What could be going on with DS and how can I help him?

[PhoboPhobia]

Sorry - this might be long.
DS is 17 and in his first year of college doing car maintenance. He was never very keen on school from the work point of view although had lots of friends, got on well with teachers and didn't get into any trouble.

He got very low grades in his GCSEs and is now retaking Maths and English at college.

All through senior school he would often say he didn't feel very well, try and get out of going to school. Often he would get quite worked up and anxious and for a while in Y8 we had to work with the pastoral team to get and keep him in school as he would become hysterical every morning. That all seemed to stem from a bout of actual sickness when he vomited at school and then became anxious it would happen again.

He was obviously at home a lot during lockdowns and he finished Y11 in April. I wfh full time and so we have spent a fair bit of time together.

He really seems to be enjoying the new course and has had great feedback as well as full marks on all of his assessments so far. He thrives on practical work and picks things up really quickly - it's onlt written work he struggles with. He sort of got labelled in middle school as having 'high functioning dyslexia' but senior school didn't really support that and I don't even know if that's really a thing? He was never struggling enough to get ed psych assessment.

The week before half term he had a really bad cold. He had a temperature and aches and ended up all week off college and in bed. He was really quite unwell, verging on flu like. Since then he has gone back to the 'feeling sick' in the mornings and either not going to college or coming home half way through the day.

I'm pretty sure it's an anxiety thing. I don't doubt he feels a bit unwell, DH had the same cold and hasn't felt 100% since but I wonder if the fear of vomiting thing is making him anxious?

The main issue is he just will not talk about it. DS has always been a bit of a closed book emotionally. You can't push him and he has stated clearly that if he keeps being asked, it makes him clam up even more so I want to respect that.

He has the opportunity to start a pt job alongside college but I am worried about his ability to be committed (haven't said that to him).

Any ideas on how to support him? He has a 40 minute train journey to college so I can't take him - that used to help with school.

He's such a lovely lad, he's got nice friends and he's happy and fun most of the time. We eat together as a family most nights and he will chat about his day, films, games he his playing etc. He just doesn't want to talk about how he is feeling.

He probably has normal post-viral feeling-a-bit-crap, but complicated by the history of somatic nausea. Obviously this isn't a medical opinion at all - just based on your post and I'm not a doctor. Vomiting at school was probably embarrassing and distressing, caused a lot of anxiety, and created a bit of a feedback loop for him. Or I wonder if he could be suffering rumination syndrome? Gastrointestinal issues and anxiety/distress are very commonly linked, and it's not really surprising this could trigger it off again. I have a lot of sympathy for him, poor thing, as I also had a lot of nausea as a teen and developed a psychological aversion to vomiting.

It's hard to know what to suggest regarding support/how to move forward. Given he is so reluctant to talk, my (layperson's) suggestion would be to just keep things as calm, normal and routine as possible, and try not to let him know you feel anxious, as it may wind him up more. I'd hope that it will calm down again with time and getting back to normal / feeling more secure in his environment.

He could of course see the GP to discuss the nausea - I'm not sure if they'd be willing or able to do much, because it likely is a somatic symptom, but that option is there if you or he feel it's needed. It's a shame that mental health support is so hard to access.

@Innocenta thank you so much - I hadn't heard of rumination syndrome but a brief read does seem to ring bells. I'll do some more reading.

You're absolutely right, I try and not let him know that it worries me too much. We have some plans at the weekend and he'll be seeing his older sister who he has a great relationship with so hopefully that will help.

I think you're right about giving it time. He is at least attempting to go to college so it's not like he's completely shut down.

Thanks for your thoughts - they have been so helpful.

Could he have fallen behind at college and so is worrying about it?
That's what comes to my mind.

@mineofuselessinformation that’s a possibility. I will try and contact his student tutor. It’s so hard at this age because you don’t necessarily have the same contact with staff as you do with school.

You could see if the college or your GP/NHS can offer some counselling. Someone who he could talk to about his issues and give him some exercises and tips about managing things.

Is his tutor aware of his health issues causing absences? College can be difficult to navigate as they often keep parents at arms length but if your DS doesn't open up to a teacher then your DS can get hammered with attendance penalties and moves made to deregiste etc. In my DD's case her tutors never saw they absence letters I sent in (as per the college requirement) explaining her situation, they just went to office admin staff and her tutors were all giving her a hard time and she didn't explain to them what was happening in her life. So it would be worth finding out who his teachers are and dropping them an email explaining things (with your DS's approval ideally).