enjoyed it, even though it was meant to be for DS's benefit.

 

Now that I think about it, we should bring it back out. I haven't seen it since we moved this spring.

 

ETA: This book/CD is specifically designed for a young child as the audience.

[Guest]

Three things work for anxiety in our home in a broad sense:

 

- music

- exercise

- nature walk in a peaceful setting

 

More specifically, it depends on the trigger. I teach my oldest to stop what he is doing and do some deep breathing exercises. I do this loosely with my youngest. With my youngest I focus more on sensory stress relief. For him it's a hug. This has made my hugs for him the equivalent of Temple Grandin's squeeze machine. For now this work fine and we are at a level where a brief hug will help him self-regulate quickly. I don't do most of the sensory gear either. No weighted vests, sacks, etc. I bought my youngest the heaviest duvet I could find and he loves it. The hug helps during the day and he knows to ask for it now. Just randomly sharing what works in our home, which is different for each boy. With my oldest I use logic and discussion. I channel his brain towards the positive. I help him take his brain away from negative thinking. Music works very well for him also.

 

Again, that's what works in our home. I try to make the steps we take simple and easy to stick with. The main point though is figuring out, or getting professional help to figure out, the root cause for the anxiety.