Help with DD

[N00tN00t]

My dd is currently under assessment for ADHD. She isn't in school ATM, and is receiving 90 mins 121 online with a tutor. She has had anxiety issues for some time which came out in school as 'fight or flight' and often got her into trouble. That's the background.

For the last 10 days She has had a really sudden and extreme fear of allergies. She is refusing to eat, and has only had a mouthful of noodles, half a dinner and half an ice cream since last Thursday. She had not much more than that in the few days before.

She used to shower twice a day and use face masks like they're going out of fashion, but she hasn't showered in over a week, and her her is greasy and getting matted. This is the complete polar opposite to how she was just 2 weeks ago.

I spoke the the gp last week who told her it was highly unlikely she will develop a sudden allergy and this helped for about a day before she was back to being adamant she is allergic to something, she just doesn't know what, so can't eat anything.

Has anyone else had any experience of such a sudden attack of anxiety around something so irrational? I've managed to get her a face to face appointment with gp tomorrow, I'm just running out of ideas to help and I'm really worried.

I don't know anything about ADHD but I have teen girls and this sounds like anxiety manifesting itself big time.

This programme (although it's a comedy) explains the science behind the development of the teenage brain and is really worth a listen:

Google - BBC sounds - The Infinite Monkey Cage - The Teenage Brain

(Sorry can't seem to link for some reason.)

Also Google "ARFID" Avoidant, Restrictive, Food Intake Disorder.
It is very common among teenage girls, particularly those with ADHD and it sounds to me like your DD may have this.

In your shoes op, I would be doing everything I could to take your DD "out of herself" and "out of her own head" doing lots of different activities if possible. Does she like nature, or animals, cycling or art, jigsaws, or shopping... basically the aim is to distract her big time to help her through this hump.

Maybe construct a very simple timetable together, something very undemanding, so she does the same thing every day and finds it reassuring eg, get up and dressed by 9.30am, eat breakfast (however small), go and stroke animals at open farm, or or walk a dog, or collect autumn leaves (basically anything that is undemandingly physical but outside at same time) home for lunch, jigsaws and board games, nap time etc etc. Or just let her help you do chores or go for a hike ride with her.

I personally would restrict the time she spends alone on a screen.

Also she needs some help from a licensed psychologist who specialises in adolescent mental health. I know it's not easy when they are not cooperative, or the fear is making them intransigent and you are so worried about her, but don't go too far down the rabbit hole of fear with her, let her know you are there and treat her sympathetically but equally keep modelling "quiet cheerfulness", "normality" and "reassurance" and keep the lines of communication open, listening to her fears but not dwelling on them. Let her know she is loved and that loads of other teens go through this sort of thing so this is normal for adolescence. She may think she is the only person in the world suffering like this and that's a scary thought so let her know she is not alone and loads of teens have similar issues, especially after going through a pandemic, which basically comes down to the plasticity of the adolescent brain. She needs you to be very steadfast right now so sending you lots of strength and patience. I hope the GP is helpful

That's great @gogohm. How long did it take your dd to come through the worst of it?

Musthurry.
That’s sounds like really good advice grounded in experience. This must give the OP comfort and hope.

Could you put an antihistamine on the table and explain how they work and promise her if anything goes wrong she can pop it immediately. Also explain that any reaction will happen straight away so as soon as meal is over she doesn't need to worry that something will react hours later.
I have issues with swallowing and the only food l will eat is anything without lumps/ bones etc so could you make sure all her food is very simple to swallow as if l feel any of those in my throat it can cause me to panic. My issue is caused by reflux and l am years older. It is very debilitating for her, poor girl.

[quote N00tN00t]@BonnesVacances that is interesting and I have saved a Web page on it. I'm just a bit reluctant to start looking into too many things at once. I don't want dd to think there's definitely something 'wrong' with her. I am keeping all suggestions in this post, though as a just in case.[/quote]

It's the rash that made me think tbh. If DD has a flare (and we're still trying to figure out the triggers but stress is a big one), she gets a rash and her anxiety levels go through the roof. The first one she got we tried Canestan on as we thought it was a heat rash. Antihistamines cleared it up.

@BonnesVacances I don't think it 'is' PRS, obviously it's inappropriate to claim it 'is' anything. But it should be on OP's radar alongside various more common things like OCD, which my comment also mentioned.

Having a heat rash does not translate to having MCAS. True MCAS is also rare, and NHS doctors are frustrated by people self-diagnosing. They're aware of it, but many people think they have it who really do not.

@N00tN00t Don't let your daughter find out about MCAS, if you can possibly avoid it. She will absolutely begin to over-interpret her physical responses to anxiety as 'MCAS reactions' and it will make treatment much harder.

(Speaking as someone with a fully established MCAS diagnosis!)

[quote Innocenta]@BonnesVacances I don't think it 'is' PRS, obviously it's inappropriate to claim it 'is' anything. But it should be on OP's radar alongside various more common things like OCD, which my comment also mentioned.

Having a heat rash does not translate to having MCAS. True MCAS is also rare, and NHS doctors are frustrated by people self-diagnosing. They're aware of it, but many people think they have it who really do not. [/quote]
Likewise, it's important to be aware of it in the context of having anxiety, as anxiety is usually treated as a MH condition when there could in fact by underlying cause for it. This is also where PRS is dangerous as it's easy to miss genuine conditions if that's assumed.

MCAS is unfortunately not rare and is strongly linked with Long Covid. I'm glad to hear that doctors are aware of it though. That's not been my experience, but I know because of LC it's coming to more doctors' attention. I'd be amazed if it was picked up by a GP or consultant without any signposting though as it doesn't show up on any NHS testing. So felt it would be helpful to mention.

Yeah, I agree it's not a bad idea for OP to have MCAS as one of the causative possibilities in the back of her mind, @BonnesVacances - but if (as seems more likely) this is a MH issue, it could be harmful for her DD to become aware of it. I think you are overestimating how common true MCAS is, but obviously with the impact it's had for your own DD, I'm sure you're v aware of how wretched it can be to have it missed!

@BonnesVacances has your DD been assessed for anticholinergic urticaria?

[quote Innocenta]@N00tN00t Don't let your daughter find out about MCAS, if you can possibly avoid it. She will absolutely begin to over-interpret her physical responses to anxiety as 'MCAS reactions' and it will make treatment much harder.

(Speaking as someone with a fully established MCAS diagnosis!) [/quote]
Speaking as a DM of a teenager with a definite diagnosis MCAS too from extensive testing and clear high levels of mediators, I saw the relief that this was the cause of her anxiety and the peace of mind this gave her. Obviously OP will know what's best for her daughter, but to suggest that overanalysing her symptoms will make it worse is baffling to me and the kind of nonsense you get from doctors who don't understand it.

I'm going to bow out of this thread now, but if you want to PM me for anything OP, feel free. Good luck to your DD.

@Musthurry that's a really great help, thank you

Poor lass - she needs referral to someone to treat her anxiety. GP needs to focus on this, either by prescribing some relevant medication or/and making referral to CAHMS.

The allergy is a focus for her anxiety, which is the basic problem.

Can you afford a private appointment for her with a child psychiatrist to address both her possible ADHD and her anxiety? That would be the quickest way for her to get help. You can be drawing your pension by the time CAMHS send an appointment.

My DGD of similar age went down the private route. She is on medication to calm her anxiety and is doing well.

Unfortunately, I can't afford to do that. I will look into trying to fund it somehow, though, if I can't get appropriate help soon.

to suggest that overanalysing her symptoms will make it worse is baffling to me and the kind of nonsense you get from doctors who don't understand it Again, I have an established, unequivocal diagnosis of MCAS. I have had this for years. I am the last person to suggest it does not exist.

The mind is part of the body. Physical sensations arise as a result of thoughts and emotions; this is normal. It is not 'nonsense' or stigmatising to observe this. Over-fixation absolutely can be harmful for a child with additional needs of many different sorts (including 'just' a physical disability!).

@BonnesVacances If your DD continues to struggle with these issues long-term, it might be worth not being deliberately hostile to experienced adults who have spent years/decades learning how to manage them effectively, as we are often the best placed to share tips, etc.

@N00tN00t It's great she's taking fluids. Keep gently trying with drinks, especially anything with calories - doesn't matter if it's sugary!