I haven't posted for a while. This is a bit of a convoluted story.
The background is that my 14 y/o daughter was diagnosed with anorexia Dec 17 aged 12. Took a long time to refeed but currently good weight for height. ( 163 cms 55/56 kgs). We are associated with CMHS but D would never engage in talking about her negative thoughts about her appearance/ anorexic thoughts I guess. Currently she eats what is given but not a scrap more and trying a bit of sneaky restricting lately). OK do you really feel she is WR? And is she is at her historical weight for age?
Various meds have been tried: olanzapine, fluexatine- a disastrous reaction,back to olanzapine, quetiapine, then added lexapro- another disastrous reaction where it increased her anxiety to the point where she couldn't leave the house and made her stutter- which she is just now recovering from.
Honestly I have pretty much lost faith in meds and feel that olanzapine was possibly the best of the bunch, Seeing her psych tomorrow and plan to ask for no meds at all just so the poor kid can clean out and we can see where she is . Remember depending on meds, it may take a while to get out of the system and depending on the dose there may be side effects (undesirable) as weaning off them.
Good to discuss with the doc.
Social anxiety has been becoming increasingly apparent. On reflection she possibly had this all along to a lesser degree, which I know can be common. Over Christmas she stopped participating in healthy outdoor activities, swimming, walking, bike riding and now does no exercise due to her anxiety I believe ( thinking she is too fat to be able to do this stuff).Yes very common to be co-morbid and something that needs addressing properly.
In the 2nd half of last year she began having panic/anxiety around attending school and this has escalated to a worrying level. She is worried about what people think of her, says she is too fat to be herself, being alone at school, friends,people asking why she has been away, sports uniform, doing sport.....She has been isolating herself from her peers, and compares herself to them and finds herself lacking. She was unhappy about my supporting her with lunch at school and we trialled backing off from this but she wasn't eating her lunch. When I said I would have to start supporting her at lunch again this escalated the school avoidance. We tried some half days around this.This anxiety is common for her age BUT it is seems more that normal. Is she eating lunch now? and if not you may need to go and supervise her. Or would a friend be trusted? I normally would not recommend that but if she feels less upset that you are not supervising could a friend that you trust help out sometimes and not all the time.
She has not managed to return to school this term, asks about home schooling/ distance educationI think trying to do some with in class too may be a balance. Can you do a bit of in school and on line learning?
I do think trying to get her to face her fears a bit has to happen. How do we overcome our fears if we do not face them, even if you need to do it slowly over time. Can you acknowledge her fears and also push her a bit?
. I have started exploring this as it can take several weeks to get this started, but have not decided myself either way, just hedging my bets. The therapist has been "surprised" that she hasn't returned to school as she told her how important is was- DUH!! Therapist told me that the issues my D is scared of re school needed to be resolved with the school. So I arranged a meeting. I contacted the therapist for a support letter for distance ed and she today ( well yesterday now as its 4 am) told me that the process is that she needs to meet with the school and return to school needs to be explored before distance education.
So i met with the school today/ yesterday to talk about some of the issues, they are happy to do whatever they can, we came up with some ideas and keen to meet with the therapist to develop a " return to school plan" .. ( Silent scream) Add another week for this. I stated that I will continue to explore distance ed due to time factors.I think that is fair and well thought out.
My thoughts are that Distance education is not ideal and it will isolate my D further. It will also isolate me further as she will need to be supervised and cause additional ongoing financial stress as I cannot return to work. So I would rather she went back to school. But honestly I don't think she is capable of returning to school, it is too much.
To me she seems very unwell and I believe anorexic thoughts have strengthened in recent times. It is all very well for them all to have their " return to school plan" and write their case notes but at the crux of it is that I don't think I will be able to get her out the door.Can you go to school with her and sit in the parking lot first, then into the school when no kids are in the halls, then into the office. If it takes one whole week or more to do one thing at a time, baby baby steps moving her closer to the school or even outside your own door of your house. What can she do a bit of? Coach her on the small steps out of the house first, then 10 steps from the house. Will she drive in the car? Go anywhere at all outside the house?
Sometimes I get the impression that people think I don't try hard enough!!!Well you know we know how hard you are trying! We really know!
Have had ideas around developing an agreement with D around distance ed including outings, social and peer contact etc but do not know how ( if she agreed) I could make this happen in the face of her refusal/ fear. Slow steps, first outside the door, then a few feet away from the door. Until you can get her away from the house, yes online schooling may be best while you work open moving her outside. Well she may not agree and you may need to do it anyway you can. Her default may be always to agree with you now, but then when it is time for an outing etc.. she may flat out refuse and you need to do what you plan. To get through you have to go through.
I need to decide this week so am gathering information and asking opinions and that includes you guys. My Husband says I am smarter than him so he will go with whatever I decide. My family says she really should go back to school, risk of further isolation at home. My D says she doesn't care about her education , friends or getting a job one day she just wants to stay at home. ( I know this comes from fear and panic). But I also know she also thinks I don't listen to her and disempowered ( refeeding etc).It feels so hard right now. I can sense that. What one thing can you work on right now? Is it getting her outside? Then do that. She is only 14 and school can wait if she cannot go right now. Her other issues take precedence as well as her eating properly too.Getting them out and feeding are similar. Exposure exposure exposure. Simple things you think she and you can manage first. Take the "first bite" by doing something tiny, gain the confidence then add again. Laddering approach.
On reading over this I can hear my stress, yes I am seeing someone for myself and will ask her opinion tomorrow. I am glad for that.
Thanks for listening.Anytime!