Why is my mom late? What if she never comes? What if she got in a car accident? … This isn’t the normal routine. This isn’t the road we’re supposed to take. … What if there’s a dog at the park? I can’t go to the park. I can never go to any park. … I need to get a 100 on that test. I must get a 100. What if I didn’t study enough to get a 100? I’m not ready. I can’t take that test. What if I panic during the test? What if I can’t breathe? What if everybody notices and laughs at me? … What if no one wants to sit with me at lunch? What if I sit alone every day forever? … Why doesn’t anybody like me? Why didn’t they invite me to the sleepover? What if they did and I miss my mom too much to stay? … I can’t fall asleep. I’m going to be too tired tomorrow. I’m going to get sick if I never sleep. What time is it? How many hours is that until I have to get up? What if I never fall asleep? … My stomach hurts. What if I throw up at school? I can’t go to school. Don’t make me go to school. … What’s going to happen at practice with my new coach? What are we going to do? Who is going to be there? Is she going to yell at me? … Is everything going to be OK? Am I going to be OK? Am I going to be OK?
The questions don’t stop for children with anxiety disorders. They cannot answer them. They cannot ignore them. They cannot handle daily life without the excessive stress of these concerns.
Whether it’s separation anxiety, social anxiety disorder, generalized anxiety disorder, specific phobias or obsessive compulsive disorder, the anxieties overtake the kids.
“OCD for me is like a little guy inside my brain that makes me do stuff that I don’t actually want to do,” said Albert, an 8-year-old who sees psychologist Matthew Goldfine, who has offices in Cresskill and Manhattan.
Albert is not this boy’s real name. No parent or child interviewed for this story was willing to use their real name. Parents are afraid their kids would be teased by peers or treated differently by adults if publicly identified as struggling with a mental health issue. The children who agreed to talk about their experiences didn’t want to call further attention to themselves. While education and awareness has brought a measure of understanding to mental health conditions such as autism, post-traumatic stress disorder and even depression, anxiety remains stigmatized.
“I think for so many people it’s like, ‘Well everyone’s nervous about something,’ ” said Albert’s father. “‘When I was a kid we just called them Nervous Nellies.’ Or ‘When I was kid, they were just weirdos, they didn’t have a diagnosis.’
“You don’t want your kid looked at differently.”
Children with anxiety disorders aren’t seen as children struggling with a health condition and in need of help. They’re often viewed as spoiled and immature, oversensitive and dramatic, difficult and demanding.
“Anxious kids you find have big tantrums or big meltdowns, as parents call them, where they just can’t handle all the stress they’re experiencing,” said Goldfine. “They end up acting much more immaturely than their age indicates, or they’ll behave in a very inappropriate way, because they’re so stressed, so overwhelmed and so worried that it comes out as very poor emotion regulation.”
This series focuses on how anxiety affects North Jersey kids, their families, school systems and the mental health community. If you have questions or want to share your story, contact Kara Yorio at firstname.lastname@example.org
Albert’s father compares trying to rationalize the issues with his son to using logic and statistics to try to convince an adult who is afraid of flying to get on a plane. They listen, they nod and say they understand, but they don’t change their behavior; they are controlled by their fear.
These kids are controlled by their anxieties and suffer the social, emotional and academic consequences.
“In school, I would do something that Bossy Brain told me to do, but I got blamed for it, because I was the one who did it, even though I didn’t want to do it,” said Albert, who has largely gotten control of his anxiety and OCD, using tools learned in therapy along with medication.
His family can alter the route to their regular diner without him becoming hysterical. He can touch one side of his face without having to touch the other. He still struggles, however, especially when there’s a change in his schedule like a school field trip that can create unknown situations and a change of environment and routine.
“All those things I don’t know can get really hard for me,” Albert said.
He can get so anxious at times, he throws up — an improvement over when he would throw up multiple times a week.
His OCD had disrupted his friendships. He admits, for example, that he was overly rigid with his rules and often unable to compromise. With help, he is back comfortably in his social circle — unlike Martin, a fifth-grader from Tenafly who feels the impact of his anxiety disorder every day.
“It changed things with friends,” he said.
Lunch is the most difficult time of the day, Martin said, because he often gets teased. Largely unsupervised time like lunch and recess can be particularly difficult for anxious kids. They not only lose their desired routine, they can be targets for children who see their vulnerabilities as easy marks.
“Now they know how to get on my nerves, so they’re doing it more and more,” he said.
Martin has improved, though, not getting very angry or upset in front of them as often. At times, to cope, he retreats to the school counselor’s office to calm down and regroup before rejoining his peers.
Still, his core group of friends rarely invite him to do things outside of school anymore. His mother guesses the other parents, and possibly the boys themselves, have tired of his fits and just don’t want to deal with the outbursts anymore — although no one has spoken to her directly about that. The other mothers don’t even respond to his mom’s emails asking to get the boys together.
A 13-year-old Bergen County girl is in therapy and on medication. She has found a way to cope with her anxiety so she can join her peers. Having overcome phobias of elevators and loud noises in second grade, her anxiety came back this past summer at sleep-away camp.
Despite having been to the same camp for years, she became very anxious the first night and couldn’t sleep. That one nervous, sleepless night turned into multiple nights fueled by building fears, which led to weight loss and suicidal thoughts. Her parents were called and brought her home to see her therapist. She even returned to camp and got through the summer with some extra help — including medication, attentive counselors, therapists talking to her on the phone and a loosening of the rules about calling home.
She didn’t share her ordeal or speak openly about her anxiety disorder with her closest friends until they shared a room with her on an overnight school trip where the rules were altered so she could have her phone with her. The special accommodations were necessary for her to conquer her anxiety about sleeping — or, more accurately, not sleeping.
As that middle schooler now manages her anxiety disorder through therapy and medication, a North Jersey elementary student struggles. Diagnosed with Attention Deficit Hyperactivity Disorder, her mom believes her troubles stem from anxiety, not ADHD.
The 9-year-old constantly worries about social acceptance. She stresses excessively about tests. She cries more than a typical fourth grader would, can’t sleep without her preferred routine and is held back from typical experiences by fears. She watches her twin sister take off down a steep waterslide and navigate the treacherous world of elementary school girls without tears or concerns, but she cannot mirror that behavior. She seeks reassurance, imagines the worst and worries.
What if I get hurt? … Why don’t they like me? … What if the teacher knows I didn’t practice my instrument? … What if I don’t get 100? … Is it OK? … Is it going to be OK? … Am I going to be OK?
Coming Sunday: What are developmentally typical fears, and when should parents be concerned?
For parents concerned about their children, the most difficult question to answer: Is something wrong with my child, or is this behavior developmentally typical? For help, the first step is often to call their pediatrician or school counselor. Here are some other resources:
- Anxiety Disorders Association of America, adaa.org, 240-485-1001
- American Academy of Child and Adolescent Psychiatry, aacap.org, 202-966-7300
- American Psychological Association, apa.org, 800-374-2721
- Association for Behavioral and Cognitive Therapies, abct.org, 212-647-1890
There are many anxiety assessments, and experts debate which is best, according to Cresskill psychologist Matthew Goldfine. One, the Screen for Child Anxiety Related Disorders (SCARED), while not perfect, is free, available online and “very useful as a screener for parents who are wondering if their child has clinically significant anxiety and whether to see a doctor about it,” he said. There is one questionnaire for the parent and one for the child; it can be found at psychiatry.pitt.edu (search SCARED).
Research, evaluation and treatment centers specializing in childhood anxiety disorders in the Northeast:
- Youth Anxiety and Depression Clinic at Rutgers, yadc.rutgers.edu, 848-445-3905
- Columbia University Clinic for Anxiety and Related Disorders, anxietytreatmentnyc.org, 212-246-5740
- Child and Adolescent Anxiety Disorders Clinic at Temple University, childanxiety.org, 215-204-7165
- Center for Anxiety and Related Disorders at Boston University, bu.edu/card, 617-353-9610
- “Growing Up Brave: Expert Strategies for Helping Your Child Overcome Fear, Stress and Anxiety,” by Donna Pincus, Ph.D.
- “You and Your Anxious Child: Free Your Child From Fears and Worries and Create a Joyful Family Life,” by Anne Marie Albano, Ph.D.
“Freeing Your Child From Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries and Phobia,” by Tamar Chansky, Ph.D.