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8 year old with OCD and food aversion


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I would really appreciate some help or advice in dealing with my daughters OCD and severe anxiety, as my husband and I are extremely worried about her. Three months ago my 8 year old daughter developed sudden anxiety around food, which was triggered by me going away on a work trip for the first time since Covid. Within a week she could eat nothing except shreddies and hummus sandwiches and has eaten nothing else since then. Over the last 3 months we have had short periods of 1-2 weeks where the anxiety lifted and eating food was easier, but for the majority of the time her life has been ruled by food as even eating her 'safe' foods is difficult - eating a bowl of shreddies can take hours as she checks each one multiple times, rejects bowls and spoons and often throws up to 80% of the bowl away. She also won't let us make her anything and it can take her a lot of time to prepare her food herself. She has lost a lot of weight, but so far not enough to trigger urgent support from CAMHS (she is being weighed regularly by our GP, who is also checking blood pressure etc). CAMHS have assessed her and have offered therapy, but as the waiting time is still very long, we have been seeing a private psychologist online in the meantime. Therapy doesn't seem to be helping as her anxiety is so high it's hard to do any CBT. She also needs to eat regularly, so there's rarely any respite from the anxiety i.e. it takes so long to eat anything at all, that she's worrying about having to eat again soon after she's finished. Until recently we've been able to distract her, which helps, but in the last two days her anxiety around eating has been so bad that she's started hallucinating and seeing black shapes climbing the kitchen cupboards/smoke and red shapes coming out of her food. This is obviously very distressing for her, and it's heartbreaking to see her so terrified and be unable to help. Has anyone had any experience of anything like this, or ideas how else we can  support her? Or even any recovery stories to give me hope? I'm phoning CAMHS regularly to get a psychiatrist evaluation, but not getting anywhere. Our therapist is extremely concerned and has been contacting CAMHS on our behalf, along with our GP. It's so hard to see her go from being a happy, fun 8 year old to her current anxious withdrawn state in such a short time and we really are at our wits end. Thanks in advance for your help, Sarah

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Hi Sarah,

I'm so sorry to hear how much your daughter is struggling at the moment. I understand how hard it must be to watch your daughter in such distress over something seemingly so simple like eating food. The symptoms you describe sound a lot like those with OCD with contamination fears around food, but there is another condition that I know of called Avoidant Restrictive Food Intake Disorder (ARFID) that can co-occur with OCD, or be a condition on its own. We have a presentation from the specialist CAMHS team in London talking about it here https://www.ocduk.org/conference/conferences-across-the-uk/2021-virtual/family/ocd-and-co-morbidities/

They do suggest some resources, but just knowing about ARFID might help better inform the approach of CAMHS. You mentioned that your daughter's therapist has contacted CAMHS and so has your GP, have you heard anything back yet?

Gemma :)

 

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Thanks Gemma, that's really useful. I have read about ARFID and it sounds as though it includes OCD behaviours. In Phoebe's case she was initially scared that the food was poisoned, but this has now changed into an additional fear that the food is 'cursed'. She hasn't really articulated what she thinks will happen if she eats, but she got very upset at the full moon last week and has said that she worries she will 'turn into something' overnight, so I think that werewolf fears are part of it. 

 

Since posting earlier in the week, the situation has really deteriorated. Phoebe now has hallucinations every time she tries to eat and has eaten nothing since Thursday evening. We have everything to reduce her anxiety, but we just can't - if we succeed in distracting her, the anxiety comes back when she tries to eat something. She is so hungry that she has been vomiting and she is very weak and lethargic, but she still can't eat anything. I called 111 yesterday, but they just sent me to CAMHS, who have said that they will discuss her case again at their next team meeting on Monday, with no advice on what we do if she doesn't eat over the weekend. It has been almost 48 hours so far without food of any kind and she is now refusing water. I'm tempted to go to A&E, but I think they'll just send her home. 

 

Does anyone have any advice on how to get a child eating after a period of absolute food refusal? I can't see her being able to eat over the weekend, as we just won't be able to get her anxiety to a point where this can happen.

 

We're absolutely terrified and have no idea who to turn to for help.

 

Best wishes

 

Sarah 

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Hi Sarah,

If she's refusing water as well as food that makes it a medical emergency as persistent dehydration can be life-threatening. Do you know if she's still passing urine? I suggest collecting all the urine she passes in the next 24 hours in a clean container or jug so you have a total volume and colour concentration to report to the next doctor you speak to, and a 24 hour sample ready to test her kidney function and electrolyes.

Encourage her to drink even if she can't take food, but if this fails then tomorrow you can either call your GP or take her to A/E. Either way explain to the doctor you speak to your concerns about hydration and describe the sample you've collected. Ask if she can be admitted direct to paediatric services for redhydration (IV fluids) from where she can be refered on and assessed by psychiatric services later as required. 

Let us know how it goes.

 

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Hi Sarah,

I agree with Snowbear in that not being able to drink makes it a possible emergency situation so I hope you have managed to reach out to either your GP for immediate assistance or if you have to go to A&E, then please do so. It is really hard because I'm sure it feels like your total responsibility to get your daughter eating and drinking, but really you need support to tackle this problem, because it will be very distressing for you and your husband too.

Gemma

 

 

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