Should we seek a private psychiatrist for our daughter's severe anxiety?

[Pleachedpeartrees]

Hello, just so worried about my 20 year old daughter. She's had anxiety on and off from age 8. She's now worse than ever. Travelling, exams, unfamiliar places, crowds, social gatherings set her off. Panic attacks can last hours, she describes it as a stomach flipping sensation that can last hours. No particular trauma in childhood. She's tried various ssris, lots of talking therapy including cbt and emdr. Doctors only suggest increasing ssris. They won't refer her to a psychiatrist. She's not really living life and it's now making her depressed. Do I pay for a private psychiatrist, which will be thousands, or try hypnotherapy? Just running out of ideas.

Well yes… if you have the funds you should have done about 11 years ago

Yes. ASAP. I did thos when my daughter was 12. She literally is a different child now, she was debilitated and barely functioning before this

"No particular trauma in childhood". Nothing that you were aware of. But something prompted her to be afraid of new experiences.

Sometimes people just get anxious about being anxious. Might be worth watching this :

We don't have health insurance, so it looks like it will be £400-650 a session for a psychiatrist. We can find the money. I'm just not sure what they can offer different from all the therapists she's already seen, and I don't know how to choose one, it looks like a bit of a minefield. I'd be interested to hear from people who have had success from psychiatry and advice on finding the right one, thank you. She improved when younger and I thought she was over the worst of it, but thank you Bleina for your compassionate reply 🙄

Yes, though check what methods they’re using as if CBT didn’t work last time it’s unlikely to again. Is she ND or do you think she might be? If so make sure you get someone with experience of that as a lot of the standard therapy needs modifying for autistic people.

She isn't ND in any way I can see

Are you sure? I couldn’t see it with DC2. Between age 18 and 20 they were diagnosed with dyslexia, ADHD and autism. The main sign was anxiety.

If you can afford to, I would say yes pay to go privately. My daughter is 13 and struggling with anxiety and I'm also considering a private psychiatrist for her as a family member has offered to pay as the GP and school haven't been much help. It completely controls her life and she is existing/surviving rather than enjoying life. I hope your daughter improves with help from a psychiatrist if you do go privately

She's never had sensory issues, no dyslexia or adhd behaviours, a wicked and sometimes sarcastic sense of humour from quite early on, lots of interests, no obsessions. Very good in social situations, when she does make it out, friends find her very funny. I know about masking, but I've never thought her ND in any way. She has slight OCD about switching things off/locking up before going out.

I would also second ND. My DS is still awaiting Autism/ADHD assessment at 20 but has struggled with anxiety since being a child. Seen school councillors, CAHMs and then I paid for a private therapist specialising in ND. She did hypnotherapy and EMDR with him with some success for treating panic attacks. He still struggles at uni though and is now trying SSRIs. If there's no trauma or any other obvious causes it's very often ND so it may be worth looking at. Hope she feels better soon.

Sounds very similar to DC2!

How’s her sleep?
Does she tend to assume the worst about what people say to her or what they think of her?
Does she argue with you or get upset if you ask her to do a chore?
Were her grades at school disappointing?
Did she get told off for chatting?
is she sporty?
likes coffee? Alcohol?

One of the advantages of seeing a private psychiatrist is that they can often prescribe different medication, or combinations of medication, that an NHS GP wouldn’t really prescribe. I’ve tried plenty of ‘off label’ medications, some of which have been extremely helpful but which wouldn’t be available for that purpose on the NHS.

She's always been a straight A grade student, excellent concentration. She likes a glass or 2 of wine now and then, has cut caffeine out. Sleeps well generally unless particularly anxious about the next day. Organised and competent with most things. I'm not willing it not to be ND related, but I know in my gut she isn't - if I suspected it, I'd be straight on to it, if such a diagnosis could help in some way.

How long was she on the medications? And how many different ones did she try?

Some work better than others for anxiety

If she has learned CBT does she actively apply what she has learned?

Is there a relative or someone close to her who has also been anxious?

Has she tried meditation?

I used to be terribly anxious and even had agoraphobia at one point and OCD

Medication really did help as did meditation every single day

I just want to say that it really is possible to completely overcome this

If you ring the Priory group, they can help you and tell you prices etc ..

I also 2nd the ideas around neurodiversity.
However the gp absolutely should be referring her to cmht after several different medications haven't suited her and the level of impact this is having on her day to day life and functioning.
I'd go back to GP and ask specifically for a referral to cmht for their specialist assessment and medication review and mention Martha's law as this is clearly something that has been discussed with them several times.
Sounds like she definitely meets the threshold for secondary mental health services.

A psychiatrist will do a full assessment and diagnosis, to check you’re treating the right thing, then prescribe meds if needed

A psychologist will offer psychological therapy

The psychiatrist is probably only going to be useful if you think the diagnosis is wrong or you’d like to try different meds. Otherwise go with a psychologist

My advice is to try everything you possibly can. That way you won't regret not trying things later IYSWIM.

I'm the meantime. Buy Claire weekes book titled self help for your nerves. It's brilliant. If she follows the advice in there to the T she may never need to be seen by a psychiatrist.

The EMDR bit caught my attention. What was that for if there wasn’t any particular trauma? And as her mum, what do you think is behind her anxiety? Especially as it started so young?

You need to find the right therapist. It's HARD. My DD10 has had anxiety meltdowns (is ND but this is her main issue) when presented with surprise tests, etc. We have been through many therapists, psychs etc. all paid privately (extortionate prices too). None were much help.

Thankfully DD's school has just employed a psych who has a different approach. Sees DD weekly at school & DD has improved dramatically in a few weeks. The psych's methods and way of engaging are non confrontational and easy for DD to use. It's taken years to find the right fit. Now I just have to ensure DD still fits the criteria to keep seeing her (lots of kids need the help).

Pay for family therapy.

I would pay for talking therapy (not CBT) rather than a psychiatrist. Psychiatrists are more for diagnoses and medication, when it sounds like she needs a space to talk about these feelings and try to understand herself better.

I’m autistic and nothing you’ve said screams autism to me. Sounds like classic generalised anxiety. I would at least try a private psychiatrist, looking for one that specialises in anxiety.

Sorry but NT people can and do all the above. How are those signs that someone is ND? No wonder many people question the validity of all those mild ND diagnosis. By those criteria literally everyone could be classed as ND.

Did you see a psychiatrist? What did they do that helped?