Friend's daughter: panic attacks post-separation, won't consider help

[murru36]

sorry if this has all been covered before. Best friend had a very nasty separation, DD is 15 and was close to father but now refuses to see him at all (it was very ugly/violent separation). Since he left she has started having panic attacks which have resulted in a lot of time off school, despite severity of the attacks (which end with vomiting) and now also agoraphobia, she absolutely refuses to see any medical professionals. Friend is distraught and doesn't know what to do. Has been going on for 6 months and is worsening. Friend has found CBT expert in this area, who will even come to house, but DD won't contemplate it . Any advice welcome?

My suggestion is its best to try and get to a GP/start with a school counsellor rather than bring someone in. CBT is hard for teens, even when they agree to it. If she is vomiting, I would suggest trying to get to the gp for a physical check up . She sounds in some distress but she wont understand how to or who can help. Try to help her practically with relaxation idea etc and maybe mum could go on to young minds website and offer some information and look at the family and friends info. Suggesting she keeps a notebook, bakes , anything which keeps her calm is a good start. In my experience its important if she sees anyone its a specialist in adolescents I also would try not to worry too much about school, as that can be caught up (my DD missed a year) - do you know any older teens who may have had some help themselves who might be able to persuade her to at least check it out. Its often harder to talk to parents at that age. Another lesson I learned a bit late was to be calm and practical. My distress made things harder for my DD. good luck to your friend.

Sorry to come in a bit late. Wise words from anthropology. As a parent it feels awful that you can't Do Something & fix immediately. Sounds not surprising DD is having panic attacks. And not at all unusual to not want to see professionals.

Your friend & DD are not alone, believe me. She can connect up with other parents in similar situation through MN, School refuser or other forums - useful because you can see different paths that people followed.

Similar-ish stuff with DS 14. What worked was ramping down the expectations, letting him create a safe space at home: watching comedies & reading fanfic. Sadly we followed CAMHS advice for too long to "be firmer with your boundaries" and "just make him go back to school". Disastrous. "Pull your socks up" is not a treatment plan.

Usual advice: carry on being imaginative at finding resources & ideas for future strategies. DD might go for creativity, mindfulness, yoga, head massage, connecting with other teenagers in the same situation, CBT, horse riding, who knows. Right now let her do whatever feels good so she can feel safe. DS's psychologist suggests relaxation; pets; other social activities like baking, helping others; and special interest activities that give a sense of enjoyment, security and help social interaction e.g. online games, board games etc

GP is good (if not empathetic then change). If DD refuses to go then friend can go for herself saying situation is affecting her. GP can also be effective in future in driving other professionals. CAMHS - people have mixed experiences: good/bad, fast/slow so get the ball rolling. Check out other local resources for teenagers e.g. support groups. My DS now takes meds (fluoxetine) which he says helps with anxiety.

School - don't worry about it not that I would have said that 2 years ago. There is a lot more imagination now in how teenagers can access education - in school or at home, part time or full time. For instance my son has gone to school but done his work in a quiet room and he's had a tutor (from the LA) who comes to his home. When he feels a bit more robust that 1:1 tutoring can happen outside home e.g. in school or library.

And even though this drives me completely wild whenever a professional tips their head on one side and says to me in a soothing voice "make sure you look after yourself" it has some truth. For me this is , sleep, watching comedies with DS & meeting friends for chats.

Thanks hackneyLass. Since posting, friend's DD agreed to see a CBT therapist on condition she could have 2 best mates with her - and for 1 session only. Therapist came to house, agreed to see her on those terms, advised friend to keep up gentle pressure so that panic attacks don't prevent her from leaving house (or indeed moving house, which is also in the pipeline). does this contradict your warning about the CAMHS/pull your sock up attitude? Also: someone told me that 13/14 is too young for CBT and she should have psychotherapy instead. What are your thoughts?

Hackneylass, what you said!

My DD has severe anxiety, is a school refuser and is on a therapy holiday from CAMHS. Your advice about safe space and activities that nurture the feeling of security and comfort is spot on!

In her case it's One Direction and the resulting on-line friends she has made all over the world (literally - Holland, Sweden, Turkey, USA, Australia!). The downside is that she is up all night 'chatting' to them.

She also watches a lot of comedies and Netflix. When she is particularly anxious she revisits SpongeBob and other kiddy cartoons.

It's a slow process. I've learned the hard way not to push her too hard with activities (eg shopping) that are out of her comfort zone.

Wishing you all the best.

MoodyBlueGreen phew we're not alone! Netflix, comedies, kids cartoons (works for an adult friend who has recurrent depression too). Shoot 'em up games when feeling cross.

murru36 Well done to your friend's DD for laying down her own terms. IME its really up to the individual what works for them, & you only find out by giving it a try. And whether you click with the professional doing it. Obviously with statutory sector only certain treatments may be on offer, and there can be long waits between them. This is when i found our GP useful for leaning on CAMHS to hurry up.

CBT seems to be all our CAMHS offers - DS has been offered it since he was 12, had 2 poor experiences but now has a very experienced psychologist he respects so seems to be a bit more effective.

And sounds good to keep DD's world from contracting too much - whatever works for her.

Hope your friend's DD gets into a better place soon...

Placemarking .... similar symptoms in my DD12 but we have no idea of cause. I am finding it extremely distressing, but shall take on board some of the very useful advice here. Thanks.