Kiddo with anxiety and migraine questions...Also testing???

[MamaKath]

I am wondering if any of you have experience with anxiety and/or migraines in kids. Ds has been really struggling with some major issues this year which have led us to make some major changes (I posted in the lounge about our homeschooling (http://windsorpeak.com/vbulletin/showthread.php?t=407548)this upcoming year). When sitting down with a good friend to go over some of the concerns and make some decisions about school, she pointed out that all of his incidents at school have had major anxiety components to them and all of them seem to be fight-or-flight reactions. Talked to his therapist and there is agreement there for that, however we have planned to do some more testing over the fall (dx'd with spd and adhd but we want a bit more accurate dx and careplan).

If your child has anxiety, how was it diagnosed. Are they currently being treated for it? Meds, therapy, combination?

Now fast forward to tonight and migraines. He didn't look great when I picked him up from daycare. He was not looking great. He kept trying to lay down and go to sleep. I gave him a snack and his color was better. We had to pick up dd from a friends and go to OT so he sipped water and then fell asleep, complaining of a horrendous headache. I figured the water might help, they had played outside for awhile. Get to OT, wake him up, take him in. About 30 minutes later he vomits. We leave. He started feeling better very shortly thereafter. DD and I are talking as we drive home and she reminds me that every time he has thrown up this year, it has been accompanied by the same things- he starts feeling funny, doesn't eat/drink much, gets a wicked bad headache (hurts all across, constant not pounding), wants to sleep, eventually vomits, feels fine very shortly after. This has happened probably 5 times this year. Do these sound like migraines? I get them, but mine are related to cycle stuff, so some different triggers and symptoms. He also has tons of food allergies/sensitivities; playing outside (pollen?) seems to trigger sometimes.

I'll be calling the ped in the AM re: headaches, but any thoughts in the meantime? Also what type of doc would I need for an eval to cover all these things- ped neuro or a team of some kind?

I am research hospitals for testing and want to make sure I ask for the right things. Kennedy Krieger was not what we had hoped and did not do any team eval and really did very little testing, so they are out. We are currently researching doctors at Georgetown, Children's, CHoP, and NYU to see where we can get the most complete evaluation done.

Most of all, thank you for any insight offered!!! Feeling pretty frustrated and down with the whole big situation right now. :/

[Melbel]

I am sorry that your son is suffering. The symptoms you described do sound like migraines. My DS, age 11, has a 2.5 year history of migraines. This past spring, he began suffering from not only daily migraines, but also migraine associated vertigo and other neurological symptoms.

He also has a history of some anxiety (perfectionist personality) but he managed well until the vertigo. Following a severe medication side effect, he began suffering from major anxiety and panic attacks. We are still on the road to recovery. His psychiatrist/psychologist diagnosed him with anxiety/panic attacks secondary to a medical condition. He currently takes anxiety medications and goes to a therapist who uses cognitive behavioral therapy techniques.

For migraines, DS has had several brain MRIs (follow up MRIs have been to monitor a cyst and in response to his spring neurological symptoms), EEGs, EKGs, allergy testing. His neurologist diagnosed migraines. We have found that 100 mg of Riboflavin (water soluble B vitamin with no side effects) has been the best preventive treatment. He takes Motrin or Advil at the onset of a migraine. We have been advised that it is better to catch it early.

We have definitely found that anxiety exacerbates any pain symptoms.

If your son has anxiety, I would select testing sparingly and only if absolutely necessary (testing will likely exacerbate anxiety). Given the severity of DS' neurological symptoms, we were trying to get him admitted out patient for comprehensive testing and care. We were unable to do so, but did consult with a great doctor at Texas Children's Hospital in Houston. There is a US News and World Report ranking for neurology departments at children's hospitals.

I hope this helps and wish you and your son the best.

[hillview]

I would go to a pedi neurologist. So sorry for your DS!
/hillary

[egoldber]

That does sounds like migraines. Migraines and anxiety (and panic) very often go hand in hand.

Older DD struggles with moderate anxiety with occasional flares of panic. She has a GAD diagnosis. We had her evaluated by a neuropsych in second grade when she was borderline. But in third grade she was bullied and had a terrible teacher fit and she really flared into major anxiety. We did CBT therapy with her for about a year and then we did a social skills group in 4th grade.

About half way through 4th grade we decided that even with all the therapy and help she was still struggling a lot, so we went to a ped psychiatrist for a medication consult. We had to try a couple, but she has been on an SSRI now for about 5 months and the difference is amazing. We went back to her regular therapist today for the first time in several months and she was amazed at how changed she was: more calm, more confident, etc.

So for us, therapy and meds together have made a big difference. She is on a super, super low SSRI dose and we will probably leave her here for a year or so unless she flares again.

[MamaKath]

Thanks for the replies! I am definitely feeling that this might also help us get the right treatments nailed down for ds. I wonder how much of some of his reactions have had to do with headaches and allergies in the past. He has had great days since the headache last week.

[MamaKath]

That does sounds like migraines. Migraines and anxiety (and panic) very often go hand in hand.

Older DD struggles with moderate anxiety with occasional flares of panic. She has a GAD diagnosis. We had her evaluated by a neuropsych in second grade when she was borderline. But in third grade she was bullied and had a terrible teacher fit and she really flared into major anxiety. We did CBT therapy with her for about a year and then we did a social skills group in 4th grade.

About half way through 4th grade we decided that even with all the therapy and help she was still struggling a lot, so we went to a ped psychiatrist for a medication consult. We had to try a couple, but she has been on an SSRI now for about 5 months and the difference is amazing. We went back to her regular therapist today for the first time in several months and she was amazed at how changed she was: more calm, more confident, etc.

So for us, therapy and meds together have made a big difference. She is on a super, super low SSRI dose and we will probably leave her here for a year or so unless she flares again.
Beth, I keep thinking about this post. I really think after having him home rather than in school and seeing him in action that the anxiety is a huge component in his school problems over the last few years. There are things I am picking up on that I know even a good teacher would probably miss that definitely make a huge difference. Also things that may have had an affect (like his teacher having talked about hurricanes last year and he can still recall the entire word for word conversation with complete terror and fear) even if it wasn't directly related to what they were doing at that moment. Most of his reactions, movements, tendencies are made worse with anxiety. So far he hasn't had another migraine so that part is good. How did you find a CBT (am I right in thinking cognitive behavioral therapy) practitioner. The doctor we use in VA has been very limited in having names of counselors, but we are only able to get in with him about 1 a month to begin with. Do you have any recs for therapists and neuropsych that you can pm me?
Thanks,
Kath