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mbsmom

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Reply with quote  #1 
Hi! I'm back with an update on my 16 yr old. He recovered from his wisdom teeth removal easily - which is a blessing! I made smoothies 1-2 times a day but he was back to eating normally in less than a week.

The month of April was almost "normal" but this month has been a lot more challenging. Not in terms of food but anxiety. It is the last few weeks of the school year and he is under a lot of extra stress with testing, presentations and general end of year stuff. My H and I have been extra supportive to him as he moves through this period but I am also coming to the conclusion that he has more anxiety then what I originally thought. He has always been somewhat of a perfectionist and inflexible but the ED increased this. He is early in recovery and WR so hopefully some of this will decrease as he continues to heal but I also believe seeing an anxiety specialist would help. I spoke with a gentleman that works specifically with teens and young adults on anxiety, ocd, perfectionism and ridigity. This dr has a waiting list but believes his schedule will open up over the summer. I have not shared this with my s yet - waiting until after school is out. My H is not very supportive of a therapist but I think he wants to avoid any more conflict (which I totally understand).

I would love some advice on the subject - if your teen needed therapy for anxiety/ocd. Also, any advice on getting him to therapy. I can totally say this is not negotiable as he is still 16.

My worry and anxiety is once again thru the roof which doesnt help anyone (seeing a therapist myself) so feeling defeated and lacking confidence. 😔

Thanks so much. Xo
tina72

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Reply with quote  #2 
Hi mbsmom,
anxiety and perfectionsm as well as ocd are going together with the special AN character. That is something our kids had before AN and you will not get rid of that totally after WR because that is part of their genetic character. So that is the "bad news". I don´t think that therapy (normally behavioral therapy or cognitiv behavioral therapy) will help before proper WR. He cannot work with the therapist before brain healing has started.

The "good news": anxiety is increasing at the moment because of stress in school and because of getting back to WR. That is what we call "extinction burst": around the target weight anxiety and AN behaviour increases again until you got over target weight with some pounds/kilos. The stress with learning takes power from body and brain. The brain normally needs about 500 calories a day only to work. With learning for exams this can be doubled easily. My d has lost 2 kg in January only by learning for her final exams. We had to increase 300 calories a day just to keep weight. So with less stress in summer holiday and with more weight gain his anxiety and perfectionism will decrease again.

So, I would try to stay calm, increase calories during this learning period, try to give him some distraction and wait. If the anxiety and perfectionism is still going through the roof after summer holidays, you can chose plan B.
You can get him on the waiting list and try it if it is not better after summer. But be aware that this therapist should not interact with your refeeding and not make things worse by telling him he should have more freedom at his age and you should not be the food police...
Tina72
mbsmom

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Reply with quote  #3 
Quote:
Originally Posted by tina72
Hi mbsmom,
anxiety and perfectionsm as well as ocd are going together with the special AN character. That is something our kids had before AN and you will not get rid of that totally after WR because that is part of their genetic character. So that is the "bad news". I don´t think that therapy (normally behavioral therapy or cognitiv behavioral therapy) will help before proper WR. He cannot work with the therapist before brain healing has started.

The "good news": anxiety is increasing at the moment because of stress in school and because of getting back to WR. That is what we call "extinction burst": around the target weight anxiety and AN behaviour increases again until you got over target weight with some pounds/kilos. The stress with learning takes power from body and brain. The brain normally needs about 500 calories a day only to work. With learning for exams this can be doubled easily. My d has lost 2 kg in January only by learning for her final exams. We had to increase 300 calories a day just to keep weight. So with less stress in summer holiday and with more weight gain his anxiety and perfectionism will decrease again.

So, I would try to stay calm, increase calories during this learning period, try to give him some distraction and wait. If the anxiety and perfectionism is still going through the roof after summer holidays, you can chose plan B.
You can get him on the waiting list and try it if it is not better after summer. But be aware that this therapist should not interact with your refeeding and not make things worse by telling him he should have more freedom at his age and you should not be the food police...
Tina72


Thank God for you Tina! This totally makes sense! I forgot about the extinsion burst after WR. I also didnt think about needing more calories while studying. We will start those smoothies again every evening. I will expect some push back from him but that is ok. I know he will drink them and I know he likes them.

Thank you so very much!
tina72

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Reply with quote  #4 
We are still doing smoothies every day one year after WR!
Keep swimming! It will get better again soon.
Send you a big hug!
Tina72
teecee

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Reply with quote  #5 
So pleased you got through the wisdom teeth issue.
My D is in the same position as your S in terms of exams.
She is maintaining weight and in early stages of CBT for ‘perfectionism’ and I have to say it seems to have really helped with her anxiety.
She could never ever in the past (and it worsened a lot more during AN) be content we studying/relaxing in equal measure. She missed 44 days of school this year and even though she wasn’t happy about it, as she wants A* across the board, she is accepting that if she passes its a positive.
The T has helped us to understand her frustrations. She will want to please others often even if it’s something she doesn’t want. We hold back now in commenting and allow her to do things and after she’s completed the task then we offer feedback for next time without correcting her at the time.
I’m seeing positive things happening at the moment which is so encouraging.
mbsmom

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Reply with quote  #6 
Quote:
Originally Posted by tina72
We are still doing smoothies every day one year after WR!
Keep swimming! It will get better again soon.
Send you a big hug!
Tina72


I will take that hug Tina! Much needed for this mom. Xo
mbsmom

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Reply with quote  #7 
Quote:
Originally Posted by teecee
So pleased you got through the wisdom teeth issue.
My D is in the same position as your S in terms of exams.
She is maintaining weight and in early stages of CBT for ‘perfectionism’ and I have to say it seems to have really helped with her anxiety.
She could never ever in the past (and it worsened a lot more during AN) be content we studying/relaxing in equal measure. She missed 44 days of school this year and even though she wasn’t happy about it, as she wants A* across the board, she is accepting that if she passes its a positive.
The T has helped us to understand her frustrations. She will want to please others often even if it’s something she doesn’t want. We hold back now in commenting and allow her to do things and after she’s completed the task then we offer feedback for next time without correcting her at the time.
I’m seeing positive things happening at the moment which is so encouraging.


Teecee,

Thank you for your response about your daughter! I am so happy to hear therapy is going well for her. My s would really struggle with missing 44 days (so glad your daughter is handling that well as it will build resilience in her) he hated having 2 days off for his wisdom teeth and even said he felt good enough to go to school the day after surgery.

I hope her therapy continues to help her build her tool box of life long coping skills! Xo
teecee

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Reply with quote  #8 
Yes she hated having time off as she is super diligent and hated the thought of missing out. She did a lot of catch up work herself. She just couldn’t physically (initially) and mentally cope. Lots of panic but kept putting herself out there and got there.
Good luck with your S. our T feels the perfectionism may have been a potential trigger for the AN (not the sole reason obviously but if not treated he feels she may not have the skills to prevent relapse).
All the best. Xx
mbsmom

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Reply with quote  #9 
Quote:
Originally Posted by teecee
Yes she hated having time off as she is super diligent and hated the thought of missing out. She did a lot of catch up work herself. She just couldn’t physically (initially) and mentally cope. Lots of panic but kept putting herself out there and got there.
Good luck with your S. our T feels the perfectionism may have been a potential trigger for the AN (not the sole reason obviously but if not treated he feels she may not have the skills to prevent relapse).
All the best. Xx


That is what I am wondering about my s - the perfectionism being the potential trigger.
Torie

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Reply with quote  #10 
Hi mbsmom - I can totally relate to the anxiety it creates in us as our kids suffer through their final exams.  Ugh.

From my own personal experience, I can offer both good news and bad.  My d, 4 years weight restored, experienced through-the-roof anxiety during final exams this year as a freshman in university.  Just crazy stressed out.  The good news is that she made it through with good grades and her weight/eating intact and after a few days seemed no worse for the wear.

The bad news is that I have never been able to find anyone who can help her with the anxiety.  I think CBT and DBT are promising, but we've never been able to find anyone who can actually help.  Please keep us posted. xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
tina72

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Reply with quote  #11 
As the anxiety is in my eyes part of the genetic character and not caused by education or real events I think it is unlikely to get rid of it totally.
But they can learn how to comfort themself in stressy life periods and what triggers anxiety. With my d anxiety is triggered by new situations, or by having less information about something or by thinking she must deal with something alone. So it helps her to talk about new situations before (what will happen, how can she do this or that), to practise situations often, to make sure she is well informed about xy and to tell her that she is not alone and can phone xy when needed.

The perfectionsim is genetic, too, hubby has that too (without AN [wink]) and I think we can only try to show them that we love them as much when they have no A grades or when they fail with baking that cake... Life will learn them that routes are not always straight and that many ways lead to Rome and that we can stand up again and go on after we have fallen. That is something my d learned from having AN, that although she did something very harmful to her body she knows now that we love her unconditionally. And I try to show her that I make mistakes, too, because she thinks everybody around her is perfect and so she needs to be perfect, too. And that is not true.

Tina72
Foodsupport_AUS

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Reply with quote  #12 
One of the theories as to why anxiety and perfectionism are such common pre-existing traits in those with anorexia is that often these are dampened down by the illness itself. This of course means that the anxiety and perfectionism can worsen with weight gain and become a risk factor for relapse. It definitely should be treated often with CBT/DBT type skills to learn how to better cope with these issues, so I think you are correct in planning on getting him ongoing treatment. Weight and food alone only treats a small proportion of people and these are things that can need ongoing treatment. 


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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
mbsmom

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Reply with quote  #13 
Hey Ladies,

I agree with Tina that our genetic makeup can make us more sensitive to anxiety. We all have anxiety - it's evolutionary and serves a purpose to protect us from danger but some of us are naturally more cautious, fearful and sensitive so anxiety can become more of an issue.
I personally have a history of panic attacks, anxiety and some ocd - I have had cbt therapy - which is by far the best to manage symptoms. I am not surprised that my s would also have symptoms. My (non ed) d had some anxiety issues last year but we worked through it with the help of a child psychologist and this year she has been great! My s is very stubborn and a teenager so much more challenging to get him to see anyone.

Obviously, current anxiety is focused on my worry over my s - so, I am myself working with an anxiety specialist.

One book that I have had since my first panic attack at age 25 is called Hope and Help for your Nerves by Claire Weekes. It's an older book but the tools are timeless. I still refer to it when I am feeling anxious. I also think the website http://www.anxietycentre.com is a wealth of knowledge for anxiety.

mbsmom

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Reply with quote  #14 
Quote:
Originally Posted by Foodsupport_AUS
One of the theories as to why anxiety and perfectionism are such common pre-existing traits in those with anorexia is that often these are dampened down by the illness itself. This of course means that the anxiety and perfectionism can worsen with weight gain and become a risk factor for relapse. It definitely should be treated often with CBT/DBT type skills to learn how to better cope with these issues, so I think you are correct in planning on getting him ongoing treatment. Weight and food alone only treats a small proportion of people and these are things that can need ongoing treatment. 



This is very interesting! Thank you for sharing!
mbsmom

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Reply with quote  #15 
Quote:
Originally Posted by mbsmom
Hey Ladies,

I agree with Tina that our genetic makeup can make us more sensitive to anxiety. We all have anxiety - it's evolutionary and serves a purpose to protect us from danger but some of us are naturally more cautious, fearful and sensitive so anxiety can become more of an issue.
I personally have a history of panic attacks, anxiety and some ocd - I have had cbt therapy - which is by far the best to manage symptoms. I am not surprised that my s would also have symptoms. My (non ed) d had some anxiety issues last year but we worked through it with the help of a child psychologist and this year she has been great! My s is very stubborn and a teenager so much more challenging to get him to see anyone.

Obviously, current anxiety is focused on my worry over my s - so, I am myself working with an anxiety specialist.

One book that I have had since my first panic attack at age 25 is called Hope and Help for your Nerves by Claire Weekes. It's an older book but the tools are timeless. I still refer to it when I am feeling anxious. I also think the website http://www.anxietycentre.com is a wealth of knowledge for anxiety.



I want to add that my anxiety can go into what I consider *remission* for long periods and will re-emerge with a major stressful event/change or too many changes at one time. That is when I jump back into therapy for a refresher.
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