Severely anxious teen with agonising anxiety triggered abdominal pains

[BlueMoanday]

My DD(17) with ADHD traits and likely on spectrum (but undiagnosed as yet) has severe anxiety.
She curls up on the floor with agonising abdominal pain, 8/10 scale, for hours. Starts when she wakes up and comes in waves. Absolutely nothing helps.
(It isn't medical - we have spent a FORTUNE on ALL the physical tests)
College is being understanding but she has missed SO MUCH.
Fluoxetine didn't work (2 months) nor propanolol added to it.
Now she is on Sertraline (50mg) .... Been on it for a week.

What has worked for your child?
How long until she might feel better on this?
If it is abdominal migraine triggered by anxiety is there anything else we can do?
It is breaking all of us.

Am sorry you are going through this. My eldest dd was exactly the same 17, autistic severe anxiety and depression was hospitalised with stomach pains which turned out to be psychological. DBT via Camhs saved her life the antidepressants and the CBT/counselling were not helpful at all. Has she been offered DBT?

@BlueMoanday I have never had your DD's sypmtoms but one thing I would say ( trying to be helpful but I am sure you are all over this ) SSRIs take a while to kick in.

Take better advice than those who know better but the only advice I can give and I truly wish you and your DD well

Try and see a neurogastroenterologist.

Try and get a referral to a psychological pain clinic via the GP.

Norotryptiline is worth looking into.

Look into Ehlers Danlos Syndrome.

Just because there’s no cause yet found doesn’t mean it’s not physical. Don’t focus on it being psychological as no matter the source of the pain, it’s harrowing for her.

There is a very strong brain-gut link. Research functional gut disorders, where nerves misfire pain messages to the brain; it doesn’t mean it’s not real, and to her it feels very real.

So sorry to hear this OP. My DD had similar severe abdominal pain plus anxiety. We saw a gastroenterologist and she was diagnosed with dysbiosis. She was put on a low FODMAP diet and the severe intermittent pain (which had been going on for months) disappeared in 3 days on the new diet. It could be worth a try. Good luck.

@DragonFly98
Thanks. DD is seeing a counsellor but I don't know which type.

I will read up on DBT as I'd never heard of it

www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/

Hi,

This used to be me with an unknown pain/problem. I know now from the age of 16-30 I had horrendous health OCD along with potential hormonal issues playing into things.

Also just wanted to start with 2 months on an antidepressant isn’t enough time to figure it out. Sertraline seems like the best option here and really helped me (I didn’t overcome things whilst on sertraline but I felt a little better overall with anxiety.)

I did have a few issues which weren’t picked up until later but these were mostly gynae problems which also made me untrusting of drs for not picking these things up earlier. I would also hyper-fixate on a different thing every few month/year or so.

I did go through so many tests for different things from multiple MRI scans, colonoscopies, CT scans, ECG, X-rays and at least a monthly visit to a&e because I was “dying.”

When I had the stomach issues which were horrendous, I actually ended up at one point in a serious situation after passing so much blood and was in hospital for a few days yet a colonoscopy didn’t show any physical issue. I fixed my diet (no gluten, low sugar etc) and my stomach issues haven’t come back since. Prior to that coming to a head I would have bad stomach pain, my stomach would constantly gurgle and I had general IBS issues from a young age. I would have horrendous periods and would be in agony along with diarrhoea which would result in a lot of time of school/college/work.

Other issues were;
neurological -pins and needles, smelling things which were not there, struggling to use limbs, pain in different areas, extreme fatigue, vertigo. I truly thought I was having a stroke when this would play up or that I had MS. It was terrifying.

Heart - tachycardia, struggling to catch my breath, chest pain, rib pain (costocondritis) I was adamant I had a serious heart condition and they just kept missing it.

I spent years trying to find a cause and was enabled by family/friends at the time because no one wants to see a loved one in pain. It’s honestly such a hard situation for all because the psychological pain it causes is REAL. Then once the pain sets in it causes panic because it’s all you can think about even if it only started out mild. Personally I would then body check and google so much and get myself even worse to the point where I couldn’t get out of the sensations.

They never found anything 100% wrong with me but also I noticed;
-Drs weren’t looking into my bloods properly (for example the NHS normal ranges for things are not optimal nor are they normal in other countries.) have a look into blood test results and research how to optimise these as much as possible.
-Healing my gut with my diet and probiotics was super important. Balancing my hormones with inositol and other supplements.
-Therapy including EMDR would be a good option.
-Also something to help your daughter in that moment maybe look into diazepam as it can stop the panic which results in worse pain

I hope this helps and if you’d like to DM me feel free. I’m sorry you’re all dealing with this x

And along with all this the closest I got to an answer was that it could be set off by silent migraine which would then trigger these OCD and panic episodes x

@mfhtoeh and @Willow12345 thank you 🙏🏽. We totally believe her. It is real pain and we now know it is triggered by anxiety.
She has seen child gastro specialists and had THE WORKS as far as tests. To the point you are praying they find something (awful). (Double endoscopy, full MRI, all the blood and stool tests etc etc). Still nothing.
Tried diets.
In a well period she had a school residential trip and the pain came back, right out of the blue, the week before the trip. So we know it is anxiety rather than diet triggered.
Just SO SO struggling.

@Nttttt thank you. DD says this sounds a lot like her. We will look into the gut health again and read again what you said.
It is so hard living with this.

Hopefully they can get to the bottom of things and help her.

Medication-wise she needs a Dr to supervise her, especially at such a young age. There may be benefit in diazepam for 2 weeks to stop the cycle, but she’s still got to settle into Setraline first and you don’t want her zonked unnecessarily.

Just keep in mind that just because there’s no known physical cause yet it doesn’t mean there isn’t. Gastro issues can be an absolute nightmare for both patients and doctors.

A something that there’s no harm in trying is Symprove. It’s expensive but is actually really good. Go for the mango one!

Have they tried biofeedback? No harm trying if not.

The bowels LOVE routine.

Buscopan?

I’m sorry OP and I’m sorry for your poor DD. If she uses Instagram a really great person to follow is Cherellethinks she talks about health anxiety and overcoming it which was helpful to feel not so alone at all.

Also I used to be terrified to take medication because I was so scared of the side effects. The first time I took diazepam(2mg) I was absolutely terrified and it look my multiple panic attacks to actually bite the bullet. (I then cried and was sure I was going to die lol.) Diazepam sounds scary like a really big drug but such a small amount (under 5mg) can even be safe in pregnancy so it’s honestly not a big deal as long as someone helps you monitor it as it can become addictive which is why I only take it when I’m having a panic.

I had a morbid obsession with thinking I would die and would set times like I wouldn’t make it to my 16th/18th/21st birthday. My 30th was my first big birthday without this thought 🙌 I also would focus on statistics like how many people get a certain disease of certain ages and would be sure that I would be that percentage.

I’m also pregnant now which I would’ve been terrified by the thought of and after the gynae issues I had I really didn’t think I could conceive, so it’s happiness all round now, unmedicated with just a normal amount of anxiety here and there :)

Has she had gynae issues looked into? Sorry if this has already been mentioned

Careful as buscopan can constipate and if the pain is linked to constipation it can worsen things. Same with mebeverine.

My advice is to ask a neurogastroenterologist about it all but in the mean time avoid anything that can constipate or cause trapped gas.

Trapped gas is AWFUL. Simeticone can help (infacol/windeze). Trapped wind can be as painful as appendicitis in my experience.

You’re doing amazingly! Congratulations on the pregnancy. Inspiring how you’ve turned your life around.

If you google pain science education there are some good explanations and exercises such as this https://www.greglehman.ca/pain-science-workbooks
but for any of us especially teenagers it will take a radical reset of thinking so would need to be worked through with a trusted adult or counsellor.

@ArseInTheCoOpWindow love the user name 😁
Yes tried every single bowel med, buscopan, wimdeeze, fibre / laxatives, lanzaprazole etc etc etc

Thank you so much!! It’s been a tough journey but it feels so great to be here now x

@mfhtoeh I bloody hope not!!! 😱😱😱😱

How miserable for her.
Wishing you all the best of luck.

Did you see any other specialists/get tests for other than gastrointestinal issues?

There are a lot of different organs in the abdominal area that can cause such pain.

• Ovaries- cysts, cancer, ectopic pregnancy
• Endometriosis/fibromyalgia
• Kidneys- infection, stones
• Gallbladder-stones, cancer
• Pancreas- infection, cancer
• Hernia
• Lupus
• Hepatitis infection
• Thyroid- Graves disease(which causes anxiety too)

“In a well period she had a school residential trip and the pain came back, right out of the blue, the week before the trip. So we know it is anxiety rather than diet triggered.”

This could be coincidence, or flare up of a physical cause due to extra activity/stress.

@BlueMoanday I have been where your daughter is now. What saved my life was following the plan put forward by Claire weekes in her book SELF HELP FOR YOUR NERVES. Google it. It's really simple but by no means easy. Read it yourself, then help your daughter follow it to the T.

DBT works well with people who are neurodivergent, regular counselling and CBT is rarely effective.