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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by cmcdougall on May 1, 2002, at 12:53:55
Dear Babblers,
I just spent the last two hours hyper-focused on writing a very detailed letter about the subject line - my 12 yr old stepdaughter. Wouldn't you know it, right before submission I was kicked off line! I can't be bothered re-doing the whole thing so here is a summary.
12 yr old, healthy female, not yet menstruating, treated for OCD w/ Luvox 100mg/2xday for the past year. This child had touching/counting rituals that severely impacted her daily activities (strong history of OCD on both sides of family). The Luvox seemed to be keeping the symptoms manageable. The child experiences a lot of anxiety at school because she tries so hard to hide the OCD. Add that to the "normal" troubles of being a girl in 6th grade, and you can just imagine what this innocent is suffering.
Recently "Girlie" wanted to try out for the drill/dance team. Her mom encouraged it, thinking it would help her fit in if she made it. I secretly prayed she wouldn't make the team, thinking (upon reflection of my own 6th grade experiences) that fitting in with that group would just create additional stress.
Her mom stated that during try-outs, she had never seen Girlie so animated - eyes darting back and forth, etc., however she made the team. Later that week, after a fight w/ her "best friend", Girlie sliced her upper arm w/ a pair of scissors! She tried to blame the cuts on the dog, but when pressed admitted what she had done. Girlie described an immediate feeling of relief and calm after cutting. She claims this is the first time, but I wonder...
Pdoc (child specialist) was called immediately and is switching Girlie from Luvox to Paxil. I do not know the downward titration schedule of the Luvox, but I warned her mother that there could be withdrawal symptoms. Anyone out there know what they might be?
Girlie is now taking 30mg Paxil per day. Her OCD symptoms seem to be spiraling out of control right now. Non-stop touching/tapping and counting, running up and down the stairs, etc. Sunday night, Girlie said she wanted to kill herself! Her mom thinks the thought of being in school and having to work SOOOO hard to hide her disorder are too much to bear right now. I think thats probably right. Girlie has an appt w/ pdoc later this week. He wants to rule out BP - may add a mood stabilizer. I have not noticed any BP behaviors, but as the "wicked" stepmother I only see Girlie every other weekend.
I know some of you are cutters and OCD sufferers. Please, please help me to help this innocent baby and her mom. There is a lot of bad blood between my husband (Girlie's daddy) and Girlie's mom. They do not communicate at all, and I know this stresses the poor kid out even more. I have a fairly good relationship w/ the mom, and she will listen to what advice I can pass along.
Thanks in advance.
Love and luck,
Carly
Posted by n0matter on May 1, 2002, at 13:21:11
In reply to Help - 12yr old caught cutting!, posted by cmcdougall on May 1, 2002, at 12:53:55
I'm beginning to wonder whether ANY doctors out there know exactly what a particular medication does. It seems like they just pick six random meds, roll a die, choose the corresponding med from their list and then hope it does the trick. From what I understand, Paxil is used mainly to treat general anxiety disorder and depression. I've never heard of it being applied to treat OCD. In fact, Paxil has a very mood-elevating effect on me...even at only 10mg, I get sweats and giddiness often. I can only imagine it intensifying the effects of an OCD condition. But then, I'm not a doctor and maybe I don't know what the hell I'm talking about. Of the four Psychiatrists I've had in my lifetime, however, they all seem to agree that the source of OCD, anxiety, depression and most other common psychological illnesses are a result of insufficient seretonin uptake. And paxil would certainly contribute to helping resolve this problem in Girlie...as well as her anxiety experienced at school. I felt paxil start to work almost immediately and the majority of the side-effects disappeared after about a month. If it's still not working after 4 weeks, maybe she should switch to something else.
Posted by Wade on May 1, 2002, at 13:29:56
In reply to Help - 12yr old caught cutting!, posted by cmcdougall on May 1, 2002, at 12:53:55
Carly,
I was diagnosed with OCD in 1995 and have taken Luvox. I still take 25MG a day because it seems to help take away a sleeping problem that I deal with.
I am not a doctor, but sometimes going through something can equip you quite well. I used to be on 300-350Mg per day. I did experience withdrawl from Luvox. I experienced feeling very nausiated, depressed, music sounded a little slower, and I would see colors flash different colors at times. Sounds a little wierd - I know.
I am on Paxil now, but it has different effects than Luvox. For me Paxil hypes me up, where Luvox makes me sleepy. It is sometimes hard not to feel depressed when you use all of your energy just to feel normal when you are trying to hide the strange feelings of an anti-depressant from others.
Switching anti-depressants can be difficult for anyone, especially if you are hyper-sensitive to physical changes (I am). Although she still has Luvox in her blood stream, she is probably feeling like she is on nothing, since Paxil might take 4 to 6 weeks to build up in her blood stream.
Luvox is probably one of the best medications for OCD on the market. With OCD, as well as anxiety and depression, there can be times when it is not so bad, and times when it seems rougher than normal. I sympathize for your 12-year old.
During withdrawl, I have felt like I didn't want to live. Nobody likes to suffer. It is very important that even if you don't understand the illness, (I have some and I don't even understand it) that you show her that you care for her and want what is best for her. My parents said "It was all in my head", and even though it was an imbalance or whatever, that doesn't make it any less real.
I am better now, but there are times when I don't understand what sets anxiety, depression, and OCD off. Tell her that she is not alone in this. You can tell her about me. Sometimes it is easy to think you are the only one that feels this way - like the anxiety differentiation I just wrote. But talking with someone else, or hearing someone else has a similar problem can help you feel a little more normal.
I hope I have helped and my wife and I will be praying for her.
Wade
Posted by IsoM on May 1, 2002, at 18:20:15
In reply to Help - 12yr old caught cutting!, posted by cmcdougall on May 1, 2002, at 12:53:55
Carly, I wish I could add something constructive but I have no experience with OCD. But I can empathise because of problems with my youngest son & his depression exaceberated by his father whom I'm separated from. I care but can't offer anything. Do keep us updated though, please.
Posted by jay on May 1, 2002, at 21:00:33
In reply to Help - 12yr old caught cutting!, posted by cmcdougall on May 1, 2002, at 12:53:55
Carly,
My god, I am sorry you have to deal with this, but it's sad as more and more kids are presenting psychiatric problems on levels never experienced. I don't want to act like I am something *special*, but I am a social worker who deals with both pre and post adolescent psychiatric issues, and sad to say your case is very common. That doesn't mean it is ever acceptable, though.
I've checked through the literature in regards to OCD and Paxil, and am a bit confused on this one because she was on SRI monotherapy before, but maybe the doctor is trying to treat the Dx of the anxiety component of the OCD. The reality is, though, Paxil has not stood strong as itself in relieving anxiety symptoms. Bringing cutting into the picture adds major complications, as I have not seen a lot of data involving Paxil efficacy and self-harm in kids. The fact is, it usually takes a trial of a number of medications to find the one that works best, but sadly time is what we don't have. For a co-existing anxiety disorder, I don't see why Paxil monotherapy would be used. Either a newer anti-convulsant/mood-stabilizer or/and an atypical antipsychotic seem to be used in similar cases I have seen in conjunction with an SRI or Anafranil. Many Pdocs I know see OCD as an extension of a major anxiety disorder, and even it's effects such as self harm. The problem is the SRI's as monotherapy in these cases have scant evidence to back up their efficacy. Benzos aren't usually used because they induce disinhibition, but again, I have seen them be of some use in *certain* and very scrutinized and managed situations.
Most of all though, and this is something you and your stepdaughters Mom can work to do, is possibly initiate some type of formal therapy work. It sounds like Dad needs to get his stuff together to, and he *has* to face this, even if he doesn't like it. Even just a supportive "family dynamic" therapy can be very helpful, but this is something you will want to look at as long term maintenance therapy. It *won't* relieve your daughters symptoms asap as medications will. Combined treatment in this area, from my experience and from the literature, seems to have the most efficacy. Also, don't forget to check out Dr. Bob's resources on treatment of children.
Also, on another note, I don't mean to be blunt, but tell your husband and his ex they have to get over their own problems, period, as their daughters life is at risk. It is as plain and simple as that. If they need their own help and support systems, fine, but they are not what is at risk here.
I can toss you my email addy if you feel the need to talk more. But, please keep posting, and I and others will do our best to help.
Best wishes...hopes are with you
Jay
> Dear Babblers,
>
> I just spent the last two hours hyper-focused on writing a very detailed letter about the subject line - my 12 yr old stepdaughter. Wouldn't you know it, right before submission I was kicked off line! I can't be bothered re-doing the whole thing so here is a summary.
>
> 12 yr old, healthy female, not yet menstruating, treated for OCD w/ Luvox 100mg/2xday for the past year. This child had touching/counting rituals that severely impacted her daily activities (strong history of OCD on both sides of family). The Luvox seemed to be keeping the symptoms manageable. The child experiences a lot of anxiety at school because she tries so hard to hide the OCD. Add that to the "normal" troubles of being a girl in 6th grade, and you can just imagine what this innocent is suffering.
>
> Recently "Girlie" wanted to try out for the drill/dance team. Her mom encouraged it, thinking it would help her fit in if she made it. I secretly prayed she wouldn't make the team, thinking (upon reflection of my own 6th grade experiences) that fitting in with that group would just create additional stress.
>
> Her mom stated that during try-outs, she had never seen Girlie so animated - eyes darting back and forth, etc., however she made the team. Later that week, after a fight w/ her "best friend", Girlie sliced her upper arm w/ a pair of scissors! She tried to blame the cuts on the dog, but when pressed admitted what she had done. Girlie described an immediate feeling of relief and calm after cutting. She claims this is the first time, but I wonder...
>
> Pdoc (child specialist) was called immediately and is switching Girlie from Luvox to Paxil. I do not know the downward titration schedule of the Luvox, but I warned her mother that there could be withdrawal symptoms. Anyone out there know what they might be?
>
> Girlie is now taking 30mg Paxil per day. Her OCD symptoms seem to be spiraling out of control right now. Non-stop touching/tapping and counting, running up and down the stairs, etc. Sunday night, Girlie said she wanted to kill herself! Her mom thinks the thought of being in school and having to work SOOOO hard to hide her disorder are too much to bear right now. I think thats probably right. Girlie has an appt w/ pdoc later this week. He wants to rule out BP - may add a mood stabilizer. I have not noticed any BP behaviors, but as the "wicked" stepmother I only see Girlie every other weekend.
>
> I know some of you are cutters and OCD sufferers. Please, please help me to help this innocent baby and her mom. There is a lot of bad blood between my husband (Girlie's daddy) and Girlie's mom. They do not communicate at all, and I know this stresses the poor kid out even more. I have a fairly good relationship w/ the mom, and she will listen to what advice I can pass along.
>
> Thanks in advance.
>
> Love and luck,
> Carly
Posted by judy1 on May 1, 2002, at 23:05:23
In reply to Help - 12yr old caught cutting!, posted by cmcdougall on May 1, 2002, at 12:53:55
I started SI (self-injury) at about the same age. It is a coping skill (although an extremely unhealthy one). Personally, no medication has helped me with this behavior of over 20 years- but therapy has. I do not have OCD, but am diagnosed with bipolar among other disorders. I cannot stress the importance of therapy enough for this issue, and to start at this age before it becomes ingrained bodes well for her future. I wish you and your step-daughter all the best- Judy P.S. Stress often brings on my SI and I wonder if her try outs produced the same feelings within her.
Posted by puffer on May 1, 2002, at 23:08:23
In reply to Re: Help - 12yr old caught cutting! » cmcdougall, posted by jay on May 1, 2002, at 21:00:33
Sorry to hear about your stepdaughter. My family doc and pdoc are strong in their opinion that clomipramine(anafranil)is still the "golden standard" for OCD treatment. Luvox is also highly rated for OCD.I did quite well on anafranil combined with clonazepam(rivotril). Not sure how your stepdaughter would tolerate anafranil but you might ask her doctor. I hope all will be well for you and your family. Rick
Posted by cmcdougall on May 2, 2002, at 11:46:06
In reply to Re: Help - 12yr old caught cutting!, posted by puffer on May 1, 2002, at 23:08:23
Dear Friends,
You have no idea how much your support and advice are helping. Thank you from the bottom of my heart. I am forwarding all your posts to Girlie's mother, and she sends her thanks as well.
Girlie saw the pdoc yesterday and he is keeping her at 30mg per day of Paxil. He might augment in a week or so if there is not dramatic improvement. Girlie is also starting to see the therapist regularly now. Her mom now understands the importance of keeping up w/ it even if things seem to improve.
Again, thanks!
Love and luck (sincerely),
Carly
Posted by cmcdougall on May 2, 2002, at 11:49:42
In reply to Re: Help - 12yr old caught cutting! » cmcdougall, posted by jay on May 1, 2002, at 21:00:33
Posted by ecuadoriang on May 2, 2002, at 11:52:27
In reply to Help - 12yr old caught cutting!, posted by cmcdougall on May 1, 2002, at 12:53:55
Ok, First of all I'll try to o my best here, since I'm not a native speaker english is hard for me. But I have to post up a message since I know I can help. Ok, here's my story, 21 years old, female, lesbian, drug addict! Yeah.. that's me... Now I'm on antidepresants. I'm using 150mg Zoloft and 1.5 Xanax.
the reasson why I really needed to post this message is because I really identified myself with this little girl.
My early memories are just like that. My first suicidal atempt was on 7th grade. I cut my upper arms too. I remember that just to feel the pain was great... I felt so much better. no one got to knew what happened, so it continued and got preatty bad like a year ago. I have had 3 really near to dead suicidal attempts but i don't even know how many times I've harmed my self to deal with what my Pdoc prescribed as Panic Attacks. I don't know if that's what this little girl is suffering from, but I really understand the urge she has to harm herself! i can tell you that in those second fractions you really want to die! And we are really convinced of that!In my case, what has helped is to admit that this is not normal, but it took me 10 years to realice that! I don't know exactly how can I help you, but if you need someone to talk to that has lived in flesh what Girly is suffering contact me! my e-mail adress is: marele_v@hotmail.com I will be more than glad helping you deal with this. I hope that what I experienced will help you to deal with this problem!
Hugs!
Ecuadoriang
Posted by jay on May 3, 2002, at 20:32:43
In reply to I would appreciate your email.... (nm) » jay, posted by cmcdougall on May 2, 2002, at 11:49:42
Pls email me at: jay_ghostrider@yahoo.ca. Anytime is fine! Thanks...
Jay
This is the end of the thread.
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