Kids and Anxiety: Child’s fear can become parents’ nightmare
By KARA YORIO STAFF WRITER | The Record
The knot in the stomach rarely disappears. The lump merely grows and shrinks amid the turbulence of raising a child with an anxiety disorder. It is fueled by anticipation (Will the school nurse call today? Can we get through this family dinner in a restaurant without incident?), frustration (Why can’t he just get over it? Why can’t I help? When will it go away?), guilt (Did I cause this? Am I making it worse?), and stress (Who’s going to judge me today? How can we afford treatment? Why doesn’t my husband understand? What will I tell my boss this time when I have to leave work early?).
"It’s hard," said the mother of a Tenafly fifth-grader who suffers from anxiety. "You never know what every day is going to bring."
The dread of the unknown and concern for a child can overtake the parents’ world just as the anxiety has taken control of their kid’s life.
Anxiety is the most prevalent psychiatric illness among children and teens. As many as one out of four children and adolescents are affected by an anxiety disorder at one or more times in their lives. Disorders can strike children as young as 3 but typically are diagnosed when kids are between 7 and 9, according to mental health experts.
A North Jersey fifth-grader has struggled with anxiety about school since kindergarten, often crying, going to the nurse’s office and calling home unable to make it through the day after the emotional battle over going to school in the first place. Her father described his difficulty at drop-offs, knowing his daughter needed to get in the building as much as he needed to get to work. In desperation and frustration, he promised rewards if she would just get out of the car and go into the school — ice cream, a puppy, whatever she wanted. The child herself has pointed out the problem with his plan.
"That’s actually worse," she told him finally when she was in the second grade. "Now I can’t get in [school], and I can’t get the thing I really want."
Still struggling at times today, she wants people to know it’s not that she is choosing not to go into the building or deliberately failing to get through the day without going to the nurse or calling her mom.
"I don’t want this to happen," she said recently. "I’m trying, really trying. Sometimes it’s just hard for me."
Anxiety isn’t logical. It is frustrating and infuriating — for the person experiencing it and the ones trying to help. The proper actions to help a child overcome an anxiety disorder go against most parental instincts, said psychologist Donna Pincus, director of the Child and Adolescent Fear and Anxiety Treatment Program at Boston University and author of "Growing Up Brave: Expert Strategies for Helping Your Child Overcome Fear, Stress and Anxiety."
Reassuring an anxious child that everything will be OK actually makes the cycle worse. Coming to the aid of a child — to ease his pain or simply function day to day — only perpetuates avoidance that fuels more anxiety and makes the issues more severe.
"What we train the parents to do is do the opposite of what their instinct tells us," said psychologist Brian Chu, who runs the Youth Anxiety and Depression Clinic at Rutgers. "Even if the child is upset or distressed, continue to provide firm encouragement to go on because that will teach them how to tolerate that distress and learn more self-confidence."
But parents whose children are not in therapy or those just trying to ease the tension understandably often do whatever they can to make life less of a struggle for everyone. Often that means avoiding triggers when possible.
"At home, she was OK, we knew what would set her off, and we avoided it," said one North Jersey mom.
Outside the house, however, the family had less control.
"It was frustrating as all could be," the mother said. "I didn’t see other kids behaving that way after a certain point. Three-year-old tantrums? Four-year-olds? Yes, but coming into kindergarten, it’s very out of place. I would get angry with her sometimes, although I knew she couldn’t control it."
Parents actions are dictated by guilt and desperation.
"I was so confused," said another mom. "‘Is it my fault? What am I doing? What are you saying? Let me try this. Let me try that.’ "
From tough love to being over-sensitive to a child’s concerns to begging and promising rewards, whatever it takes to get out the door. Even those who understand it is often out of a child’s control can struggle to stay patient.
"A lot of time, I have to be honest, I’m not always perfect at it," said a Bergen County mother of a daughter in the fourth grade. "She’s getting anxious, and I’ll be like, ‘Just stop, just stop, you’re fine.’ "
Becoming angry adds to the feelings of guilt, which in this case, is a further burden on the parent, who like so many others sees herself in her child.
"I had anxiety. I still have it as an adult," said the mother of a 9-year-old girl. "I know what she’s going through. I’ve been through what she’s going through. The thing with me when I was her age, I remember it being blamed on the fact that my parents got divorced when I was 8. ‘Oh she’s just like that because her parents got divorced.’ My [older] sister tells me all the time, ‘You were like that at her age. That was you.’ So, then I feel even worse."
Anxious children can seem less mature, no matter their intelligence. They can have meltdowns, be afraid of school, play dates or getting sick. They can be unable to go to sleepovers and to crowded or new places. They try to avoid any uncomfortable experience by any means necessary and are often perceived as manipulative or spoiled.
Parents are often blamed for a lack of discipline that others say is the cause of the issues. Adult relationships suffer as friends, family and sometimes strangers offer unsolicited, critical and counterproductive advice.
"The first few years, there was a lot of judgment going on," said one North Jersey mother whose child has suffered with severe anxiety for years. "You always have those couple of parents that are so kind. … Then you have a handful, overflowing, of ‘This is what I would do if that were my kid.’ Just judgment, upon judgment, upon judgment."
Even close friends and family who vow to help no matter what it takes can end up unable or unwilling to keep that promise. Parents tell stories of feeling betrayed and abandoned by those they trusted, confided in and counted on to help. The circle of friends grows smaller and tighter as people decide spending time with the child (and, in turn, her parents) is not worth the drama, stress or frustration.
Children with anxiety disorders get angry, yelling at their parents when overcome with fear, nervousness and emotions they can’t control. When everyone is calm, the adults spend hours talking with their child about the worries, reliving the day’s events that are bothering the child and trying futilely to use logic to fight the illogical, invisible beast always in the room.
Marriages struggle, not only if parents disagree on the problem and how to solve it, but from the everyday stress and tension in the home — not to mention the financial strain of treatment. The child’s concerns often become the parents’ issue. They are kept up nights wondering about the consequences of their child’s behavior and what the next day might bring.
"When she’s upset about something at school, I don’t sleep," said one mother.
Anxious kids have trouble sleeping, too. Bedtime becomes a constant battle of tears and "What ifs?" The middle of the night is met with bad dreams or a visit to their parents’ bedroom.
Late-night panic attacks would send Hawthorne’s Lauren Lehr into her parents’ room where she paced while her dad tried to reason with her, explaining why everyone needed to go back to sleep. Her mother tried to get Lauren to use the skills they had learned to try to lessen the anxiety.
"We’d do the breathing, we would sit together, we’d count backwards," said Jen Lehr. "I’d get up during the night, and we would sit together, or we would put a movie on. After a little time, it would pass."
A lack of sleep, combined with the strain of a house always on edge, the financial burden and the sadness of watching a child struggle, all lead to a very stressful day-to-day existence for these parents.
A Bergen County mother of a 13-year-old girl who suffered from panic attacks and other phobias has lived through it. Her advice is to reach out, do what’s best for your child.
"Ask for help, no matter what," she said. "There’s nothing more important than your child. Don’t care what anybody thinks. If someone in your family is saying this is embarrassing or there is a stigma on it, it shouldn’t’ matter. You don’t want to see your child in trouble. You don’t want to see your child in pain."