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Mental health

Anxiety in children

19 replies

cocolepew · 10/11/2009 09:32

I hope nobody minds me posting here. my DD has anxiety, she's 11, she is having thoughts or impulses to harm herself. She is saying the thought pops into her head to kill herself but she doesn't want to.

I took her to hospital last Thursday when this first happened, she was assessed by the crisis team and we saw one of them again yesterday. She is going to have therapy within the next few weeks.

I've had to keep her of school today as she can't rid her head of the impulse, I've left a message at the teams center.

She is taking all the awful things that happen in the world onto her shoulders and can't cope. She just seem exhausted.

I don't know what to say to reassure her, I'm trying to help her to forget the thoughts by distraction.

There isn't really a point to this post. I just feel so alone and sad for her

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madmouse · 10/11/2009 10:56

Why would any one mind you posting here hun - children struggle with mental health problems just as much as adults. well done for taking her so seriously.

All I can say is big hugs and I think you are doing all the right things and thankfully so is CAMS from the sound of it.

She must trust you very much as a mum because she shares all these feelings with you.

It must be so so hard for you - when they hurt their knee you stick a plaster on but this is in a totally different league and must be so sad and stressful for all of you.

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cocolepew · 10/11/2009 11:52

Thank you MM. The crisis team member who we are dealing with has rung back. There isn't much we can do until she has her Drs appointment through. Just to reassure and distract her from her thoughts. We can go to see him tomorrow but she needs to know he isn't her longterm help.

I'm a bundle of nerves myself. She has a genetic medical condition which anxiety is a part of and we are going to have her assessed for Aspergers.

I just wish we were weeks ahead and she was well again.

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Winetimeisfinetime · 10/11/2009 11:55

coco I don't have much experience of this as a parent but was myself a very anxious and sensitive child. I agree with madmouse that you are doing all the right things and that it is good that she trusts you with her feelings and is open with you. Hopefully once she starts therapy it will help her get her feelings in perspective and not feel so overwhelmed by them.

I had a quick look on Amazon and found this there is also a version aimed at adults which might be more appropriate as your dd is older. I wondered if this sort of book might help you both whilst you're waiting for the therapy to start.

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cocolepew · 10/11/2009 12:08

Thanks for the link, I'm sure the book would be useful.

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claw3 · 10/11/2009 12:15

My ds is a very anxious child, he wants to stay in bed and die and has all kinds of anxieties and phobias, so i can sympathise with you totally. (He is only 5.5)

He is awaiting a referral to CAMHS, one of the things we have is a 'worry box' where we write/draw on a piece of paper what is worrying him, we then talk about it ie 'i would do x in that situation' and throw the 'worry' ie piece of paper away.

Another thing we do is to pre-warn him about things (thereby alleviating some anxiety)

Hope this may be of some help to you.

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spinspinsugar · 10/11/2009 12:23

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cocolepew · 10/11/2009 12:37

I was just going to link to that book for Claw3 DD found it helpful when she was younger.

I had thought of OCD from reading other posts on here. I think the therapist might try EMDR with her which I think is similar to CBT.

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claw3 · 10/11/2009 12:49

Thanks coco, i also have some info on anxiety from the NAS, i notice you mention Aspergers (ds is suspected of being on the spectrum) I can copy and paste if you feel it would help?

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cocolepew · 10/11/2009 13:02

Yes please Claw. DD has a condition called NF1. It's very complex, I work in a Special School in the Autism unit so I picked up on DD being similar to Aspergers. It's now coming to light, through studies in the U.S that there is a definate link between ASD and NF1. There is also a heightened risk of anxiety getting serious in adolencents with NF1.

There seems to be a lot against her at the moment.

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claw3 · 10/11/2009 13:09

What is NF1? My own ds, has been recognised to have sensory modulation disorder (involves lots of sensory issues, which in turn lead to anxieties) SMD is apparently a symptom of ASD, which often goes unrecognised.

Here you go, here is the info----This information sheet tells you about anxiety in adults with an autism spectrum disorder (ASD). It tells you how anxiety affects someone psychologically and physically. It tells you about different ways to help manage anxiety, from keeping a diary to learning relaxation techniques and getting support from others in a similar situation.

Anxiety in someone with an ASD

Anxiety is common in people with an ASD. It can happen for a range of reasons and people can vary in their ability to cope with it. Anxiety can affect both the mind and the body, and produce a range of symptoms. The psychological and physical symptoms of anxiety are closely linked and so can lead to a vicious cycle that can be difficult to break. The psychological symptoms of anxiety are:

? easily losing patience
? difficulty concentrating
? thinking constantly about the worst outcome
? difficulty sleeping
? depression
? becoming preoccupied with or obsessive about one subject.

Its physical symptoms include:

? excessive thirst
? stomach upsets
? loose bowel movements
? frequent urinating (going to the loo)
? periods of intensely pounding heart
? periods of having gas
? muscle aches
? headaches
? dizziness
? pins and needles
? tremors.


If you do experience any of these symptoms, it is important to also get medical advice to rule out other medical conditions.

Understanding anxiety

Emotions are abstract. To understand emotion you need an imagination. One of the areas of difficulty for people with an ASD is not being to imagine things so understanding emotions can be difficult for them. People with high-functioning autism may understand some emotions and recognise the feelings that are associated with them. By helping someone to understand anxiety, you can help them to manage it better.

Resources such as those sold by Incentive Plus (see Further information and contact details) as well as the Autism Research Centre?s CD ROM, Mind reading (available from NAS publications; contact details below), can help teach someone with an ASD about emotions.

Strategies for managing anxiety

Once someone understands anxiety and has identified the things and situations that make them anxious, they can then take steps to cope with the anxiety. If you are looking after someone with an ASD, try and be aware of what makes them anxious and how best to help them manage certain behaviours.

Keep a diary

To help someone with an ASD understand anxiety, get them to understand the symptoms they display when they are anxious and to look at the causes of their anxiety. Keeping a diary in which they write about certain situations and how these make them feel may help them to understand their anxiety and manage it better.
Use the diary also to think about the physical changes linked to anxiety. Someone with an ASD often retreats into their particular interest if they are anxious about something ? use the diary to monitor this as well:

Time and date Situation How I felt at the time On a scale of one to ten, how anxious did I feel?



Meltdown prevention plan

Create an ?anxiety plan? when someone with an ASD is feeling positive about things. An anxiety plan is a list of things and situations that cause anxiety as well as solutions and strategies they can use to help them manage their anxiety levels. The plan can be adapted, depending upon how well someone understands anxiety:

Situation
Symptoms of anxiety Solution
Going on the bus
Hearts beats fast; sweat and feel sick. Have stress ball in pocket.
Squeeze the ball and take deep breaths.
Listen to music.

Relaxation techniques

Someone with an ASD can find it very difficult to relax. Some people with an ASD have a particular interest or activity they like to do because it helps them relax. If they use these to relax, it may help to build them into their daily routine. However, this interest or activity can itself be the source of behavioural difficulties at times, especially if they?re unable to follow their interest or do the activity at a particular moment.
Some people may need to be left alone for short periods of the day to help them unwind.
Physical activity can also often help to manage anxiety and release tension. Using deep breathing exercises to relax can be helpful as can activities such as yoga and Pilates, which both focus on breathing to relax. Use a visual timetable or write a list to help remind the person when they need to practice relaxation.

Any other activities that are pleasant and calming ? such as taking a bath, listening to relaxing music, aromatherapy, playing on a computer ? may also help reduce anxiety. Some people may find lights particularly soothing, especially those of a repetitive nature, such as spinning lights or bubble tubes.

You may need to encourage adults who are less able to take part in these activities so that they can enjoy their benefits. You can do this by explaining when and where they will do the activity and what it will involve. You may have to go along with the person at first and do short periods of activity to begin with.

Talking about anxiety

Some people with an ASD find direct confrontation difficult. They may therefore be unable to say they don?t like certain things or situations, which will raise their anxiety levels. If they identify they are anxious, they could use a card system to let family or friends around them know how they are feeling. At first, you may need to tell them when to use the card and prompt them to use it when they do become anxious.

They could also carry a card around with them to remind themselves of what they need to do if they start getting anxious. You could also give them a ?stress scale? that they can use whenever they find something particularly stressful.

It may help them to buy our Autism Alert card, which is the size of a credit card. They can use the card to let members of the public know they have an ASD. The Autism Alert card is available from NAS publications (see contact details below).

Getting support from other people with an ASD

Personal accounts

It may help someone with an ASD to read the personal accounts of other people who also have an ASD, and to see how they dealt with certain situations and managed any anxiety they experienced. A number of people with an ASD have written personal accounts of their experiences:

*Glass half empty, glass half full: how Asperger?s syndrome has changed my life by Chris Mitchell

*Making sense of the unfeasible: my life journey with Asperger syndrome by Mark Fleisher

*Thinking in pictures by Temple Grandin

We also produce a quarterly newsletter called Asperger United. It is written by people with an ASD and includes personal accounts of having an ASD. Contact us to subscribe to the newsletter.

Online resources

The following online resources may be helpful to someone with an ASD as they are all aimed specifically at people with ASDs:

? www.aspiesforfreedom.com
This site has a range of forums and a chat room, articles and lots of information and aims to help build the autism culture.
? www.assupportgrouponline.co.uk
This website is run by Emma Thomson, who has an ASD. It has lots of information, including a blog.
? www.autism.org.uk/nas/jsp/polopoly.jsp?d=120
This is on the NAS website and includes personal stories, thoughts, reflections, short films, articles and lecture transcripts about life on the spectrum from people with ASDs.
? www.inlv.demon.nl/irc.asperger
This website is for people with ASDs and its priority is to provide support.
? www-users.cs.york.ac.uk/~alistair/survival
This website includes chapters from a book by Marc Segar, who had an ASD. ?Coping: A Survival Guide for People with Asperger Syndrome? has tips and advice on how to cope with a range of feelings, written from the perspective of someone with an ASD. For example, Marc not only talks about the unwritten rules about behaviour, but offers lots of tips and advice.
? www.wrongplanet.net
This website is designed for individuals and parents of people with ASDs. It has a discussion forum, a section for articles, ?how-to guides? and a chatroom for real-time communication.

The resources on external websites are provided for your help and information only. They are sites maintained by other groups, organisations and individuals and are provided in good faith. The presence of a website does not necessarily imply that the NAS endorses or supports the originator(s), nor does the absence of a group imply that the NAS does not support it, and cannot be held responsible for the quality of the information provided.

Support groups

Going to a support group for people with ASDs means meeting other people with ASDs, which can be helpful in some cases. Different support groups will offer different activities, from going on outings to discussion groups about particular topics. Go to www.autism.org.uk/directory for information about support groups in the UK. You can also contact our Autism Helpline to help find various services.

Getting specialist help

Some people with an ASD are not able to identify their anxiety or to put in place strategies to manage it on their own. A specialist or a counsellor with experience of ASDs may be able to help them. Our Autism Helpline has details of counsellors and specialists in different areas.

The following information sheets may also help and are available from our Autism Helpline:

? Counselling
? Counsellors and psychotherapists: a guide
? Obsessions, repetitive behaviours and routines
? Organisation, sequencing and prioritising
? Preparing a person with autism spectrum disorder for change
? Social skills: an introduction
? Understanding behaviour
? Using visual support

Further information and contact details
Incentive Plus
6 Fernifield Farm
Little Horwood
Milton Keynes
MK 17 ORP
Tel: 0845 180 0140
www.incentiveplus.co.uk
Incentive Plus sells a range of resources to promote social and emotional skills.

Recommended reading

  • Attwood, T. (1993). Why does Chris do that? Some suggestions regarding the cause and management of the unusual behaviour of children and adults with autism and Asperger syndrome.
    London: The National Autistic Society
  • Attwood, T. (2006). The complete guide to Asperger's syndrome. London: The National Autistic Society

    Bourne, E.J. (2005). The Anxiety and Phobia Workbook. USA: New Harbinger Publications

    Cuomo, N. (2007). Integrated Yoga - Yoga with a Sensory Integrative Approach.
    London: Jessica Kingsley Publishers

  • Ghaziuddin, M. (2005). Mental health aspects of autism and Asperger syndrome.
    London: Jessica Kingsley Publishers

    Greenberger, D. and Padesky, C. A. (1995). Mind over Mood: Change how you feel by changing the way you think: London: The Guildford Press

  • May, F. (2005). Understanding behaviour. London: The National Autistic Society

    Mind. (2006). The Mind guide to relaxation. London: MIND

    Trickett, S. (1997). Coping with anxiety and depression. London: Sheldon Press

    Williams, D. (2003). Exposure Anxiety - The Invisible Cage. An Exploration of Self-Protection Responses in the Autism Spectrum and Beyond. London: Jessica Kingsley Publishers

  • Wing, L. (2006). What?s so special about autism? London: The National Autistic Society

    *If an item is marked as available from the NAS please contact:
    NAS Publications
    Central Books Ltd
    99 Wallis Road
    London E9 5LN
    Tel: +44 (0)845 458 9911
    Fax: +44 (0)845 458 9912
    Email: [email protected]
    Online orders: www.autism.org.uk/pubs

    If you require further information please contact the
    NAS Autism Helpline
    Tel: 0845 070 4004
    [email protected]

    Last updated: June 2009
    © The National Autistic Society 2009
    The National Autistic Society is the UK?s leading charity for people affected by autism.
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cocolepew · 10/11/2009 13:18

NF YThanks for that the physical symptons are very interesting.

DD doesn't have any educational difficulties, she's actually very bright. But she's very naive and I admit we have sheltered her to protect her from being too anxious. Now she is frightened of puberty and is aware of the world. She likes fantasy, Dr Who, Harry P, Twilight, Merlin etc and I think she has realised that the world is a horrible place and can't be fixed with magic.

She always presumes the worst is going to happen. At her school yesterday they said it might not be the right one for her (it's slightly rough) and because she got an A in her 11+ (we're in N.I) what about a Gramma r? But the local Grammar would put too much pressure on her academically and I want her to be happyat school. I couldn't care less if she left with no exams TBH. She says she loves school.

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claw3 · 10/11/2009 13:25

Coco - Link was interesting, i note nerves are mentioned, my ds's disorder is related to the central nervous system. Does you dd have any sensory problems? For example my ds is over responsive to noise.

Ds, academically he is very bright, something which served as a bit of red herring to me (not suggesting this is the case for you of course)

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cocolepew · 10/11/2009 13:33

DD is very sensitive to texture , she doesn't like to try new foods and certain foods make her vomit just by looking at them, eg blueberry youghurt, melted chocolate. She's sensitive to noise, a balloon popping sends her into orbit.

I don't know if it's a placebo effect but she relies on these If you go to the personal remedy mixer youcan get one tailored to you or your childs needs.

We've coped with her anxiety all her life, it's got to the stage now where we are not enough to soothe and help her.

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claw3 · 10/11/2009 13:41

Your dd does sound similar to my ds in some respect! Ds doesnt like bright lights, loud noises, textures, very limited diet,food phobias, water phobias and even a baby phobia now! (babies touch you and cry loudly, so are to be avoided)

Your dd is quite a bit older than my ds, i assume you have already tried the suggestions in the NAS info ie stress ball, diary etc?

I was impressed with the diary and will be giving that a try, even though ds is very bright i think its difficult for him to understand why he feels like this, especially as he sees others coping with the things he finds difficult ifswim.

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cocolepew · 10/11/2009 13:49

It is hard for them to understand, we always thought DD might need therapy if she couldn't cope with her anxiety as she got older but we didn't hink it would occur through a crisis.

The crisis tem member asked a Consultant for advice. He knew a bit about NF but they have said they wanted DD to get her treatment before we got in touch with her medical consultants. I'm a bit about that.

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claw3 · 10/11/2009 13:50

Would also suggest posting your thread on the special needs section. Im sure there are lots of parents on there, who have to deal with anxiety as a side dish to a disorder and have older children and lots of helpful ways that may be of some help to you.

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claw3 · 10/11/2009 13:55

I suppose they need to assess her first and make sure they are the right service before they do too much work!

What seems like common sense to us is often double dutch to them!

Anyway i must dash and do some housework, will keep an eye on the thread and let you know if i can think of anything which might help. Must be very upsetting for you.

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cocolepew · 10/11/2009 14:18

Thanks

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spinspinsugar · 10/11/2009 21:10

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