Please help me help my daughter

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Please consider an SSRI medication for anxiety. Anxiety can cause a lack of appetite in itself. I find it nearly impossible to eat or desire food when I’m anxious. An SSRI can relax the mind and gut enough to desire food. Anxiety can also make for extremely difficult and contribute to homework taking forever. If you treat the anxiety you may just find that it resolves the growth issue and eases the school issues.

Yes, I'm open to trying SSRI's when we get to that point. I don't know how we will actually get her to take the pills though. We have been unsuccessful in getting her to even take a single vitamin pill. She even refused gummies. I think we may have the world's most stubborn child - it is so frustrating on all levels.

"When we get to that point"? Your daughter is in a mental and physical health spiral already. What more do you need to get to that point?

It makes more sense to me to have her evaluated first for anxiety and depression before just giving her SSRIs.

New patient appointments can take months for psychiatrists and some therapy practices. I would get on some waiting lists now in anticipation.

Also, given the various things you describe, has she ever been evaluated for autism?

She should be evaluated for autism as well. It presents differently in girls and is a real possibility.

That's why we wanted to get a full evaluation. I think that she has multiple things going on and it will be hard to tease out what's what until we have the whole picture. I think some of the things are feeding into each other. I don't think it makes sense to at this point to just dive in and start prescribing her medication until we have a better understanding of where she's at.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are you sure that the all-hours laptop use isn't about something not related to school, like social media or something else? And she's just making it seem like school? If she has ADHD and is getting diverted, she may not even really appreciate how much time she is losing to diversions. I'd keep a better eye on her usage.

She's not on social media. I have gone through long periods where I've monitored her computer usage closely. A little more than half of her time is spent on actual homework - which goes painstakingly slow, or she just gets stuck. She says her brain stops working and feels empty. A lot of it is massively inefficient use of her time - spending exorbitant amounts of time on things that clearly don't matter.

She also takes "brain rot" breaks which often go too long. I've discouraged her from doing this, and take movement breaks instead. I've tried to drag her out for a quick walk. If she must do the brain rot breaks, I suggest setting a timer. But like many of my suggestions and urgings, she just doesn't listen to anything we say.

She is also not on any social media and is completely disinterested in any kind of social apps or even texting her friends.

You need to actually parent. Not "suggest". Take the device away, period. No brain rot. Your "gentle" approach is failing, can't you see that? People are being harsh to you because you seem to very much need a wake up call. You say she is stubborn and uncooperative, I say anxiety disorder and OCD and maybe autistic rigidity. Maybe rejection sensitive dysphoria. Read up on the SPACE protocol-- it's designed to not require any cooperation from the kid, at all.

Speak with the school about homework. That way the reduction in workload can come from the school and she can still feel like she is doing well academically, rather than you telling her it's fine if she gets bad grades.

Yes, we are going to start taking away her devices at night and not return them to her until the next morning. If you have suggestions on how I can prevent her from taking brain rot breaks, I'm all ears.

I'll read the book. And I'll reach out to the school about pausing homework.

You sit by her and watch what she's doing. When she does brain rot, you say "No brain rot" and you take it away from her.

You can ask the school for permission to do assignments on paper instead of computer. If you don't have a 504 plan, start the process of getting one today.

For our DD we have a "homework computer" which is a separate Chromebook that is very locked-down and does not even connect to the Internet at all without a parent connecting it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Please consider an SSRI medication for anxiety. Anxiety can cause a lack of appetite in itself. I find it nearly impossible to eat or desire food when I’m anxious. An SSRI can relax the mind and gut enough to desire food. Anxiety can also make for extremely difficult and contribute to homework taking forever. If you treat the anxiety you may just find that it resolves the growth issue and eases the school issues.

Yes, I'm open to trying SSRI's when we get to that point. I don't know how we will actually get her to take the pills though. We have been unsuccessful in getting her to even take a single vitamin pill. She even refused gummies. I think we may have the world's most stubborn child - it is so frustrating on all levels.

"When we get to that point"? Your daughter is in a mental and physical health spiral already. What more do you need to get to that point?

This! A child psychiatrist diagnosed her with anxiety 3 years ago and you say she definitely still has anxiety, but you don’t medicate her and you have dodged answering whether she’s in therapy. No wonder she’s struggling with mental health to the point that it’s impacting her daily functioning and physical health! The poor child needs treatment. If she also has ADHD on top of that, she’s completely dysregulated.

She already has a diagnosis of anxiety. Don’t wait to start medication and therapy. Call the child psychiatrist she saw 3 years ago and make an appointment. Do it today. Then log on to your health insurance company’s website and look for therapists who are near you and in-network. From those, make a list of the ones who see children and have experience with anxiety and ADHD. Once you have a few names, you can look them up on Psychology Today, read their bios, see their photos. Start calling to see who has an opening. When you find somebody with availability, start the intake process. It all takes time. Get on it today.

We only had an intake appointment with the child psychologist. They did not meet with our daughter or diagnose her, only said "it sounds like anxiety to me" At the time, DH was very much against intervening, apart from providing something like EF coaching. It was tough even getting him to agree to see the psychologist. He had very strong feelings on it, so we compromised and said we would wait and see if she would eventually adjust.

Your husband needs to know that eating disorders are the most deadly mental illness, with a survival rate similar to leukemia. If he wouldn't delay testing to wait and see if your daughter recovered on her own when she had symptoms of leukemia, then he shouldn't now. I know that's blunt, but this isn't something where waiting and seeing is a safe approach.

I'm not saying that this is an eating disorder, but the possibility is there. You owe it to your daughter to explore a diagnosis and treatment now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How do you know she doesn't feel hunger? Because she says so? Lol. She may be restricting because that is one thing she feels she has control over in a chaotic unsafe world. She will lie. That's what we with eating disorders do.

Could be. But some people really do have poor interoception. If she doesn't notice being cold, took a while to learn when she needs to pee as a toddler, stuff like that, it's interoception. Which suggests ASD.

I think this is right. (This is OP). Or it could be some of both. She has never sought out food in her entire life (except candy). She will eat it if it is conveniently prepared and presented to her. Otherwise she will not remember to eat. She's also always been a pretty picky eater and doesn't like strong flavors.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Please consider an SSRI medication for anxiety. Anxiety can cause a lack of appetite in itself. I find it nearly impossible to eat or desire food when I’m anxious. An SSRI can relax the mind and gut enough to desire food. Anxiety can also make for extremely difficult and contribute to homework taking forever. If you treat the anxiety you may just find that it resolves the growth issue and eases the school issues.

Yes, I'm open to trying SSRI's when we get to that point. I don't know how we will actually get her to take the pills though. We have been unsuccessful in getting her to even take a single vitamin pill. She even refused gummies. I think we may have the world's most stubborn child - it is so frustrating on all levels.

"When we get to that point"? Your daughter is in a mental and physical health spiral already. What more do you need to get to that point?

It makes more sense to me to have her evaluated first for anxiety and depression before just giving her SSRIs.

New patient appointments can take months for psychiatrists and some therapy practices. I would get on some waiting lists now in anticipation.

Also, given the various things you describe, has she ever been evaluated for autism?

She should be evaluated for autism as well. It presents differently in girls and is a real possibility.

That's why we wanted to get a full evaluation. I think that she has multiple things going on and it will be hard to tease out what's what until we have the whole picture. I think some of the things are feeding into each other. I don't think it makes sense to at this point to just dive in and start prescribing her medication until we have a better understanding of where she's at.

You can’t get a prescription without a diagnosis, so that makes sense that you can’t medicate yet, but regardless of her diagnosis, she needs therapy and doesn’t require a prescription for it.

[Anonymous]

Practical issue here for you regarding testing. You say to are pursuing testing from two different sources - school and private. The testing overlaps and some testing cannot be repeated within the year. So you may need to decide which provider you want to do which specific parts of the testing because if both do certain tests to invalidate the results.

IME, when my son’s psychiatrist recommended retesting, the psychiatrist, the school and the neuropsych all recommended that only the private neuropsych be done. Some might say the school was trying to get out of testing but I don’t believe that was the case. My son, like your daughter, is complicated and needed a more
Comprehensive approach. The downside is that it often takes longer to accomplish.

Anyway, bringing this up so you can have a conversation with your providers before you spend a lot of money and time and don’t get all of the benefit that you can.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are you sure that the all-hours laptop use isn't about something not related to school, like social media or something else? And she's just making it seem like school? If she has ADHD and is getting diverted, she may not even really appreciate how much time she is losing to diversions. I'd keep a better eye on her usage.

She's not on social media. I have gone through long periods where I've monitored her computer usage closely. A little more than half of her time is spent on actual homework - which goes painstakingly slow, or she just gets stuck. She says her brain stops working and feels empty. A lot of it is massively inefficient use of her time - spending exorbitant amounts of time on things that clearly don't matter.

She also takes "brain rot" breaks which often go too long. I've discouraged her from doing this, and take movement breaks instead. I've tried to drag her out for a quick walk. If she must do the brain rot breaks, I suggest setting a timer. But like many of my suggestions and urgings, she just doesn't listen to anything we say.

She is also not on any social media and is completely disinterested in any kind of social apps or even texting her friends.

You need to actually parent. Not "suggest". Take the device away, period. No brain rot. Your "gentle" approach is failing, can't you see that? People are being harsh to you because you seem to very much need a wake up call. You say she is stubborn and uncooperative, I say anxiety disorder and OCD and maybe autistic rigidity. Maybe rejection sensitive dysphoria. Read up on the SPACE protocol-- it's designed to not require any cooperation from the kid, at all.

Speak with the school about homework. That way the reduction in workload can come from the school and she can still feel like she is doing well academically, rather than you telling her it's fine if she gets bad grades.

Yes, we are going to start taking away her devices at night and not return them to her until the next morning. If you have suggestions on how I can prevent her from taking brain rot breaks, I'm all ears.

I'll read the book. And I'll reach out to the school about pausing homework.

You sit by her and watch what she's doing. When she does brain rot, you say "No brain rot" and you take it away from her.

You can ask the school for permission to do assignments on paper instead of computer. If you don't have a 504 plan, start the process of getting one today.

For our DD we have a "homework computer" which is a separate Chromebook that is very locked-down and does not even connect to the Internet at all without a parent connecting it.

I can't realistically do this for 3 hours every evening. I also have a job that requires working some evenings. I can see what the school says about doing assignments on paper. I imagine that might be challenging since EVERYTHING is done on the computer now, AND requires internet access.

[Anonymous]

I have issues like this with two different children. My oldest does not generally feel hunger cues and has very restricted eating (gags if she eats certain types of textures)—it’s not voluntary, she’d love to be able to eat more. Just focus on getting calories into her eating what she likes (on the healthier side — like cheese and pasta is fine, even better if you can add an apples and some tomatos). It’s okay if she eats the same stuff over and over and if it helps her or watch TV while she eats, that’s not the end of the world. When you get to a better place, you can try moving into so of the Ardid type treatments. Also note that for a lot of kids with anxiety, it manifests as stomach problems which can really impact stomach cues. I really doubt it’s a traditional ED. It’s more likely Arfod or anxiety induced stomach pains. We avoided stimulants for this child because they make anxiety and the food issues worse but she was on a low level anti drepressant for several years.

My other kid is like this with getting really upset when I try to help him organize. We hired a really nice executive function coach who meets with him via zoom and does all that stuff and he is a million times more willing to talk with her. She is teaching him strategies to work on stuff himself. Does he have the grades he should have, given him intelligence and the amount he works? No. But he’s still in school and still trying and making progress on those issues. You have to have a certain level of acceptance yourself, and figure out how o make this not a personality clash between you. Maintaining your relationship with the your child is the most omportant part of all this.


Finally, I’m not in the “take the computer away stat” camp. It depends. Is she using it to engage with friends? Are they nice friends? One of my top prooorites is making sure my SN kids have friends and that they are decent people. If she’s already tangential to a social group, limiting her connections with that group could result in her being shut out …. Which will be way works for her mental health and increase the likelohood that when she does go on like (and she will, even if you limit access), she will be engaging with harmful content. When I limited my son’s phone access, he was using hils school Chromebook and finding awful content on line. With his phone, he is sending silly memes to his friends, and they get together sometimes in the evening to blow off some steam playing joint video games. I know the computer stuff is really really hard — I just don’t think the answers are as bright line as some people suggest.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Please consider an SSRI medication for anxiety. Anxiety can cause a lack of appetite in itself. I find it nearly impossible to eat or desire food when I’m anxious. An SSRI can relax the mind and gut enough to desire food. Anxiety can also make for extremely difficult and contribute to homework taking forever. If you treat the anxiety you may just find that it resolves the growth issue and eases the school issues.

Yes, I'm open to trying SSRI's when we get to that point. I don't know how we will actually get her to take the pills though. We have been unsuccessful in getting her to even take a single vitamin pill. She even refused gummies. I think we may have the world's most stubborn child - it is so frustrating on all levels.

"When we get to that point"? Your daughter is in a mental and physical health spiral already. What more do you need to get to that point?

It makes more sense to me to have her evaluated first for anxiety and depression before just giving her SSRIs.

New patient appointments can take months for psychiatrists and some therapy practices. I would get on some waiting lists now in anticipation.

Also, given the various things you describe, has she ever been evaluated for autism?

She should be evaluated for autism as well. It presents differently in girls and is a real possibility.

That's why we wanted to get a full evaluation. I think that she has multiple things going on and it will be hard to tease out what's what until we have the whole picture. I think some of the things are feeding into each other. I don't think it makes sense to at this point to just dive in and start prescribing her medication until we have a better understanding of where she's at.

I wrote the post that said I wished we'd started medicating my kid before her evaluation. My kid has a pretty complex profile and I think taking steps to address the symptoms of her anxiety/depression with an SSRI before the evaluation would have allowed the evaluator to get a clearer picture of her needs. Hindsight is 20/20 of course, and if you're working with a spouse who is resistant, I can understand waiting. I hope your evaluation is soon.

In addition to all the dx that have been mentioned, I suggest you read up a bit on PDA (persistent drive for autonomy or pathological demand avoidance) - if you have a kid that matches this profile and you end up in a power struggle with them over food, homework, devices, etc, progress is next to impossible.

[Anonymous]

Anonymous wrote:Practical issue here for you regarding testing. You say to are pursuing testing from two different sources - school and private. The testing overlaps and some testing cannot be repeated within the year. So you may need to decide which provider you want to do which specific parts of the testing because if both do certain tests to invalidate the results.

IME, when my son’s psychiatrist recommended retesting, the psychiatrist, the school and the neuropsych all recommended that only the private neuropsych be done. Some might say the school was trying to get out of testing but I don’t believe that was the case. My son, like your daughter, is complicated and needed a more
Comprehensive approach. The downside is that it often takes longer to accomplish.

Anyway, bringing this up so you can have a conversation with your providers before you spend a lot of money and time and don’t get all of the benefit that you can.

Yes, we are trying to figure this out as we know this is a thing. This is helpful advice, thank you!

[Anonymous]

I think you are being far too influenced by your husband and not taking this seriously enough. Your daughter needs to be evaluated by an eating disorder specialist in addition to looking at OCD/ADHD/Anxiety/Autism and other alphabet soup diagnoses.

As you meet with these specialists, you need to be prepared for them to suggest that you pull this kid out of school. This sounds like a serious mental health crisis and she may refuse meds. Perhaps you won’t need this, but you and your husband need to get very serious about the fact that your child’s life may be on the line. Missing a semester of school may be the least of her/your concerns.

I am wishing nothing but the best for you. But you may need to overrule your husband here. If he is saying no to stuff, just go do as much as you can without him. There are times when you have to do the right thing over the other parent’s objection.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How do you know she doesn't feel hunger? Because she says so? Lol. She may be restricting because that is one thing she feels she has control over in a chaotic unsafe world. She will lie. That's what we with eating disorders do.

Could be. But some people really do have poor interoception. If she doesn't notice being cold, took a while to learn when she needs to pee as a toddler, stuff like that, it's interoception. Which suggests ASD.

I think this is right. (This is OP). Or it could be some of both. She has never sought out food in her entire life (except candy). She will eat it if it is conveniently prepared and presented to her. Otherwise she will not remember to eat. She's also always been a pretty picky eater and doesn't like strong flavors.

Just wanted to add that those issues can also be associated with adhd. Imagine your brain has signals with crossing guards directing traffic. With adhd, some of your crossing guards are just terrible at their jobs, or failed to show up for work. So sometimes signals like hunger, bathroom urge, etc., just don’t get through while the crossing guard lets “read this book” through for hours.

Arfid is common with ASD but can be present in other people as well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are you sure that the all-hours laptop use isn't about something not related to school, like social media or something else? And she's just making it seem like school? If she has ADHD and is getting diverted, she may not even really appreciate how much time she is losing to diversions. I'd keep a better eye on her usage.

She's not on social media. I have gone through long periods where I've monitored her computer usage closely. A little more than half of her time is spent on actual homework - which goes painstakingly slow, or she just gets stuck. She says her brain stops working and feels empty. A lot of it is massively inefficient use of her time - spending exorbitant amounts of time on things that clearly don't matter.

She also takes "brain rot" breaks which often go too long. I've discouraged her from doing this, and take movement breaks instead. I've tried to drag her out for a quick walk. If she must do the brain rot breaks, I suggest setting a timer. But like many of my suggestions and urgings, she just doesn't listen to anything we say.

She is also not on any social media and is completely disinterested in any kind of social apps or even texting her friends.

You need to actually parent. Not "suggest". Take the device away, period. No brain rot. Your "gentle" approach is failing, can't you see that? People are being harsh to you because you seem to very much need a wake up call. You say she is stubborn and uncooperative, I say anxiety disorder and OCD and maybe autistic rigidity. Maybe rejection sensitive dysphoria. Read up on the SPACE protocol-- it's designed to not require any cooperation from the kid, at all.

Speak with the school about homework. That way the reduction in workload can come from the school and she can still feel like she is doing well academically, rather than you telling her it's fine if she gets bad grades.

Yes, we are going to start taking away her devices at night and not return them to her until the next morning. If you have suggestions on how I can prevent her from taking brain rot breaks, I'm all ears.

I'll read the book. And I'll reach out to the school about pausing homework.

You sit by her and watch what she's doing. When she does brain rot, you say "No brain rot" and you take it away from her.

You can ask the school for permission to do assignments on paper instead of computer. If you don't have a 504 plan, start the process of getting one today.

For our DD we have a "homework computer" which is a separate Chromebook that is very locked-down and does not even connect to the Internet at all without a parent connecting it.

I can't realistically do this for 3 hours every evening. I also have a job that requires working some evenings. I can see what the school says about doing assignments on paper. I imagine that might be challenging since EVERYTHING is done on the computer now, AND requires internet access.

You might have to take time off from your job. Your daughter is in a serious crisis here!

If you can sit with her for a 30 minute block of focused work (or at least no brain rot) twice each day, that will help. Or you can hire someone to sit with her.

[Anonymous]

Take away her computer today. I don’t understand what you are waiting for.

[Anonymous]

Anonymous wrote:I think you are being far too influenced by your husband and not taking this seriously enough. Your daughter needs to be evaluated by an eating disorder specialist in addition to looking at OCD/ADHD/Anxiety/Autism and other alphabet soup diagnoses.

As you meet with these specialists, you need to be prepared for them to suggest that you pull this kid out of school. This sounds like a serious mental health crisis and she may refuse meds. Perhaps you won’t need this, but you and your husband need to get very serious about the fact that your child’s life may be on the line. Missing a semester of school may be the least of her/your concerns.

I am wishing nothing but the best for you. But you may need to overrule your husband here. If he is saying no to stuff, just go do as much as you can without him. There are times when you have to do the right thing over the other parent’s objection.

I would not go to an ED specialist. She needs to see an arfid soecjalkst. ED is different and if you treat arfid like an ED, it may make it worse. Most asd specialists will have at least some familiarity with arfid and there are specialists and books you can buy on Amazon that are targeted to this. But the best treatments are CBT type treatments and you need her in a slightly more receptive place before she can successfully start on that. So for the moment, you need to educate yourself on the dos and fonts with arfid.