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511019 tn?1214340923

Does anyone have any suggestions for my 14 year old daughter?

My 14 year old daughter was adopted from a Russian orphanage when she was 3 years old.  She has suffered from abuse, and has been in regular therapy since her adoption.  She has been diagnosed with OCD, PTSD, Selective Mutism, and Tourette Syndrome.  She takes Paxil, Klonopin, and Pimozide.

My husband has a panic disorder, so he and Mary share a special understanding.  They are able to communicate openly about their feelings, and are very supportive of each other.  I've encouraged both of them to talk with me, or other family members during times of difficulty.  It's kind of a rule in our house that no one suffers in silence.

My husband is a writer, and works mostly from home.  He has good control over his anxiety symptoms during the day, but often has panic attacks at night.  During his attacks he is very fearful.  He often calls out to either myself, or our older children for help.  We try to help him through these attacks with gentle conversation, and reassurance.  Between panic attacks, his anxiety seems well managed.

Mary doesn't experience panic attacks in the same way as my husband, but is consistently fearful throughout the entire day.  She only speaks with family members, but prefers to communicate in sign language.  In some situations she cannot communicate at all because of her Selective Mutism.

She follows me around the house every moment she can, and offers to help me with many family chores.  Although I appreciate her help, I don't want to take advantage of her.  She is 14, and I want her to be able to play with other children her age.  Does anyone have any suggestions?
5 Responses
Avatar universal
The treatment for Selective Mutism is multi-modal - intervention, therapy and possibly medication.  The earlier the diagnosis; the better the prognosis.  I belong to a support group for parents and teachers of children suffering from anxiety and we have had excellent results with our younger children using the above treatment (of course - medical personnel are involved).  However, there seems to be a resistance to "helping" our teenagers in dealing with this disorder.  For some reason, they just do no respond to treatment as easily as our younger children (some as young as three years of age).  Surprisingly, the adults in our group have responded very well to the above treatment.

Is she taking CBT?  This seems to be the therapy with which our children have been most successful - of course, there must be a personal desire to "get better".  As far a "playing with children her age" - this one will be difficult.  Due to her poor and underdeveloped social skills, she probably does not relate well to children her age.  Perhaps, younger children might be a wiser choice for playmates.  Does she attend school or is she homeschooled?  

I'm wondering about the use of Pimozide - this medication is often used for chronic schizophrenia.  Also, the Klonopin is used to control seizures - I suppose for the Tourette's disorder. As you know, OCD, SM and PTSD are all anxiety disorders - we did find in our group, though, that Prozac was very helpful with our younger children; our older children are more responsive to some of the other SSRI's as Celexa.

It really seems to me that perhaps your husband and daughter should seek out another professional for help.  I really am wondering about the diagnosis of your daughter - severe anxiety (whether it is called OCD, SM, PTSD) can mimic the tics of Tourette's.  Have you seen a professional with experience in anxiety disorders?  As you know, your daughter will not outgrow her fears nor will they go away but with proper treatment she should be able to learn "how to control and thus manage her anxieties".  I wish you the best ...
511019 tn?1214340923
We started Mary in therapy when she was 3 years old.  She has been in CBT since she was 9-10 years old.  She has been seeing the same therapist twice weekly for the past 4 years.

Mary's therapist works closely with a child psychiatrist that we see every 3-6 months.  She prescibed the Paxil and Klonopin for Mary's anxiety.  Her pediatrician prescribed the Pimozide.

Mary goes to a public elementary school, and is in the 6th grade.  She's a smart girl, but has an IEP for severe emotional desterbance.  She still cries every morning when I drop her off.  Her younger brother Jordan walks with her to her classroom.

When she is not following me around the house, she spends a lot of time with my oldest daughter Julie.  They are both very artistic, and enjoy painting murals throughout the house.  They communicate through sign language, since my oldest daughter is hearing impaired.

She really is a very sweet girl.  She is always willing to help her siblings, and is very helpful around the house.  Does her anxiety effect her desire for friendship?
480448 tn?1426952138
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Avatar universal
Does her anxiety effect her desire for friendship?  No, not her desire but her ability.

I'm sorry to hear Mary is struggling so much.  I really do not know what to say as it appears that you have "done all of the right things".  If she is still crying, then there is too much anxiety remaining.  This can be from too much or too little or the wrong kind of medication.  I'm surprised at the prescription of Paxil - are you aware that it is banned for use by children until they are at least 16 years of age in many countries?    It does seem to me, though, if the psychiatrist and therapist have not made inroads in her treatment, then maybe you should be looking for another professional.  Are you living near a center with a research facility - these centers often provide more current therapies.

But, things may not get better until Mary decides to get better.  Unfortunately, we have three or four teenagers in our support group similar to your daughter and it is so disheartening.  This age group is very difficult to treat - maybe they just have "given up".  School can be difficult but the job market is even more so.  One more thing - the psychologist in our support group is concerned about many of our parents "enabling" their anxiety-prone children; sometimes being kind is not a good thing.  Have you discussed this possibility with your daughter's professionals?  I really wish I had more to offer - I wish you the best ...
511019 tn?1214340923
Thank you for opening my eyes about some of the medication she is on.  I am beginning to suspect that Paxil may not be the right thing for her, and that she may not need the Pimozide at all.

I've thought about changing her therapist in the past, but it took us so long to find one that she was comfortable with.  By comfortable I mean doesn't cry, run away, or try hide from.

As for enabling her behavior, I've been spoken to about that a number of times.  She will sometimes cling onto me in tears, burying her face into my clothes.  This could be in a super market, at the park, or even at school.  I don't know exactly what to do about this behavior, but I refuse to push her away.
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