Question:
Male, 33 years-old, Deletion
My son is mostly behaving, and he is not aggressive. However lately he gets up in the morning upset, anxious, and wants more food. For the rest of the day, he is OK. He used to take Cipralex. He does not want to take it anymore. Not that I have seen much of a difference.
How can I help him????
Nurse Lynn’s Response:
It is often a helpless feeling for both the individual and the people that care for them when hyperphagia causes behavioral changes. Food related anxiety is commonly related to food security issues or changes to routine. I would evaluate the food security measures both at home and at work (or when he is away from home). From your question, it does not sound like he is gaining weight, which would be an indication that he is getting into food somehow. In addition to looking into the current food security measures, investigate if there have been any changes to the routine including meals and mealtimes. Look at the nutritional content of the meal and make sure that he is getting enough macro and micronutrients. Sometimes, medication changes can trigger this behavior also. When did he stop taking his Cipralex? There are different medications in the SSRI category that may help with this anxious behavior but making it his idea or getting him on board may be difficult. If adding a medication is something you are considering, having the provider suggest this and answering questions may be helpful.
Being intentional about the structure of the day, such as pictures, charts etc. and using first, then language can help. You can acknowledge the feeling of anxiety and suggest something to fill the time such as a preferred activity until the meal is served. If this anxiety is after the meal, coming up with an activity afterwards may distract him from these feelings/ideas.
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Jennifer Bolander has been serving as a Special Education Specialist for PWSA (USA) since October of 2015. She is a graduate of John Carroll University and lives in Ohio with her husband Brad and daughters Kate (17), and Sophia (13) who was born with PWS.
Perry A. Zirkel has written more than 1,500 publications on various aspects of school law, with an emphasis on legal issues in special education. He writes a regular column for NAESP’s Principal magazine and NASP’s Communiqué newsletter, and he did so previously for Phi Delta Kappan and Teaching Exceptional Children.
Evan has worked with the Prader-Willi Syndrome Association (USA) since 2007 primarily as a Crisis Intervention and Family Support Counselor. Evans works with parents and schools to foster strong collaborative relationships and appropriate educational environments for students with PWS.
Dr. Amy McTighe is the PWS Program Manager and Inpatient Teacher at the Center for Prader-Willi Syndrome at the Children’s Institute of Pittsburgh. She graduated from Duquesne University receiving her Bachelor’s and Master’s degree in Education with a focus on elementary education, special education, and language arts.
Staci Zimmerman works for Prader-Willi Syndrome Association of Colorado as an Individualized Education Program (IEP) consultant. Staci collaborates with the PWS multi-disciplinary clinic at the Children’s Hospital in Denver supporting families and school districts around the United States with their child’s Individual Educational Plan.
Founded in 2001, SDLC is a non-profit legal services organization dedicated to protecting and advancing the legal rights of people with disabilities throughout the South. It partners with the Southern Poverty Law Center, Protection and Advocacy (P&A) programs, Legal Services Corporations (LSC) and disability organizations on major, systemic disability rights issues involving the Individuals with Disabilities Education Act (IDEA), Americans with Disabilities Act (ADA), and the federal Medicaid Act. Recently in November 2014, Jim retired.