Stress/anxiety and no sleep

[kernelmom3]

DS is 17 and was diagnosed with Crohn's a little over two years ago. He's been on Remicade since diagnosis and is responding well (THANK GOD). He is a perfectionist in every sense of the word, talking 5 AP classes this year with no lunch period in high school (NOT my idea). He has finals today and for the next two days before winter break. He finished one final and vomited in the classroom but insisted he could handle the next two. I got a call from the school nurse that he vomited again in his next final! They told him to come home so he's in bed sleeping now. He obviously has issues with stress and anxiety but refuses to to take any meds or go to counseling to help. He is always tired, even when he is able to sleep in on the weekends. I'm really worried he's headed for a flare or maybe a nervous breakdown. I feel helpless because even if I MADE him go to counseling or take meds he'd have 9 more months until he's 18 and could stop them. I'm really hoping the vomiting today was just anxiety/sleep deprivation and empty stomach and not Crohn's related. I guess I just wanted to vent and maybe get some advice if anyone has any. He seems SO high strung 100% of the time and I'm ALWAYS trying to tell him to calm down/let things go/relax but I don't think he knows HOW. He's had counseling in the past but feels like it didn't help so it won't help him now. Thanks for reading this far, I didn't know where else to go with this because no one understands having chronically I'll kids like we do

 

[my little penguin]

I see your point but
If in 9 months he has tools in his toolbox to help him cope better with his anxiety then it's all good
I wouldn't rush to meds
Has he seen a psychologist (not psychiatrist) who has experience with medically complicated kids ?
Most ped GI clinics have one or can recommend one
Plus most need to try several psychologist before they find a good fit
Some are better than others
Can the GI talk to him about not eating all day ?
Or even strongly suggest to see a psychologist so mom isn't the bad guy
Sometimes with teens when it comes from the doc they are more likely to do it
Starting as family therapy also helps take the pressure off him since the disease affects everyone and then transition to just him so he isn't singled out
We did this and it worked out better

 

[Maya142]

I would also strong recommend seeing a psychologist. Ask your GI for a recommendation - sometimes they even have one in the IBD clinic or one that works specifically with kids with chronic illnesses.

My daughter was like your son - very stressed out, very high achieving and absolutely refused to see a psychologist. There was no way I could convince her. Luckily, her GI also thought it was necessary and eventually insisted she had to go.

It has been a HUGE help. Within a few months, she was reminding me to make appts. with the psychologist. Now she looks forward to going!

Even if he only has 9 months, a lot can change in that time. He may learn some good coping skills and he may realize it's helping him and might even decide to continue.

Not having a lunch period does not seem healthy. Can he take Ensure or something like that and sip it in class? Or can he get permission to eat a sandwich in class?

I would also talk to his GI to get him/her to suggest the psychologist - sometimes kids respond better (and actually listen) if it isn't mom telling them what to do.

I wouldn't jump to needing medications yet - he might need them in the future, but I would at least try working with a psychologist first.

My daughter also has LOTS of issues with sleep. She found that listening to audiobooks as she falls asleep helps and as does using a relaxation app (the one she uses is called iSleepeasy and was recommended by her pain management doctor).

Good luck!

 

[kernelmom3]

Thanks! I know of one female psychologist around us with IBD but not sure he'd want to see a female. I think starting as FAMILY therapy will be the way to go. It will be helpful for all of us because we could ALL use the tools! He does eat during the day in his fifth period class, luckily the school is really good about that. I always pack him 2 sandwiches (along with chips, snack and drink) because that way I know he has food. I'm just seriously overwhelmed and really hoping he doesn't flare.

 

[CarolinAlaska]

I'd give it a bit of time to get through the finals. I used to pass out in my college finals. It is so easy to overpressure yourself. Make sure he keeps himself hydrated through this and see how he does over the Christmas break. Don't worry about whether he's flaring until it is obvious that he is.

 

[Mehita]

My son is a junior and taking three AP classes. I can't image taking five. Holy cow! Like others have suggested, I'd get him into therapy, but it might need to be a direct order from his GI so that he doesn't have a choice. We did this in a round about way and now my son is seeing a therapist once a month and actually enjoys it.

Another resource might be his guidance counselor. As much as it annoys my son, his guidance counselor pulls him out of class once a month to "check in". I think hearing from another adult (who isn't mom or dad) that he's got a heavy load and needs to keep his health in check has opened my son's eyes a bit that he needs to keep his life balanced.

It's so hard with teens, especially when WE see them burning out and they think they're just fine. Been there, done that!!

 

[Maya142]

I wanted to add that lack of sleep is probably worsening anxiety (and of course, it's possible anxiety is keeping him from sleeping!).

I also wanted to say that sometimes it takes a while to find the right therapist. Don't give up - we saw 2 before we found the one my daughter is currently seeing. It has made all the difference in the world.

Finally, my daughter was also a perfectionist. I say "was" because she has loosened up a little bit in college and has realized that the sky won't fall if everything isn't perfect. She also took 5 AP's at once and it was an AWFUL idea. She was often up till 2 am working and then up again at 6 am to get to school.

I'm a teacher and I tell kids again and again NOT to do that. Obviously, your own kids never listen...

 

[kernelmom3]

I knew his class load would catch up to him but he thinks he's invincible (like every other teen I know). I had a talk with him tonight and said grades don't matter if you're sick. NOTHING matters if you're sick. I told him to remember how painful it was after they perforated his intestine during his colonoscopy and asked if he cared about his grades then. I don't know if I got through but I'm not giving up, I'll never give up

I think I'll call around after the holidays and start family therapy and then sneak in individual sessions for each of the kids. Thanks again all!

 

[Mehita]

Not sure where you live, but you may want to call know just to get on waiting lists. It took three months to get my son in anywhere and with the holidays around the corner here, the wait lists might be longer than normal. Just a suggestion.

 

[Maya142]

I definitely agree - it can take a surprisingly long time to get in!

Good luck!! I hope it really helps him.

 

[Tesscorm]

I'd also agree with the psychologist but maybe from a different perspective. It doesn't seem that his anxiety, etc is related to his crohns and, perhaps, this is part of the reason he's fighting the idea. He may believe you feel he needs to learn to cope with his crohns and, in his mind, he has no issue with crohns?? My daughter, who does not have crohns, had lots of anxiety in high school. Before tests, exams, etc. it was horrible. She'd start stressing, leading to crying, leading to a feeling of being overwhelmed, by this point, she couldn't concentrate or remember anything she'd learn, which just reinforced the initial worry that led to the stress, and on and on it went! She would break out in hives and be itchy all over from the stress! All I could do was physically move her away from her desk and slowly try to calm her and talk her down from her anxiety (with only limited success).

In her last year of high school, she was the one who asked to speak to someone about her stress. To be honest, I didn't believe it would help because I thought it was more her study 'skills' that needed help but, I didn't think it would hurt and arranged for her to meet with a psychologist (through her ped). It was the BEST thing we could have done!! She met with her only a short time, a few weeks??, because psychologist went on maternity lv, but her stress/anxiety have NEVER returned! I have no idea what this doctor said to her but, my daughter recently graduated from a tough university program and, in all the years, never had the same stress/anxiety again.

Perhaps, if you broach the psychologist issue as not crohns-related but just as a learning tool to learn how to deal with heavy workloads, prioritizing, how to manage stressful situations, etc., he may be more open to the idea??

And, of course, and as you know, not eating for hours can have an impact. Again, my daughter is like that... she absolutely needs to eat every couple of hours or her personality completely changes! When she's hungry, she's very irritable, has headaches, can't concentrate, etc.... all things which lead to anxiety. Will he eat protein bars? My daughter will not usually eat the whole bar at once but, will carry it with her and eat it half mid morning/afternoon.

Good luck! It's always tough trying to convince teens to try a suggestion. :ghug:

 

[cmack]

I think if he got more sleep his body and mind would start to heal. I am taking 50 mg of amitriptyline. It is an old school antidepressant that made people very sleepy so it wasn't used for that purpose for very long. Of course we don't want to be sleeping during exams or such.
The dosage for depression is 200-300 mg I believe, but 50 mg an hour before bed makes you sleep (for sure) and it helps relieve aches and nerve pains. Ask the doc and see if he can convince him (this is an off label treatment). We all need sleep, if we don't get enough our body can't heal. By the way there are very few side effects besides sleepiness, Hope this helps. I hope your son aced his exams.

Chris

 

[cmack]

Merry Christmas all. Hope you get a better new year.