We've been at the doctor a lot this winter - recurring sore throats that are sometimes strep, sometimes not. We have spent a lot of time sitting in the exam room, waiting for the results of the strep culture.
Greta was perched on the exam table; the thin paper covering crinkled as she fidgeted nervously. I was standing in front of her, rubbing her arms to comfort her, when I noticed the posters on the wall of the exam room. I've been staring at these posters a lot this winter, but for some reason this time I actually read them.
My eye wandered over bed wetting, ADHD, eyesight problems and immunizations, when a little section in the lower right-hand corner caught my eye. Generalized Anxiety Disorder in Children and Teens. I felt a tightening in my gut, a reluctance to read what it said, because somewhere in my heart I knew.
"All children and adolescents experience some anxiety. It is a normal part of growing up. However, when worries and fears do not go away and interfere with a child or adolescent's usual activities, an anxiety disorder may be present. Children of parents with an anxiety disorder are more likely to have an anxiety disorder."It went on to describe some of the symptoms:
- many worries about things before they happen
- many worries about friends, school, or activities
- constant thoughts and fears about safety of self and/or safety of parents
- frequent stomach aches, headaches, or other physical complaints
- muscle aches or tension
- sleep disturbance
- feeling as though there is a lump in the throat
Greta has been experiencing all of these symptoms, to varying degrees. Lately, though, some of them are getting worse.
She complains of muscle and joint aches in her heel and her knee, and uses these discomforts as reasons to try to avoid activities. She complains frequently about stomach aches and head aches, and recently she has been talking about a lump in her throat that "feels like it does before I throw up, but I don't need to throw up." She is full of "what-if" questions, and most of them are geared toward disaster scenarios. She has been having increased trouble falling asleep, because of fears and anxieties about scary monsters, school, activities, or what will happen if she misses the bus or forgets her homework.
Reading the poster, I could no longer deny what I knew in my heart was happening: she's struggling with anxiety.
Steve and I have done a lot of research over the past few days. We are talking to her pediatrician and getting professional help with what I have discovered is a very common problem among young children and adolescents.
I have my own fears to conquer, too. Children with untreated anxiety have alarmingly high rates of substance abuse, eating disorders and self-destructive behaviors as they enter their teens and early adulthood. Greta has already been dealt a biological card which increases her risk for alcoholism; add anxiety to this mix and you create fertile ground for addiction.
Even more difficult to digest was all the information on children of alcoholics. Children of an active alcoholic are put at an increased risk for anxiety disorders, especially in their formative years, between the ages of 1 and 5.
I got sober just before Greta turned 5.
I started to fold in on myself, desperate to look away, to not see what I was reading. I did this to her, I started to think. She got alcoholism and anxiety from my genes, and my drinking in her formative years has made everything worse.
Immediately on the heels of this thought, though, came that gentle Inner Voice, the one that I don't control, who sounds a lot like me but who, somehow, isn't me.
You don't have that kind of power, Ellie, it whispered in my ear. Don't hijack this situation and make it all about you. If you lose yourself in regret and guilt you are of no use to anybody.
But I don't want to know this, I thought. I desperately want this not to be true.
Don't you see? it replied. You went through what you did and when you did so you could help her. You could have lived your whole life never understanding your own anxiety, drinking your way around it, making it worse every step of the way, and never breaking through to the other side.
Gratitude pushed aside fear and guilt. I can help her, I thought, because I know how she feels. I know how to give voice to her problem, how to advocate for her and help her advocate for herself. I have tools I can show her. I can't change the past, but I will do everything I can to help today, now.
Last night Steve and Greta went to a father/daughter square dance with her Brownie troop. She had been withdrawing all afternoon, drawing into herself, complaining of a stomach ache. She lasted about 20 mins at the square dance before complaining about knee pain that didn't exist, and then tearfully retreating into the corner, telling Steve she wanted to leave but couldn't, because she was afraid the Emcee of the square dance would be "mad at her". Steve gently persuaded her to leave, and after she was in bed Steve and I talked about how her withdrawing, feeling overwhelmed and "looked at", her fear of doing the wrong thing and complaints of physical ailments have been increasing, so we resolved to start talking to her about her anxiety.
This morning Greta, Steve and I sat at the kitchen table and talked. Finn was in the next room, absorbed in Mario Kart. Our message was simple: no matter what you're feeling, no matter what, you can talk to us and we will listen and try to help. We will never get upset with you for feeling scared or anxious. Ever.
We explained anxiety to her, that it is something many people have, and that there are ways to help her feel better. I told her I have anxiety, too, and explained some of the tools I use to overcome fear.
We could see her body loosen, her face brighten, as she listened. She saw that she wasn't alone; the relief that there was a name for what she was feeling was palpable. Anxiety, she said out loud, trying the word on for size. That's what that funny feeling in my stomach is? Like butterflies, except I don't know why I'm nervous?
The temptation to look away is strong. And the symptoms could be easy to miss, because Greta is thriving in most ways: socially, academically, physically. She has many friends, loves sports and is doing very well in school. Ironically, success in school and activities can be driven by anxiety; a gift from our old friend perfectionism.
A lot of Greta's anxiety revolves around fear of making a mistake, doing poorly in school, failing to meet others' expectations or making someone angry. A primary difference between a child who is hitting a developmental milestone (worrying appropriately), and someone suffering from anxiety, is the inability to stop the ruminating cycle. This eventually inteferes with sleep, appetite, sociability and enjoyment of day-to-day activities. Greta is on the very cusp of this; we have caught it early.
"Making mistakes is part of life," I said to her this morning, as she sat on my lap and we gently rocked back and forth. "It's what we do about them that matters most. If we never made mistakes, we'd never learn, we'd never grow."
She drew a deep breath, and nodded once, twice. "Okay," she said.
"Want to know something else about people who have anxiety?" I whispered in her ear, as we finished up our talk. "They are smart, imaginative, creative and they love with their whole heart. They are amazing friends, and incredible daughters."
"Yeah, that does sound like us," she said, and smiled.