Is there ocd lurking behind her anxiety?

[Ellen H]

Hello! If I’m going to be honest, I had to force myself to sign up. Things are going so well with my daughter (15, anxiety) and it’s easy to push things off onto the back burner. But rationally I know that now, when I’m not overwhelmed, it’s the best time to start learning and really getting in deep with this. We watch your YouTube videos and they have been a huge help- one thing I’ve noticed shortly after we started watching was simply how it gave us the right vocabulary to use- it made it so much easier to communicate what was going on!

 

Anyway, I’ll get to the point! My daughter was born with some gastrointestinal issues that started at birth (literally in the hospital) so we’ve dealt with a huge roller coaster of doctoring since she was young. She’s had no diagnosis besides chronic idiopathic constipation. Her lab results have always been borderline but nothing has shown up definitively “wrong”.  Some years were awful and some fine. For the most part she rolled with it. When she was about 12 she started having anxiety. At that time her GI was out of control and her GIdoctor didn’t help much. When we finally found another (super awesome) doctor, she helped immensely with her physical health and also set us up with a gastroenterologist-psychologist. That was a game changer. She learned how to “turn down the volume” of listening to her body. We saw the psychologist for about 6 months, then she felt like we could carry on at home with what we’ve learned. It’s helped, but recently in the last year her anxiety has been fluctuating up and down and it feels like we are always on edge. She stated a low dose of Zoloft 6 months ago and that really seems to help. What I can’t get a handle on is what are her triggers and core fear. Some weeks she’s just thriving and loves life and the next week she’s sick. Her main complaint is her physical feelings. She has belly aches. Or headaches. Or a sore throat. Or her leg is aching. Mostly belly aches. It’s so hard to differentiate between real physical problems and psychological ones. She’s dealt with poor-ish health for so so long and I know her GI problems make her feel crummy but I also know she focuses SO intently on them. that for someone else, a sore throat or leg wouldn’t stop them completely but for her, she just can’t get over it. The GI psychologist really worked well with us and hopefully we can get in to see her again, but I’m curious if she could have some OCD hiding in there. Or maybe I’m looking for something that’s not even there. She has had panic attacks and knows the difference between feeling panicky and when she just feels sick, so I don’t really feel like her belly aches and other sick feelings are just anxiety- I feel like she is just so in tune to her body feelings that it’s making life hard! I want to get started on watching your class for either ocd or anxiety but I’m not sure which one. What are your thoughts?

[Natasha]

Hi Ellen,
Welcome! I’m glad you did sign up because it is so much easier to work on things when the world isn’t caving in! They key difference is the compulsions. Do you see her doing anything when she is hyper focused on these bodily issues?

[Ellen H]

That’s where I’m getting mixed signals from her. When she is hyper focused on her body, I can’t tell if it’s compulsions that’s driving her or not. She goes to the bathroom A LOT. Her hands get very raw from washing, but she doesn’t seem to have a fear of germs, just needs to wash after using the bathroom (obviously). If her throat is sore, she takes her temperature many times. She has to tell me each and every symptom such as if she felt sweaty for a little bit, or her toe was hurting or she has a bump or little bruise.  She likes to know where I’m at, but is satisfied with my answer and doesn’t usually ask more than once. I’ve wondered about separation anxiety for sure, but at the moment that seems ok. It’s strange because when  she’s feeling good, everything is good! She isn’t anxious or didn’t need to go to the bathroom often and is happy. But  when she’s in a moment where she isn’t feeling good, she might be sick, need to regulate her breathing,(she has an app on her watch she likes to use) she needs to know where I am, tell me about her intrusive thoughts, tell me about her worries, and apologize for not being super helpful or fighting with her brothers and ask about different symptoms (she’ll want reassurance after telling me about each symptom). It’s like she has everything at once, or nothing.

I watched your video about habit vs compulsions and I suppose it does seem like she has a lot of habits. She’s has low growth hormone  and is pretty small- so she is obsessed with weighing herself. We talk about it and it doesn’t upset her if she can’t weigh herself but if she’s in the bathroom then she does it (and reports her weight) she has to say good night twice, but she will stay at friends house and not even text. She likes most things to be just so, but I guess doesn’t melt down if they aren’t. She will ask a lot of questions but is usually satisfied with the answers she gets and doesn’t keep going back to the same thing. It guess it’s just that she seems to have some things she obsesses about or is particular about, but maybe not the compulsions .

 

[Natasha]

Hi Ellen,
It is hard to say. I would talk to her about you pulling back your reassurance. I think regardless of it being anxiety or OCD, there is a reassurance loop that is happening. That can also grow separation anxiety at times (i.e. I need to be near my mom to get that reassurance when I’m not feeling well).

I would instead say things like, “what do you need to tell yourself?”

I would also educate her on health anxiety if she isn’t educated yet: https://youtu.be/GTamU2r-2Ng

[Ellen H]

That sounds great, thank you! I guess the reason I’ve wondered about ocd is that she seems to have obsessions, but not so many compulsions. My goal for now is to learn- would you suggest I do the anxiety course then?

[Natasha]

She actually has quite a lot of possible compulsions from what you described:

She has checking compulsions (she asks you which is a compulsion)

Hand washing (hands don’t typically get raw unless there is excessive washing)

Takes temperature

Excessively goes to the bathroom

Checks where you are

Weighs herself excessively

regulates breathing (I’m not sure if this is compulsive)

I’m wondering if the OCD course might be better for you, as anxiety is more intuitive and OCD isn’t?

[Ellen H]

That sounds good, I’ll start there. It’s not that I WANT her to have ocd, I’ve just felt like there is something we are missing. Is ocd on a spectrum? Like mild to severe? Can it kind of come and go? I’m curious because while she does do those different things we mentioned, she can easily go stay at her friends for the day and not use the bathroom excessively or not weigh herself if there isn’t a scale or some days she won’t ask where I’m at at all. Or maybe she disguises her compulsions so well I don’t know she’s doing them. I’m excited to learn more and hopefully help her before it can morph into something bigger.

[Natasha]

Yes, OCD is on a continuum and it can come and go. Also people normally do compulsions only when having intrusive thoughts, so the pattern isn’t always consistent. I think learning about OCD is the right way to go with all you told me.

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