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<blockquote data-quote="SRL" data-source="post: 73773" data-attributes="member: 701"><p>My difficult child was similar in that he presented with Autism Spectrum Disorders (ASD) traits but didnt' meet the diagnostic criteria. Around age 5 his anxiety over every day things reached the level that it was seriously impacting every day functioning and when nothing else worked we went with Celexa. We were dealing with the seperation anxiety at bedtime as you describe as well as stuff like hysteria over everyday experiences such as water level in the tub, fire in the grill, momentarily taking one hand off the steering wheel, etc. </p><p></p><p>Celexa did relieve his anxiety within several days and I was very glad to give him relief. At the beginning I thought I noted an increase in activity level and shortly afterwards more difficulty in handling anger. Over the next 9 months both of those side effects did increase to the point where I brought it up to the doctor. He recommended an increased dose of Celexa because he felt it would help the anger control plus adding Straterra for the hyperactivity. I nixed the Stratera idea (difficult child doesn't have ADHD and I didn't want to give a second medication just to counter side effects of the first. Against my better judgment I trialed one increased dose of Celexa and had both of my suspicions confirmed. I decided then to decrease and then quit Celexa just to see where he was at. Hyperactivity ceased almost immediately, anger control improved slowly, and he also started to cry again which is something we hadn't realized Celexa had supressed in him. Anxiety flared up a little but not to the unmanagable points it had been. He'd overcome many of his previous fears and with a little extra support from us he was functioning pretty well in the anxiety area. </p><p></p><p>All anxiety hell broke loose 9 months later when he started all day first grade. We couldn't get in to see the doctor (medical leave) so I opted to try Celexa again figuring if it would help the anxiety I could deal with the side effects we knew at least temporarily. This time the side effects came on fast and hard and he started into a downward spiral which was hurried along by Zoloft which we tried next. Virtually all of his issues soared to all time high levels and I'm sorry to say it took a year until he was back to near baseline again. </p><p></p><p>I don't mean to discourage you because any of the SSRI's can be great medications for the right person. My difficult child obviously wasn't that person. If you note any side effects or rapid behavioral changes, see the psychiatrist immediately. Doubly so if he's had negative side effects to any previous SSRI medications.</p><p></p><p>After that experience we were way too frightened and exhausted to trial any more medications, and here are some of the things that helped the anxiety area. Obviously we had to do a lot more because we had an out of control child on our hands whose every issue had been exacerbated by anxiety.</p><p></p><p>1) difficult child needed to have some connection to me at all times, until he was emotionally well again and could stand on his own two feet. I told him in advance when I was leaving the room, took him with me when I could, made sure he understood I was available by cell phone at all times when we were seperated. As for sleep, I got it whenever and whereever I could because when I was tired I couldn't cope with him...well, I couldn't cope really great when I was rested but it was better. In a nutshell, what my difficult child needed was a period of security after being so emotionally upset by anxiety.</p><p> </p><p>2) We looked for ways to make transitions easier. He was panicking at school drop off (and perservating before we left) and finally I made a list of what I was to do in his good bye routine. I took it out every morning and carried it with me. When the panic or obsessions took over, I'd whip out the list and remind him that I was going to worry about this so he wouldn't have to. </p><p></p><p>I also found that having some kind of daily tangible connection with me helped. Every morning he'd select two small stuffed dogs and choose one to give me and one to hang on his backpack to go to school with him. I took that pet with me in my purse or pocket or van through my day and then at the end of the day I'd tell him where we'd been and what we'd been doing. This is a simple thing which I've shared before--I think it was Andrea Danielle who reported good results with this as well.</p><p></p><p>3) We looked for every possible way to empower difficult child to handle anxiety situations. Panic over water level=using permanent marker to write on the tub stall how to turn off the water. Noise too loud= wear ear plugs or ear phones. Need a break from class=give a card to your teacher telling her you need a break. Afraid of being in the basement=practicing calling mom through the baby monitor. Children with anxiety feel totally powerless against this monster in their life and it's critical to find them ways to take charge, often starting in small ways.</p><p></p><p>4) My difficult child started totally shutting down in terms of not wanting to leave the house. I wound up using incentives to keep him going to school part time (while homeschooling the other part of the day) and I don't know that I'd use incentives to that degree again. The other thing I did was to take him out once a week on sort of a date night just to keep him going places. The deal was that I got to pick once place and then he got to pick one. At first I started with familiar places I knew would be easier on him (like Toys R Us or the bookstore cafe) and when he started improving I expanded that. He got to choose whatever after we'd done my thing. </p><p></p><p>difficult child just started 5th grade without notable signs of anxiety. He's been medication free for all of that time. I won't pretend it's been easy--it was a big drain on the family in those early months. and had there been some guarantee that a medication would work there were times I would have gone for it but I would have had to be desperater than desperate (or not seen any signs of progress long term) to go that route again. difficult child does still show signs of anxiety from time to time but they've been managable. I also know that could change any day. </p><p></p><p>Good luck with this and keep us posted.</p></blockquote><p></p>
[QUOTE="SRL, post: 73773, member: 701"] My difficult child was similar in that he presented with Autism Spectrum Disorders (ASD) traits but didnt' meet the diagnostic criteria. Around age 5 his anxiety over every day things reached the level that it was seriously impacting every day functioning and when nothing else worked we went with Celexa. We were dealing with the seperation anxiety at bedtime as you describe as well as stuff like hysteria over everyday experiences such as water level in the tub, fire in the grill, momentarily taking one hand off the steering wheel, etc. Celexa did relieve his anxiety within several days and I was very glad to give him relief. At the beginning I thought I noted an increase in activity level and shortly afterwards more difficulty in handling anger. Over the next 9 months both of those side effects did increase to the point where I brought it up to the doctor. He recommended an increased dose of Celexa because he felt it would help the anger control plus adding Straterra for the hyperactivity. I nixed the Stratera idea (difficult child doesn't have ADHD and I didn't want to give a second medication just to counter side effects of the first. Against my better judgment I trialed one increased dose of Celexa and had both of my suspicions confirmed. I decided then to decrease and then quit Celexa just to see where he was at. Hyperactivity ceased almost immediately, anger control improved slowly, and he also started to cry again which is something we hadn't realized Celexa had supressed in him. Anxiety flared up a little but not to the unmanagable points it had been. He'd overcome many of his previous fears and with a little extra support from us he was functioning pretty well in the anxiety area. All anxiety hell broke loose 9 months later when he started all day first grade. We couldn't get in to see the doctor (medical leave) so I opted to try Celexa again figuring if it would help the anxiety I could deal with the side effects we knew at least temporarily. This time the side effects came on fast and hard and he started into a downward spiral which was hurried along by Zoloft which we tried next. Virtually all of his issues soared to all time high levels and I'm sorry to say it took a year until he was back to near baseline again. I don't mean to discourage you because any of the SSRI's can be great medications for the right person. My difficult child obviously wasn't that person. If you note any side effects or rapid behavioral changes, see the psychiatrist immediately. Doubly so if he's had negative side effects to any previous SSRI medications. After that experience we were way too frightened and exhausted to trial any more medications, and here are some of the things that helped the anxiety area. Obviously we had to do a lot more because we had an out of control child on our hands whose every issue had been exacerbated by anxiety. 1) difficult child needed to have some connection to me at all times, until he was emotionally well again and could stand on his own two feet. I told him in advance when I was leaving the room, took him with me when I could, made sure he understood I was available by cell phone at all times when we were seperated. As for sleep, I got it whenever and whereever I could because when I was tired I couldn't cope with him...well, I couldn't cope really great when I was rested but it was better. In a nutshell, what my difficult child needed was a period of security after being so emotionally upset by anxiety. 2) We looked for ways to make transitions easier. He was panicking at school drop off (and perservating before we left) and finally I made a list of what I was to do in his good bye routine. I took it out every morning and carried it with me. When the panic or obsessions took over, I'd whip out the list and remind him that I was going to worry about this so he wouldn't have to. I also found that having some kind of daily tangible connection with me helped. Every morning he'd select two small stuffed dogs and choose one to give me and one to hang on his backpack to go to school with him. I took that pet with me in my purse or pocket or van through my day and then at the end of the day I'd tell him where we'd been and what we'd been doing. This is a simple thing which I've shared before--I think it was Andrea Danielle who reported good results with this as well. 3) We looked for every possible way to empower difficult child to handle anxiety situations. Panic over water level=using permanent marker to write on the tub stall how to turn off the water. Noise too loud= wear ear plugs or ear phones. Need a break from class=give a card to your teacher telling her you need a break. Afraid of being in the basement=practicing calling mom through the baby monitor. Children with anxiety feel totally powerless against this monster in their life and it's critical to find them ways to take charge, often starting in small ways. 4) My difficult child started totally shutting down in terms of not wanting to leave the house. I wound up using incentives to keep him going to school part time (while homeschooling the other part of the day) and I don't know that I'd use incentives to that degree again. The other thing I did was to take him out once a week on sort of a date night just to keep him going places. The deal was that I got to pick once place and then he got to pick one. At first I started with familiar places I knew would be easier on him (like Toys R Us or the bookstore cafe) and when he started improving I expanded that. He got to choose whatever after we'd done my thing. difficult child just started 5th grade without notable signs of anxiety. He's been medication free for all of that time. I won't pretend it's been easy--it was a big drain on the family in those early months. and had there been some guarantee that a medication would work there were times I would have gone for it but I would have had to be desperater than desperate (or not seen any signs of progress long term) to go that route again. difficult child does still show signs of anxiety from time to time but they've been managable. I also know that could change any day. Good luck with this and keep us posted. [/QUOTE]
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