Anxiety/OCD/Depression - What to test for, ask, etc.

[RootAnn]

Please do not quote.

 

I've spent a couple of hours this morning reading old threads dealing with this, so I have some insight.

 

I've put out feelers to the relatively nearby Big City homeschool group for a homeschool-friendly pyschologist who might see my kid for possible anxiety/OCD/depression issues.

 

One of my kids has always been a sensitive child with self-esteem issues. Before going to sleep, it was common to have the "is there going to be a tornado (or fire) tonight?" question. When a pet (baby chick or baby bird, for example) would die, said child would have lot of sadness/tears and questions on if it was that child's fault. Fear of getting West Nile started to keep the child in at night (mosquito worries). No more hiking because of fear of a tick.

 

When this child first started to read fluently, this child reported feeling like every single sign on the road had to be read. A need to count things has been reported over the last couple of years - with the compulsion getting more bothersome for the child.

 

Over the last year, with the onset of puberty, it is now showing up in social things - with not wanting to spend time with friends or go to social outings. Fear of the future and some signs of depression have also cropped up. This is a kid who is gifted in non-academic ways who has an incredible imagination & a unique way of seeing the world. (ETA:  Most recent is trouble getting to sleep & trouble getting back to sleep when waking up in the middle of the night/early morning.)

 

I'm completely new to all this, but know I need to get this kid in to see someone before the issue is debilitating.

 

What sort of testing should I make sure they do? When finding a psych, what do I ask? (There are a few OCD specialists in the Big City.) Do I also get her into a (OCD-specialist) counselor in the meantime/concurrently w/the pysch? I am going to start making some notes on things I've noticed or have been told by my child. I feel so helpless right now because I don't know how I can help. (From the threads, there are some books I'll be ordering or putting on hold at the library.)

 

ETA: Do I need to have testing done w/Pediatrician? Levels of B/D, thyroid, were mentioned in previous posts.

 

I recognized many of your names when reading previous (2008-2012) threads & wonder how it is going with your ocd/anxiety kids? (Feel free to PM.)

[OneStepAtATime]

I have a friend going through this with her daughter.  She highly recommends the following to other parents:  Start a journal.  Keep it simple so you will be more likely to keep it up.  Dates, what was said, actions, other things going on around the child at the time.  Maybe create a form that is easy to check mark for simple stuff and a place to record observations.  The more you can document, the better the picture a therapist will have.  Memory is notoriously unreliable.  Be prepared to try several different therapists.  An OCD therapist that specializes in children may be the most help, but get recommendations.  Again, be prepared to shop around to find a good fit for your family.

 

:grouphug:  :grouphug:  :grouphug:  :grouphug:

[texasmama]

OneStep had sound advice.

 

My little dd is a sensitive soul with sudden onset moderate anxiety triggered by great-grandmother living her last months at our home and dying there earlier this year combined with going to children's church and a former foster child with a traumatic background telling her the plot to a horror movie in great detail, pretending like it had actually happened to her.  I have a child on the autistic spectrum who tells her things like there is a ghost in the garage, the world is a terrible place, and if mom and dad died they would all be in foster care - all without realizing the impact this has on her.

 

She has refused to sleep in her room since July and has been in one or the other brother's room.  She has some OCD-like rituals when family members leave the house to go somewhere.  She is afraid I will die, in particular.  She is afraid her brothers will kill each other in an argument.  (not reality-based) She would cry and cling to me when I was going somewhere for an hour.  She refused to go to children's church unless a teen helper was assigned to her.  

 

What we have done:  She has seen a counselor weekly for two months who uses a Brief Solution-Focused Trauma-informed approach.  I bought her an amber necklace to wear 24/7.  I put her on chelated magnesium and a probiotic.  We put her in a brother's room to sleep.  I purchased and use the MindUp curriculum with her at home.  For a few weeks, the only way her dad and I could have our brief time out together once a week was to leave the three kids at my dad's house so that is what we did.  She did an intake for a children's grief and loss group and will start as soon as there is an opening, not so much for her to deal with grief as the sequalae of the experience of great-grandmother living and dying in our home.  I discussed the girl at children's church with the leader, and we all spoke to the girl and her mother.  The girl admitted to dd that her story was not true, essentially.

 

These measures have slowly but surely provided some relief, and she has improved quite a bit.  We just switched to every other week counseling.  For a time, her anxiety took over the whole family's life.

 

Getting a diagnosis is relatively simple.  A therapist can help you with that.  What is more tricky is finding good therapy.  You don't need a psychologist for a diagnosis, as a therapist can do it.  What you need is a therapist experienced in working with kids who have anxiety and OCD.  This sounds like an ongoing problem over a long period of time so medication may be needed to help break the cycle.  If you think that is needed right off the bat, see a psychiatrist.  Generally, the evaluation does not involve testing necessarily.

 

Wishing you all the best in this journey.  I felt like I would lose my own mind at times. :grouphug:

 

 

[texasmama]

Coming back to add that since I put my ASD kid on a good quality fish oil (Carlson's) and chelated mag, his moods have been more even.

[VANURSEPRAC]

My BFF's 13 y/o daughter is extremely disabled by generalized anxiety with panic attacks . She has been in cognitive therapy for appox 2 years with some improvement. She was placed on Zoloft approx. 3 months ago and has improved a quite a bit.

 

Just a thought.

 

The PhD she sees works with her pediatrician. She is continuing in therapy.

 

 

Hugs to you and your child.

[Pen]

From what I know about this based on a relative and with OCD (obsessions, but not compulsions) and anxiety, who you see to some degree pre-determines the treatments that will be tried.  A psychiatrist is more likely to give prescription medicines, some psychologists may be more likely to try Cognitive Behavioural Therapy or other such treatments that fit their field, a pediatrician might refer to one of the above and/or might test for presence of or absence of something that might be a cause, a naturopath might look for some natural treatments, an orthomolecular physician might go toward vitamin treatments.  Any of these might or might not help, and might or might not be best for your child and family.  

 

Personally, I'd be inclined toward first checking for anything that is missing that should be there (say minerals and vitamins--I had anxiety once due to seriously low potassium and getting the potassium normal solved the anxiety as well as likely saving my life), or anything that is present that shouldn't be, like say a high lead level. 

 

I also had a friend who thought she was having a panic attack, but actually was having a heart attack.

 

So, I'd tend toward ruling out something physical before going toward medicines or CBT. Then, if something physical is ruled out, once having a pretty good idea of what is going on, I'd either start with what is least invasive, or with what seems based on research to be most likely to help the most. I know from the relative I mentioned that pharmaceuticals is what keeps him functioning well. But I also know someone else who manages their similar problem with orthomolecular vitamin therapy (which seems safer to me).

[Minerva]

:grouphug:  :grouphug:  :grouphug:

 

 

[sbgrace]

I have a child with OCD. :grouphug:   :grouphug:

I'm so glad you're taking action.

 

I do like the idea of keeping good notes/records. This will help in making a dx and treatment plan.

 

I know this may vary by area, but you may find the the psych will medicate, but not dx. If you can see an OCD specialist cognitive behavioral and ERP therapist who works with pediatric patients, I would start there. You might ask that person if they recommend you make an appt with a particular psych or wait. OCD foundation online does have databases with OCD specialists. I don't think the list is exhaustive, though, depending on the area. For the therapy part, it's really important to see someone who specializes in OCD, because it is treated differently than other anxiety disorders.

 

Dawn Huebner's book is really great. http://www.amazon.com/What-When-Brain-Stuck-What/dp/1591478057It's kind of home CBT. It's not a replacement for a professional, but might give you some ideas to use while you wait. At the least it would give you an idea of how it's treated.

 

My son responds well to a supplement, NAC. Here is a pediatric clinical trial using it for OCD. https://clinicaltrials.gov/ct2/show/NCT01172275

If it's going to help, it may take 9 weeks to get to level/see effects. I feel fortunate that it seems to help my son so much. I suspect some people's OCD might be more responsive than others to this type of intervention--mediating glutamine (side note: we dropped 1 (out of 2) Culturelle probiotic pills a little over a year ago and saw bits of OCD pop back up until we put it back in; so my son may be benefiting from more than just the NAC/I'm thinking he's more complicated than I thought in this area). Anyway, I thought I would mention since it does seem to help here.

 

 

[Joker]

I would start with going to your regular pediatrician/doctor and requesting blood work. A complete panel and include iron, B, and D vitamins. Dd was anemic and low on B vitamins. It did help a bit to get that straightened out as well as everything else.

 

If you have a good doctor that you trust and respect, ask for recommendations for a psychologist. If not, start investigating, asking, and calling around. If your dc doesn't like the therapist, find a new one (even if you do like them). I really liked one of our therapists but dd did not and I waited a bit too long to switch. If your dc is not on board, it will not work as well. We finally found someone dd loves and things are much better.

 

My dd needs, and does better on, medication but we resisted at first. Don't rule it out completely. I had to come to trust our doctors, psychologists, and psychiatrists before I was okay with it but it's made a huge difference.

 

The biggest help for dd has been her psychologist. She is given ways to deal with the anxiety and depression that is helpful rather than harmful. She is learning to deal with the way her mind and body work instead of trying to force them to work how she thinks they should.

 

Lastly, don't rule out therapy for yourself, dh, and the rest of the family. There have been really hard times dealing with it and we kept thinking we would be okay. We are okay but we still need to vent, discuss, and get tips on how best to deal with certain situations. And, don't blame yourself (that's a hard one for me).

 

:grouphug: