Year 11 and refusing school due to emetophobia

[breadhead]

Hi, I'm not sure whether to put this on the education board or mental health but here I am! My son has been suffering from anxiety and self-diagnosed emetophobia (fear of sickness). This all started in Year 10 when he complained of feeling continually nauseous, and sometimes dizzy and light-headed. He said he had actually felt like this for at least 2 years before that but it only started affecting his attendance last year. His attendance dropped 75% by the end of last year.

The last few weeks of last term were very fraught as he found it more and more difficult to go in. He was up and dressed for school every day but it always ended up with him not making it as he either felt too sick, lightheaded or dizzy (due to anxiety). I did everything I could to get him in including walking to school, waiting in the school car park for 2 hours, having teachers come out and escort/assist him in, even (on the advice of a doctor) locking him out of the house for the day so 'make' him go in (he didn't - just wandered the pavements instead :( He even missed 4 days of his work experience placement at a nursery.

This term he has so far been in 1.5 days. He now says he cannot bear to feel so awful in school for one more day and that he simply doesn't want to go in anymore. He says he cannot concentrate or focus anyway so won't learn anything He's in the final year of his GCSEs- this is stressful !!

Of course we've seen doctors, have school attendance on our backs - quite rightly - and have also been referred to CAHMS, but with a year's waiting list we decided to go to a private therapist instead.

So we have had one meeting with the therapist yesterday and she, along with the school, say that he should be in school and that it will only be worse for him in the long run if he avoids school.

I agree with this, but my main concern is his mental health. I don't want him to feel awful in school but at the same time I don't want to worsen it by enabling him to stay off. Saying that, I don't think there's any way I can get him in now.

School are very supportive and want another meeting next week to try and avoid court proceedings. So I am now at the stage of thinking - 'what do we do?!!' Do I effectively give up, pull him out of school and homeschool (impossible with a 9 month old baby too), pay for online school such as Interschool, (so much money we can barely afford) or keeping on trying to get him in whilst feeling deep down that we are wasting his Year 11 away?

Any advice welcome!

sorry to hear about this and sorry you've had so little response. I posted about this last year but in Chat and got a lot more response.

my son was severely ill with emetophobia but has improved enormously with medication and a course of CBT through CAHMS. I had to fight to get seen. I actually turned up at A&E in the middle of the night in order to access the duty psychiatrist. he had stopped eating, sleeping and drinking by that point though. he was very ill and it escalated so quickly.

my advice to you is to stop thinking about his education and treat the emetophobia as fast as you possibly can. there is a book by Micheline someone called 'when a child's anxiety takes over' which you may find helpful.

Good luck!

Hi, thanks so much for replying. So sorry to hear about your son. How is he doing now? My son isn’t as severe, thankfully, and of course I want to stop him getting worse. You are right are right about focusing on his mental health more than education at the moment. After a few more fraught attempts at getting into school we’ve finally made the decision to home education for the last few months of Year 11. He is going to work through his ‘Thrive’ book, which is for Emetophobia, and hopefully we’ll get him to agree to see a psychologist too, as he doesn’t want to go back to the current therapist (after 2 sessions). I will take a look at the book you suggest, thank you.

Could there be something more going on than simple anxiety, eg something that has happened at school?

My DD developed severe anxiety last year (equivalent of UK Y13) as a result of low-level bullying/social exclusion, a poor relationship with one teacher, and self-imposed pressure to succeed. Her main physical symptoms were constant nausea and dizziness. She was off school for three months and only returned to take her exams. She saw a private psychologist who focused mainly on coping with stress/anxiety through relaxation and mindfulness - she enjoyed the sessions which I think were moderately helpful, but what helped most was just not going to school.

She is now at university and so far is doing absolutely fine. Obviously she has some background mental health vulnerabilities but it's clear that her issues were at least partly reactive ie caused by the school environment.

I hope your DS starts to feel better soon.

Hi Mistigri, glad to hear your daughter is doing better now. The anxiety symptoms (nausea and dizziness) sound similar but with my son it’s definitely due to his fear or sickness. We’ve been through all other possibilities with him and he says there’s no issues with friends, and school watched him and said he seemed as involved as ever in
his friendship group. Moreover, his nausea is constant, whether he’s in school or not. He felt awful over the summer holidays too. It would almost be simpler if it was just school!

My son is doing much better thanks. Cbt was very useful. His therapist wasn’t that great to be honest but we still saw good results. He is attending school now and has an active life.

I hope you son does accept going to a psychologist. There are quite a lot of private cbt therapists about now. I don’t think we could have got where we are today without professional help.

In our case there were underlying issues with school which we are also now dealing with.

Ds appeared to genuinely struggle to differentiate between different bodily sensations such as nausea, hunger, nerves etc.. he ended up feeling constantly sick just as you describe. The problem is that the anxiety feeds off itself.

I have heard good things about thrive so hope that goes well

As a 41 year old with Emetophobia id say concentrate on that rather than school. (hard i know but i pulled my girl out of yr 11 for anxiety/bullying and got her into college on a foundation course,they take 14-16 yr olds). My emet over the years has left me housebound for years at a time and i really struggled with pregnancy/dealing with a sick child.My emet started at age 7 and got worse as i got older to the point i now suffer with panic attacks/agoraphobia (panic attacks make me feel really sick and they are all based around me not being able to cope with feeling sick) and im convinced if i didnt have emetaphobia id either not have panic attacks or at least i`d be better able to cope with them better.Mental health is more important than school and grades.He can always go to college and take GCSES in a year or two if he feels able x

Hi Pixie8, sorry to hear you’ve struggled so much with Emetophobia. Becoming housebound is one of my fears of my son developing, which is why I am keen to get him back into school. I don’t worry so much about the GCSEs but the psychological 0impact of home education away from his peers.

Saying that, I do not know whether it’s best for him to be in school if he’s feeling so anxious, or if being homeschooled will just feed the anxiety, and even create new ones. Such a minefield of decisions. Anyway, I really hope things improve with phobia.

My DS had anxiety and emet. We went through CAMHS and private counselling over several years. Every time we found someone good they seemed to go off on maternity leave at the point where we seemed to be getting somewhere. In the end we self-taught a lot of the strategies, and used the exposure ladder from www.emetophobiaresource.org/. It was an enormous effort for everyone in the family, but we worked hard at it (having 'ladder time' with him every day after supper), and over the months he got gradually better. He was younger than yours, and we also used a book called 'what to do when you worry too much', which was very effective. I think the books on anxiety more general are likely to be useful, as they teach the strategies to manage the anxiety. But dealing with the fear of vomiting alongside that was also essential.
My son (now Yr11) is a different child now - although I don't think the emet or the anxiety will ever go away completely - but he now manages and leads a 'normal' life.
Hope this is helpful and good luck with it.
ps - I amended some of the resources from that website, as I didn't want to introduce fears that he didn't already have.

Hi tadpolefeet, i really appreciate you listing the link and the resources. The website looks great, really informative and useful, and for free - what a great lady. So glad your yr 11 son is much improved, that gives me great hope for my son. I think we will have to go down the self help route too as my son isn’t engaging with the counsellor. I have a teach yourself CBT book so will try to teach him some strategies. Thanks again.

This is probably irrelevant but I just want to put it out there. I have a condition called vestibular migraine. The symptoms are 24/7 dizziness, lightheadedness, and nausea amongst many others. Easily mistaken for anxiety. Mine is definitely not although a regular GP would never have diagnosed this, I had to go to a private specialist.

I’m not saying he has this but that it may be a possibility that his symptoms are down to something other than anxiety. My condition does then cause anxiety for many people. But it’s the dizziness causing anxiety not the other way around. I’m not affected by this luckily.

Hi AroundTheWorldIn80Days , thank for your suggestion of what it might be. It's quite timely actually, as you are quite right in not to disregard physical causes. We did ask for a blood test (though convinced it wouldn't find anything) and it actually came back showing that ds had something called Gilbert's Syndrome. This is a condition where the liver doesn't properly process bilirubin levels and symptoms can include nausea, dizziness and fatigue - exactly what he's complaining about.

He definitely has a fear of sickness now, which has compounded the whole issue, and I also suspect some school phobia now after not having attended for so long. But I am convinced the main reason for all this is the Gilbert's Syndrome. Unfortunately it's not something that can be fixed, just managed through diet, and even that's hit and miss.

Thankfully school have now supported us as doctor has confirmed he's too unwell to attend school due to his anxiety, so we are now working from home, much more happily. I hope this post can be useful for someone else in the future who might have similar issues.

Glad you have found the cause. Everything seems to be so quickly blamed on anxiety these days so your post may well be useful for others.

Glad your son is doing better and hope he learns to manage his condition.

Hi BreadHead, 6 years later and your post has been very helpful to me. My son is Year 7 but is refusing school due to Emetophobia. I have been so worried but it’s clear I need to put his Emetophobia first. I hope your son is now doing ok. xx