Anxiety and executive function/memory

My 13 yr old has severe anxiety.  We are about to start her on medication, Celexa.  We've spent 13 years 'walking on eggshells' around her, but recently she has started lying about things going on at school which are not, with the common thread of 'everybody is really bad and everybody hates me'. She came close to being disciplined for something she didn't do because she is known for lying.  She also  has a sever problem with her memory, can't recall conversations that we have with her and can  not take direction.  She also can not do a hygiene routine.  she'll go into the bathroom and stay for along time, accomplishing NOTHING>  she's taken showers  and not washed anything.  Does anyone see the correlation between anxiety and executive function in this way?  I'm wondering if the executive function part of it could improve with the medication, also. She's always been fine at school and terrible at home, until this year, 7th grade, with this new addition of story telling and social anxiety.  The only problem academically is her lack of rote memory.  She gets the concepts in math, but could not tell you what  7+4 is quickly.  thank you for any thoughts.  

[Sandman2]

     I am wondering if you are treating the cause of the anxiety by giving her Celexa?  In the book,  "The ADD/ ADHD Answer book," by Susan Ashley. (on p. 53), she states that 25 to 30% of children with ADHD have Anxiety Disorder.  25% have Conduct Disorder and 33% have Oppositional Defiant Disorder.  She goes on to say (on p64), "that the worrying experienced by children with anxiety disorders can appear similar to symptoms of AD/HD.  When children cannot get their mind off their worries,, it is difficult for them to concentrate, pay attention, focus on their school and homework."
    I mention this because her symptoms are very common for ADD.  I would assume the doctor you used for the Celexa closely checked for ADD.  It may be she has only anxiety, but its also possible the ADD is causing the anxiety, or they both are coexisting.  
   My point is that you need to be sure.  I would be using a psychiatrist for this - certainly not a pediatrician.  A good child psychologist with experience with ADD would probably be ok.  
   In terms of her lying, you might want to check out my answer to that on the ADHD forum.  its link is http://www.medhelp.org/posts/ADD---ADHD/Is-it-common-for-children-with-adhd-to-lie-and-steal/show/1472651#post_6696897
    And if you haven't already looked up information on ADD.  I would suggest it. An interesting site is totallyadd.com which is completely done with video clips since it was a PBS special awhile back.  I closely watch the ADD forum, so if you have any questions - if you post there I will see them.  Best wishes.

[specialmom]

I wanted to add to Sandman's comments that what you describe sounds like it could be an issue with motor planning as well.  Motor planning does not mean clumsiness (although it does often involve this) or even dyspraxia (inability to coordinate movement to do things necessary for functioning) but also in how one processes conversation and thought.  The brain has to organize all information coming in and all information coming out.  If the processing is slow or interrupted, you are going to see a child that forgets, doesn't follow directions, takes forever to do something, etc.  You also talk about issues performing her own hygeine needs.  Again, there can be different reasons.  One could be that it is uncomfortable or unpleasant to her because of tactile issues with her sensory system or again, motor planning making the process difficult.  Anxiety and sensory (and add/adhd) can look similar and are often comorbid.  

Please google motor planning as it pertains to language and thought organization.  As you read about it as a whole, think back if anything past or present fits.  Occupational therapy works wonders.  

I always love Sandman's information and find it quite valuable in understanding kids.  I plan on looking into the link he provided as well myself!
good luck

[allmymarbles]

When children have these sorts of problems, the question is to drug, or not to drug. The latter leans toward behavioral therapy. But before you do anything, get her a complete physical checkup. Also check her diet. Is it healthy, or is it junk food, or lots of sugary stuff? How well does she sleep? Lack of sleep is hard on memory. And remember, she is in puberty. This is a very difficult period for some children..

[specialmom]

I wanted to add as well that a well regulated nervous system often requires physical activity. There are exercises and things that a person can do that help the brain stay focused.  There are all kinds of tricks of the trade that help regulate a processing issue such as chewing thick bubble gum prior to working, doing a set of push ups, etc.  Things you may not be aware of that help organize our executive function.  So make sure she is getting a healthy dose of exercise.  Swimming is probably the perfect nervous system exercise.  

[jdtm]

I belong to a support group for parents and teachers of children suffering from anxiety.  We have always believed that learning issues (including executive function) were caused from the anxiety "smothering" the ability to learn.  Because of our beliefs that anxiety prohibitied the child from being able to learn (not that the child had a specific learning disability), a noted researcher in our area studied this point for several years.  The study did show that anxiety does impede learning and often it may appear as if the child has a learning disability; when in fact, there is no learning disability at all, only severe anxiety.  The study believed that treating the anxiety would improve the learning ability.  However, I now believe that "anxiety" is in itself a "learning disability"; albeit one not recognized by the educational system.  Perhaps a new focus for our group, but I digress ....

I suspect the above paragraph describes what is happening with your daughter.  The medication, Celexa, is one that is often prescribed to children in our group (and frankly, we have had a lot of success with it).  Celexa is not addictive but it does lessen the anxiety to the point where the child is able to function, and hopefully, use the techniques taught in intervention and therapy.  If your daughter is suffering from anxiety, she will not outgrow this nor will it go away.  Our child has been on medication since she was six years of age (now in her mid-teens) and frankly, without her meds, she would not have had much of a life.  Today, she is doing quite well.  But with medication, the mantra is always "go low and go slow".  And, the same SSRI (selective serotonin reuptake inhibitor) or dosage amount does not work the same way in every person.
  
Anxiety also mimics ADD/ADHD and is often co-morbid with depression and sensory issues.   Usually when under stress, those with anxiety display the "hesitation factor" which I suspect is what you are seeing when your daughter cannot answer immediately mathematical questions or respond quickly to other questions/demands.  One other point - if a person's brain is overwhelmed with anxiety, the brain will ALWAYS choose the emotional factor over the cognitive factor.   Not being able to recall conversations and even situations and activities can be a part of this "overriding" affect of the emotional part of the brain.  Lying can be a part of this scenario and when our child was under great stress, she said "anything" to relieve that enormous stress, not to deceive or mislead another.  Anxiety can be so confusing at times.

The showering issue is also common to those suffering from anxiety.  Our child started having these "bathing" issues at about the same age as your daughter.  I suspect that we are seeing some OCD tendencies as well as the social and separation issues.  Anxiety is common in some of our family members so it appears that our child inherited this trait from more than one parent.

I hope your daughter is seeing a medical mental health specialist with experience in anxiety issues as a child neurologist or child psychiatrist to assist you and your daugher in devising a plan to help her manager her fears/anxieties.  As I said before, the medication only allows the plan to work; there is no "cure" for anxiety.  But, that being said, anxiety is very common and highly treatable and manageable.  The prognosis for your daughter can be excellent.  If you have any additional questions, please write.  All the best ....

[specialmom]

I just want to say that anxiety was secondary to my son's anxiety issues and in using non medicated routes to treat his sensory issues, all anxiety symptoms resolved.  My son has never required medication.  

[specialmom]

Ha, typo.  I meant secondary to my son's sensory issues.  If given a choice, as a parent and psycholigist by profession-----------  I'd look to underlying causes to anxiety symptoms first.  This can often be the root of a problem in a child as it was for my son.  So, I'd rule those things out first before going the route of antianxiety medication.  SSRI's do carry precautionary warnings for children for two reasons----------- one due to lack of studies involving children (who wants 'their' kid to be the guinea pig in a study) and second because of things that have surfaced over years of their use.  Most psychiatrists that I have dealt with in treating children will medicate with an ssri when the symptoms are such that they warrent taking the benefits over the risks of the drug.  But it should be later in the process that medication is introduced, in my opinion.  This is NOT addressed to the original poster but as a general opinion about anxiety and children.  

[jdtm]

The original poster's daughter was diagnosed with severe anxiety and not integrated sensory disorder.  The opposite of what your child suffers would be the issue in this child's case - the sensory issues will be secondary to the anxiety issues.  Anxiety disorders result from a genetic trait and not as a result of life experiences.  Anxiety issues is the reverse - that is they are the result of life experiences and not an inherited trait.  This is the difference between "being anxious or having anxiety issues" and "suffering from an anxiety disorder".  From what you have written, it seems your child has anxiety issues or is anxious, but does not suffer from an anxiety disorder.   Semantics - just trying to clarify ....

[specialmom]

Actually sensory integration disorder is a developmental delay.  It couldn't be caused by anxiety.  It can, however, be the lesser of a problem that a child is struggling with.  Sensory is not something that results from life experience but is how the brain and nervous system process stimulus.  Also clarifying.