Dry hands and anxiety

[nysnanna]

Looking for some advice/suggestions to help my grandson at what is proving to be a very difficult time for him. He is 12 years old but physically a very mature 12 - 5ft 9 tall, 10 and half shoes, facial hair etc. Throughout his life he's had anxiety problems but the severity of it varies. Over the last 6 months it has gradually got much worse and is now affecting his life to the point where he is not wanting to do the things he had previously enjoyed. He is struggling with sensory things like lumps in his socks and different fabrics not being right. Most sounds and smells related to his sisters are driving him to distraction, he is constantly yelling and threatening them. The biggest problem he has at the moment though is the feeling of dry hands - he just cannot cope with it. When he first started school this was an issue, he used to lick his hands constantly but gradually this subsided, now it is back BIG time.

He has jars, tubes, pots of cream everywhere and is constantly putting it on to moisturise his hands or running them under the taps. This is every couple of minutes and is now interfering with his life. He is worried about the fact that his peers at school are aware that he is doing it, he is now refusing to go to school on days that he has PE as his cream is in a locker. Swimming has stopped because it makes his hands feel funny. He has even gone back to asking us to dry him when he gets out of the bath because he cannot touch the towel.

Not sure what has triggered this again, he thinks it may have started when he had to put his hands in some washing up water during cookery at school, but he started to senior school in September which he hates and is going through puberty so it could be a combination.

He is waiting for an appointment with CAMHS and we have applied for a Statutory Assessment and are waiting to hear about this. Not sure what else we can do to help him at the moment but am extremely worried about him as he seems to be going down hill rapidly and his appointment is not likely to be for another 7 weeks we were told. Any ides from others who may have similar problems about a kind of cream that will keep his hands feeling moist for longer. I suggested baby wipes but he tells me that he cannot touch baby wipes any more. He is no longer wanting to go to places where he has always been happy going, wanting to stay at home, mainly in his room, where he then yells at and tries to control his Mum and 3 younger sisters.

He used to spend a lot of time with us but no longer wants to do that. Any ides appreciated.

Thanks in advance

Teresa

[nysnanna]

Sorry, forgot to say that Grandson has ASD and ADHD

Teresa

[LancsLad]

Teresa, I am a 46 year old with AS and I am a finger licker at times, whats my problem?

 

Am I killing myself, do I pick up germs and am sick all the time, am I doing something highly offensive and abusive to other people in society and as such need punishment, or do I lick my fingers?

 

My fingers get really sensitive at times and I lick them. For me this is more than dry skin it is about making a conection with my mouth, sometime this can happen a lot so is it about underlying anxiety. Sometimes but a lot of the time this behaviour pattern is very evident when I am designing which I do at a professional level. I need to lick my finger tips for example before I pick up a pencil, why because it makes it come alive in my fingers. It increases the responsivness to exectute the most subtle of fine motor control, its about getting my system up to maximum speed to be in racing mode. Does that make sense? Often if I think of something creative I will lick my fingers in anticipation of how I might respond.

 

I think this is a case of firstly not understanding the behaviour of babies and toddlers. I suspect they do the same thing as me because they are expolring and learning about their world. They want to feel texture, temperature etc so they can learn about their environment. To do so they maximise their body potential and lick their fingers, lick their lips etc, we lubricate our bodies in many ways to heighten out sensory perceptions of things, will leave the rest to your imaginition grown ups!

 

Unfortunatly because of staid Victorian attitudes we challenge anything a young child might do and try to be different and grown up, but are we? I am a finger licker, no one in my adult life has ever commented about it. I have been in design meetings and have seen a lot of finger licking behaviour amongst a creative community. I in fact challenge non-finger lickers out there to give it a try it really does make live better, but you have to look after your hands to really benefit from this and this mean keeping them soft, subtle and nails at the right length to provide the right amount of resistance and variation of pressure across the finger tips. Overly long or short nails really get in the way of this as it reduces variation.

 

Is this a simple issue yes and no, but depends on what angle you view it from. Should you try to stop it, no understand it and make sure as a behaviour it is within context and appropriate. Even the most logical and not so logical behaviours can move into the realms of OCD type behaviour. Often this is not about stopping the behaviour but about getting it back into an appropriate context and under control. To do that you need to understand it, respect it and value it, placing negatives all over it does not help.

 

Hope this helps all in a bit of fun Teresa.

[Sally44]

If he really is unable to go into school then I would talk with him seriously about it. He must trust you and you have to trust him - and explain that to him. If he cannot take it [because remember, these are anxiety/stress reactions, that he may not have linked to school or to things within school and may not be able to process his own emotional state anyway]. But if he is refusing school I would not force him above gentle encouragement. And get that confirmed when you visit CAHMS.

 

In the meantime you could visit your GP and go through what is happening with them so that they could write you a letter to give to school stating that his anxiety state is such that he is unable to attend school. Again pass a copy of this letter to CAHMS.

 

When we are very anxious we get into a fight or flight response. That is the state he is on alot of the time. So it is a chronic level of stress and anxiety. This will affect how he copes generally and will make any sensory issues worse, and will make any ASD behaviours worse. He will be on a short fuse, easily upset and angry. You should state all this to your GP and CAHMS too.

 

For his hands try dove soap first, as alot of people say they can tolerate it. Also try a good home made kind of soap. Something that is very moisturing which maybe is made from goats milk, or which has camomile or calendula in it to help sooth the skin.

 

If he has dermititis with it [red itching skin], the GP may prescribe E45. Also ask about whether to try an antihistamine - because that seems to help my son too with the itchy feeling. My son also breaks out in hives too. And we also have hydracortisone cream too.

 

Our our programme is that my son washes his hands with soap [i've ended up making our own], puts on E45. If that is not stopping the itchy feeling he has antihistamine medication, and finally hydracortisone cream. Most days soap is enough, but if they feel especially dry he uses the E45 too.

 

I would also add that he is on a mild sedative to help him get to sleep [because his worries were keeping him awake until very late - and that in itself makes you feel even worse]. And he is also on Prozac for his OCD thoughts and repetitive hand washing and fears of germs and contamination.

 

But definately make sure that everyone [GP, CAHMS and school] know about these things and that they are getting worse.

 

Your GP maybe able to get an earlier appointment with CAHMS. My GP speeded up the referal process for us. Make sure you see a GP you have a good relationship with, because you will probably need to see them a number of times about these same issues and you want to be seeing someone you have trust in and who is going to understand how serious these problems are for your grandson and understand the implications for him not being able to attend school.

Edited April 21, 2012 by Sally44

[Tally]

Dry as in cracked/sore, or not wet? Running dry (cracked/sore)hands under the tap is going to make them worse in the long run, although it will relief soreness for a moment. It's an odd one, it sounds like he's using the cream to make his hands feel wet. Soreness may well be a result of the problem, rather than a symptom of it.

[Sally44]

Yes, it can become a vicious circle.

 

And it would help alot to know why he is wetting his hands.

 

Does he have fear of germs and contamination and is therefore washing his hands. Or is it about the sensation of his skin and that it feels dry, so he wants to wet them [but wetting them can make them sore].

 

He sounds very hyper sensitive about touch too. Probably made much worse by the stress he is under.

[JeanneA]

hi I also think that you should go to the G.P. Your grand-son may need cream for his hands but it is difficult to know which cream is best so explaining it to the G.P. would be in yours and your grand-son's best interests. He obviously a very anxious boy as is my son (18). He is obviously going though puberty which will make his more aggressive. The sooner he gets some help the better. I am appalled that you have to wait for 7 weeks to be seen by CAMHS perhaps by seeing your GP he/she may be able to get you in sooner to be seen by CAMHS, you never you could by try. Good luck and please let us know on the forum how you get on.

[justine1]

Hi

 

I am guessing he licks his hands to try and moistirise them(?) My son is 8 and he does the same with his lips,he does bite his lips alot in times of stress/anxiety and he gets big blisters because of it. I give him vaseline to take into school and he has two at home as well. It does ease it a little but I find the anxiety has to go in order for his lips to heal completely so takes time.

 

I agree with everyone else it is worth seeing the GP. It could be down to anxiety,like OCD behaviour but also our body reacts to stress in various ways,some lose hair,feel physically ill,get many colds or as in your grandsons case gets dry skin. Or pehaps it is hormonal again hormones can cause similar problems and the heightened senses he has may also be to do with his hormones. Or it could be both anxiety and hormonal. Either way its a good idea to see if the GP can prescribe something more effective for his hands but ultimatley it will be about getting to know the cause of the anxiety and addressing that issue.

[nysnanna]

Hi

Thanks for your replies, my grandsons hands are dry, as in not wet, rather than cracked or sore. I think it is the sensation of dryness that bothers him, he says it is driving him crazy and it prevents him from touching things. He walks round with his hands screwed up into a ball so that he doesn't touch anything, especially fabric. He tries to put his clothes on without actually touching them with his fingers. He goes through huge tubs of emollient cream, diprobase, E45, reapplying it every 5 minutes or so His skin doesn't look sore or dry, it just feels dry to him.

 

We took him to the GP who referred us to the CAMHS who have told us it will be 7-8 weeks before he is seen, outrageous I know. I phoned CAMHS who were apologetic and got the duty worker to contact me to see if she could offer any advice, she couldn't really without speaking to him.

 

He does have a fear of germs and contamination but I'm not sure if this is part of that or a sensory thing. He now constantly appears to be agitated and does not want to go to places where he has once been comfortable going, he just says he no longer feels comfortable. We think its anxiety related but not sure what has triggered it, to be as bad as this so quickly, it went from not being a problem to having an impact on anything he does. He's stopped wearing a lot of his clothes because of the way they feel when he touches them and his clothes are hugely important to him, bathing/showering/swimming are all difficult for him, he cannot touch the towel with wet wrinkly hands.

 

His counting and touching rituals have all come back big time, at the same time at the dry hands issue, so I imagine they are all related to anxiety. He has developed some great strategies to help himself, i.e. he puts his cream into small bottles to enable him to carry it about, he now carries a small shoulder bag with him to keep his cream and his mobile in and he chooses his clothes carefully. We give him loads of praise for managing and coping with what he describes as things that are driving him mad but would like to help him in anyway that he can.

Thanks for suggestions

Teresa

[Sally44]

It does sound like this is OCD, and anxiety and related to the difficulties you have previously posted about school.

 

I do think you need to talk to him [because he is capable of talking about how he is coping], and be honest with him and say that if he gets to a point that he feels he cannot cope with going into school, that he must tell you. And if that day comes before the CAHMS appointment, then go and see your GP.

 

This is often a very quick downward spiral. And his anxiety/OCD will make any sensory issues much worse. Because he is in a constant high state of anxiety that makes everything hyper sensitive anyway.

 

My sons symptoms improved after he was out of school for about a year. Yes a year is how long it took. And to get him back into his new school we still needed medication because he had anxiety and fear related to past feelings and events that made it very hard for him to cope or comply.

 

And remember that OCD means that his brain will be telling him to do things all the time, and those thoughts don't stop until he does what his brain is telling him. So it is a build up until the thought cannot be suppressed any more - they complete the action and get an immediate relief [rather like the relief after a sneeze], but then it starts building up all over again. And the comparison to a sneeze to to just explain the concept. The obsessions and compulsions are MUCH stronger than the build up before you sneeze.

 

Did you find he was any better during the Easter break?

 

Or have things deteriorated further since returning after Easter?

Edited April 22, 2012 by Sally44