I read so many posts on here about increased anxiety experienced by children when they reach weight recovered.
Does anybody know of any actual research / evidence to prove that this phenomena happens, other than anecdotal evidence from parents. I believe it definitely does happen.
After a long hard slog of refeeding my D achieved 104% weight for height and is now deemed weight recovered by CAHMS. There’s lots of work to be done with her, though to address ED behaviours.
However, this was met with a huge increase in her anxiety levels, a drop in her mood, and the commencement of self/harming, resulting in an urgent referral to the psychiatrist and her being placed on medication for extreme anxiety. She is eating well but her anxiety is such that we now cannot get her into school and we believe that she needs a period of time off, to allow her to heal and to deal with her anxiety.
The school are supportive and, for the moment they accept that she is too ill to go in school. Unfortunately this assessment is not supported by the CAHMS therapist who says that, taking into account her physical and mental health, as she is weight recovered, ‘there is no reason why she should not be in school’.
CAHMS say that, because she is weight recovered, the anxiety therefore must be being caused by other factors than the ED, so she simply has general Anxieties about going into school as any other child could have. They refused to take account of the fact that she was only diagnosed with anorexia in May, and only just achieved 104% weight for height.
They are making a distinction between anxiety that is caused through having an eating disorder and anxiety that is caused by being in school, despite the fact that my D cannot articulate what her anxieties are about school, she just says she can’t make it into school anymore as she feels she will have an emotional breakdown whilst there. In the last few weeks we have been getting her into school but she has not been eating there and we have had to bring her home on a few occasions. Now it is impossible to get her in school and she has panic attacks just at the thought of going to school.
However CAHMS are making a clear distinction, and saying that the problem with going in school is definitely not connected to having an eating disorder.
In the UK, in order for schools to authorise long-term (more than a couple of weeks) absences for illness there must be confirmation from a psychiatrist (in CAHMS usually) to confirm that the child is too ill to be in school. At the moment CAHMS are refusing to provide this confirmation for our D.
It is causing problems because, without the support of CAHMS , the school may not now be able to access extra funding to give my D support while she is not in school and to prepare to support her to reintegrate back into school when she’s ready.
Also, in the UK some parents have been prosecuted in cases where they have kept their their children off school due due being mentally ill, but they have been unable to get the medical opinion from CAHMS (for various reasons including being on long waiting lists) that they are too ill to be in school, so I am quite worried about this as the last thing we need to be doing now is defending ourselves against legal action
The assessment that our D is not well enough to be in school was agreed at a joint meeting of professionals involved in the case, including various members of the school, pastoral care, the school counsellor the school attendance officer and the deputy head. They agreed a package of measures to provide my D support while she is still at home, sending work home etc and measures to slowly help her to get back into school when she’s ready, including extra tuition to help her catch up with studies. The CAHMS therapist was at the meeting and she was the only one who disagreed with the conclusion that D needs to be off school and gave the contrary opinion that my D needed less support, not more support, and to be given the responsibility for attending school. Unfortunately I was not present at that meeting so was not able to challenge the therapist directly. That is a another story!
I have discussed this with the therapist in private and she recognises that she is in disagreement with everybody else involved but that this is her honest opinion, as she is worried that our D will become over dependent on being at home and will find it difficult to get back into school if she has an extended period of absence.
I am going to seek a meeting with the clinical lead on the CAHMS team and challenge the therapist assessment that she is healthy enough to be in school so I am looking for some actual research / evidence to show that anxiety occurs at weight recovered, to back up my argument. I’m fully aware of all the experiences of parents and the anecdotal evidence. I fully accept state and weight but, going off past experience, I fear CAHMS will not accept anecdotal evidence. I’m hoping to be able to get the therapist to reconsider her opinion that my D is well enough to be in school so that we can get on with providing the support that she so badly needs