help with major anxiety in 16 yr old partic over exams

[febel]

hi all, just looking for some advise as not sure where to go next. Had a bit of a rocky ride over this past year with YD and now has just admitted she hates college, hates some of her courses and is very anxious over it all. Is a bright child, all A s at GCSE but tends to worry (needs to know what we are doing in advance, won't have volume on certain numbers, flatly refused to take long flight when we wanted to go to USA etc) and unfortunately bottles it all up and disguises it very well ...she is a pretty good actress! I knew she was anxious over college as every now and again we have had an outburst (god only knows what our neighbours think cos when I say outburst I mean a VERY LOUD OUTBURST which ends in us both feeling mentally bruised and battered!)

Anyway, I know she doesn't eat at college really , or go to the toilet etc and college are aware of this as some time ago I persuaded her to go to student support. However, mock AS levels are now happening, AS levels looming and her anxiety has increased so much that the other day she had a major anxiety attack in class whilst her classmates were just talking about exams, her lecturer noticed and encouraged her to leave the room and discussed that perhaps she ought to see her doctor. I have had to physically take her in this week (I am off work this week) as she hasn't/won't get the bus) Had tears, sleepless nights etc.

We duly went to the doctor (she has flatly refused to do so until yesterday as she says they can't help her) and she wanted to see her on her own. (she is typical teenager, wants me, doesn't want me) Which was fine but I did worry she wouldn't put across her point well, though didn't say this to her, but she is 16 and it's good to be independent. I waited in waiting room. However, she came out of the doctors steaming, really cross, as all the doctor suggested to help her was to... "think of calm thoughts and pictures" and said "you shouldn't miss meals"...talk about basic advise!

She also suggested applying for CBT,which I had also suggested to YD, would possibly be good in the long term but we need something short term for NOW really. The doctor also added as she gave daughter the leaflet, "I don't know if you are old enough for this particular organisation" !!!! I am also waiting for CBT with this particular organisation....my appointment was made in Feb...and it's for JUNE. So no help with her AS levels.

She won't be able to do her exams unless she gets help, she panics that much that her hands shake and she can't think. We are looking at non exam courses for next year but not to complete her AS levels in itself is causing her anxiety and stress, and the fact her exams are looming. What is the point of her having studied and revised if she is so very anxious she cannot sit the exam...and I am afraid the calm pictures scenario does not work.

Any suggestions/experience PLEASE!

My dd sounds very similar to yours and has had panic attacks at school and physiological problems due to stress and anxiety. In the end we got desperate and I went private for CBT/counselling, as I wasn't prepared to wait for a catastrophic breakdown before she got some help. The good thing about doing it privately is that you can make appointments that are convenient to you and your child can help to choose a therapist whom they feel they can relate to. It has helped my dd immensely. We had tried CAMHs but she didn't like the experience and found it 'useless'!
She also gets extra support through the school counsellor and I went with her on a short course on meditation. I also bought some high strength St John's Wort (Kira) which although they are quite pricey she says they really help and whether this is just a placebo I don't know. What I do know is that a few months down the line she is a change person and much more able to handle her feeling, emotions and anxieties.
Good luck x

I have a DS with very similar symptoms.
I also found the GP to be less than helpful, although I went in with DS. He is 18 but would never have managed a frank discussion with a doctor on his own.
His college have full time counsellors who are used to dealing with all kind on anxiety related problems.
I would suggest you speak to student support about your DD and go back to (a different) GP with her.

Thank you so much, am so worried about her and feel the longer it is left the more entrenched her anxiety will become. Will look at going for CBT privately too perhaps, am waiting for organisation the doctor referred us to to get back to us (I phoned them as doctor was less than helpful and they said they judge each case on its merits...though am slightly concerned that the appointment will be months away..in which case will look at private)
The doctor being so unhelpful also didn't help as it has taken a lot for YD to go to a doctor about her anxiety, she kept saying they wouldn't be able to help...and lo, the doctor didn't help at all..which reinforced the lack of faith my daughter had in the medical profession on this particular matter. I was going to see if I could see another doctor next week and daughter has agreed for me to go in with her so I could remember all the doctor said....cos apparently she also mentioned blood tests, but then changed her mind when she read daughter's medical notes (has decided she doesn't like needles..you can imagine the fun when the cervical cancer jab was due) and also mentioned a brain scan..god knows why. But daughter doesn't know if either are taking place (sigh!)

My DD had very positive outcome for anxiety with CBT. However it was a 10 week course - I don't know whether it works over shorter courses as there was a lot of work involved in identifying the stress points and working out small steps towards tackling them. We got into a specialist teen anxiety clinic via GP referral in about 2 weeks and then DD agreed to take part in research which bypassed the waiting list. So definitely worth exploring, but probably too tight for June exams. I wonder if you could go privately for a few specific sessions about exam related anxiety while she waits for a more general assessment and treatment - might that be an option?

I think There is no quick fix pre-exams for your DD. CBT can be helpful, but it also requires a bit of homework so teens sometimes find it challenging . A few private sessions with someone specialising in adolescents might help through this exam period.

It seems harder than ever to get assessment referrals to camhs via gps(who are not usually v experienced in teen mental health) and I think you need to understand more about her triggers to stress and why she is so anxious so you can best help her. A camhs psychiatrist can also help if she isn't sleeping etc . Can you get a wisc 4educational assessment via an Ed Psych over the summer. we were able to get one through a dyslexia charity. This may point out memory processing issues/asd traits etc, and gives a document for schools to support her with.

My DD has ASD traits, and has similar responses to exams. At 14 she suffered severe depression/anxiety. It was quite a long road to recovery, but she understands her vulnerabilites now and how to manage them, so can focus on her strengths.Although my DD struggled with exams, she 's very bright and the assessment gave her the confidence to pursue university.

My advice is to think in the medium term about these exams.....they are not more important than her mental health. Try to take the pressure off at home (as school won't). and remind her that whatever happens, lots of kids retake AS's . If she can't take some modules, try not to worry as she can do it next year and many schools dont give AS results out to prospective unis. .

Maybe, Tell you think that she will benefit from some therapy but it might take a bit of time to find the right person, and this year is not as important as next, so you and her have time to find her the best support. My DD even changed colleges during A levels, and it was fine.

The first GP we saw was brutally dismissive and told him to get a grip . The second one was better though not great.
We were told that the wait for an NHS counsellor would be months whereas the college counsellors could see DS immediately. I questioned whether these were properly trained people, and was assured they were professionally qualified counsellors.
Even if you go down the private route eventually, it's worth a try.

yourlittlesecret. Its so much harder when they turn 18 isn't it as GPS are not specialists. Even though my DD had been hospital several times, it took over a year for them to allocate an adult therapist . However, as an adult - there is a bit more low cost /charity support available. I think higher educational counselling seems better organised than further ed/schools, but a counsellor is not a psychotherapist or psychiatrist, and I think its worth paying for an assessment with someone qualified who might suggest counselling will be enough but might pick up if they need stronger support. best of luck to you and your son.

Have you looked at computer based cbt or mindfulness based apps for her phone? Whilst I don't think these are quite as useful as face to face appointments, they might help get through the next few weeks? I started with anxiety issues at 16, it was really hard. Talking helped, as would have did reassurance from parents that things will be ok.

Have been trying to think of some other things which helped my 16yr old self.
Writing stuff down, not in any structured way just getting it out, was good, though I worried others might read it.
Quiet life tablets or similar, which are herbal valerian type things, were useful in low quantities. (Didn't want to be zonked out.)
Also thinking through questions such as 'What if..?' So for example, 'what if I feel a panic attack coming on in an exam?' Then talking/writing through the possible outcomes. And for each outcome then saying again 'well what if X happens?' Digging down into the answers to explore why things seem such a problem. Even if they are hard to think about at least I felt I had prepared myself. I don't mean it to sound like 'Well, so what?' in a dismissive sense by the way.
Sorry if I've not explained it very well.

DD is currently under CAMHS for a panic disorder. She likes the therapist and he has been very helpful with strategies for the school and is trying to give her some techniques to control her breathing and thoughts, but it's early days.

I am very interested in the St John's Wort and Quiet Life suggestions - would they be appropriate for a 14 year old? Do they just aid general calmer feelings, or help in a moment of panic?

Quiet life could be used for either I think Tilly. Rescue remedy spray is another one that helps for an instant burst of calm I find. Not miracles but all part of a parcel of tricks that can give back a feeling of control.

His counsellor suggested those things to DS. I made no comment about woo in the hope that there would be a placebo effect and I bought him some rescue remedy.
Unfortunately I think you have to believe in that kind of thing for it to help and he really doesn't.

He is better now than 6 months ago and he has learned to notice when he feels good and to remember it when he has a wobble. This has helped.

Thanks pudding/secret - I must go and find some!

I have just been through this with DD also. You need to find a good GP who understands. Don't give up, you need support and understanding. We ended up with a private GP and also psychologist who were great. We did not have time for long term CBT as exams were approaching, but just talking through things with the psychologist helped dd a lot!

Also, a combination of fresh air, walks/exercise, fresh food, good sleep and vitamins (B5 and magnesium are very good and calming). And lots of parental support and reassurance!!

It's a difficult time but remember....this too shall pass.

Good luck!