Gifted Issues Discussion homepage Forums Twice Exceptional DD just diagnosed with anxiety disorder

I tried to do a search for a topic this might fit into but really didn't see anything so here goes. My DD9 was just diagnosed with an anxiety disorder today. It manifests in perfectionism, strict adherence to schedules, test anxieties and shyness with select mutism. She's been in counseling but finally got into the psychiatrist to find out what other steps needed to be taken. He put her on 10 mg generic Prozac once a day. Is this a "normal" solution to anxiety and are there any other children this age on Prozac. I hate to be nosey but I am new to this situation.

DD9 has been in gifted pullout classes for 2 years at her school but last year spent two months on homebound due to anxieties. She was allowed to go into school for the 30 minutes of gifted class everyday and her gifted teacher was her homebound teacher as well. I believe that two months really helped her "reset" herself to deal with the anxieties this year and is doing much better along with the counseling. I have heard some scary things about some of the medications out there and was wondering if it is best just to go with the counseling. I am very confused about all of this. Any information would be wonderful.

I don't have personal experience with this but a good friend of DD's was put on Prozac earlier this year at the age of 7. It was a huge help. She was in a very, very dark place and was on homebound the last couple of months of last school year. Talk/play therapy was not enough for her but the Prozac made all the difference. We just saw them yesterday and she seems basically back to her old self. Her mother said they have now removed all the supports that were in place to transition her back to school. I think she will probably always be an anxious kid but she is no longer crippled by it.

Good luck!

Cassmo451, I can't help with the Prozac question, but I do hope that it helps your dd. I noticed in your other thread that your dd has a large dip in processing subtest scores on the WISC - I am just curious if there was any thought from her evaluating psych that the dip might be caused by something other than anxiety? The reason I ask is that my dysgraphic ds, prior to being diagnosed at the end of 2nd grade, had developed huge anxiety - to the point of having panic attacks both at school and at home, not being able to sleep due to extreme worries etc. The reason he was referred for a neuropsych eval by our ped was his anxiety - before we went to the neuropsych when he was melting down over panic attackes we'd also already been through almost a year of combined medical evals (gastrointestinal etc) plus counseling for severe stomachaches etc. We were convinced he was dealing with severe anxiety - and he was - but what we didn't realize was that the anxiety was secondary to a challenge. Once we knew he had developmental coordination disorder and dysgraphia and made accommodations available to him (as well as explaining to him what was going on with it), the anxiety for the most part disappeared. He's still a child who worries as a first reaction to any challenging situation, but he no longer has panic attacks or worries that are so severe that we needed to consider medication.

Please know I'm not anti-meds and not questioning what your psych diagnosed, just wonder if there might be something more to the dip in processing score and if that in turn might be fueling your dd's anxiety.

Best wishes,

polarbear

Portia, I tried GABA with our 3 year old but it has no effect on him, actually I think it made him even more anxious. But for ME it works like a charm!

DS3.6 has diagnosed Autism but we're pretty sure anxiety is affecting him more than anything else. We're waiting to get him evaluated officially for anxiety, hopefully soon (just got the script earlier this week).

I know hydroxyzine (strong antihistamine) is sometimes used to treat Anxiety but it hasn't worked on either of our boys. DS5.2 has it prescribed to help him with sleep but it's also used as anti-anxiety drug. But in his case it only makes him drowsy but no other effect.

Yes, that is a normal treatment and I think prozac for that age and ailments you are describing is good short term scaffolding as an aid in the counseling process, but shouldn't be a long term solution without good counseling. Without knowing all the particulars, I will throw out a few generalizations/ideas that will hopefully help you...
1. Does your counselor have experience with gifted perfectionism anxiety vs. regular childhood anxiety? They are two very different beasts and should be treated as such. Your daughter's anxiety sounds very situational based so make sure the counselor or her g&t teacher is working with her to create a step by step plan of HOW she will address the anxiety as it manifests during class, test etc. rather than just exploring the "after the fact" feelings.

2. 9 year old girls are a tricky group to medicate b/c their bodies and hormones are changing so rapidly so make sure you have a really good psychiatrist working with her to make dosage changes as needed. You and your daughter also should have a constant dialogue to "check in" about how the medication is making her feel.

It is great that your daughter is willing to work with you and so many professionals, and it is wonderful that you have the knowledge and ability to support her through this difficult time. Good luck!

Polarbear, He did ask about the score because he had some concerns about that. But when she took those test in second grade she was so concerned about being taken out of class (and missing classwork) for testing that she stressed out a lot! The school's counselor had to test her one subtest at a time to get them all in without her freaking out. They stated that she was terrified of not getting her classwork done.

Everyone else, the plan right now is to get her to calm down so we can work on other things. If there is still something else going on we will address it then. I know we may just be at the beginning of the road but she doesn't seem to have a lot of other issues going on. Her grades are fantastic even her PE grade came up which is usually not her thing (she is a bit of a clutz), but she seemed to like the Tennis section.

She likes being with her friends again and this year there are more of the gifted kids in her classroom. So when they go to pullout she is not the only one going. Last year she felt like she was being teased for that and she didn't like it obviously. She is starting to learn to own her giftedness, and dare I say geekiness (Her father and I are absolute geeks so we are trying to show her it's okay).

We were in the middle of a move last year too but now are settled in our new home so that has helped. The only big concern I have is that she doesn't like to write. She said that if she could type out her writing assignments it would help her. Her handwriting is getting better but she is slow at it. So I would like to address that soon but want to see what the med's do for the anxiety. We will see the Psychiatrist again in 3 weeks for med checks and just checking in.

I am concerned there may be a motorskills issue going on but not sure at this point. She has trouble tying her shoes still. I don't know I guess it's just working with one thing at a time until we fix each issue. Thanks for the advice and if you think of anything else let me know.

My son was diagnosed with anxiety disorder. He was having such a breakdown, he was like a completely different kid. Like Polarbear, it was indeed secondary to learning challenges that no one realized he had, i.e., dysgraphia/dcd and vision issues. I had a strong suspicion that the anxiety was being caused by a learning problem like dyslexia or dysgraphia ... especially after watching him take the WISC IV. I pursued getting his vision tested by a developmental optometrist and I had him evaluated for dysgraphia and dyslexia. He has EDS, dysgraphia and he had intermittent convergent strabismus. I got him strong writing accommodations in school and vision therapy and his anxiety melted away.

Cassmo451, you're right - our kids can often have more than one issue going on at the same time, and focusing on one thing at a time is a good approach that helps keep life sane and also helps you see what makes a difference vs what doesn't help.


The big question I have here though is - in spite of all that anxiety, didn't your dd do really much better on all the subtests except for processing speed? In the face of such overwhelming anxiety, I would expect to see it impact scores a bit more evenly across the board instead of just that one specific area.

I'd also put that dip in processing speed together with:




Both of these combined with the extreme dip in processing speed on the WISC, when considered together, point to a possible fine motor issue - which could be causing her stress, especially in school. For some kids who have anxiety-prone personalities, like my ds, that type of stress, even though it might not seem like a big deal to us as parents (I'm speaking for myself here - I never would have realized it on my own) can lead to incredibly debilitating anxiety.

polarbear

Yes, yes, yes. BTDT. My poor child was unrecognizable - turned out he was over 2 years delayed in fine motor and was having terrible visual issues. But was smart enough to get by and look like a normal, bright kid with crazy behavioral issues when really a gifted kid trapped in an inadequate body wondering what the heck was wrong with him.

I think you need to get her evaluated asap by an OT and a PT ... They won't diagnose but they will tell you where she falls compared with age-peers on fine motor and gross motor. Then you will know what your dealing with there. I would also pursue a neuro-psych eval to see if she has dysgraphia and/or DCD. To be quite honest, she sounds a lot like she could have DCD and dysgraphia... Once you get a challenge like that identified, accommodated and remediated the child will soar.

Oh wow. Thanks for the feedback. I never thought of these things as abnormal. Her dad has trouble tying his shoes and never learned how to tell time on an analog clock, and his handwriting is so tiny you have to have a microscope to see it. But he has a neurological disorder so wasn't sure if that was related.

I have always been a clutz with having stitches and broken bones most of my life just from tripping and falling a lot. So it never occurred to me that with her it might be something different that could be treated. I just thought it was all genetic and maybe it is. I will bring this up with her doctor and counselor and see what they think.

Maybe once she is less stressed she will be able to help us identify why she is stressed. She is getting pretty good at telling me why things bother her now but sometimes she is just too upset to explain. We made one modification in the classroom already and she is allowed to use mechanical pencils (last years teacher wouldn't allow it in the classroom) so she won't have to wait in line to use the pencil sharpener and then have to fight with it to get her pencils sharpened. She said that was one of her biggest aggravations. The teacher said the pencil sharpener is a pain and she had an electric one but it broke too.

Would dysgraphia or these other issues effect her drawing and art because she loves to draw and her sketches are pretty good. At least you can tell what she is drawing but she especially likes abstract art.

The WISC IV was given to her at school and they did not express to me which tests she panicked on so I don't know if that had something to do with it.

I don't know what DCD is can you clarify that?

I have looked up dysgraphia and it sounds similar to what I have seen so will definitely talk to them about that. Her spelling is wonderful and loves teasing her older cousin (who lives with us)when he has trouble with words that she knows. And she would like harder words in school so he brings his words home from High School so she can go over them. He has been very supportive with her and it's been like her having an older brother now.

Sorry this post is all over the place. I am just thinking about all you have said and I appreciate it very much. Thanks for the help.

This just happened a few hours ago so I thought I would share with you. My DD and I were talking about why she doesn't like writing and she stated that it was hard for her to make her d's and b's correctly without having to really think about it. Also M's and N's bug her. She stated that typing was so much easier because she knows the letter but her hands won't make the letter right.

On a side note, and I never really thought about it before just thought she was quirky. We are always looking for pull on jeans that don't have a zipper and buttons because it takes less time for her to get dressed in the morning that way. Buttons are as difficult for her as tying her shoes. Zippers aren't too bad though.

So much has happened in the last year. My DD now 10 was just diagnosed PDD-NOS although they said she was just inside the autism spectrum disorder. Mild enough that the anxiety issues and the giftedness was masking a lot. She has an OT for her small and large motor skills issues. She is seeing a therapist for anxieties and a case worker to sort out her social issues.

In the last three months she has improved enough to take a vacation without me and did fantastic. She did summer school without issues and a Theatre camp at which she tried out for a Solo and won it. I am so proud of her and had to brag with those who understand the struggle and who understand why I am so proud. It took us a while to get here but here we are. Still have a long road ahead but at least it has fewer obstacles and potholes...LOL.

Thanks everyone for your advice and encouragement.

This is heart-warming news! Thanks for sharing. This may be an inspiration to many.

Thanks for sharing. It's good to know things are looking up. My DS15 also has anxiety issues and we haven't decided yet if it is masking other issues or not.

bluemagic, All I can say is go with your gut feeling. If you feel it needs to be looked into more closely then do it. These gifted kids are becoming more aware of themselves in relation to other kids and they start questioning things about themselves. Also talk to your DS and see if he feels something else may be going on. My DD was able to express to me that she felt different in more ways than just the gifted. That helped validate what I saw was going on. The good things about the Gifted part is that some are very capable of expressing profound things about themselves. Communication is a key thing.

My DD and I had a long discussion about the tests that were run and how she felt about the outcome. I told her she really isn't any different than anyone else when you really look at it. Everyone of us has something we are good at and something we struggle with. Learning that most times we cannot avoid the struggle so we need to learn how we work best in those situations and work with that. And that is why we are trying to help her learn how to work with the struggles so she can be the successful person I want her to be in whatever she chooses to do with her life.

It's amazing how well these kids understand a very complicated conversation like that.

Yes, Cassmo. That is exactly the kind of conversation I have with every child, gifted or intellectually-disabled alike, when I review their test results with them. Everyone has strengths and weaknesses, places we can help others, and places where we will need support from others. If you took anyone of the adults or other kids in your life, and ran the same battery of tests on them, you would find something that was a struggle and something that was a breeze. Testing is not ultimately about identifying a disability (although it may have that immediate function when attempting to jump through IEP/504 hoops), but about understanding yourself, and putting yourself in a position to make informed decisions about how you will use your strengths to leverage your weaknesses, in order to achieve your personal goals in life. Even fairly low-functioning adolescents generally understand this, so I would absolutely expect gifted youngsters to get it.

We routinely invite 14+ year-old students to their own IEP meetings (it's mandated that they have a right to be there if they choose). For some gifted kids, the age at which they ought to be present for the discussion, or at least part of it, may be younger than that. Parents may ask that they be present (since you can invite anyone you want to an IEP or 504 meeting).

I have to add my 2 cents here about the strengths/weaknesses discussion. Not wanting to argue but just have representation for an alternate view.

Life is not a competition where we compare ourselves to each other and develop an order of strengths and weaknesses. There are kids who are good at just about everything they ever attempt. With a little work, they can do anything they set their minds to. We'll call these golden kids. There are also kids whose best will never hold a candle to the worst of the golden kid. We'll call him platinum kid. I happen to have a golden kid and a platinum kid. My platinum kid could look til the cows come home for something he could do better than the golden kid. Should he stop trying? Absolutely not! It's not about whose better or worse. It's about doing what you can with what you have. Finding a personal meaning in life and experiencing life through your own lens. Whether that's better than everybody else or absolutely the worst anyone has seen. It just doesn't matter.

In competitive sports, I tell the kids that there will always be someone better and worse than they are unless they are the world champion. And even if they are, that won't go on forever. Someone will topple them. I do not tell them that if they are bad at one thing, they will be good at something else. Yes, they have strengths and weaknesses but that must be in the context of their own life, not the judgement of others.

For my kids, I work with them on figuring out who they are, what they enjoy and how they can find fulfillment in life. Not necessarily doing what they are "best" at in someone else's eyes. But doing what makes them feel satisfied and contributing what they can to make the world a better place. There is so much more to life than what can be measured anyway. We all bring something to our world when we bring ourselves.

I realize I'm not disagreeing with anyone here, just trying to put this sort of discussion in a slightly different perspective.

Amen.

We do portions of these meetings with DS12 present and portions without, and we started this at age 10. It has been VERY important for him to see what others think of his struggles and offer them corrections of perspective as needed. He is increasingly astute about what supports have helped.

And as to what MON said: oh, yes. Entirely.