Teenage Anger, Anxiety and Constant Complaining

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Hello everyone! I haven't posted here in a long time. My daughter, Grace, is now 13 years old. She was diagnosed with AS at age 6. At the beginning of 6th grade she developed extreme anxiety and stomach issues. We are still dealing with both. I took her out of school (by necessity-she wasn't participating) and started homeschooling with a tutor.

I had high hopes we would fix the stomach issues and reintegrate her into school. However, we are still chasing an explanation for her chronic stomach issues. She tests positive for something, they treat it, the pain continues, they find something else, treat it and it goes on. They most recently ran a CT scan and found an infection in her mesentery and they now don't know if possibly it could be auto immune related.

Anyway, all of that helps explain my issue but isn't really the problem. Over the past two years my daughter has become non functional. She doesn't want to go anywhere and will double over in pain if I try to push her to do anything. She won't help around the house. She does very little school work and I fear she is falling behind. She's angry and rude a lot of the time. Her tone and words are almost always biting/terse/demanding/complaintive. I've tried rewards. I've tried counseling. I've tried taking away her internet.

I realize she truly has issues but it's like those issues are the only thing that matters in her mind. She is miserable so everyone else must be too. I can't find anything she enjoys to help pull her out of this. She has moments of happiness but they are few and far between. She doesn't even really have a special interest now although she is becoming a bit obsessed with medical things and watches Bones and House on tv. When I take her out of the house she can become anxious and this past week even started screaming and I couldn't calm her down. She calls me all the time whining and complaining.

We tried SSRIs but she gained 30 pounds on them in 15 months, going from 76 pounds to 110. She now seems to have no control over her overeating even though we went off the SSRI 4 months ago.

I don't know how any one here can help but I am feeling very lost and hopeless. Her life is miserable. My life is miserable because I hate to see her suffer.

Any ideas, thoughts, suggestions? Thanks.

How about addressing the chronic pain directly? I like this method: https://www.amazon.com/Mindfulness-Medi ... 1591797403

I'm also very sensitive to SSRIs. I take the herb St. John's Wort. It doesn't have any side effects for me. (You can't combine St. John's Wort with medications, so a little care is called for.)

Hi, and welcome back!

How is the homeschooing going? it is possible that she is still being stressed even with homeschooling. You might need to add scaffolding if it is the work load. It might also be that she has anxiety about her future or issues with puberty or something like that.

My son had recurrent stomach issues, which will very rarely crop up, now, but it was mainly anxiety caused by school for us. He also does have some issues with lactose and he tends to be more susceptible to stomach flu than most people, so it is not always that.

As far as the attitude, that might be puberty too, or the gastric pain, or also worry and anxiety.

I think I would be inclined to step back from trying to get her to do things that are stressing her out, even if that means allowing her to be more withdrawn. Maybe she *needs* to be a bit withdrawn right now. I know when I'm feeling stressed out and the extroverts in my life are trying to force me to "get out" and socialize, it really backfires.

I pulled my son from public school for similar reasons (he wasn't participating at ALL) and last year (our first homeschool year) I allowed him to completely cocoon himself in the safety of our home and just find himself again in a very low-stress environment. I had basic and concrete requirements for him (get up, shower, be "present" at school during our school hours), but I dialed my other expectations of him WAY back so that he could recover from all the stress of those bad years at public school. Everyone kept needling me to find social experiences for him, but my instincts were screaming at me to just let him be quiet and alone and to not keep thrusting him into situations that are overwhelming for him, "for his own good". So I kept him at home, didn't make him do any extracurricular activities, and basically allowed him to be a hermit, which suited him just fine.

If I were in your shoes, I think I would gently encourage her to explore that new medical interest. Watch the shows, find other shows she might enjoy, maybe incorporate something related into her homeschool curriculum. I schedule in at least an hour every day of my son's special interest into his curriculum, and it has proven to be a great motivator.

FWIW, my son (9) has also recently developed some lovely new behaviors like shrieking over any minor little frustration, verbal abuse of whomever is nearby, and cursing (he even writes curse words into his homework, which I choose to ignore as long as he's still doing the assignment.) I sort of see most of this stuff as normal tween crap, but experienced through an Aspie who has limited impulse-control and very poor social skills. I choose to deal with that stuff as I would any child-- I ignore it when possible, but if it's creating a toxic environment for others, then he gets warnings and, eventually, consequences (limits on computer time.)

I would suggest reading this article, as it might give you some insight on your daughter's condition:
http://www.autism.org.uk/about/what-is/pda.aspx

When I pulled her out of school in May 2015, I did dial everything WAY down. I removed all requirements letting her de-stress as much as possible. The problem is, she's just not bouncing back from that. I pay for a tutor 2 hours x day 3 days a week. My daughter loves her and they work well together. But they are doing very minimal work. My daughter doesn't perform her homework. She used to be obsessed with doing her work and getting good grades, now she doesn't care and doesn't try.

I have looked into PDA. It does describe my daughter a lot. Out of the 26 questions on the questionnaire, she meets all but 7. But I am in the US, where it's not really recognized so not sure how I would go about treating/dealing with the issues. Guess I need to read up on it a bit more.

I used to think my son had PDA also (and, like you, living in the US, know it's not recognized here), but now I'm not so sure. He is so different than he was last year at home, or, prior to that, at school. If I really pay attention to patterns, it seems like he only exhibits these behaviors when he's under stress. If he's generally relaxed and well-rested and otherwise healthy, he has a much better attitude and willingness to TRY and, with maximum support, even focus for limited amounts of time on non-preferred activities.

When he was still at public school, he absolutely seemed to meet all the criteria for PDA. His teachers were so frustrated because they were WELL aware that he was CAPABLE of doing the work-- he just flat-out refused to. They couldn't make up their mind whether he was truly disabled, or just a stubborn brat (I don't think it has to be an either-or). They sort of treated him as one or the other based on what was most convenient for them in the moment. He spent a lot of time at in the principal's office-- not because of being "bad" but because he refused to do anything and they didn't know what else to do with him. They kept hoping that shaming him would somehow motivate him to try harder. NOPE.

With my son, we went through a REALLY ugly breaking-in period for homeschooling. At first he started out pretty motivated but then he slid into 100% refusal, just as he'd done at public school. He would literally lie on the floor, face down, and refused to move or speak, for hours. I had to remain firm and just keep reiterating my expectations-- that he show up, participate, and do the work (well within his capability) that I'd planned for that day. He frequently "opted out" and I had to place firm & consistent consequences for these "refusals" as we came to call them. This was a battle of the wills that went on for several months and it was very tiring and sad and frustrating for both of us. But I needed him to accept that I wasn't just going to give up on him and let him Opt Out of education. In my son's case, what I was eventually able to figure out was that he was having major OCD-type inner thoughts that were making pretty much every second of a task a living hell for him, especially a non-preferred task. At school they found this to be very "convenient" (that he could only muster a will to TRY for tasks that HE found interesting) but doesn't that just make simple sense? If you are plagued with inner voices criticizing every single thing you do, picking apart every action, thought, other people's actions, word choices, etc, then it seems obvious to me that doing something you ENJOY might be easier than having to tolerate that just to do something you don't even WANT to do.

In my son's case, when he's having a very OCD-strong day, he can be very touchy with things like being ASKED to do something, if he already understands that he's MEANT to do it. Having the directive STATED can flood him with anxiety and shut-down behavior. So you can see how this might look like PDA on the outside. I think in actuality, he would LIKE to get on with things and do the activity, or at least get it over with if it's something he doesn't like, but he's battling his own irrational thoughts, and they are VERY persistent and powerful when he's having a bad day. Having the nearby adults berate and criticize him for his refusal doesn't help - it just makes him feel like more of a broken person. Now that I understand this, and HE knows that I understand what's going on, he's gotten better at communicating to me when he's in one of those highly-sensitive modes and then I can "back off" a bit in the way that I present directives to him. That said, I've also made it clear that the goal is for NEITHER of us to be held hostage by his OCD thoughts.

Does your daughter have these types of inner thoughts? I truly had no idea the extent to which my son was being "directed" by them until he opened up about it. I wish I had known sooner. He is doing better this year, and I think some of that is maturity, but any kind of stress, illness, lack of sleep, etc, can trigger really nasty flare-ups. Any kind of physical or mental fatigue makes it very hard for him to resist going into that mode of thinking and reacting. It seems like a natural defense mechanism (trying to control everything) even though, ironically, it just makes him more miserable.

I do think it takes a really long time to "de-stress" from all the trauma of school, much longer than one would expect. Although in your case it sounds as though things were going well until recently. I wonder what has changed that has caused her motivation to plummet? Is she just not at all inspired by her curriculum this year? I know my son is bored to tears with a lot of what we do, and so I have to make sure I include stuff that is specifically geared towards his personal interests. That way he can have a "carrot" every single day to help get him through the stuff that he's uninspired by. I also have to structure the order of our classes very carefully. I have to make sure we do the non-preferred stuff when he's "fresh" and I have to give him breaks after completing non-preferred stuff. I end the day with at least an hour of something fun for him (electronic engineering), although that can be taken away if he hasn't finished his work leading up to that. Fridays are "fun day" and we do games and art and educational apps, or sometimes a field trip, gardening, etc., but that too can be taken away if he's got lots of work to make up.

Does your daughter have any consequences she can count on, for not doing her homework? I know it's a really hard balance to find, between not adding anxiety, on the one hand, but also holding them to some basic expectations of effort.

THIS is why I boil every time I see the phrase PDA. It's like the theraputic community is finally coming to understand that their hard-assed autism treatments are really demeaning and making our lives harder. So, playing tough love on autistic people just doesn't work. But wait! THESE kids, these ones that we've also labeled PDA, well, with THEM, its OK to be tough on them. With THEM we can apply 100% compliance demands because they are DIFFERENT. They require a firm hand because their demand avoidance is pathological.

Its just sickening to see this ugliness rear it's head again.

There is no such thing as PRIMARY demand avoidance in children. That's another way of saying that demand avoidance always leads back to something else. Most likely executive functioning difficulties, but also sometimes a deeply broken hearted child who doesn't believe that he/she is able to succeed. That's called learned helplessness. It is not primarily a desire to avoid.

I clicked the link on PDD, and maybe I didn't look closely enough, but it did not seem the approach was to recommend harsh responses. It seemed to be the opposite.

I have read the descriptors of PDD before, and it is interesting, but I am also not so sure what I think of it. Here in my corner of the US, non-compliance is met with accusations of parenting problems or suggestions of ODD.

When my son is non-compliant I think some of it is out of anxiety, sometimes it is because he thinks his way is better/easier, sometimes he just seems to want to shake things up.

I am not sure that PDD is so much a separate thing, so much as at least recognition that you can't just put all autistic kids on a rigid, all year, structured system and expect them to thrive, if that makes sense. Usually, the choices are rigid structure (except when the school changes things, of course) and doing it the regular NT way.

Anyway, back to the OP. Detoxing from public school can take a long time, depending, and I still think that if you have a child in the midst of pubescence, that this in itself make it harder. Our son was not functional enough in the context of a school system for us to have made it as long as your daughter did, and I think, paradoxically, the fact that we had to pull him after the end of second grade made it easier for us then it is for you. My son is 11, now and I can see the beginnings of pubescent sulking and grumpiness, but we can deflect most of it for now. I don't know for how long, and I am glad we were forced to make the transition before, b/c based onw hat I am seeing, I am sure it would have been more problematic.

There may be a part of your daughter that wanted to participate in the rituals of young adolescence--many of which are social and school-based. My son is oblivious to it, and has no yearning for any of that (and probably has no clue, b/c he is really very culturally disconnected and always has been) I don't know this to be so, and I don't have a solution, unless you know of some safe social spaces nearby with things of interest where parental hovering is not out of place.

If she is happy with the tutoring, maybe she views it is a safe way for her to feel social and maybe that is why she likes it. Everyone is different, and some aspies do need it.

Another possibility is to do more field trips. If she is a person who likes to get out of the house, or learns more while moving around,; you could maybe visit places where like museums or places where her coursework is applied.

Yes, yes, and YES. One of the reasons I finally HAD to pull my son from school was because the school was so bent on their 100% compliance model and simply couldn't see that they were SHATTERING him. They were actually very irritated with him as though he was purposely making their lives more difficult. As though it was personal. They honestly had NO idea what they were really dealing with (his inner dialogue, his own self-torture) and even if they had, I doubt they would have changed their attitudes or methods. As much as they would talk the talk about everyone having their "individual journeys", they really just wanted all kids to do things ONE way-- THEIR way. So if they got a "stubborn" kid like my kid, they pretty much needed to "break" him, or so they thought. Well, they DID break him. They broke his self-confidence and it has taken me more than a year to get my boy back to where he wakes up happy and enthusiastic about his life. He recently admitted to me that being at school felt like a huge weight on his chest, ALL THE TIME. But he couldn't communicate that when he was inside of it. And even if they had, again, it wouldn't have changed their approach. On some level they simply didn't BELIEVE that he was not TRYING to be "difficult".

I do think my son was actively AVOIDING. But there was a misunderstanding about what, exactly, he was trying to avoid. They thought he was avoiding his work. Well, yeah. But why? Because the deeper explanation was that he was avoiding the horrible, horrible, horrible feelings he would get in trying to do the work he was being given, within their definitions of "success". It took me the entire 3rd-grade year (homeschooling) to really break down his thought process as he approached something that made him anxious and to realize what was really going on, and what he was running away from. That never would have happened at school. At school they would have just kept pushing him for being Noncompliant and/or, harass us into warehousing him in a full-time dead-end special room for people who "can't" learn.

Anyway, sorry for sort of hijacking this thread for a couple of posts.

Back to the OP, have you seen that documentary about autistic girls (in Britain) that attend a boarding school specifically for autistic girls? It was an interesting film, but parts of it made my blood boil too. In particular, there was a very "difficult" girl they were trying to reach, who'd been diagnosed with PDA. There was so much about her that reminded me of MY son, and their approach (they literally compared it to "breaking" a wild horse) seemed about as effective as the school's approach to my son was. It's like they don't know any other way to approach these kids who are shutting themselves off in an attempt to cocoon away from the anxiety. Not that I think this video would help you figure out what YOU should do, but it might be interesting for you to watch, as the girls are teens and have a wide range of issues/capabilities. I wonder if the girl dx with PDA would remind you at all of your own daughter.

A couple more thoughts:

Is the homework an optional thing, or is it something you are required to assign as part of a homeschooling organization or attached school? If it's optional, I wonder if you could find a way to give her a break on the homework as long as she's making progress in her lessons and showing in other ways that she's understanding the material? You said that she gets along well with the tutor, so it doesn't sound like she's necessarily averse to the actual material. I assign a very small amount of homework to my son, but it's not about the material- it's more about stretching his ability to tolerate non-preferred activities, and to help him develop his own personal strategies for doing so. With that in mind, I only assign him what I think he can handle, and never so much that it becomes torture and therefore counterproductive-- so it's enough to SLIGHTLY challenge him, but no more.

If the homework *is* required, can you set up some kind of reward system for her? What's her currency? Can you find a way to motivate her to get the work done so that she can earn some rewards? She's probably not feeling very happy about the situation either, and would probably feel a lot better about herself if she could get motivated back into wanting to get the work done.

Wow, everyone thanks for the responses. It is a lot to process so I'll make a first stab. I'll try to find my post from about a year ago that describes the genesis of our current situation. My daughter was in a small private school until 5th grade and then we tried to move her to public (the private only went through 5th). At first in public she 'appeared' to be doing well. But looking back it was a ticking time bomb. Unlike PDA my daughter had (doesn't anymore) an almost pathological need to follow directions, not get in trouble, do her work, and get good grades. She tested extremely bright cognitively and she had always enjoyed the winning involved in doing well academically.
Some things happened at public 6th grade and one particular bad episode with someone messing with her clothes in gym led to her first full fledged panic attack.
She then had a stomach flu that just seems to have never gone away.
After being sick at that school and 'using all her bathroom passes' she became phobic of the school in general and flat out refused to get out of the car in the morning. The nurse would come out and try to coax her in. They put her in a room by herself and she basically watched Netflix all day. This went on for months.

I finally withdrew her under medical leave terms. By this time she was having 3+ panic attacks a week. They sent us to psychiatrist for meds. Counsellors. Gi docs. Bio feedback. On and on.

The next fall I bought a homeschool curriculum, found a young, smart woman to administer it. This woman is great. Being different is a thing to be proud of! She has wonderful acceptance and patience.

My daughter never recovered a desire to do well academically. She breezes by in math, science, some things like history-but she is very far behind in reading. That's another long story.
The stomach pain occurs now whenever there's something she needs to do or is supposed to do. If it were up to her she'd never leave the house-although she misses social interaction with her few friends who are leaving her behind as they mature and engage in activities.
It's like she fell into this mode of pain and fear. I don't know how to help her out of it.
Her homework is minimal. Write vocabulary words and definitions. A simple language exercise-she always refuses-she has a real disability with reading. Math she can do without a thought (I bought freshman high school level math to challenge her this year). I worry that her brain is going to waste and that this inertia will continue.

Here's my old original post: original post

My daughter does have OCD type perfectionist thoughts (or she used to). Doing work can be quite difficult still due to her being critical of her work. I'm not sure that's the issue at hand here, though it's possible.

Puberty could be causing some of this. Although she is delayed in that regard. Barely any development at all, though I think things are starting to change. She is still very immature in a lot of ways at times.

Some of the description of PDA doesn't fit at all-she doesn't have better insight into ways to manipulate people, she doesn't have a rich imaginary life, matter of fact she doesn't deal in fiction at all. She likes documentaries, non fiction, black and white facts, she has trouble following along with fictional story lines.

I think she is just really weighed down with anxiety-that causes her to try to control every situation and everyone around her. This past week we were out and she just started screaming "you haven't thought this through. How are we going to get out of here" repeating herself over and over. I think the main reason she doesn't want to leave the house is she cannot predict every possible outcome when she is not in control of her surroundings. She tends to think through every possible scenario, dwelling on the negative or even catastrophic things that could occur. And if anything goes wrong she fixates on it and uses it as further proof nothing and no one can be trusted. The negative outweighs any positive that may happen. And it's getting really overwhelming to her.

You gave some great background, and it may take my brain some time to fit together what I am thinking into a more coherent whole. Here are my initial thoughts:

1)This issue of bad experiences poisoning things forever (or a very long time) is something I am very familiar with, from very early on. When my son was an infant, the pain of the shots (not the vaccines--the act of being punctured with a sharp object) made him not only afraid of the pediatrician's office but generally claustrophobic. (The exam room was very small, even for an exam room, I guess b/c it was designed for infants) He was afraid of any and all small spaces from that time on for years afterwards. He would not let me take him into elevators--I could not close his bedroom door. Later on he did not want to close the bathroom door. It took a very long time of desensitizing hm and even now, while unafraid, he will sometimes forget to close the bathroom door, just out of habit.

Once things in public school got bad for us, when his teacher was on medical leave and everything went to poop, I think he started to feel that way about the school, especially since the educational autism expert decided he need to be broken like a horse, as she put it--just like what Carpenter Bee said, too. I don't think they care what label they slap on it--they just don't know how to handle autism unless the kids are always very docile.

So, I totally understand what a daunting thing this now is. To me as a lay person it seems like PTSD, or something like it. Anything that reminds her directly of the bad things needs to be purged and replaced, until she is more stable-- and then you can introduce things in baby steps.

I would recommend taking anything about her current homeschooling that is not working or upsetting and think about ways to revamp it. My son is younger, but if you want, you can PM me the specifics, and I can help you brainstorm ways to keep some challenge there without traumatizing her. You may have to go back to go forward.

Once she is calm, she may want to challenge herself. I would really recommend child-led independent study for some of what she is doing. That is what we do during the summer instead of homeschool ESY, which is typically the recommendation, b/c we get burnt out.

2) Reclusiveness: During times of trauma, and upset, this is my personal go to response. Some of it is restorative and necessary, but there is a point where you have to get out for your own sanity. I would try to use special interests or maybe at first, start with very small outings: Feeding ducks, taking a short walk past the Halloween decorations in your area, a trip to a restaurant she likes. Something you can get buy in for.

3) Stomach issues: This one is tough because it seems like a combination of anxiety and the ulcer bacteria, which is a bad combination. I think once the bacteria colonizes, it may be a life long issue. I am not a doctor, of course, so I really don't know what to suggest. If she feels her stomach is too acidic, she could try Tums or something, maybe? I know it does not manage the bacteria, but I have this issue to a mild degree, and I don't know if it is a placebo or if the acid control is useful despite not fixing the root cause, but I think I feel better after taking it. I defer this to doctors b/c there are a lot of moving parts here, but it could also improve once her general stress level is managed.

I am going to think about this some more. I hope this was not a rambling mess.

I'm 41 years old and I still get panic attacks when I accidentally drive by my old elementary school because nobody got this about me. I was SO well intentioned. But I couldn't do what they wanted me to do. And the more I froze, the more they punished me for freezing. Before long it became a battle. Them wanting me to finish my homework. Me trying to hang onto my very soul. I was a suicidal ten year old before they were finished with me. This was long before anyone understood that verbal and intellegent people could be autistic. I hope most kids today have it easier than I did.

I haven't been diagnosed specifically with PDA, but many of the symptoms do fit for me, and I would say that my demand avoidance is, well, pathological. Now, how do I think it should be treated? I don't know; my school of thought on the matter is that it's not something that really CAN be treated, rather it's something a person would have to adapt to living with. Of course, the same can be said for pretty much every other form of autism.

I don't see PDA as being a separate disorder; I see it as being a sub-type of autism with a specific set of features. Autism is kind of a weird condition since the symptoms can vary wildly in severity from person to person, and no two cases are the same. PDA is kind of interesting though because it describes a series of symptoms that I identify strongly with, so I was surprised when I found that my pattern of symptoms was common enough to warrant its own name.