My 17 year old DD has been struggling with anxiety for the past 2 years or so. She sets high/ unrealistic expectations for herself and feels disappointed and like she has let everyone down if these have not been achieved. Initially the anxiety was fairly mild with overthinking and nausea, however in the last academic year it has become terrible. She suffers regular panic attacks at school and a full range of anxiety symptoms. This has lead to her skipping full days of classes (attending school but refusing class) or having to leave class halfway through due to a panic attack. She often suffers severe nausea in the mornings to the point where she is retching and something brings up a clear liquid (tmi). She is often dizzy and shaky also. She has been attending CBT for the last year and hasn't found it very effective due to the irregularity of sessions and working her self up into feeling sick beforehand. We went to the GP and she was prescribed beta blockers to help with the anxiety symptoms and she was offered anti depressants as she also shows signs of depression i.e self harm, suicidal thoughts, mood swings, affected sleep, tearfulness and feeling worthless etc but she refused the medication. My worry is that when she goes back to school at the end of August it's all going to get worse again, what should I do??