Anxiety in children: what’s wrong with that kid?

Disclosure: I am not a medical professional – what is contained in this post is my own opinion as a parent.

Yesterday I attended a family reunion and while we were sitting at the table I had a discussion with someone who’s teen has been suffering from anxiety symptoms for years – I’m guessing since childhood.

The kid in question, just short of graduation, dropped out of school. He was finding it very hard to attend school at all as I remember the parent having told me about it a while back. Unlike his friends, he doesn’t drive or isn’t involved in sports. He works two days a week and I’m guessing he’s hiding at that place as I’ve never seen him there. In a previous discussion, the parent had told me he would no longer support him financially or otherwise and would give him an ultimatum. Of course, he’s out of solutions and out of desperation is trying to push the kid to the limit to get him going.There’s no doubt here that he’s being told by everyone what to do with the “ruthless” kid to get him going. The parents here appear as the victims of awful kids. I know, because I’ve been there.

An aunt was sitting at the table openly criticizing the kid and saying he wasn’t sick like my daughter was. The thing was that not so long ago – before my daughter’s diagnosis – that same aunt was telling other family members that there was nothing wrong with my daughter, that she was spoiled and manipulative.

As the mother of a teenager who’s been paralyzed by anxiety for years, I have my own thoughts on the topic and I’m pretty tired of hearing ignorant comments on kids who appear “normal” but can’t get on with their daily lives. I will say this:

THERE’S SOMETHING THERE.

What’s the likelihood that a child will not want to play, go to the circus, zoo, beach, or participate in other fun games or events such as a birthday party? My daughter used to sit under a tree in the shade when she was three. She was very sociable but couldn’t keep up with anyone and was more comfortable with adults.

What’s the likelihood that a teen will not want to go out with his friends to a school dance, party, or sporting event, or better yet that he will not want to drive a car? My daughter has never been to a school dance, will never know what it’s like to graduate from high school as she can’t attend school – and it’s not just because of her physical condition. She loves Dallas Green and I got her tickets to go to a concert but the preparation it took was excruciating. It didn’t matter that she wanted to go more than anything – it was hell for her. Her IQ is very high and she will make it to college one day, I’m sure of that. She’s pretty, tall, and has beautiful hair. She’s not particularly shy and is very articulate. Does she sound like someone who can’t go out? Not at all when you first see her.

It doesn’t matter how healthy, cute, smart, normal looking the kid is, if that kid can’t go about his daily activities as other kids can, there may be something serious to worry about – and I’m not talking about mental issues.

Anxiety is often associated with various illnesses. From the information that’s available is appears as though children, teens, and adults may become anxious because they are suffering from an illness. It doesn’t come out in lay terms to explain that certain illnesses cause anxiety from a physiological standpoint. Although dated, this 1990 article by Billings states that “Certain medical conditions may present as anxiety so that the unsuspecting physician may inaccurately misattribute a patient’s symptoms to a psychiatric rather than a medical condition.” This year, my daughter was diagnosed with a connective tissue disorder and orthostatic intolerance (OI) and the report states that her anxiety and panic attacks are of physiological (medical) rather than psychological nature. In other words, her psychological state is caused by her medical condition and otherwise related thereto.

Other than her behavior as a young child, where she essentially tried to exclude herself from any or all social situations, the first sign that something was terribly wrong should have been noticed when her anxiety symptoms couldn’t be relieved by any type of mood medication, nor cognitive behavioral therapy, nor threats. And yes, “threats” as we threatened to take everything away from her and it went so far as to send her to foster care as I was deemed an irresponsible parent who couldn’t handle my oppositional and controlling child. And yes, that really happened.

The first signs of relief came when she was first diagnosed with a thyroid disorder. A few months into thyroid treatment, the anxiety medication started kicking in – it wasn’t 100% effective, but it was so much better. And the literature shows evidence of that. Here’s an article published in 2012 by Hage and Azar in the Journal of Thyroid Research where the first paragraph says it all.

Around the same period of time, she was diagnosed with polycystic ovary syndrome (PCOS) – a condition where anxiety is often seen. This meta-analysis published in 2013 shows strong evidence of that. That being said, how do we know that her mood is affected by PCOS itself and not the thyroid issue at this point? I’m not sure just how much overlap there is between the two conditions, which by the way should be monitored more closely. Her thyroid levels appear to fluctuate considerably (for some other reason I will not get into here) and she may not be receiving sufficient thyroid medication. Furthermore, she’s on Metformin to treat her insulin resistance but is not receiving the full dosage usually suggested for PCOS (note that guidelines are not necessary updated to include this treatment option). There’s one thing we know for sure: Whenever she takes a break from hormone therapy (every 3 months or so) her anxiety levels increase and it’s a difficult week for her and for us.

Recently, with the OI diagnosis and its treatment which includes a vasoconstrictor and salt tablets to increase blood volume my daughter’s panic attacks and anxiety have diminished considerably. Her mood has notably improved. It’s still not perfect but it is remarkable.

During the appointment with the neurologist who diagnosed my daughter, I asked the following question “What child doesn’t want to play and run outside?” And he replied: “A child who is not well.”

I stopped the aunt dead in her tracks at the table. I rarely speak up as to not intimidate people in front of others, but what got to me was the parent sitting across from me who suffers greatly because of what is going on and the things that society is telling him to do to correct his teen’s behavior when that’s not the solution.

As parents and adults we need to represent these children in order to stop this madness. No one should be robbed of their lives or be left to fend for themselves. As adults we have the ability to make a difference for the children.

Many illnesses are connected to anxiety and how this happens is not well understood. Treating anxiety while ignoring an underlying illness may not improve quality of life which is low in these children.  Let’s bring that to the table shall we?