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Behavior, Rigidity, Anxiety, and Mood Swings

Question

My teenage daughter is very high functioning; however, the older she gets, the more rigid and unwilling to accept changes in daily routines she becomes. She will cry uncontrollably, or become reclusive until she feels the situation has passed. Although she enjoys school, she will look for, or make up, reasons to stay home. It seems our home is her safe place. Please give us some suggestions on how to deal with these new behaviors.

Answer of our experts

Here are a few thoughts: Your daughter is a teenager and probably more susceptible to mood swings in general. Many teenagers get grumpy at home. If this is related to adolescence (i.e., hormonal shifts, etc.), it should get better as she gets older. These behaviors can occur in teenagers with or without CdLS.

The part about her feeling comfortable at home and being reluctant or rigid about changing her schedule sounds like a different issue. Sometimes children/young adults seem to get more anxious about change as they get older. Several practical things can help to lower their anxiety. First, use a daily schedule and review with her (the night before) what will happen each day, i.e., she will go to school but then she will come home and play and have fun, etc. Build rewards and leisure activities into her schedule both at school and at home. Review if there is something about school this year that is not going particularly well. Try to make school a positive and fun experience (just like home). Sometimes, if all interventions do not adequately lower anxiety, a low dose of a Serotonin inhibitor (an antidepressant) can help. These medications are used to treat anxiety and are not habit forming. For example, Lexapro (Escitalopram) can make teenagers feel calmer and more relaxed. Side effects and long-term risks are minimal.

As with any of these behavior issues, they can be multi-faceted and, therefore, a challenge to figure out. Seek help from a professional if these suggestions don’t help.

EA/ TK 7-13-10

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Recommendation(s)

Anxiety

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Interventions targeting problematic repetitive behaviour in individuals with CdLS should be sensitive to anxiety, sensory problems and social demands. These interventions should also consider environmental factors.
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Atypical presentation of anxiety and mood disorder should be considered when behaviour changes occur.
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As anxiety is common in individuals with CdLS during periods of environmental change/transitions, a planned program should be implemented.
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Treatment of anxiety and mood disorders in individuals with CdLS should be considered using psychosocial interventions (therapies) and pharmacotherapy (medication).

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