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Ok, this is about my older child...


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The one who doesn’t have any diagnoses.  Who has sailed through life as a high achiever, friendly, social, with good mental health and excellent executive functioning.

Except, it’s always kind of niggled at the back of my head.  She started early intervention at 15 months.  I called them, despite the military pediatricians saying she was fine, because she would say words once and never again.  So I called.  She qualified for speech and later occupational therapy, and it was awesome.  She had oral motor issues, so we taught her ASL and worked hard with nuk brushes and licked whipped cream off mirrors and blew whistles.  She had 250 signs by her second birthday, and by 2.5, her speech was well above average.  There were a couple weirdnesses. We did a brief round of therapy at three because she never asked questions.  She had a weird phobia about fast food playgrounds but really really wanted to participate.  We had a developmental pediatrician exam at three that looked at her for autism (no flags on test) but said she was at risk for ADHD and learning disabilities.  Ironically, one day while working with Anna, the speech therapist looked at four month old Cat and said, “Now that’s a neurotypical child if I ever saw one.  No worries about autism there!”   That actually made me doubt my thoughts about Cat for years.  

We moved a bit before Anna turned four.  I was unable to find a preschool for her, but we got her involved in lots of activities (church, Little Gym, swim lessons, ballet).  One lesson I had picked up from the OT was that she needed a lot of vigorous physical exercise to stay in sync.  So we did.  We started homeschooling when she was 4.5, and she excelled academically.  She got lots of sleep, lots of exercise, listened to lots of books, had lots of social opportunities.  By the time she was about ten, she was rebelling against me and needed more consistent peer experiences than I could provide.  We sent her to Catholic school and she absolutely thrived.  

The plan had always been to send her to public for high school, but finances made us send Cat early too.  She loves the public high school with 2000 students.  She’s taking top tier classes (and the not top tier classes are chess pits of behavior).   She’s making all A’s.  She’s involved in theater.  She loves the excellent art classes.  She is involved in the amazingly good theater.  She has friends and is dating.  She’s been out about being a lesbian since about age 12, which was kinda big at the Catholic school but doesn’t raise an eyebrow at public.  She loves the diversity of public school and thinks in general the kids are nicer.  I think she’s right.  She has started having some gender issues, and I don’t know if it’s genuine dysphoria or teen discomfort with changing body and hating boobs.  

About a year ago, she started really struggling with depression.  At first it seemed to be hormonal but by Christmas it was pretty all encompassing.  We bought her a couple binders.  We got her a counselor.  But things haven’t gotten better.  They’re getting worse.  We put her on birth control pills and then Zoloft.  Going back to dr tomorrow for two week check on that.  It’s a tiny dose.  Not a psychiatrist because there are very few psychiatrists for kids around here.  She’s crying pretty much all the time.  She’s terrified of not making A’s.  She’s worried about college and scholarships and the future.  She’s quit doing a lot of what she enjoys and even when she is doing stuff she likes, she’s not happy.  Everyone in the house is having nightmares about her anxiety and depression.  She’s resisting going to school.  I have offered to homeschool her but she doesn’t want to.  And she’s miss out on the great arts stuff.  I think a chunk of it is sensory.  Her teachers this year are good at keeping order, but there are over 30 kids in most classes, which is a big step up from 12 or so at Catholic.  I think classes at Catholic were more rigorous but they didn’t have the fine arts.  

But my alarm bells are going off.  I don’t think things are getting better.  I worry she needs to be hospitalized.  I worry she needs us to pull her out of school.  But she really really doesn’t want us to. I also cannot find OTs who work with teens with sensory issues, and she doesn’t want to do anything that would make her stand out, like noise canceling headphones or ear plugs.  But even at home she doesn’t want anyone talking.  

Anyway, I am worried.  Not sure letting her stay home is right call but I’m too sick to fight.  And maybe she needs the break?  She still cries and is a mess at home, but it’s definitely better than when she’s in school.  

So anyway.  Thoughts?  Ideas?

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Call the school counselor.

Does the school have an anxiety program.

If she stays home this gets into school refusal or avoidance.  You can google this.

I get there’s more to it but these are places to start.

I had a long-going thing with one of my kids with school avoidance issues that started with him missing school with feeling sick.  

It turned out the school had something of a plan/program with the counselor and nurse.

It’s worth checking.  

 

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Just more information..... the school counselor did some kind of CBT program with my son.  She talked to his teacher often.  The teacher made several changes.  

I also signed up for a voluntary truancy avoidance program, because he had missed enough school by then to qualify for this program.  I committed to taking him to school unless he had a fever or unless I was taking him to a doctor.  They wanted me to do that.  

 

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Unfortunately if she misses school and gets behind on schoolwork, that can increase the anxiety about going back.  That was what happened here, he was really sick probably 2-3 days, but then he was anxious about going back and being behind, and then it snowballed badly from there.  

But there were changes at school almost immediately so things were being addressed.

They had suggestions for me also but I think mainly just — take him to school.  Which was not easy!  

He was also not wanting to go anywhere else and I was not succeeding in getting him to go or do other things, so it was not something where school in of itself was causing all the problems.  

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We had a very bad summer in there where he barely left the house, and it was like — it made pulling him out of school not a good option, because I could not get him to engage or participate socially AT ALL and it was like — he did worse without school and with me doing the absolute best I could.  

The thing is if it’s anxiety where it would be about a lot of things, sometimes it can make things worse to pull from school, because then it can be really hard to get into other things and it also can mean kids spending more time alone.  

I also could basically tell that before summer, I knew it was that way.  

That is different than if problems are just in a school setting!  Then it makes sense to pull from school!  

So I think it can be the right choice, but it’s not a panacea and it can get harder for kids to get back out the longer they spend at home or avoiding activities.  

 

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Your daughter is in crisis. This has happened gradually. Her current mental health supports are inadequate and her antidepressant dosage is not effective.  In your shoes, I would keep her home from school and get help today. The scenario you describe leads me to wonder if your daughter is having suicidal ideation. If she has a current therapist, call that person. If not, find a local mental health crisis hotline. She needs an evaluation for safety. She may not need to be in-patient hospitalized, and there are other options, but I would not wait to act.

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I am just going to comment on it being better when she does stay home from school.  

Okay — I get that. 

But for me it was the same if he skipped church, stayed home from the library, stayed home from the park, was not forced to do soccer, etc etc etc.  

It was *anything* where he could stay home.  Sure school is a big thing that is out of the house, and it’s obvious, but here it was like that for anything, it wasn’t just school. 

I think you have to look at if it’s only school issues and issues that only are barriers at school.  Like — I think sensory issues sometimes can be a huge barrier in a school setting, but then there are other settings where things are going great, and it’s not like things are super constrained and limited.  

I think that is a different situation.  

But if she is anxious about many different settings then here — school was by far the easiest thing to address.  It was the highest structure, the most consistent, and had people willing to help.  That was not the case for other options available.  

There were a lot of things that “would” be great but if he won’t participate then they are not great.  A lot of things that in theory would work well and be good alternatives would not be the same if he would not participate.

He was kind-of sadly young when this was going on more, and he would just sit on the ground and not participate whenever he felt like it, and that could be a lot of the time.  Or just sit there and not participate if it was a sitting activity.  And that is even when I could get him somewhere. 

So anyway — I can understand relating this to school, but a lot of times with anxiety it is not just school.  And then if you pull from school, it can happen that kids are happy at home but it is hard to get them out of the house.  And this can be better than a school that will not do anything helpful imo, but I think it is trading one problem for another problem more than actually solving a problem inherently related to the school setting.

Also for the son I mention here, he did have many many red flags for autism as a baby.  He really did.  But I have taken him to be evaluated and the person told me that he has many spectrum traits, but he does not reach the level of a diagnosis.  His brother does have autism and she said this son’s spectrum traits are what you might see with a sibling.  And this son really had red flags as a baby.  

So anyway — I don’t know what your situation is with your daughter’s situation, but I do understand wondering “should I have done more about these red flags when he was a baby.”  Well — I do feel like I did what I needed to do there for my situation.

Anyway ————— on one hand, it doesn’t matter, if she has sensory issues, depression, anxiety now, then that can be addressed now, it doesn’t require an autism diagnosis.  

On the other hand, if you think there is some way that recommended treatments aren’t going to work for her because of autism-type issues, then I think that could matter.

But right now probably nobody is going to pay attention or care about the early childhood issues, and that is okay.  It might be something or it might not.  

I am totally in favor of kids being diagnosed when needed and of overlooked people getting a good diagnosis ———— but I’m also okay with this soon not having a diagnosis even though he did have red flags as a baby.  I did not know what the red flags were when he was a baby, but for things I’ve seen since, he did have red flags. I think it can be something where it did happen, but it doesn’t have a huge amount of meaning if there’s not current meaning to it.  

But for another person there could be a lot of current meaning.  

But I do think for this son it’s fine to say he has some spectrum traits but nothing is at a level where he would be diagnosed.  It’s still information but it’s not like — there’s something special and different I should be doing with this information.

 

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I called the school.  They have a program, but she’s ineligible because she doesn’t have Medicaid.  Honestly, I think we need to get the meds straightened out.  I wish there was a psychiatrist but there don’t seem to be that take insurance and see kids.  I think we need to deal with sensory stuff, but can’t find an OT.  

There don’t appear to be school supports for kids on track to be valedictorian who have no behavioral issues.  The school seems flummoxed.  

The therapist doesn’t think she’s having suicidal ideation.  

Edited by Terabith
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Terabith, no answers, but many hugs. My anxious, not-quite-ASD, high achieving dd is harder to help than her sister with multiple diagnoses.

9 minutes ago, Terabith said:

There don’t appear to be school supports for kids on track to be valedictorian who have no behavioral issues.  The school seems flummoxed.

Yup. Similar here.

I think the *really* high functioning kids might be kind of the next frontier in autism. 

Can you directly ask her about suicidal thoughts?

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16 minutes ago, Innisfree said:

Terabith, no answers, but many hugs. My anxious, not-quite-ASD, high achieving dd is harder to help than her sister with multiple diagnoses.

Yup. Similar here.

I think the *really* high functioning kids might be kind of the next frontier in autism. 

Can you directly ask her about suicidal thoughts?

We have.  She denies them.  She says sometimes she wishes to escape, that she wishes she could sleep forever with no obligations, but she has no plans to put that in place.  So... I guess passive but not active?  I don’t think the hospital would keep her or really even help her.  I think more aggressively bumping up the antidepressant would be worth trying though.  Or something like buspar for anxiety.  I really think it’s biological.  Both parents have pretty bad depression and anxiety.  Her sister went on meds right at her fifth birthday and should have by age three.  Multiple grandparents and cousins have significant mental health histories.  She did so well up till puberty we thought she’d escaped it.  But puberty has brought up major body dysphoria....which doesn’t help.  

Edited by Terabith
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That is a disappointing response from the school!  

This may not be your top priority right now or the direction you go in, but I think it’s worth trying another phone call to school at some point.  I don’t know about it but with anxiety she may qualify for a 504 plan.  You could google how to write that.  

Sometimes you have to put things in writing and/or find someone else to talk to.  

And sometimes it is still nothing great.

But it doesn’t have to be the last word on things yet.  

I don’t know this about Medicaid but sometimes you don’t have to qualify for Medicaid as a family.  Sometimes that means more — kids have to qualify as severe enough to fit some paperwork box.  I don’t know but it might be something where it really means something like — if she qualified for an IEP then she could be in the program.  And maybe she would.

Does she have a diagnosis from the counselor?  If so — can you google the diagnosis and school accommodations or see if it might mean getting an IEP?  

This might be low down on your list for sure, but I have known many times when someone has been told no and I know if they kept trying there are things. They didn’t talk to the right person.  A lot of people in schools aren’t informed about every thing going on in the school.  Especially at a large school.  

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Also — this is something that was not on my radar at all.

But — the school probably has some policy about how many excused and unexcused absences are allowed.

And then for what counts as excused.

I did not know this — but it turned out that after a certain number of absences, I could not “excuse” an absence anymore.  It would be unexcused unless I did provide a doctors note or something like that.  

I don’t know your situation with how many days she has missed or if she has been to the doctor.

I took my son to the doctor when the school secretary said I needed to start bringing in a doctors note (I guess he was out of unexcused absences but I’m not sure).  

The doctor said he was not physically sick but psychosomatic and probably something was wrong at school, and if the school wouldn’t do anything to go back to him and he would have suggestions for me.  

But I got a note then that was like — saying my son was at the doctor but not excusing him from school.  

I don’t know what the policies are where you live or if they will let you excuse her absences with no hassle.

Well — it started to be like this and I think my son had missed less than 10 days, and then all of a sudden it was like — they had some number they looked for and then it was a big deal.  

I think this is a low priority for you right now, but it’s like — if it is like this where you are, there may be a limit to how many days she can miss.  They may have some rule.

Rules like that absolutely get adjusted when there are medical issues and this is a medical issue.  But it’s like — if she is missing days staying home, there is this stuff that can come up.

If you let it go too long without contacting them forcefully (writing a letter requesting an evaluation, taking a copy of a diagnosis to school and requesting an evaluation, request a meeting in writing, etc) then it can get into ————— things where she might end up without enough attendance to get credit, because they care about that at some point.  

I did not know about any of this and never paid attention to excused absences or having a note or anything like that.  

I think if she is near a point or at a point of going into in-patient then you will have documents from that to take to school and coordinate with them and they can waive things like attendance requirements.  

I think it’s a low priority and can wait until later if that is where things are headed.

If not and she keeps missing or has already missed then it might be an issue and worth trying more to see what is possible.

It also may not be something they care about at this school.  They may let her make up everything.  Some schools don’t let kids make up things if they have miss for an unexcused absence once they have too many unexcused absences.  I believe it was that where we lived at the time.  

Obviously things got away from me but I think he had 7-8 absences when it got to be a serious thing and he was getting into a range where they were concerned.  

I think that number came very quickly for me and with him telling me he felt sick etc.  I think they ended up being all unexcused absences.  

It was not on my radar at all.  

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She’s missed three days total.  So, not a ton, but not the right direction.  The school doesn’t excuse any absences with parental notes.  Only doctor note count, and only the same day as the absence.  So if she had the flu and missed five days, she would need five doctor’s notes.  Which is ridiculous and nobody follows.  

She does avoid other settings, but it’s pretty consistent with how chaotic it will be.  So, no theme parks.  But she will go to the mall or target or the library with no problem.  

Pep rallies are a big problem and how to avoid them.  It seems to mostly be teacher discretion if they’re allowed to go to the library or something instead.  The school is not super supportive from what I can tell.  One of the stressors is they just redid lunches seven weeks into the school year, and now she has nobody to sit with at lunch.  They constantly change kids schedules.  Classes have 34, 36 kids in them.  Her teachers are good this year, but she’s playing catch-up from Spanish last year, where she learned nothing.  

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Another big issue is her perfectionism.  She’s freaking out about what would happen if she doesn’t get all A’s.  She’s terrified about college and being able to get scholarships, and a job to afford life as an adult, but she doesn’t know what she wants to do when she grows up.  She’s paralyzed by this sense that everything counts and is momentous and she isn’t going to be able to measure up.  And she’s doing really, really well.  Her grade has like 500 kids, and she’s somewhere in top 25, last I checked.  But she’s stressed because she doesn’t have passions.  She’s stressed because she doesn’t have a job.  But she needs a ton of sleep and a ton of down time.  She didn’t like the kids as well at the Catholic school, but she was much mentally healthier.  It was quiet and predictable and structured.  Fights didn’t break out in the hallway every class.  Drug deals didn’t go down in class.  Classes had 12 kids, not 32.  

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Three days is not bad!!!!!! 

I hope you get some direction for this, it doesn’t sound like a good situation for her 😞

I think maybe she could get a 504 with the pep rally stuff even if she doesn’t get an IEP.  Also sometimes kids leave class early or arrive late so they can be in the hall when it’s not a crowded passing period.  These kinds of things shouldn’t be that hard for a school to agree to.  

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I was an undiagnosed high-achieving Autistic teenager with a lot of anxiety.  I grew up in a high COL area and was terrified I wouldn’t be able to afford my home town as a grown-up. (I can.)  I was an undergrad at UC Berkeley and convinced I wasn’t good enough to be grad school material.  (I was.) Success seemed unreachable. (It wasn’t.)

I think it boils down to a couple things:  

1) Poor perspective taking about my own ability.  I was a way above average student but I couldn’t internalize that.  If a random newspaper article said getting into a good college was “hard” (for an average student) then I was sure it would be hard for me, the National Merit Semifinalist with a 4.0+.   I just couldn’t see that the article wasn’t written about kids like me.

2) Feeling defective.  A lifetime of being subtly socially off-kilter makes you suspect that deep down there is something wrong with you, and someday everyone will find out and you will fail. 

3) Executive Functioning deficits.  Planning to launch yourself as an adult takes planning.  I wasn’t great at that. 

Everything you are saying about the structure and the downtime and the sensory and everything says Autism to me. Autistic kids can really fall apart around college transition.  I would definitely pursue this angle.

What would I have wanted to hear at that age?  It seems silly but “You will always be able to live with us, we will always love you, we will always support you” because the fear was failure and rejection, even through I had everything going for me.

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We tell her over and over not to worry because she can always live with us and we will always support her.  Heck, that’s pretty much the plan for Cat.  We were ready for Cat to struggle with public school but not Anna.  Maybe the difference is that the middle school is smaller?  Or maybe that Cat is autistic in a way that she doesn’t care much what other people think?  So while Anna won’t wear ear buds to dampen sound, Cat will read a book to tune everyone out or do something else to block sound. 

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I lost track. All this went firestorm this school year? Can she go back to catholic? They may have been providing more support (demeanor, calm days, coregulating) than you realized.

If anxiety is up sensory will go up. Reverse is true for ds too. If sensory was tolerable at catholic then issue is the school or whatever stress. How is her D?

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Issues started last year, when she started public.  We simply cannot afford Catholic for high school (or in general) at this point.  And she’s adamantly opposed to going back.  Academically, she knows it was better, but the kids were upper class jerks. She had a few acquaintances but no real friends. And they don’t really offer the fine arts programs that are so important for her.  

Tomorrow we talk to doctor.  I think we need to get more aggressive about meds and run some nutritional tests.  Will keep trying to find both a psychiatrist and an OT who can work with sensory issues.  And talk to school guidance counselor about options, including part time homeschool.  

However, all of this is more or less dependent on my being able to stand, not running a fever, and able to talk.  How long do these viruses run anyway?  This will be about day 3 tomorrow, and I still feel dreadful.  

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She was way better at Catholic.  I don’t know if issue was sensory or if it was the sense that nothing counted in the way high school does.  Public school puts a ton of pressure on them about every single grade and decision can potentially wreck their future.  So while Catholic was significantly less grating to her sensory system, it was also less stressful.  

She is definitely better at home than school.  She’s still depressed at home but she’s functional more or less, most of the time.  She masks at school but it’s clearly very hard for her.  But she also loves aspects of it and doesn’t want to leave.  

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She seems more or less okay at home.  She has crying jags and is jumpy, but she’s not hysterical.  Her counselor never responded to me.  The doctor never replied to my note to him about her refusing to go to school.  The guidance counselor said the person who might be able to help won’t be in until next week.  She suggested I email her teachers to get her assignments, but only one teacher replied to me. 

I don’t know.  i feel helpless.  And both my mother and my mother in law are being mean to me about it.  

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I just looked it up and I was recommended the book “Growing Up Brave” by Donna Pincus.  It’s been a while, the book was fairly new at the time and it has a 2012 publication date!  I don’t know if there are other books out now.  

I am sorry people are not being more helpful.

It is very hard!  I also had some responses like “why can’t you do this basic thing?” 

It really is hard.

Keep going, it is a process.  

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Called the psychiatrist she saw a couple times years ago; she'd be considered a new patient.  They aren't accepting new patients.  Without Medicaid, NOBODY is accepting new patients.  Inpatient is the only recourse, and even then, there's decent odds you won't get anyone.

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1 hour ago, Terabith said:

She seems more or less okay at home.  She has crying jags and is jumpy, but she’s not hysterical.  Her counselor never responded to me.  The doctor never replied to my note to him about her refusing to go to school.  The guidance counselor said the person who might be able to help won’t be in until next week.  She suggested I email her teachers to get her assignments, but only one teacher replied to me. 

I don’t know.  i feel helpless.  And both my mother and my mother in law are being mean to me about it.  

 

Try the school principal by phone—before things get busy with kids and staff for most principals at start of school if your school principal goes in early,  mid-morning, and/or after school.  

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2 minutes ago, Terabith said:

Called the psychiatrist she saw a couple times years ago; she'd be considered a new patient.  They aren't accepting new patients.  Without Medicaid, NOBODY is accepting new patients.  Inpatient is the only recourse, and even then, there's decent odds you won't get anyone.

 

Seriously?

how awful  

does your area have a crisis phone line?

How about a NAMI group? 

 

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I put something re dd on thread about u feeling sick

https://www.thecenterforultrahealth.com/services/functional-medicine-roanoke-va/

idea to go for a whole person type doctor where mind/brain will be included 

 

your dd is 16 going on 17 or 15 going on 16?  

If 15 going on 16, she could probably take year off for medical reasons if necessary and go back next year (not a homeschooling year but a get mentally and nutritionally etc stabilized year).  If necessary U perhaps could enroll her as a homeschool student to not be truant, study health intensively, and then have her return to school as a sophomore again next year. 

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Pen — I think that sounds like a good idea, but it is shockingly hard to get kids out the longer they stay at home.  Kids can become recluses for long, long periods of time.  I don’t know the family situation, but I was a stay-at-home mom and really struggled.  If parents are out of the house then kids alone at home — it is often really not a good situation.  The time alone can mix in to depression pretty easily.  

And then if sleep schedules get mixed up kids can start sleeping in the day and being up at night, and that can be very hard.

Just being at home can be like hiding. 

I think taking a year at home is great for a lot of things.  And then depending on some details for this it could be a good idea for sure.

But it is not a panacea.  It is not a treatment for anxiety for sure.  

Terabith — I don’t know what your steps are for in-patient, but honestly I think it is worth looking into it pretty seriously.  I know it’s a big step and maybe it’s not the right thing, but I think it can be a good option.  

Also in in-patient I think they could actually figure out her medications, which I think would be really helpful.  I think so at least.  I have a relative who went to in-patient and they did get his medications straightened out.  I went to visit him there (long story but he really liked to get to see my son who was a cute toddler at the time).  I also let his wife take my son there to visit him.  Anyway — I don’t know how typical this place was but it was a nice atmosphere, not like I pictured from the movie Girl, Interrupted.  

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34 minutes ago, Pen said:

I put something re dd on thread about u feeling sick

https://www.thecenterforultrahealth.com/services/functional-medicine-roanoke-va/

idea to go for a whole person type doctor where mind/brain will be included 

 

your dd is 16 going on 17 or 15 going on 16?  

If 15 going on 16, she could probably take year off for medical reasons if necessary and go back next year (not a homeschooling year but a get mentally and nutritionally etc stabilized year).  If necessary U perhaps could enroll her as a homeschool student to not be truant, study health intensively, and then have her return to school as a sophomore again next year. 

She's 15 going on 16.  The issue is she has to buy into any plan.  And school and society have told her that the only way to succeed in life is to make straight A's in all AP classes (seriously, fewer than four AP classes is considered remedial at the school - and those have daily fights and drug deals going on in them), do a million activities, and have a job.  She knows she needs college scholarships.  She doesn't know what she wants to do, and the school says if you don't know, you will never succeed at anything.  They also have told them that because of climate change, society will collapse by the time she's 30, but even the collapse of civilization will not allow her to not pay back student loans.  They say she'll be crushed under debt her entire life.  Honestly, hopelessness and despair seems like the only rational response to this.  

I've offered to homeschool.  I've offered to find her a different school.  This school is the only school with any fine arts opportunities.  

And they changed the lunch periods so she doesn't have anyone to eat lunch with anymore.  This was actually the even that triggered her refusing to go to school. 

She's a night owl by nature and has been since infancy.  Any time she's off school for more than three days, she instantly reverts to up all night, sleep all day.  It's pretty hard wired in.  Everyone in the family is the same way.  

The sensory stuff is HUGE.  She's completely overwhelmed by the loudness and constant chaos and throwing things and screaming and banging of school.  She's constantly on edge, from a sensory point of view.  My concern is that adolescent inpatient is also loud and chaotic.  There appear to be NO OTs who work on sensory stuff with teens in this half of the country.  

Edited by Terabith
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Does she still take her medication every 24 hours when her sleep is shifting?  That can make it harder to take medications at the proper time.

Look — part of being up at night is that everyone else is asleep.  No demands to be around other people.  No demands of them talking to you.  

If everybody else is awake in the day and sleeping at night, it can be a very effective way to avoid people and any demands of being around them or dealing with things they might say.  

It is not good in that way.

Even if it is hard-wired — and I get that — it can still have this effective.

It is hard to talk to her etc if she is asleep while you are awake.

It’s hard to have her participate in family activities or even the most basic outings, if you are trying to do these things while she is basically sleepwalking around.

It’s just not a good situation.

That is hard about adolescent in-patient being loud and chaotic, I did not realize that.  I think that is a real problem.  

But I am afraid I think what you are getting into is a really, really hard cycle to get out of, and just does get worse with time.

And I do think in-patient still might be the best of a lot of bad options.  I don’t know and I understand you will have to do what is possible and what seems like the best to you and your husband.  It can not be easy and I’m so sorry your mom and MIL are not able to be more supportive.  

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At this point, I would call the therapist again and leave a message like this - "My daughter is in a crisis, is refusing to go to school, and I am concerned for her safety."  What were you instructed to do by the therapist in case of crisis?  

In-patient is a mixed bag, but it sounds like she is approaching this.  A family doc or pediatrician can miss this call sometimes that a psychiatrist would not miss.  If you are in the US, call your insurance company and ask about in-patient coverage so you have the information.  Ask what facilities in your area are covered.  You can take her to an ER, but that is the least favorable option.

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Also look — I will try to look up a website about this.

Sensory is not static.  If stress is higher, sensory is worse.  If anxiety is higher, sensory is worse.

But sensory also makes anxiety worse, and stress worse.

But when various other things are going better, sensory can more easily be handled.  Not that it’s easy and I still think a 504 could be possible to mitigate what is possible.

But there is a total demand and if any part is lessened the other parts can also ratchet down a bit.  

Have you heard of spoons for this?  Basically if a lot of spoons are being used then what is left to deal with sensory (or anxiety or stress) goes down.  

So less total stress/anxiety/sensory can help without how much of the others can be handled.

So it IS hard but I think there is hope there for her to be able to handle more with some treatment and some accommodations.   

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I do agree with Texasmama.  

Frankly I am very concerned about her alone at night and sleeping in the day (as I picture — I know this may not be the case).

It is just not a good situation.  She could really, really spiral down in this situation.  Like — really, really, really spiral down.

If she is going downhill, it’s better to try not to let it keep going downhill.

I understand it is a very hard situation and no one is being helpful, though, and you are doing your best!!!!!!!!!

You are a thoughtful and caring mom.  

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https://www.aspergerexperts.com/defense-mode/spoons-stuck/

Maybe not the best article, I just skimmed, but it does talk about sensory, anxiety, and the idea — you have so many spoons and they are being used up.  

When they are used up, ability to deal with sensory plummets... ability to deal with anxiety plummets...

But there are coping skills, there are ways to make accommodations.  

Just an idea I find helpful.  

Edited by Lecka
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Also I feel I should let you know if you don’t know this — to a great extent, for a teen with sensory issues, you are looking at management and not a cure. 

There’s probably nothing that will make her not have sensory issues.

There are probably ways for her to manage being a person who does have sensory issues.

I don’t necessarily think you are going to find a breakthrough with OT.  

If she were to click with the right person — okay, that could be amazing.

But I don’t think it’s likely that you do some OT thing and her sensory issues go away.  

Just to say — I am also frustrated with you at the lack of OT options, but I don’t think it is a huge loss as far as — being able to find ways to help her.  

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Especially if you are getting into — she is anxious because it might be too loud and then she would be overwhelmed.  

Then there is the anxiety about the sensory even when the sensory is not that bad!

As far as I know — CBT is appropriate for this kind of thinking.  So that is something that doesn’t require an OT.  And — it is something OTs often also do (to use the same strategies for management).  

I am not a big expert but this is my impression.  

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Also — try not to buy into or be convinced by her catastrophic thinking.  It is hard but — try, lol.  It is very hard for me.  

Edit:  I am sure — especially when she is hurting.  But I think it is worth trying.  

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41 minutes ago, Terabith said:

She's 15 going on 16.  The issue is she has to buy into any plan.  And school and society have told her that the only way to succeed in life is to make straight A's in all AP classes (seriously, fewer than four AP classes is considered remedial at the school - and those have daily fights and drug deals going on in them), do a million activities, and have a job.  She knows she needs college scholarships.  She doesn't know what she wants to do, and the school says if you don't know, you will never succeed at anything.  They also have told them that because of climate change, society will collapse by the time she's 30, but even the collapse of civilization will not allow her to not pay back student loans.  They say she'll be crushed under debt her entire life.  Honestly, hopelessness and despair seems like the only rational response to this.  

 

She needs other input. 

Is she actually being told that? Or is she selectively hearing that? 

What are u telling her? 

Btw Many scholarships have nothing to do with AP classes or similar 

41 minutes ago, Terabith said:

I've offered to homeschool.  I've offered to find her a different school.  This school is the only school with any fine arts opportunities.  

 

Her fine art is drama? 

It seems unlikely to be true that only one school has anything .  Especially if wider world of learning is considered.  Including possible boarding schools, community theater groups, etc.. 

 

41 minutes ago, Terabith said:

And they changed the lunch periods so she doesn't have anyone to eat lunch with anymore.  This was actually the even that triggered her refusing to go to school. 

 

That’s understandable.  

Already on the edge and then no friends to be with. 

Contact Principal. 

 

Also try places that may have ideas ideas for alternatives .  

Charter schools, after school programs... 

See if there’s a gifted children’s association in your state or county...

 

 

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