I don’t know if you’re still reading, OP, but I totally understand what it’s like to feel overwhelmed and paralyzed into inaction. Do you have a trusted person in your life who will keep information confidential and would help you? If a friend or relative told me they needed some extra support, hand holding, a shoulder to cry on, someone to do some research or make some phone calls for them, I’d be happy to step up. You don’t have to bear all burdens alone. Let the people who love you help you out. Even if you don’t feel ready to share your DD’s struggles yet, someone may have some suggestions for resources to help your parent with health issues and dementia. This is not the time to be too proud to ask for help. I’m praying for your family.

I’m not sure I buy into the “be more strict” posters

I think you have moved way beyond the territory of trying to impose limits and parent this issue away. I need to jump directly to professional help

A lot of these behaviors sound exactly like my friend who ended up hospitalized for eating disorders, particularly all of the control issues and the inability to skip a process or have any flexibility. Those are all classic eating disorder symptoms. Once you are into the eating disorder territory, there is no amount of love or kind suggestions that are going to help because there is the body dysmorphia aspect, which means your goals will not match her goals.

I unfortunately don’t have any really helpful suggestions because I don’t know what the solution is, but I don’t think the strict parenting approach is going to do anything other than waste more time when you need to be getting eating disorder treatment ASAP

OP, you asked for help and you have received it.

I'm guessing most of us doing the advising have been where you are - an ignorant parent who is completely out of her depth, overwhelmed by what she may be facing and frozen.

A full evaluation is unlikely to spit out a perfect plan for your kid. Waiting for things to get worse is foolish (I know this because I did what you did until my kid was suicidal). Make the psych appointment. That is your best first step here, in addition to planning the full neuropsych which could be many months away.

Feed your kid anything she will eat in the mean time. (I have a kid with Arfid who drinks gallons of chocolate milk. )

This is NOT going to get less overwhelming.

The pediatrician should be a wakeup call. They have nurse practitioners who can walk you through what you need to do and have al list of psychiatrists who can help. Pediatrician is not likely to feel comfortable prescribing an SSRI, so you need to find a psychiatrist and there are many who will not have a waiting list. Psych evaluations take at least a week or two...intake from parents and child and then coming back with recommendations. Your first call after pediatrician is a psychiatrist and then find a good therapist who can work weekly. Through that you can do the evaluations.

OP you need to take this seriously. Your daughter has real problems. I read through this entire thread because it reminded me of the first phase of my sibling’s mental health crisis (depression) that ended in suicide. You can not continue to punt like this. The pediatrician has already flagged failure to grow and she is eating less!!! On that alone how have you not taken her back to the pediatrician and gotten help!!!

I am going to be blunt and harsh here. It sounds like you and your husband have no perspective on how badly your child is doing. So you need other people who have better judgement involved TODAY. Start with the pediatrician and BE HONEST and ask them how much of a crisis this is. They can also help you get in earlier with a specialist sometimes and can help you identify the points at which you escalate to in patient or crisis treatment.

I hope it doesn’t come to that but you are wringing your hands and talking about homework and using the excuse of waiting for the perfect evaluation when your child is actively worsening and that is not ok. I know my parents would give anything for the chance to go back in time and take medical leave and get my sibling they help they needed.

Anonymous wrote:OP here with another question, that I hope doesn't get lost in the thread.

Is this also something I should bring up with the pediatrician? Is that helpful at all? What are the pros and cons?

The pediatrician can see you quickly and start her on an SSRI. The speed is key because SSRIs can take awhile to be fully effective.

You don’t seem to realize your kid is in crisis. Right now. Not “might become a crisis.” She is IN crisis, clearly a mix of anxiety, ADHD, and eating disorder. She needs immediate help, jot future evaluations.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Is she on any medication?

No. Hesitant to do so for many reasons. Worries it will suppress her appetite even more. She doesn’t experience hunger as it is and has fallen off the growth curve.

She also may have a heart condition that would be exacerbated by any stimulants.

She’s also still very young and hasn’t hit puberty yet, so I’m wary of putting anything in her system before she even hits her key growth stage.

Stimulants are for ADHD. Anxiety is treated with an SSRI or an SNRI. I’m not a Dr so I won’t say they can’t impact appetitive but I have 2 kids on anxiety meds and it’s never impacted their appetites.

OP, I’m also going to add that anxiety meds don’t necessarily take away appetite. There are many choices. You are making a big mistake to trialing medication - multiple if necessary. Her anxiety is too big to control through therapy or parental support and consequences. You have a lot of incorrect assumptions about the side effects of the medications she might need - incorrect assumptions that are preventing her from getting the help she needs. also, I would rather have a kid who turns out to be shorter but happy and able to function in school.

Also, she needs a 504 plan at school.

Does she have a therapist?

She definitely needs an evaluation - I guarantee there is an underlying component that is not anxiety that is making school work so hard. IQ, working memory, processing speed, reading, math, writing, attention, language processing, executive function, anxiety, depression and executive function - all should be assessed by normed standardized instruments. If you can only afford a school assessment, that is better than nothing, and you can ask for an IEE if you want an outside opinion after that. Or you can take the school assessment to an educational advocate or psychologist and get an independent review of the testing.

Anonymous wrote:OP here. I've read all the responses and really appreciate the helpful advice. To be honest, I'm starting to feel a bit overwhelmed now and think I need to take a day to digest. There are other things going on in my life as well, including a parent with health issues and dementia.

I am so thankful for the feedback though and it's really helped. Will come back to this when I have the bandwidth.

OP, you need to buck up and deal with this. I'm sorry you are overwhelmed but that's part of the job. Help your kid and stand up to your husband. His narrow views of what is acceptable (only EF support!!) and your timidity has allowed your kid to drive this bus when she is not equipped to do so. This is not normal kid oppositional behavior and you have to stop thinking about this as a behavioral issue at all. Something very bad is going on and your kid needs a strong hand to intervene and be the parent here.

My parents were like this -- they were weak and not on the same page and let me flail. I self-diagnosed myself with ADHD in the 90's (later confirmed as an adult) and I also clearly had multiple bouts of depression in hindsight. My mother's response when I told her at 15 that I thought I had ADHD and needed help? She burst into tears, sobbed about how I'd "always been so smart" and NEVER SAID A WORD ABOUT IT AGAIN in the 30 years since. She was too afraid to rock the boat, too afraid to even broach the topic with my dad who does not "believe" in such things even though he is also clearly neurodivergent, and I was just left to deal with all of my issues on my own. I made it through, but MY GOD if I'd only had someone to be an adult and help me, how much easier my life could have been.

Anonymous wrote:

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.

Mental health diagnoses are often made by psychiatrists. You need a neuropsych for developmental diagnoses like ADHD, autism, learning disabilities that could be playing a role, but anxiety related diagnoses and eating disorder related diagnoses would be made by a psychiatrist, so OP can go ahead and schedule that. Generally pediatric psychiatrists have long wait times for appointments, so starting that process now makes sense.

Anonymous wrote:

Anonymous wrote:Is she on any medication?

No. Hesitant to do so for many reasons. Worries it will suppress her appetite even more. She doesn’t experience hunger as it is and has fallen off the growth curve.

She also may have a heart condition that would be exacerbated by any stimulants.

She’s also still very young and hasn’t hit puberty yet, so I’m wary of putting anything in her system before she even hits her key growth stage.

I was thinking an SSRI for the anxiety which also can cause weight gain or hunger.

I was a teen (of course undiagnosed in the 90s) with ADHD, anxiety and disorder eating. I don’t like what you have described. Kids with eating disorders will fight you to death before admitting there is a problem. 1) They don’t think there is 2)If they do think secretly think there is a problem, they aren’t ready to give up their disordered eating and the sense of control and release it brings them.

Anonymous wrote:OP here. I've read all the responses and really appreciate the helpful advice. To be honest, I'm starting to feel a bit overwhelmed now and think I need to take a day to digest. There are other things going on in my life as well, including a parent with health issues and dementia.

I am so thankful for the feedback though and it's really helped. Will come back to this when I have the bandwidth.

I think you're continuing to delay. As you have been doing for years. Sorry to be harsh but your daughter needs you.

Send an email to the school today. It should say "I am requesting a 504 plan for my daughter. Please respond with a date and time that we can meet about this." It's as simple as that.

Anonymous wrote:

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.

ARFID is an ED. I am really confused by your post. ARFID treatment is different from the treatment for anorexia, which is different from the treatment for bulimia, but they are all ED's, and need a clinician who understands ED's (aka an ED specialist).

I'm not saying that's what OP needs. A neuropsych appointment, if they can get in quickly, is the right first step, to consider all possibilities. Starting with the big picture and narrowing it down to a specific diagnosis will help. Having said that, if the weight loss is significant and there are concerns about it impacting her heart, an inpatient admittance might speed things up.

It gets worse when they get older, like a teenager who doesn't hear ya!

What is she doing during the brain rot breaks? And how much homework are we talking about here? A kid that ate with those difficulties should not be doing hours a night. It’s just not realistic.
There were years when I just basically said “we aren’t doing homework” because it really was too much for my kid. After sitting in class for a long day, it’s a lot to ask them to sit at the computer and do more work for hours.

I would be tempted to say something like — 20 minutes of work. Take a 10 minute break for a snack or to do sometime tell Just Dance (I know that’s dated — but is there something similar?). Then back for another 15-20 minutes and then that’s it. Ask teachers if there is homework you can front load over the weekend. Pick which classes the homework actually matters for (math?) or the classes where she might like the homework. IME, you can skip most of HW for a class and still end up with a C or even a B. That might be the right call here for a while.

She probably has the brain maturity of like a 10 year old but the school now treats 13 year olds like 15 year olds, so the gap is too large.

OP here. I've read all the responses and really appreciate the helpful advice. To be honest, I'm starting to feel a bit overwhelmed now and think I need to take a day to digest. There are other things going on in my life as well, including a parent with health issues and dementia.

I am so thankful for the feedback though and it's really helped. Will come back to this when I have the bandwidth.