DD16 severe anxiety related to college

[Anonymum40]

Hi all, my daughter started sixth form college last September to do A levels. She was at a small private school before which we transferred her to when she was struggling in year 8 with confidence and anxiety which we thought were related to her dyslexia.

She loved her school but absolutely hates everything about college. She struggles with social anxiety and doesn't make friends easily. The latest problem is her obsession with perfection in her work. She sets herself ridiculously high standards. Unfortunately the college told her she could achieve 3 As and now nothing else will do. We don't put any pressure on her at home, she puts it all on herself.

She is a mess, working all hours to the detriment on everything else. Her room is a pit, her clothes are dirty, she never sees friends, she's been bunking off from her weekend job etc...

She's been seeing a counsellor for about a month but that doesn't seem to help. The doctor gave her melatonin tablets to help her sleep. But my question is whether we should go back and start the Fluoxetine the doctor is suggesting.

I'm really worried about starting on that as it seems like a slippery slope, but I feel like we've tried everything else now. Ideas, experiences and guidance appreciated...

I put off going on anti depressants for about 13 years despite suffering with crippling anxiety on and off since puberty. For me it was life changing and I have never looked back. Although the first two weeks I had some not very nice side effects, my anxiety disappeared and I have never regretted taking them. So much so that I will never come off of them, I will never risk going back to the shit life I had living with debilitating anxiety.

I have been on both citalopram and sertraline. Personally I'd push for sertraline as it is the one with the least side effects.

What’s the problem?
Room being a tip is normal for teenagers.
The fact she is spending all her free time studying is a good thing surely? Doesn’t she have mock A level exams coming up soon with scores that are used for university applications this autumn?

I’d be worried if she was spending all her free time hanging out with friends or working a grunt job instead of studying.

She sets herself ridiculously high standards. Unfortunately the college told her she could achieve 3 As and now nothing else will do. We don't put any pressure on her at home, she puts it all on herself.

The college would not have said she could get three As if they did not think they were achievable. Are you sure you just don’t have low expectations?

I mean if the college said she could attain BBC and she thought she could get AAA then she would be setting herself ridiculously high standards. But working towards attaining what the college has assessed as her actual potential is a reasonable standard.

Yeah, I can see you point Plan, but if you saw her you'd see mine. She's miserable, stressed out, sleep deprived and so anxious she can hardly breathe properly...

Thanks for your perspective Floatygoat, as she's 16 I'm not sure if they'll give her anything but Flouxetine (Prozac) as it's the only one tested on under 18s, but we'll see. I've heard others with a preference to Citalopram too...

Bump...

I think you are right to think this is a bad situation. A friend's daughter went on to develop anorexia as a result of perfectionism and anxiety - she was a high A* student. In the end the anorexia put paid to her ambitions. The anorexia was a result of very high anxiety - eating less made her feel less anxious.
Have you considered your daughter might have undiagnosed ASD? Knowing why she feels so anxious about achieving perfection, might help her in some way?
Medication has helped two teens I know of with severe cripping anxiety. One took Setraline, one fluoextene. Both were prescribed by child pyschiatrists through CAHMS, not GP. this was after many other attempts at dealing with the anxiety, therapy, CBT etc.
CBT helped ongoing.
Vitamin D is also the unsung hero of teen wellbeing.
Has she had a blood test for the usual culprits, vit d deficiency, iron deficiency, pernicious anaemia, folates, B vitamins. Again B12 deficiency was implicated in another friend's daughter's anxiety.
Disclaimer. I have a child with ASD (doing well, not currently anxious) and a child who had vitamin d deficiency undiagnosed at 16. (in Feb...winter is worst for depression - no sunshine, no vitamin d)

Also, any social group you can encourage outside school - choir, non team sport (yoga, dance, swimming, walking) might take the pressure off school socialising.
I would also get on to the school pastoral team asap, and alert teachers to ratcheting up pressure on academic side. Even if she doesn't engage or want to talk about it, at least they won't say the wrong thing.