Re: OCD & MDD

[Guest guest]

I don't have experience with the MDD part but here are some thoughts I

had when I read your post. First, I agree with you that you have

to "pick your battles" and I wouldn't ask her about her homework.

I think maybe your husband is grieving a bit about his loss of the "normal

kid" ideal he might have imagined. While it's true that asking about

homework is a typical thing for parents to do, you situation is not typical

and so it calls for a different approach.

I don't know about leaving your daughter alone at home, my inclination

is not to if you can avoid it, but Kathy H. probably has more insight about

this.

As far as Leigh wanting to write a book, that's great. I think

you're right that it's her way of "coming out of the OCD closet".

There is a high school student on this list (if she's still here) with

OCD who has a website with info about OCD. She wrote her "story"

on it too and invites others to do the same. Maybe that would be

a place for Leigh to start. If she wanted to share it with family

and friends she could give them the web addy and they would also be getting

lots of info about OCD in the process. I cut and pasted this from

her post about it, which was awhile ago so I hope it's still right:

Try my new website! It's still under construction though.

http://www.suite101.com/welcome.cfm/mental_health_teens

-Liz

I hope some of this is helpful to you.

Dana in NC

[Guest guest]

> A couple of weeks ago, she told us that she did

> not like being asked about homework, because she worries about it

all

> the time. When we ask, it just brings up an anxiety reaction. In

> addition, she reminded us that she has always taken care of her

> homework without our involvement. (This is true.) My husband was

> frustrated, because he feels that " normal " parents ask kids about

> homework.

I go around and around with my husband who also explains things he

does as normal and usual--even when they are not helpful given our

daughter's OCD. OCD is a fact in our family, and it does change some

things. Internalizing the perspective that " it's not my child, it's

the OCD " took me a long while to " get. " If Abby has an anxiety

repsonse to a simple question, it's a fair bet that OCD is involved.

In the midst of an anxiety response, our kids aren't entirely in

control of the tone they take, the irritation they show, etc. It's

not the child, it's the OCD.

> My feeling is that, her grades are her grades, and with

> all the other issues we are dealing with, one missing assignment is

> not the end of the world. In fact, I really don't care if she

fails

> a class this year. I'm much more concerned that she begin to learn

> how to face the OCD " head on " . My approach has been to

> avoid " sensitive " subjects unless they are life-threatening. How

are

> others dealing with angry outburts?

We let the anger cool down first. It's impossible to sort anything

out while an OCD child (or anyone) is feeling a rush of anxiety and

is angry or upset. Then it can be time for discussing the incident,

what part OCD is playing in the response, perhaps work out a signal

or another way Abby can let you know she's getting upset, before

the " explosion " occurs. Kel is embarassed and upset after the fact.

We take the position that Kel herself does not wish to have angry

outbursts. We align ourselves with Kellen against our common enemy,

the OCD and it's ridiculous and upsetting " rules " and feelings.

> Are OCDers able to handle the

> anxiety that occurs when you " accidentally " trip over an OCD

> reaction?

It depends where on the OCDer's heirarchy the issue lies. Accidental

triggers of lower-level issues may provoke an irritable--but

containable--reaction while triggering top-of-the-heirarchy concerns

may bring on a meltdown. My child (7 in Dec.) is just starting to

understand that when others inadvertently do or say something to

trigger OCD thoughts, they are not purposefully being mean to her--

not that this understanding is always in the front of her mind when a

trigger happens! Remember that triggering OCD brings anxiety, may

spark unpleasant obsessive thoughts, etc., which is very aversive to

your daughter. If someone out of the blue kicked you hard in the

shin, you would have an immediate and strong, probably negative

reaction, not a thought-out one. When our kids' OCD (especially

before treatment) is suddenly, unexpectedly triggered, they have a

similar response due to the extremely unpleasant sensations the

triggering causes. Their anger is understandably enough aimed at the

triggerer, fair or not.

> What advice do you have for us as her parents and sister

> in dealing with these outbursts of anger? E & RP has been discussed,

> but not yet started...the very thought makes her very afraid.

Exposure and Response Prevention therapy provides a controlled and

planned exposures at a level your daughter can cope with, vs.

the " surprise " triggers that lead to angry outbursts. Children

learn, by working their way up their hierarchies (and they know it's

coming)that though the anxiety is very unpleasant, it doesn't kill

them and it does go away. I'm not surprised that even the thought of

confronting her OCD is frightening to Abby. I've noticed with

Kellen, it's most often the thought of doing something, not the

actual doing of it, that causes so much distress. Is your daughter

aware that she would be in control during E & RP exercises and would

never be forced to do anything that's too hard at the moment?

A final thought: you mention new meds. If previously Abby was very

calm and avoided conflict, but recently has begun to have these angry

outbursts, she may still be acclimating to her new meds--or Paxil may

prove not to be the optimal SSRI for her.

Kathy R. in Indiana

[Guest guest]

At 07:47 AM 11/16/00 -0000, you wrote:

>On a more positive note, last night she mentioned that she is

>thinking about writing a biography. She wants to share this with her

>close extended family members to help them understand why she

>sometimes does not want to be hugged. I think it may be her way

>of " coming out of the closet " with the OCD. I was encouraged by this

>idea. Do you think this would be helpful for her or is she setting

>herself up for more struggles if she shares it with others and they

>don't respond sensitively? I'm anxious for input in these areas.

>Thanks.

>

I think that yes, she is setting her self up for some struggles by sharing

her difficulties with others BUT also YES, IT WILL BE HELPFUL. Your

description of your daughter's troubles echoes things my 17-yr-old daughter

went through last year. Like Abby, my daughter had always been a very

responsible A student -- but some of it was due to her OCD perfectionism.

She spent a lot of time and energy stuffing her feelings & working to keep

things hidden, until she got to a breaking point.

In my daughter's case, there was also some sexual abuse she had suffered as

a preschooler that her father & I didn't know about until last year. And

then she had begun drinking with her friends & discovered it " helped " --

she was self-medicating with alcohol. For whatever reasons, the pressures

of all that came to a head last year, and her OCD went out of control, and

she couldn't hide it anymore. She was terrified of people " finding out " and

really really angry with me when I admitted I had discussed her OCD with

certain close friends -- because I knew I needed help to help her.

But we have since discovered that letting people know what's really going

on - not flaunting it, but matter of factly discussing necessary things

with certain friends and family - has really helped. Which is NOT to say

that it always went well, or that certain very important people in our

lives responded beautifully -- some did not.

My daughter felt utterly naked and mortified that people " knew " things

about her at first -- but she has come such a long way in the past year. A

lot of it was a very rocky road.

But now she has hope for a future for herself -- last year she had none.

I am not suggesting that your daughter has any of the secrets that mine

had. But the secrets were killing my daughter. We are better off without

them. I think that the more comfortable your daughter is with sharing her

" stuff " in appropriate ways (and writing the biography sounds great!) --

the better she will be able to see them in perspective. And that always

helps! -- Vicki in Montana

>

>

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>

>

>

>

[Guest guest]

> I think maybe your husband is grieving a bit about his loss of

the " normal kid " ideal he might have imagined.

I think that perhaps he hasn't even hit the grieving yet. I think he

is just now beginning to understand how serious this is. This

morning my daughter asked to go back to the hospital...the depression

is back in full force and she doesn't feel that she can keep herself

safe. This was the first time he heard directly some of the more

difficult aspects of OCD she is facing.

> I don't know about leaving your daughter alone at home, my

inclination is not to if you can avoid it, but Kathy H. probably has

more insight about this.

This morning's development pretty much answered this question.

Unfortunately, the two local adolescent psych units were full

tonight. We brought her home with a contract that she must be with

someone at all times until we can get her admitted. So far the

evening has gone pretty smoothly. I'm hoping I'll be able to sleep

once she has fallen asleep.

> There is a high school student on this list (if she's still here)

with OCD who has a website with info about OCD. She wrote

her " story " on it too and invites others to do the same. Maybe that

would be a place for Abby to start. If she wanted to share it with

family and friends she could give them the web addy and they would

also be getting lots of info about OCD in the process. I cut and

pasted this from her post about it, which was awhile ago so I hope

it's still right:

>

>

> > Try my new website! It's still under construction though.

> > http://www.suite101.com/welcome.cfm/mental_health_teens

> >

> > -Liz

I checked out the site. It is operational and very helpful. Once we

get things stabalized a little, I think I will direct her to check it

out.

> I hope some of this is helpful to you.

>

> Dana in NC

Dana, it was all helpful. When the questions are tough, the

solutions so elusive and the pain so intense, it helps so much to

have input from others who understand. Many thanks!

Gwen

[Guest guest]

HI Gwen:

My thoughts are very much with you and your family as your daughter

struggles with her OCD and depression.

As Dana alluded to, it is quite important to be very alert when someone is

actively suicidal. Denial often appears as not understanding the

seriousness of the situation and is a form of protection for your husband.

As annoying or upsetting as it might be for you, it is an important coping

mechanism at such a time.

How we handled sleeping during this suicide watch period was to keep Steve

on a futon in our bedroom when things seemed particularly critical. We

also found putting the cat in bed with him helped him tremendously, she

kept him feeling connected to life, what a blessing.

IT is very hard to be on suicide watch, incredibly exhausting. If you have

good facilities nearby I hope you can get a spot to give you all a break

soon. For us sending Steve to the nearest facility (250 air miles away) was

not attractive. The Feds were trying to close down the facility for

multiple violations! Medications have been an invaluable part of Steve's

management of his MDD. We are already suicide survivors and Steve has the

top three risk factors for suicide.

If you check out the NAMI site they have lots of information about suicide

and depression in their adolescent section. (http://www.nami.org)

Good luck, please keeep us posted about how you are all managing during

this very difficult time. Take care, aloha, Kathy (H)

kathyh@...

you wrote:

>

>> I think maybe your husband is grieving a bit about his loss of

>the " normal kid " ideal he might have imagined.

>

>I think that perhaps he hasn't even hit the grieving yet. I think he

>is just now beginning to understand how serious this is. This

>morning my daughter asked to go back to the hospital...the depression

>is back in full force and she doesn't feel that she can keep herself

>safe. This was the first time he heard directly some of the more

>difficult aspects of OCD she is facing.

>

>> I don't know about leaving your daughter alone at home, my

>inclination is not to if you can avoid it, but Kathy H. probably has

>more insight about this.

>

>This morning's development pretty much answered this question.

>Unfortunately, the two local adolescent psych units were full

>tonight. We brought her home with a contract that she must be with

>someone at all times until we can get her admitted. So far the

>evening has gone pretty smoothly. I'm hoping I'll be able to sleep

>once she has fallen asleep.

>

>> There is a high school student on this list (if she's still here)

>with OCD who has a website with info about OCD. She wrote

>her " story " on it too and invites others to do the same. Maybe that

>would be a place for Abby to start. If she wanted to share it with

>family and friends she could give them the web addy and they would

>also be getting lots of info about OCD in the process. I cut and

>pasted this from her post about it, which was awhile ago so I hope

>it's still right:

>>

>>

>> > Try my new website! It's still under construction though.

>> > http://www.suite101.com/welcome.cfm/mental_health_teens

>> >

>> > -Liz

>

>I checked out the site. It is operational and very helpful. Once we

>get things stabalized a little, I think I will direct her to check it

>out.

>

>> I hope some of this is helpful to you.

>>

>> Dana in NC

>

>Dana, it was all helpful. When the questions are tough, the

>solutions so elusive and the pain so intense, it helps so much to

>have input from others who understand. Many thanks!

>

>Gwen

[Guest guest]

Gwen, I'm sorry to read that Abby is depressed to the point that

she's asking for admission to the hospital. This is definitely a low

and frightening time for your family but thankfully Abby was able to

read these symptoms and as importantly, tell you about them.

I hope there is an opening for Abby soon and she is able to get the

help she needs quickly.

Hang in there Gwen and please let us know how she (and you!) are

doing.

(((hugs)))

Kathy R. in Indiana

> I think that perhaps he hasn't even hit the grieving yet. I think

he

> is just now beginning to understand how serious this is. This

> morning my daughter asked to go back to the hospital...the

depression

> is back in full force and she doesn't feel that she can keep

herself

> safe. This was the first time he heard directly some of the more

> difficult aspects of OCD she is facing.

[Guest guest]

Kathy,

Thanks so much for your insightful responses. I've added my thoughts

below.

> I go around and around with my husband who also explains things he

> does as normal and usual--even when they are not helpful given our

> daughter's OCD. OCD is a fact in our family, and it does change

> some things. Internalizing the perspective that " it's not my

> child, it's the OCD " took me a long while to " get. " If Abby has an

> anxiety repsonse to a simple question, it's a fair bet that OCD is

> involved.

> In the midst of an anxiety response, our kids aren't entirely in

> control of the tone they take, the irritation they show, etc. It's

> not the child, it's the OCD.

I think through my reading and being a part of this group, it has

been much easier for me to understand that it is the OCD, than for my

husband or my 17 year old daughter. But with this latest episode, I

think they are beginning to understand. Last night I took my older

daughter out to dinner and I explained to her how much of Abby's

thinking is " skewed " by the OCD. When she has a normal frustration

with someone (like her sister), she hangs onto it and the OCD won't

let her get over it. This has made my older daughter feel like all

of Abby's problems are her fault because she wasn't a better sister.

I explained to her that normal sibing problems happen and then they

are over. But the OCD is causing Abby to hang onto the old hurts

long beyond what is reasonable. I've decided that it is time to get

the discussions of this out into the open. I don't think we are

helping Abby by keeping the " code of silence " within our own family.

> We let the anger cool down first. It's impossible to sort anything

> out while an OCD child (or anyone) is feeling a rush of anxiety and

> is angry or upset. Then it can be time for discussing the

> incident, what part OCD is playing in the response, perhaps work

> out a signal or another way Abby can let you know she's getting

> upset, before the " explosion " occurs. Kel is embarassed and upset

> after the fact.

> We take the position that Kel herself does not wish to have angry

> outbursts. We align ourselves with Kellen against our common

> enemy, the OCD and it's ridiculous and upsetting " rules " and

> feelings.

Discussing emotional issues is very high on Abby's list. Even after

the fact, we find it nearly impossible to " debrief " an episode of

conflict. While I know this is where we need to get...I'm not sure

how or when we will be able to start addressing this area. I like

the idea of a signal. I know Abby also feels very badly about times

of conflict. During this hospitalization, one point I want to be

able to get to is to personify OCD as a unique and separate entity

and to begin to focus the anger and frustration against the real

enemy. Early on in our marriage my husband and I agreed that when we

had a conflict we would take the stance that it was " you and me

against the problem " NOT " us against each other. " I think this will

be a helpful model to use in addressing the OCD as well.

> Accidental triggers of lower-level issues may provoke an irritable--

> but containable--reaction while triggering top-of-the-heirarchy

> concerns may bring on a meltdown. My child (7 in Dec.) is just

> starting to understand that when others inadvertently do or say

> something to trigger OCD thoughts, they are not purposefully being

> mean to her--not that this understanding is always in the front of

> her mind when a trigger happens! Remember that triggering OCD

> brings anxiety, may spark unpleasant obsessive thoughts, etc.,

> which is very aversive to your daughter. If someone out of the

> blue kicked you hard in the shin, you would have an immediate and

> strong, probably negative reaction, not a thought-out one. When

> our kids' OCD (especially before treatment) is suddenly,

> unexpectedly triggered, they have a similar response due to the

> extremely unpleasant sensations the triggering causes. Their anger

> is understandably enough aimed at the triggerer, fair or not.

Thank you for this explanation. I am going to print it and keep it

close at hand. I think if we can somehow put ourselves in our OCDers

shoes, we are much more able to handle this situation lovingly.

As always, I have gained so much insight from your experience.

Thanks.

Gwen in Oregon

[Guest guest]

Vicki:

> I think that yes, she is setting her self up for some struggles by

> sharing her difficulties with others BUT also YES, IT WILL BE

> HELPFUL. Your description of your daughter's troubles echoes

> things my 17-yr-old daughter went through last year. Like Abby, my

> daughter had always been a very responsible A student -- but some

> of it was due to her OCD perfectionism. She spent a lot of time and

> energy stuffing her feelings & working to keep things hidden, until

> she got to a breaking point.

>

> In my daughter's case, there was also some sexual abuse she had

> suffered as a preschooler that her father & I didn't know about

> until last year. And then she had begun drinking with her friends

> & discovered it " helped " --she was self-medicating with alcohol. For

> whatever reasons, the pressures of all that came to a head last

> year, and her OCD went out of control, and she couldn't hide it

> anymore. She was terrified of people " finding out " and really

> really angry with me when I admitted I had discussed her OCD with

> certain close friends -- because I knew I needed help to help her.

It certainly sounds like our daughters are very much alike. We have

walked on eggshells because my daughter would get so angry if she

felt we had discussed her situation with anyone else. The night of

her first hospitalization, I explained to her that her therpist

suggested that I call anyone I could, that could help me to deal with

what I was going through. My husband was out of town and I was all

alone as I waited to find out what would happen next. Once I

explained this to my daughter, she gave me a list of " safe " people

that I could discuss the situation with. At that moment she seemed

to understand that I also was dealing with the very difficult demands

of OCD and needed support as well. Even in her own misery she was

able to say, " Mom, you call whoever you need to help you get through

this. " Maybe the lesson for me is that I need to come forward with

what my needs are and just ask her permission to address my own

needs. I feel that would be a good example for her as well, in

asking for what you need when you need it.

> But we have since discovered that letting people know what's really

> going on - not flaunting it, but matter of factly discussing

> necessary things with certain friends and family - has really

> helped. Which is NOT to say that it always went well, or that

> certain very important people in our lives responded beautifully--

> some did not.

I am going to encourage her biography. I think she wants to be able

to be more " real " with those people in her life who are most

important to her.

> My daughter felt utterly naked and mortified that people " knew "

> things about her at first -- but she has come such a long way in

> the past year. A lot of it was a very rocky road. But now she has

> hope for a future for herself -- last year she had none.

What do you think has had the most impact in helping her through this

ordeal? Can you think of milestones along the way, things you did,

things she did that really helped her?

Thanks for your response, Vicki. I feel so encouraged when someone

who has walked the road before can lend credence to your current

experiences and hope for the future. Thanks.

Gwen in Oregon