The Beginning...

Mom's Thoughts:

My daughter Elizabeth has always been a somewhat anxious kid.  When she was very small, she hated getting dirty most of the time.  She would pitch a huge fit if something spilled on her pretty dress - a reaction way beyond what my younger two daughters would have done.  She hated sand at the beach, getting her hands dirty, things like that.

She was also easily frustrated.  If she colored outside the lines or couldn't quite reproduce a picture, she would burst into tears and tear it up.  "She's a perfectionist," I'd say to myself, and try to downplay things so she could see it was no big deal if she spilled PB&J on her dress.  At times, I blamed myself - I was obviously sending her signals subconsciously that things had to be "just so" or she wasn't good enough... wasn't I?  Isn't family environment to blame for things like that?  It didn't matter that I thought I was pretty laid back - I must be making some kind of mistake.  

In elementary school, she showed signs of having test anxiety, even though she is very smart, a very hard worker and always made good grades.  Again, I chalked it up to perfectionism.  We did kid yoga and soothing visualizations.  All the while, I pushed her to face her fears and try new things, even if it was uncomfortable for her.  Girl Scouts, swimming, tennis, soccer, volleyball, drama, chorus, piano.  She was a trooper - went outside her comfort zone and tried them all.  Some she liked, some she didn't like but stuck with them until she did, and others she quickly abandoned - just like every other kid I knew.  She excelled in school and sports, and made a few good friends, even though she generally distrusts people.  I always felt she had the ability to do even better than she did in several areas - sports, for example - but she doubted herself constantly.

We went along well like this - my husband and I figured out who she was and how to best deal with her anxious nature.  She learned self-control and began to let things go a bit.  We moved when she was 13 - a tough time for anyone.  She wasn't happy for about a year, but did as well as possible and adjusted in due time.  All was well into high school... her grades were good, boys not in the picture yet, and she made some friends.

Until about September of 2012.  She had just started 10th grade.  She began crying at night, having a hard time falling asleep.  "Hormones," I nodded sympathetically, "our women have strong hormones."  Then one night I heard her up about 1:00am, pulling clothes out of her closet.  I went in to see what was wrong and found her very agitated, cleaning her closet.  "It's such a mess," she said, "I have to clean it!"  "Not now!" I said sternly, "It's 1:00 in the morning.  You have to get to bed - you have to get up at 5:30 for school!  It can wait till tomorrow."  I was not taking no for an answer - I pulled my best mom voice out and made it clear we were not negotiating.   She cried and became almost frantic.  "It's not clean!  It's not good enough!" she kept saying.  She was hysterical.  That's when I knew this wasn't hormones - I'd never seen anything like this.  Once she calmed down about an hour later, she agreed she needed help.  She was exhausted.

We saw the doctor as soon as possible and he diagnosed her with GAD, Generalized Anxiety Disorder, and put her on Celexa.  It helped for a couple of weeks, and then the anxiety attacks (mostly late night) came back as strong as ever.  We upped her dose, and finally changed her to Paxil.  It was a very, very difficult transition - something we never want to experience again.  If you are changing or coming off an SRI, I recommend you do it very slowly.  She's doing moderately well on Paxil, but she was still having 3-4 anxiety attacks a week so we've recently increased her dose on that as well, to 60mg. 

At the same time, we noticed symptoms of OCD for the first time.  How had we missed it??  Chapped, dry hands are a hallmark of OCD.  How many months had we been trying to find just the right lotion, topical steroid, etc. to heal her "eczema?"  Duh.  She finally admitted she'd been washing her hands multiple times in a row, many times a day.  After the bathroom, before eating (OK, those are normal times,) after using the keyboard at school or home, after touching her belt... what??!!  OK, a bit odd there for sure.  But she can't help it.  We missed it - but heck, she's a teenager.  I don't sit around watching her wash her hands.  She's a big girl - she can take care of that stuff on her own!  But once we started talking about it, other things we didn't know she was struggling with came out.  Compulsive cleaning (duh, mid-night closet cleaning, my highly organized pantry - OK, so I didn't hate that, I admit it,) and so on.  Most disturbing to her and what likely causes some of the anxiety/panic attacks are some of the more violent thoughts that come to her and she can't get out of her head, like something bad is going to happen to someone, and somehow she is at fault.  I didn't even know this was OCD, but it is.

So, there it is.  It's a beginning for us, and that's how it has started.  We have so much more to learn, but we've come a long way already.  The best resource for us so far has been Talking Back to OCD by John S. March, MD, a Duke University psychiatrist and researcher.  He has given us the tools to begin CBT and start getting rid of "King Kong's Bitches."