Has my 4 year old got a mental health problem - does anyone recognise these behaviours?

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I have a beautiful four year old DD, very bright with an incredible memory, witty, friendly, loving and caring. But she's also so highly strung, anxious and insecure. She 'prefers' clothes with a certain type of label in them and can tell the difference between shops, she likes to stroke the labels when she feels anxious or upset. She has horrendous separation anxiety to the point it's crippling her, we had to pull her out of nursery and defer starting school. She doesn't like to go far from home and doesn't like people coming to 'her' home. She can't 'switch off' at bedtime and has to be exhausted to be able to fall asleep and then comes in to our bed during the night. She has a constant energy all day.

There's no trauma, bereavement, separation (DP and I are together), very loving and stable home life, we're very hands on and affectionate parents.

We've seen the GP several times but they keep telling us its general anxiety. But general anxiety in a four year old can't be normal right? Has anyone else experienced this and was there a medical condition (mental or otherwise) that turned out to be the root of the problem?

Hi OP,

Maybe go back to GP and specifically ask for referral to CAMHS/ paediatrician as they will be best placed to help with exploring any underlying issues.

An occupational therapist may also be able to help explore her sensory profile.

You could also look at resources for mindfulness for kids such as mindful monsters. There are some nice activities you could do together at home to help her with anxiety.

Also try googling social stories and comic strip conversations: these may help you work through some of her feelings and scary situations with her in a way that is accessible to a 4 year old.

The thing is without professional assessment from a Paediatrician you won't know what the problem is - and if your daughter needs support in school then that might be minimal to non existent without having seen a Paediatrician.

But saying that, by not making her gradually face her anxieties - get used to nursery, are you reinforcing them?

I was an anxious child. I wouldn’t sleep alone, couldn’t sleep unless exhausted, refused to stay at other people’s houses, had fears of things like spiders, dark etc. I then became the polar opposite as a teenager. I never stressed over anything, at all, not once in those years. Not even low level stress.

Now I experience episodes of triggered anxiety (in its truest paralysed with it, heart beating out of my chest, struggling to breathe etc form) but I think that’s more due to the nature of my life, most people would have had a mental breakdown years ago. I wouldn’t describe myself as generally anxious - quite the opposite, I’m one of the coolest people I know, but the coolness is punctuated by moments of overwhelming acute stress triggered by events such as people being diagnosed with life threatening diseases, almost going bankrupt etc (this kind of stuff happens regularly, say one event, all kinds of events that one would deem distressing so things like death, illnesses, important but looming deadlines etc, happen once every four to six months to me so fairly frequently and an they can trigger an anxiety episode lasting from half an hour to a week depending on how bad it is).

I think it may be partially genetic - I can see my son experiencing the exact same emotional patterns as I did as a child. But it was exacerbated by environment. My son isn’t as bad as I am, we’ve tried to teach him to suppress it and to have as stable a life for him as we are capable of. I, on the other hand, was allowed to indulge these feelings as a child. I also had to deal with emotional abuse, frequent shouting rows in the home, OTT emotional reactions from my mother (I suppose that was consistent with the general pattern of abuse but I think this had a disproportionate effect on me at a younger age) and substance abuse (mother).

I’m more or less fine now. I do think I have a predisposition to anxiety but I’ve learned to suppress it (and for the most part control it) very well.

Forgot to mention, no Autism/concerns. Also I was a bright child and generally shy from strangers (I would hide from visitors).

I agree with pp. Girls with ASD present very different to boys and that was my first thought with everything you listed.

Call your HV team and request an ASQ-SE to see what that shows up.

Another one thinking autism. It can present very differently in girls.

I would really consider autism, it presents very different in girls and I honestly never thought my Dd has it until around 13 after her periods started

My Dd was like your and had a lot of sensory especially around clothing from when she was a toddler and also very anxious

She sounds like my autistic 6 year old. I originally took her to the GP for anger and anxiety but 1.5years later she was diagnosed with autism. She had no developmental delays, happy, bright, friendly but has a few oddities and sensory issues. When we received the diagnosis report the consultant listed lots things we had missed. She was our first child so we just assumed her behaviour was typical or just how she was.

Sounds a bit like my childhood self. Was diagnosed with OCD and GAD by psychiatrist when I was about 5. OCD has persisted episodically over the years and I've been treated many times. I grew out of the sensory stuff but I'm not sure when, though I'm still on the sensitive side when it comes to things like loud noises, lots of people etc. I don't have autism. There is a lot of crossover in symptoms between things like OCD, ADHD, autism and more. The thing is that real brains don't fit into mental health diagnoses quite so neatly as we'd hope. Children especially are so difficult to diagnose. Some anxious-type behaviours, obsessive behaviours etc. are developmentally normal though at some points they get quite pronounced in some children. I think being bright can have something to do with it, if your development gets out of step. I remember the separation anxiety so well and I think it was because at that early age I had genuinely grasped much more than I should have about things like death so I had an awful lot more to worry about than other children. I wasn't emotionally ready for some of the things I could understand so I clung to the safe and familiar. The psychiatrist I saw when I was 5 spent a lot of time just talking to me and trying to understand my point of view. I think that's maybe the best thing you can do for your DD at the moment.