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Has my daughter got OCD or is it ASD


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Hi. My daughter’s anxiety is extremely severe and has been getting worse since March. Changes at school set this off. Over the past few months We have seen a psychologist who suggested her getting an ASD assessment. We have done this privately and it has determined she is autistic with a profile of PDA. However, The anxiety she experiences I believe is beyond just ASD. Over the past couple of months she has stopped being able to sleep at night as she is terrified of having a panic attack, she is now obsessed with thinking this and will not go to sleep until 8am in the morning. Other signs that make me think she may have OCD are below. I have researched OCD but I’m still unsure, I have been told by CAHMS they cannot help as she has been diagnosed and needs ASD support, but with her anxiety, panic attacks and violent behaviour I really need some advice on where I should go next.

Her obsession started with her teddies having to be in a particular order, non matter how many times she tried to place them down it wasn’t right and she grew extremely distressed I had to remove them from her room out of her sight. The same thing happened with her fidget toys, now they have to stay in the garden. She has to tighten lids on bottles in an exact way, she now just hands me the bottle to do this as it causes her too much distress. 
The next one was her hair, if it wasn’t put in a perfect bun and every single piece of hair was up she would have a complete breakdown, scream I was trying to kill her and that she couldn’t move, it was like she became paralysed. If she drops a cushion in the floor and it doesn’t go the right way again she gets extremely angry and upset and the cushion has to be removed from her sight. Sorry for the long message but I wanted to put as much detail in, any advice or suggestions on the best next steps would be greatly appreciated.

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Hi CSPW,

I'm sorry to hear how much your daughter is struggling at the moment, it sounds like it is impacting a lot on day to day life. We do know that the prevalence of OCD amongst those with ASD is high, so it is possible that your daughter could be struggling with both. It might be helpful to watch our conference presentation on OCD and ASD here https://www.ocduk.org/conference/conference-map/family/ocd-and-autism/ to get more insight into recognising both conditions.

You mentioned that CAMHS can't help because she needs ASD support, is your daughter currently getting support for her ASD and did you seek a referral to CAMHS or did you just contact them yourself?

Gemma :) 

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Hi Gemma. Sorry for the late reply. The video is extremely helpful and definitely highlights the ‘isn’t right’ phrase my daughter uses a lot when doing something. Is it common for children with OCD to pass something to there parents to do as they know if it doesn’t go right it will cause them anxiety and stress. For instance a bottle lid my daughter has to twist it in a certain way number of times, she has now resorted to giving it to me to do as it causes her to much pain. 
I was advised to self refer to CAHMS by the GP and healthy family team. But CAHMS have basically said the anxiety is due to her being autistic. I think because of how exteme her anxiety is I am going to book a private appointment with a psychiatrist. 

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Hi CSPW,

Yes, avoidance is a common compulsion for those struggling with OCD. Unfortunately, like all compulsions it doesn't help in the long term, because a person avoids learning that things can go alright if they were to continue as normal. But in the short term while your daughter isn't getting the support she needs, it is understandable that sometimes you might have to do things for her. It might be helpful to learn a little more about OCD together, we have a great presentation here https://www.ocduk.org/conference/conference-map/family/ocd-a-introduction-for-parents/ that is a good way to learn more about OCD.

I would suggest going back to CAMHS and asking them for an assessment for your daughter. You need to be clear that CAMHS believe the anxiety isn't caused by OCD. If you need a second opinion then please do ask for one. There is a specialist CAMHS service is South London at the Maudsley Hospital https://www.slam.nhs.uk/our-services/service-finder-details?CODE=SU0264 who we know treat young people with OCD and ASD, and this may be an option going forward.

Gemma :)

 

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