To think there must be something that can help DD?

[Owwdi]

Sorry for the shameless post for traffic, but things are a bit desperate.

DD is 22 and has ASD. She has always suffered with anxiety but it was manageable. She takes sertraline to help with it.

She doesn’t have many friends or what you’d call a buzzing social life, but she does have a few friends who are into similar things as her, they are scattered around the country though rather than living locally.

Just over a year ago she went to Japan with one of her friends and got really sick on the plane. She’s always suffered with travel sickness but this was the first time she was ever sick on a plane. Then for the next week (half of their holiday) she was too nauseous to go out or eat much at all, and spent that time stuck in their room. I managed to get her friend to take her to an international clinic where they gave her an anti sickness injection and some pills, and she managed to get out and about for the second week.

Since then, she has been feeling nauseous a lot. She’s been to the doctor and it doesn’t seem like there’s anything physically wrong, and both the doctor and DD agree that it’s a psychological issue.

It’s really getting in the way of her life. We’ve been paying privately for therapy for her for the last 4 months with a therapist who uses various methods including hypnotherapy. I’d say her general outlook and mood, and desire to get out and about has improved, but the feeling sick remains.

Day to day she seems ok now, but it’s literally every time there is something she really wants to do, eg a concert or convention, she’ll end up vomiting too much to be able to go. It’s happened several times now in the last year, she’ll travel to London to her friend’s place, feel ok, then the morning they need to go and do something, she starts vomiting. She’s just on her way back now after another failed attempt at having a social life and she’s feeling broken and like there’s no point in trying anymore. It’s hard to argue with her at this stage, I’ve been encouraging her to keep trying and believe that she can do it, but without fail she starts throwing up and isn’t able to go.

Even times that don’t involve travelling, like recently it was her birthday and her friends came to stay here, they were planning on going out, but DD woke up in the morning and started throwing up.

BTW she doesn’t drink or do any drugs, so there’s no way that’s an element to causing sickness.

She can’t go on like this. GP doesn’t seem helpful. Private therapy doesn’t seem helpful. I’m not sure what to do next, but she’s so low and what kind of a life is it if she can’t do anything fun without being sick?

I think I would try and build her tolerance.

If 0 is staying at home and 100 is a big away event with friends, what number can she get to currently? What would the dentist or cinema look like? If they are, say, 30, what could she think of that was 40 and how might she find ways to put that additional 5% within reach? Then stabilise there, then try for 45 etc.

Yep, similarities to my DD too - not ND - who has CVS. Her worst episode was a school coach trip with a 4am start to France. She vomited the whole way and then many mornings before activities. Travel definitely an issue. She also used to vomit before seeing her boyfriend (that's has gone thankfully). Also before exams. Also the morning of prom! Essentially stress or even good excitement can bring it on. Unfortunately it can become a self-fulfilling prophesy where the anxiety is not the thing itself (the event, or the travel etc) but the fear that the vomiting will occur . . . and then it's a self-fulfilling prophesy. Exposure to certain triggers has helped, and has finding ways to minimise adrenaline. My DD says 'i can't let it stop me doing stuff' but it's a horrid thief of joy. I am so sorry your DD is experiencing this.

Yes that’s exactly it. She convinces herself she’ll be sick and then it happens.

A bit of progress, I phoned the doctor and got a text saying they’d call me before 1pm, and then didn’t, so that’s annoying as no doubt they’ll phone tomorrow but today was my one day off when I’ll be near dd so it would have been good to get that sorted today. But I found an EMDR therapist nearby last night and spoke to her on the phone today, she thinks it could be really helpful for DD as there was a definite start point to it (Japan trip), so fingers crossed. It’s eye wateringly expensive but if it helps her it’s worth doing.

I think you should ask the doctor to try a higher dose of sertraline and see if it gets worse or better. This would give a strong indication as to whether it's a reaction to the sertraline or an anxiety response. I personally think it sounds exactly like an anxiety response and that means the sertraline isn't working well enough. But another medicine could also be worth trying if your doctor will prescribe something else. Given that your DD is on the lowest dose of sertraline and could be taking four times as much, it sounds to me like she simply isn't taking enough of it to have the desired effect.

And this could be the crux of the matter Op, she wants to remain a child because she can't face the responsibilities of adult life, therefore when it comes to doing adult socialising activities her nausea is triggered, so she doesn't have to go. Such a shame for everyone involved and particularly her, I hope she hits on the right therapy soon

I used to get terribly upset stomach every time I was in a car/bus/felt stuck anywhere like a lecture theatre. General concensus, including my own, was that I developed an anxiety about not being able to access the toilet somewhat linked to life long mild IBS- and that was about 2 decades before I got diagnosed autistic. I had therapy, learned hacks and was mostly managing. I then had my son who had horrendous milk allergy - and my mum went: “oh, that’s exactly like your colics when you were little, I wonder if it was CMPA too”….I cut out dairy for him…my car etc. stomach problems dissapeared…unless I over dose on dairy again. The point being: you can be autistic, which can drive hypervigiliance because NT world sucks, but ND is linked to a number of physical conditions that can often be kind of a niggle until something triggers them. With the nausea the way you describe it transport and/or sleep is preceding it and it started on a plane - I’d be wanting detailed ear investigations and look into vertigo or any trapped nerves in the neck (ND folks are frequently hypermobile and that comes with your body doing it’s own thing and POTS and MCAS)- she’s likely nervous about it all more now, so it looks like anxiety is all there is - but you’re not describing anything around that plane trip that was a trigger (unless it was midway through horrendous turbulence). Blood tests could’ve found an infection or similar but not any of the more likely causes of ongoing nausea.

Both my teen DDs have ASD and their therapist said that ASD is essentially hyper anxiety 🤷🏼‍♀️ my eldest DD had real struggles with school but has just finished her first year at college. Both my DDs have done inner child regression work with amazing results - connecting them to original feelings while under light hypnosis. They’ve also seen a sandbox therapist which seems to have been really helpful.

With her having CFS/ME is there a chance that the activities she's trying to do are outside her energy envelope. She's using up all her energy getting ready and has none left for the activity? Have a read about pacing and about post exertional malaise.

I had this.
It was triggered by having my first McDonald’s drive Thru for a my friend’s 11th birthday. I puked everywhere.
I suffered for years.
It then became a car phobia and then a plane phobia, then an eating in front of others disorder.
I made cooking my passion. Cars my passion and became a pilot as a hobby.
It dogged me for about 10 years but I had no external help. My mother and step father just ignored it.
Occasionally when invited to a supper at some socially important setting, I feel certain muscles twinging up until my 30s.
Good luck. Face the fear. Or get help!
I still can’t eat McDonald’s- that is no bad thing.

I was prescribed sertraline once and it made me feel nauseous all the time, but a delayed reaction is possible with any medication. I
would recommend asking to change her medication. I take Venlafaxine which is good for anxiety.

It must be hard for all of you.

Perhaps you could put 6-12 months of intensive effort into engaging in her activities (slowly edging away once she’s comfortable).

Life is so busy but this is a really important time for her and may shape her future. It sounds like she really needs you at the moment and maybe you can carve out some time to make it happen for her. An event in the diary once a month for example, with a view that she invited a friend along too so she doesn’t become overly dependent on you.

Bless her, life is hard and the transition from child to adult is often very tricky, especially if you already suffer from anxiety. But the answer definitely isn’t in staying indoors, it won’t get better on its own or by staying “safe” everyday. She needs to work towards getting a meaningful life for herself.

My DC also has CVS which is very affected by anxiety. They’ve found that a migraine med hs helped a lot more than an anti-sickness one, which wasn’t very helpful.
I hope your daughter finds a solution OP.