11 year old DD has OCD/anxiety - where to go from here?

[Anonymous]

Anonymous wrote:If possible, I would consider moving.

???

[Anonymous]

Anonymous wrote:

Anonymous wrote:Do you or your spouse have any issues? That should always be the first consideration. They keep telling us these things have a genetic component.

Depression and anxiety are common on my side of the family. I have had depression/anxiety for most of my life. I have never had the OCD issues though, She has many OCD/behaviors and characteristics.

Care to elaborate?

[Anonymous]

OP, what kind of CBT is she doing? Does her therapist specialize in ERP for kids? I ask because our DD saw a therapist specializing in CBT for six months and we saw no improvement. When we switched to a therapist with specific expertise in OCD/ERP we finally started making progress, No meds yet but we're open to it depending on how far we get with ERP alone.

Here are some tips I found helpful in finding a therapist for OCD: https://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist/

[Anonymous]

Anonymous wrote:

Anonymous wrote:If possible, I would consider moving.

???

I raised 3 kids in the DC area. Long story short, this area is very competitive. Our experience is that it is much more competitive, “exclusive”, than other areas we have lived in. For one of our kids, this did not play out well. For us, sports, band and other extracurriculars were not intended to pay for college. For a sensitive child who wants to fit in, this can be tough. Acting out can take many forms. Most of the US is not like the DC area.
OP: Be grateful for a great kid!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If possible, I would consider moving.

???

I raised 3 kids in the DC area. Long story short, this area is very competitive. Our experience is that it is much more competitive, “exclusive”, than other areas we have lived in. For one of our kids, this did not play out well. For us, sports, band and other extracurriculars were not intended to pay for college. For a sensitive child who wants to fit in, this can be tough. Acting out can take many forms. Most of the US is not like the DC area.
OP: Be grateful for a great kid!

Hi, the competitiveness hasn't been our experience in her school system. It's an IB program and has a much more holistic approach. She doesn't really participate in any competitive activities like sports or band. We lead a very laid-back lifestyle all things considered.

[Anonymous]

I'm sorry that she's experiencing this. I was in this place at her age and wrote in my diary a lot. During my youth, my diary was actually my bestfriend. I'm not sure why this was my journey but I am still introverted and still have OCD. I stop asking why and embraced it. I hope that she's encouraged by the love you lavish on her and reminding her that she is very special! At times, I wondered what was wrong with me as I felt in my circle of friendships that I was strange, but I discovered through reading books that I was not strange, just different. That gave me peace. I hope your precious daughter feels that she is so precious and unique and that there's no one else like in the entire universe. However, I hope she's coming to also understand that this "OCD/anxiety" affects many in society and she can be brave, successful, creative and achieve all the dreams that her heart desires in spite of this. Build up her strengths and continue to celebrate her with each new day! I hope the family and friendships are a great source of encouragement and support for your family as you continue to seek answers.

[Anonymous]

Can you elaborate on her symptoms? This sounds much like my daughter, except she has OCD “tendencies”, not full-fledged OVD. She compulsively picks at her skin, like trichotillomania. She is currently on fluoxetine, but it doesn’t seem to make a difference. Would you all recommend trying Zoloft, even though she doesn’t have clear OCD?

[Anonymous]

Two of my kids have ADHD/anxiety. The oldest was diagnosed before K. He started on Prozac in 3rd grade through an NIH study on CBT. We'd done a lot of CBT prior to the study but DS was never able to access the techniques when he was in an anxious state - and he could go from fine to crisis in 0 flat. That part of the brain that regulated fear/anxiety was hyper-reactive and the medication helped rein it in. His anxiety didn't go away completely but medication allowed him to control it rather than it control him.

My younger DS didn't start an SSRI until he was in 6th grade. His anxiety manifested a bit differently than older DSs and it took me longer to recognize how much of an impact it was having on him. Once he got to a therpeutic level, it was so much better.

My only regret with both of them is that I didn't start them sooner. They're now in HS/MS and I can easily imagine the road they'd take if we'd not treated their anxiety with medication. They can utilize their CBT tools but it just isn't enough.

[Anonymous]

Anonymous wrote:Can you elaborate on her symptoms? This sounds much like my daughter, except she has OCD “tendencies”, not full-fledged OVD. She compulsively picks at her skin, like trichotillomania. She is currently on fluoxetine, but it doesn’t seem to make a difference. Would you all recommend trying Zoloft, even though she doesn’t have clear OCD?

How old is your daughter? Prozac can also be used to treat OCD, but at higher doses than regular treatment for anxiety. What is her dosage? Has it helped at all?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Medication did wonders for my DC with OCD. I wish I had started it sooner. DC was much able better to use the techniques learned in therapy after starting meds.

Which medication worked for your DC?

Prozac. And I did the reading and knew that it may be used in higher doses to treat OCD than it is for depression, but a relatively low dose worked and continues to do so.

[Anonymous]

Anonymous wrote:Two of my kids have ADHD/anxiety. The oldest was diagnosed before K. He started on Prozac in 3rd grade through an NIH study on CBT. We'd done a lot of CBT prior to the study but DS was never able to access the techniques when he was in an anxious state - and he could go from fine to crisis in 0 flat. That part of the brain that regulated fear/anxiety was hyper-reactive and the medication helped rein it in. His anxiety didn't go away completely but medication allowed him to control it rather than it control him.

My younger DS didn't start an SSRI until he was in 6th grade. His anxiety manifested a bit differently than older DSs and it took me longer to recognize how much of an impact it was having on him. Once he got to a therpeutic level, it was so much better.

My only regret with both of them is that I didn't start them sooner. They're now in HS/MS and I can easily imagine the road they'd take if we'd not treated their anxiety with medication. They can utilize their CBT tools but it just isn't enough.

PP, I have a child with the same diagnoses. Are your kids still on an SSRI? And are they medicated for the ADHD? My son was on an SSRI for two years (life-changing) but we stopped when we left stressful public school. I haven't tried a stimulant yet. Or rather we did a quick painful train a few years ago and I am wondering if we should try again.

[Anonymous]

I heard ERP is the best type of treatment for OCD but I was totally unsuccessful finding a provider in VA who could take my 12 yo. It was so isolating and frustrating. The CBT did nothing. My child’s OCD tendencies were the result of PANDAS and seem to have subsided but I keep a close eye, not that I know who will help us if it comes back.

[Anonymous]

Anonymous wrote:I heard ERP is the best type of treatment for OCD but I was totally unsuccessful finding a provider in VA who could take my 12 yo. It was so isolating and frustrating. The CBT did nothing. My child’s OCD tendencies were the result of PANDAS and seem to have subsided but I keep a close eye, not that I know who will help us if it comes back.

Hmmm. Recognize a bit of myself here. What would be my plan to address this if it arose again? I'd definitely want to have a well thought out action plan at the ready for this contingency.

I read many of the OCD posts as my DS has it (also PANDAS) and was helped tremendously by ERP at the Behavior Therapy Center in Silver Spring. We live in the District and it was a very long haul for us as the appointments were around 6 and we had to deal with huge amounts of rush hour traffic.

I have never seen an ERP provider mentioned here for Virginia. There are references to the Ross Center in Friendship heights of DC, which could be closer for you. Or your plan could be to pack it all in and go to Florida for a couple of weeks for the University of Florida's outpatient intensive. Parents with kids going to this program can stay for free at the Ronald MacDonald House.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Two of my kids have ADHD/anxiety. The oldest was diagnosed before K. He started on Prozac in 3rd grade through an NIH study on CBT. We'd done a lot of CBT prior to the study but DS was never able to access the techniques when he was in an anxious state - and he could go from fine to crisis in 0 flat. That part of the brain that regulated fear/anxiety was hyper-reactive and the medication helped rein it in. His anxiety didn't go away completely but medication allowed him to control it rather than it control him.

My younger DS didn't start an SSRI until he was in 6th grade. His anxiety manifested a bit differently than older DSs and it took me longer to recognize how much of an impact it was having on him. Once he got to a therpeutic level, it was so much better.

My only regret with both of them is that I didn't start them sooner. They're now in HS/MS and I can easily imagine the road they'd take if we'd not treated their anxiety with medication. They can utilize their CBT tools but it just isn't enough.

PP, I have a child with the same diagnoses. Are your kids still on an SSRI? And are they medicated for the ADHD? My son was on an SSRI for two years (life-changing) but we stopped when we left stressful public school. I haven't tried a stimulant yet. Or rather we did a quick painful train a few years ago and I am wondering if we should try again.

I'm the PP. Yes, they're both still on an SSRI (year round) as well as ADHD medications (during the school year and as needed). We've tried both stimulant and non-stimulant medications for the ADHD. My oldest first tried a stimulant medication in 2nd grade but didn't do well and we switched to a non-stimulant which seemed to have no benefit so we discontinued until 6th grade when his psychiatrist suggested it to help with the emotional dysregulation exacerbated by puberty. We also had him try a stimulant medication and he did really, really well with it - very different response than in 2nd grade. Glad we gave it another try. My kids go to FCPS schools and I wouldn't call them 'high pressure' at all. The stress they experience is no different than at any other school any where else.

FWIW - we participate in longitudinal ADHD research at NIH. The researchers have been fabulous and we've had some great conversations about medication - they don't push it but are 'fluent' in the research.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Two of my kids have ADHD/anxiety. The oldest was diagnosed before K. He started on Prozac in 3rd grade through an NIH study on CBT. We'd done a lot of CBT prior to the study but DS was never able to access the techniques when he was in an anxious state - and he could go from fine to crisis in 0 flat. That part of the brain that regulated fear/anxiety was hyper-reactive and the medication helped rein it in. His anxiety didn't go away completely but medication allowed him to control it rather than it control him.

My younger DS didn't start an SSRI until he was in 6th grade. His anxiety manifested a bit differently than older DSs and it took me longer to recognize how much of an impact it was having on him. Once he got to a therpeutic level, it was so much better.

My only regret with both of them is that I didn't start them sooner. They're now in HS/MS and I can easily imagine the road they'd take if we'd not treated their anxiety with medication. They can utilize their CBT tools but it just isn't enough.

PP, I have a child with the same diagnoses. Are your kids still on an SSRI? And are they medicated for the ADHD? My son was on an SSRI for two years (life-changing) but we stopped when we left stressful public school. I haven't tried a stimulant yet. Or rather we did a quick painful train a few years ago and I am wondering if we should try again.

I'm the PP. Yes, they're both still on an SSRI (year round) as well as ADHD medications (during the school year and as needed). We've tried both stimulant and non-stimulant medications for the ADHD. My oldest first tried a stimulant medication in 2nd grade but didn't do well and we switched to a non-stimulant which seemed to have no benefit so we discontinued until 6th grade when his psychiatrist suggested it to help with the emotional dysregulation exacerbated by puberty. We also had him try a stimulant medication and he did really, really well with it - very different response than in 2nd grade. Glad we gave it another try. My kids go to FCPS schools and I wouldn't call them 'high pressure' at all. The stress they experience is no different than at any other school any where else.

FWIW - we participate in longitudinal ADHD research at NIH. The researchers have been fabulous and we've had some great conversations about medication - they don't push it but are 'fluent' in the research.

Thank you, PP, for the details. When I say "stressful" I really mean for him. He has his own particular sets of personality traits, characteristics, and issues--his miserable experience was not the school's fault at all. But getting him out was a huge positive for him--it was like he stopped holding his breath and was able to be a child again.

Re meds: we have a child psychiatrist who is pretty responsive, but I sometimes feel like I am at a store and she is willing to give us what we ask for. (I don't mean this in a bad way, like she is over-prescribing. My son's challenges are severe and well-documented and it is kind of amazing we have gotten this far with so little medication.) What I mean by that is that she doesn't give as much expert guidance as I would like. She sort of lays out the options and leaves it up to me. I am kind of wondering if we are going through the same puberty emotional dysregulation and questioning whether we should switch to one one of the non-stimulants or, like in your experience, add something different. (And again, of course, I am discussing this at length with the psych but I am looking for experiences.) Thank you!