Brain Space: Anxiety is the Symptom

This last year has been difficult for so many people.  Some have lost jobs.  Others have lost loved ones.  We have spent much of the time isolated from friends and family.  Even for the most mentally stable of us, this year has been tough.

Kids might have it the worst out of all of us.  They need the social interaction they would normally get at school.  Many kids, mine included, have spent many months going to school online only.  This doesn’t give them the level of education they deserve, and it makes them feel isolated.

At one point, the CDC said they believed the detriment to the mental health of children outweighed the potential danger of Covid spreading through schools.  Their recommendation was to reopen schools, in some capacity, for the sake of the children.  My state did not do this until recently.

This article is not about politics.  It’s not about which side was right or wrong.  It’s not even about how covid was handled at all.  I’m here to tell you about something we learned that might not have ever come up if my daughter hadn’t been put through the isolation that came with this last year.

For years now, we have known that my daughter has had issues with anxiety.  Out of nowhere, she would have a panic attack.  Sometimes she could tell us what brought it on.  Other times she had no idea.  She would worry about things that were never going to happen.  For example, she would be scared about a hurricane when it was bright and sunny outside.

A few years back, we set my daughter up with a counselor.  She fought it for a bit but ended up enjoying her sessions.   The counselor focused on the anxiety and ways for her to deal with it in the moment.  She learned techniques that she could use to help pull her out of panic attacks before they got too bad.  Sometimes this worked, but often it took me or my wife to bring her back down.  When we left Texas, she stopped seeing a counselor.

Fast forward to this past summer.  My daughter came down to talk to me and she was making some weird movements with her jaw.  I didn’t think much about it at the time, but it was worse by that afternoon.  I went into her room and she was having full-out tics.  Her jaw, neck, and arms were moving in erratic ways.  My wife was understandably freaked out.

I took my daughter to the local emergency room and then on to the children’s hospital in Seattle.  On this journey, she started making strange noises and saying random things.  Luckily, she was in good spirits.  The doctors ran tests but found nothing wrong.  By the time we were heading home, she was worn out enough and the tics stopped. 

Over the next few weeks, the tics would come and go.  It seemed to us that these would be brought on by stress or anxiety.  Sometimes my daughter would have a small tic and that’s it.  Other times it would be almost continuous for days.  We found ourselves having to make her sleepy to get the tics to calm down. 

Eventually, we were able to get my daughter in to see a neurologist.  This doctor was amazing.  She spoke directly to my daughter and listened to everything.  It was obvious that she wanted to help us find a solution that could really help.  After some simple tests and a lot of talking, she prescribed a very low dose of medication to help my daughter control things.

My wife and I still had concerns.  We loved what the neurologist had helped with, but the anxiety was still an issue.  We were able to get an online appointment with a psychologist.  My wife spoke with her first, laying out the concerns that we had.  Then, my daughter talked to her for a while.  My daughter called me after the appointment and was excited about the conversation she had just had.

During this entire process, my daughter was doing a lot of reading up on different disorders and mental illnesses.  She found them all fascinating, and I think she was in search of more answers.  One big upside to the entire situation is that she’s looking into a future of helping people with mental illnesses.  The downside is that she started to diagnose herself.

Fast forward again to today.  We had a meeting with the psychologist to follow up on potential diagnoses and pathways forward.  One diagnosis was transient tic disorder.  This is like Tourettes, except not as persistent.  We expected that diagnosis.  The doctor gave us some resources to help us keep it under control.

The other diagnosis caught me off guard.  As it turns out, my daughter has OCD.  During the appointment, we all discussed how OCD is portrayed on tv and in movies, and how that is the extreme version.  Apparently, someone can have OCD without showing signs that most people would see as compulsions. 

The doctor explained that OCD can come in forms of avoidance of specific situations.  In my daughter’s case, one of her compulsions is to avoid seeing disturbing situations.  As parents, we just assumed that she was sensitive to them, as many kids can be.  We assumed they added to her overactive fear of death or harm.  I’m sure that the diagnosis would not have been OCD if the only symptom was avoiding gore on TV.  If that was the case, there would be millions of children diagnosed this way. 

I learned a bit more about my daughter as the appointment continued.  She made a comment about her need to smile into mirrors to get a dopamine hit.  She made it sound like she will keep smiling until she feels the results.  This definitely feels like a compulsion, and I had no idea it was happening.  The signs were so minimal.

I was learning a lot in this appointment.  There were so many little things that I never noticed and wouldn’t have been able to interpret if I had noticed them.  This was a textbook case of not even knowing what I didn’t know.  I wouldn’t have even known what questions to ask to find these things out.  It’s that harsh reminder that, as parents, there are always things we don’t know about our kids.  This applies even when you are as close as my daughter and I are.

So, where do we go from here?  The doctor gave us some great resources.  She is helping us get set up with a counselor that specializes in tic disorders and OCD.  As it turns out, counselors that specialize in one often specialize in the other as well.  They have some sort of tie together.  My wife and I will also be doing a class to help us understand and deal with the diagnosis.  The road ahead is bright now that we know.

I would love to tell parents there is an easy way to know if their child needs to speak to someone on this level.  The reality is there’s not.  Kids show so many signs of problems, but they are often because the child has not had a chance to learn how to deal with life.  This doesn’t mean the signs should be ignored.  The key is being able to interpret them, but even that is easier said than done.

One thing I insist parents do is maintain an open line of communication with their kids.  Make their kids feel like they can say anything and you’ll be ok to hear it.  Both of my kids know they can talk to us freely.  My son is a little more hesitant, but that’s because he’s worried about being a burden.  All the same, both kids will tell us about how they are feeling, what worries them, and even about the people they have a crush on. 

For a long time, I worried about how communication would be.  My wife will tell you that I am not great at communicating what’s on my mind.  Maybe this stems from my childhood.  I didn’t want my kids to end up that way.    It took some work to get the relationship we all have now.  As I mentioned before, this still won’t guarantee that you’ll know everything that’s going on.  Sometimes they don’t even know there is anything to tell you.

The other thing I must insist on is to not be in denial.  Everyone wants their child to be perfect, but they rarely are.  Being in denial is delaying the actions that will help the most.  My nephew is autistic.  His parents noticed things very early on and sought help.  Because of that, they have been actively working with him from a very young age and he has the best chance at a normal life.  Taking action early will pay off.

I need to give a big shout-out to the Seattle Children’s Hospital.  Between the emergency room visit and the specialists, we received a large bill.  We had the money to pay it, but it would have taken a bite out of savings.  My wife spoke with the hospital and filled out a form.  They covered everything that had happened and everything that would come up through July.  Our healthcare system might be broken, but there are good people out there that are making important donations.

As parents, our most important job is to give our children the best hope for a happy future.  We make mistakes.  We mess up often.  These missteps are going to happen, but we can’t stop trying.  We can’t ignore what our kids are trying to tell us, through actions or words.  Be there for them, be present, and be open-minded to whatever their needs might be.

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