Ds (8) keeps vomiting when anxious

[HighlandCowbag]

Hoping someone can reassure me, am not normally anxious about health things but getting a bit worried now.

Ds (8) has always been a bit prone to vomiting. Usually the first sign he has a temperature is he throws up. Or if he eats too much rich food, or gets something stuck in his throat he voms. And he also has a very high gag reflex.

In February he had an incident in his swimming lesson which involved being rescued by his instructor. He got back in but was understandably upset. The week after he presented to be ill at school to get sent home to avoid swimming. The week after that, after being warned I wanted no pretend poorly, he projectile vomited at school, got sent home and 2 days off.

Since then at least once a week he is sick. It can be because he is over excited, over tired, doesn't want to do something.

Sunday night he said he felt sick (first day back at school after easter), yesterday morning said he felt sick and was coughing before school but I just reiterated if he was sick at school it was 2 days with no devices/internet/fun things. Just at home with me while I do uni work, he could read or play quietly with toys. He wasn't sick, but woke me up at 11.30pm being sick again.

I'm sending him to school, he's not ill and he needs to know that being sick doesn't equal being off school.

But I don't know how to help him stop being sick when he is tired, anxious, excited. Obviously I can make sure he gets enough sleep and eats well but I can't rule out anxious or excited emotions and he needs to learn to manage those emotions without projectile vomiting.

Hello, first of all sorry to hear you and your son are going through this!

I've name changed to post (weird NC but had to use a previous name, assume as a quirk of the update) as I'm giving a lot of personal detail here but wanted to share as much as I could in case it helps.

I was diagnosed with Generalised Anxiety Disorder at age 10, started presenting in the same way as your son (vomiting, particularly at night and ahead of something that made me anxious) at around age 8. I feel for you both as I know how hard it was for me and I can only imagine the strain it put on my mum.

It's such a difficult thing as it's not really about learning to regulate emotions if it's this severe - its an involuntary physical response. 20 years and 3 rounds of CBT later and I will still vomit in times of intense anxiety, but the difference is it is now manageable. The most important thing is to rule out any potential physical illness, and once that has been done work on moving past the fear of vomiting. This meant I could still attend school etc with minimal disruption, with my mum just agreeing with teachers I could get up and leave for the bathroom without permission if needed/would have an invigilator looking out for me in exams in case I needed to get to a bathroom etc. An added bonus of this is that I find vomiting bugs much easier to deal with than most people!

Secondly, and I found this one the most difficult, even once I had a better handle on it the vomiting isn't always in rational scenarios. I can cope with huge amounts of "rational" pressure, I am an Investment Banker so hugely pressured job, which I cope with fine. However bring anything into the mix which sets off my anxiety, which could be as ridiculous as a misunderstanding with a friend, and I'm back to being 8 years old and vomiting before a spelling test. When I was younger I would be ill without fail on a Saturday night (in addition to other triggers during the week) purely because it was Saturday and my brain had decided that meant I'd be ill, so I was anxious over the potential for an anxiety attack... just an example that your son may really struggle getting a handle on his triggers and it may make no outward sense!

Finally, I'd say your handling of the staying off school is scarily similar to my mum's so spot on in my opinion 😅it's important he doesn't see staying off school as a punishment as it sounds like he can't control this, but equally it's not a fun time - if you are off school poorly then you need to rest, no "treats", not as a punishment but because you need to focus on getting well. It helped me work through to a place where, as mentioned, I had coping strategies to deal with attending places/events that made me anxious. It's a real struggle between being there for your anxious child and giving the tough love to push them to not miss out life due to their anxiety - for what it's worth, it sounds like you're doing a great job.

Obviously this is all based on my experience but I just wanted to share in case helpful as it sounded so similar, but clearly could be way off the mark as you know your son best!

Hope you have a better day today

Thank you very much @SorryForTheRant that helps a lot actually. I definitely think it's mental rather than physical. I blame bloody covid and lock down. He had a tough time of it, we lost fil to covid early in the pandemic. Then lost my beloved aunt last year from cancer. Which is when the vomiting/anxiety stuff first started. He lost his confidence doing kayaking which he loved at the time, then we had the odd incident but put it down to tummy bugs but looking back I think it was anxiety.

I need to book a gp appointment I think tk rule out anything physical, then ask for some kind of diagnosis so he doesn't get sent home from school for 2 days at a time if it happens at school. That's my first job I think.

Then try and help him with coping strategies. Am not optimistic about help from the NHS, it's shocking for childrens mental health locally so may have to investigate privately.

Sounds even more similar, mine also started following several family bereavements close together! Sorry to hear about the state of MH services - feels like it's a common theme nowadays, I was lucky to get treatment when I did as it was far more available.

My most useful round of therapy was CBT when I was 10/11 - it all focused on slowly building up to doing things that triggered my anxiety by doing "homework", so as an example I had real issues staying away from home. One night a week I had to build up to this, so week one was staying up with my dad to watch a film while my mum went to bed, once I'd managed this without vomiting repeat the next week to reassure myself I could do it twice to "break the cycle". Next week stay with cousins until 10pm, aunt to drop me off while my parents stayed in bed (awake obviously so I was safe but so it felt like they weren't there), and repeat etc, all building up to a night away from home. And along the way developing coping strategies - deep breaths, mental distraction, plotting out the closest bathroom in case I thought I would be sick.

It must be an awful thing for you to watch it happen to your son, worse than going through it yourself, but if it's any consolation I got on top of my anxiety more than my parents ever thought I'd be able to, moved to the other side of the country for uni etc., something which they have told me since they wouldn't have dreamed would be possible when I was your son's age.

Good luck!

This sounds very like my youngest son. He was often sick, accompanied by stomach pains and turning a deathly pale shade. He even used to be sick every swimming lesson at school like your son. In the end, and it took a while with him being sent home from school with a ‘tummy bug’ etc, he was diagnosed with stomach migraines. They can be stress related so that would fit too - he was an anxious child too. He is an adult now and has grown out of his stomach migraines but I think some sufferers have migraine headaches as adults. It would definitely be worth ruling this out anyway.

Watching with interest as my 8 year old has had a few episodes like this, been sent home a couple of times but not actually unwell - am sure it's anxiety. His teacher was really good and spotted that it was anxiety. Hopefully just a phase but useful to hear others' experiences.

It is useful to hear others experience isn't it? He's had a good day today at school, came out happy then we were busy with pony stuff until 5.30ish, had his tea and gone to bed.

Have told dh and dd we need to be really calm and quiet and kind at home. We have a nice life but like any family we off load stress on each other. Dd doing A levels so stressy over those and uni choices, dh is soft as a brush but works on a building site so can be a bit loud and shouty at home, not at anyone just in general. So a bit moany/ranty over lifes little dramas.

Will ring GP later this week and try and get a phone call to discuss.