DD overdose. The system is broken? Any advice?

[BeethovenNinth]

I have posted about DD before. Broken by lockdown, anorexia age 12, school drop out, burn out, self harm extreme. We are five years in.

we have repeatedly been told she doesn’t qualify for help and have tried various therapists ourselves.

she is out of school and self learning. Very lonely. Seems ok recently ot so I thought.

due to intense sadness last night she took an overdose of aspirin. I suspect a cry for help and she phoned childline who got her to phone 111. (She didn’t think to wake any of us). I suspect A and E will just kick us out soon.

we are a loving family but this is a huge setback.

we are Edinburgh based, desperate desperate for the right help.

private psychiatrist? Do we suggest sertraline? Anyone in Scotland have any good suggestions?

thanks from a broken mother

sylvan totally. She can’t go. She can’t get in the place. We have tried. I will suggest again as I have suggested for six months.

sunshine I guess the interests, the obsessive interests, the lack of any signs until post lockdown, her focus and concentration are normal when she isn’t in trauma so not ADHD - she is far better than I am at organising study plans and getting places on time. Autism - I just can’t see it and never did.

I am not pushing you to see things that aren't there - I just think an awful lot of what you're noticing really resonates with me. My daughter is a bit younger (13) but covid really pushed some of her traits forward. We didn't notice much beforehand (she got a bit nervous in crowds - was the kid on my lap at a lot of birthday parties, didn't like ambulance sirens, but nothing that dramatic) and then after being just with us for too long (which she actually mostly loved), having long covid with stomach inflammation which triggered a lot of anxiety around eating, and going back into the world of lots of people and noises and smells and expectations... then going to high school and getting her period and all that, everything really fell apart quickly.

She is a massive perfectionist so no one would ever see any of this outside the home or maybe if really triggered (has had a couple meltdowns around crowds). She was perfect at nursery and primary - probably too perfect. Had a million friends and all her teachers loved her and she did literally everything she was supposed to do.. until she couldn't. No one who knew her at 5/6/7/8 would have had any idea of what she would be like at 11/12. She obviously doesn't remember everything about being little, but we have talked a lot about how she'd watch other girls and then just do whatever they did. She was/is hugely motivated by praise from teachers or adults so she works out how to achieve that - she does that more deliberately now she's older but I think that was always part of her instincts. I think puberty means so many more physical/emotional feelings all happening at once so it's harder to focus and more honesty comes out. And then she panics because she's no longer perfect.

Of course none of this really matters - you can call it PTSD or anxiety or autism or OCD or anything really but the important thing is how to help her. And unfortunately with the state of everything going on, that means throwing money at it.

Just a random suggestion - have you heard of Ponies Help Children? In West Lothian. My daughter did a couple months with them in S1 and it was enormously helpful to have a low-stress, low-expectation nice thing to do. Just wondering if some out-of-the-box ideas might help get you through the next little while so you can get some scaffolding in place around her.

Ponies help children sounds brilliant- will have a look

I have diagnosed ADHD and am very likely autistic. I totally relate to the perfectionist type stuff. I was top of all my classes the whole way through school. No one would have ever known I had adhd because i was so anxious about getting into trouble that this overruled everything. I loved making a study chart. I always made sure I was early. The autism side would probably have been more obvious at high school when I started struggling with friendships.

For me my ADHD is internal. I am.exceptionally highly organised bevause I have to be. I have planners, am rarely late, am the parent at school who is always first to bring in a form etc. But what people don't see is the absolutley enormous effort this takes. I have reminders, alarms, systems galore because without everything being scaffoldes to the nth degree it all collapses. I overthink EVERYTHING! I have to plan everything in detail. I have to create fake deadlines or games to challenge myself to clean stuff. There are post-it notes everywhere. I am always first to return a form erc because if I don't do it there and then it will be forgotten forever.

I thought all this was normal until I changed job after covid and was back in an office. People were astounded to see I had alarms to remember to pick my children up and other daily activities.

If you didn't know me you'd never guess that I regularly end up with one mile (or on occasion no miles) left on my petrol gauge bevause I think I'll just do it later. Or that I have some simple tasks I have literally been snoozing reminders for for years. Or that I need a deadline to actually get stuff done (hence thriving in a job with constant deadlines). Or that I can't watch a full film. That I always do five things at once. It's like having a million tabs open in my brain plus songs always playing too.

But you wouldn't know because I hide it.

I relate so much to this. I was top of my year at school, got a good degree, a big job - i adopted in my 40s and everything kind of fell apart because of the lack of structure.

I have just been to the gym and came out with my top on inside out. Pretty average for me. I am forever leaving things behind, getting the times of classes wrong, not recognizing people, not knowing what to say to people (I can't do small talk). I need to do classes at the gym or I would never get there. I am bored after about 10 minutes btw but being in a class means I have to stay.

Like you I have coping strategies and mostly people don't realise. I am not diagnosed with anything but autism runs like a seam through my dad's family (interestingly no one in my mum's) - all my dad's relatives in their 30s or younger are diagnosed, the rest of us believe we are. I love being with my dad's family - we are on the same wavelength. Relatives on my mum's side are outgoing and sporty and we don't click

Thing about a diagnosis of course is that you don't really need it if you are coping and other people are able to indulge you. I can't go abroad any more because I can't cope with the sensory overload of ferries, airports - my husband accepts this (and we have a dog so not a huge issue atm). But if he didn't, I would mask it and go. My elder daughter, who is an adult with autism, is the same, only she doesn't mask. She would be aggressively nasty rather than mask. My younger daughter, who is also autistic, loves travelling (til something goes wrong, when she becomes hysterical).

So many different responses. All autism.

OP, we don't mean to push you down an asd route, only so much of what you describe IS autistic traits. But if you are sure you might instead like to get your daughter assessed by a sensory integration therapist. They can provide her with a sensory diet - it can help them to self soothe both on a regular basis and if a crisis is looming. It can involve all the senses. My younger daughter had a lot of sensory issues and had OT interventions in school. I remember one involved her trying 10 different food textures/tastes to see which she found most calming. Crunching, licking, chewing, salty, sweet, spicy, that sort of thing. She went for sucking (hard lollipops). I know mine is chewing (toffee) and her sister's is crunching (crisps). There is a lot you can do with sensory stuff. Even just get a copy of The Out of Synch Child book.

I think you’re fixating on the label and it’s putting you off seeking the next step. You keep saying no it’s not ASD. But that doesn’t matter. Reach out to private professionals - let them do a thorough investigation with diagnostics checks for ADHD and ASD which will also explore things like the sensory sensitivities. And then see where you are. The diagnosis process will give you much cleaner understanding and the needs and thus inform your next steps with treatments. Whether she ends up meeting the threshold for a labelled diagnosis isn’t the end game here. My ASD child has all the bits you mention including the OCD type behaviours which for her are about a sense of control as were the periods she struggled with food. But the label doesn’t matter, diagnostic processes inform you and your child with a better understanding of needs.

Thanks - I agree about the label. She told me a few years ago to “stop going on about autism” as it was upsetting her and she didn’t see it. I bought some books on female autism and she politely put them back on my bed. there definitely isn’t ADHD.

But equally we have also not known where to turn for so long having tried so much to help her - from clubs to volunteering to online schools, countless therapists.

and I kept thinking - if she just gets a sense of belonging and community, she will learn to feel safe again.

The thing is that it might not actually feel safer to her to be around people - it might be really triggering, or just make her feel even more uncomfortable, or force her to mask (or any other word you or her would be comfortable with) for longer and then need longer to recover. I know my daughter needs a 'lot' of resetting time after things she doesn't want to do - an a decent amount of down time after things she really does want to do. It's a tradeoff for her - she loves dancing and her dance classes, but she needs to balance it with really, really quiet weekends. Being around people doesn't fill her cup in the way it does for me.

Does your daughter enjoy being outside? Being with animals? Creating? What feels safe to her might look a bit different.

Haha... yes it was having children that knocked me from highly effective to falling apart 🤣 I wouldn't have considered being ND if it wasn't for my child first getting diagnosed. Now I know so much about it it's abundantly clear that my whole family is ND.

When someone is functioning so seemingly well, but at the total max of their abilities, it doesn't take much for it to crash into burnout. Hence I am now only part time as I can't cope with juggling all the kids appointments as well as full time work.

When i worked, I used to do nothing in the evenings other than have a scalding hot bath. The sense of relief i felt when I got in.....I read later that this is classic asd. Coping during the day but needing to decompress afterwards with an extreme sensory intervention.

I have a scalding hot bath as often as I possibly can 🤣 Spicy food and strongly flavoured crisps too.

It was my son's OT who pointed out that these are common ND coping techniques.

Self harm, food control, repetitive thoughts are also things she mentioned op.

Regarding the sensory suggestion.
No it's not brain inflammation it's just her sensory profile.
She will be able to tolerate things for a long time before it becomes overwhelming.
I would seek an assesment from an Occupational Therpist.
They will be able to provide a sensory 'diet' that will aim to address her feelings before it becomes too much.

thanks deft it’s interesting as that wasn’t the case at all until her trauma when starting high school. Would that be the case? Would a child until trauma be ok with business and lights and noise and then after Covid not? Why would that happen.

as you can see I have thought endlessly about it and yes it maybe doesn’t matter but to me it does as I feel there is possibly long Covid brain (if that even exists?) and so a diagnosis of autism and ADs might not be right if in fact she has long Covid brain and it’s something else. I spoke to one of the A and E doctors a few years ago about this and think it’s akin to PANs/PANDAs but a different mechanism.

So, the thing with ASD is that triggers stack on top of each other, and as long as there is time for recuperation the ASD brain is able to cope with a lot more variety of stimulus than if it is experiencing all these things in close succession.
So my DH copes much better in a noisy, brightly lot environment if it is tidy for example. But this might be different and specific to you daughter - or, all this talk of neurodiversity could be totally wrong but only a medical practitioner with experience in the right areas will be able to help you get to the bottom of it and you sound like you are doing your absolute best to access the best support for your daughter.
But do go in with an open mind to all potential outcomes.

Thing is that covid had a huge social impact for everyone, and to add on transitions to high school this could easily explain the differences.

When I did a post diagnosis course it was really noticeable that the parents all had children that were 7-8 or 14-15. That coincided with changes being noticed when starting either primary or high school, and then waiting for assessment (at that point just a 2yr wait unlike now - we're 4yrs locally). Of course some children are diagnosed much younger but they tend to have LD in addition.

Yeah that's exactly how it would present.
Prior to the trauma she wouldn't have even acknowledged any of the sensory input as she had no reason to relate any of it to being unsafe.
Following the trauma she no longer feels safe and secure in her body and now may be hypervigilant but unable to address the sensory input as it happens and so she almost 'stores' all the feeling ( exactly like the stacking mentioned aboved).
Eventually her stored up stress will become too much and she needs a solution.

A study comparing about 1/4 m children before and after a covid infection found suicide ideation and self harm doubled after covid, but quadrupled in 11-16 year olds and was higher still for females (I’m sorry I can’t remember the exact figure for girls). It was published around a year ago I think. It also included onset of things like self harm, aversion to bright lights and sounds. I obviously don’t know what’s behind your daughter’s situation.

Thanks - I hadn’t seen it that way but it does make sense actually. She had no trauma prior to Covid and high school. I still don’t understand why the other kids are ok - including the autistic ones - but she is highly sensitive. She was also my PFB and had a heart condition at birth meaning I perhaps cosseted her before covid.

us parents like to blame ourselves.

she says she doesn’t want to be left alone as she has scared herself. We both work and have two other kids and dogs to walk and hobbies. I have cancelled everything but am now feeling quite low at the thought of being housebound. My weekly coffee with friends and music and sports keep me sane and the thought of giving all that up even short term is hard and longer term frankly scary. DH works away a lot. We don’t have family close by.

so I am feeling really low and praying to god that medication helps.

foursocks that is interesting, her OCD started after her first Covid infection. She had it very mildly but I remember her OCD starting. But she was safe ish and she said happy until high school so who knows.

that is interesting, her OCD started after her first Covid infection

I know a 16 yr old girl who was exactly the same. She does now have an autism diagnosis. I know that's not what you want to hear.

In her case her mum thinks it was just a perfect storm of puberty, covid lockdowns, starting high school during covid, understandable anxiety around health and hygiene at that time, combining at a time in life when autistic girls often struggle to carry on masking. It was all just too much. Any one or two things might have been manageable for her but everything together was too much.

She's doing well now, takes sertraline, had had some talking therapies through CAMHS, they were lucky to get good support. Still has her struggles but they're manageable. She's back in school full time and coping fine.

Having said all that, I've read a fair bit about PANS and find it baffling how an infection can upset someone's brain and ability to function on a day to day level. There are some folk on social media talking about how dramatically and suddenly their child's behaviour altered. It's frightening and so little understood.

So none of my waffle helps you. Sorry.

Fwiw I suffered terribly with anxiety after a covid infection. I took fluoxetine for a while. I'm okay now. I was just able to rationalise it a bit after a while and sort myself out. Sounds like your dd is too overloaded to be able to manage anything herself right now. I hope you manage to get her the right help.

sertraline has been very impactful with my child. Big difference.

You have to laugh - CAHMs called her yesterday and left a voicemail confirming no youth support locally but they are referring her to the youth club in the nearby city. This is what they did in April when she was in A and e. She can’t access the city for various reasons not least her fear of transport

if they had even read her notes they would have seen they did this last time.

a suicide attempt by a child - and that?

yes we are lucky we are now desperately finding cash to try pay for a psychiatrist - including remortgaging to save our child. What of the kids who don’t have this?

I know and then they got lambasted for being NEET. Until parents get dragged into this horrific reality of how dire MH services are nobody knows- so society blaims the kids instead of the services they should be accessing.

I think you really need to reply by email, pointing out that they clearly haven’t read her notes and how she’s escalating and how inadequacies have lead you here. . The whole sorry tale of inadequacy and CC in PALS and your MP. At the very least just send it to CAMHs saying you will be going to PALS and your MP.

This here where you describe a subset of autism - this is literally autism. Struggles with social communication (difficulties in a group), obessesive traits (repetition). When you mentioned walking to a particular number of steps, this is really autistic behaviour.

it’s important because the way you support your child can be a little bit different. Eg, Pilates class may be better because there is no number involved.

i knew when it was ok for dd to exercise again when she could reflect on not wanting to be anorexic again.

I have two dd autistic with ocd (3 autistic dds in total). One has a stand alone OCD diagnosis, one doesn’t. Same CAMHS! One psych refused to diagnose it as it was ritualistic autistic behaviour!

I also think autism is really helpful to explain/understand such extreme behaviour from what appears to be a well-adjusted child growing up in a supportive family, academic, no trauma etc.

my eldest, the AN suicide risk for many years, was a bright cute kid, perhaps shy and a little immature. Generally a friend group but sometimes fell out. I knew she was autistic around y6, but given the difficulties getting my other two diagnosed and they had EBSA and a lots is other obvious issues, I thought if she did have a crisis, I could seek a diagnosis then. The crisis was anorexia during Covid - I could never have predicted that.