Behaviors
Because there are so many triggers, each person’ s behavior looks completely different and complicates the diagnoses and treatments. Glode says the time from the age of onset of obsessive compulsive symptoms in children and when they are formally diagnosed is between seven to twelve years. And the time between diagnosis to an effective, evidence-based treatment is twelve to fourteen years.
“ They retreat from activities they enjoy or stay away from peers, avoiding the things that cause them anxiety. The avoidance reinforces their fear— because they feel OK, they continue to avoid social situations that provoke fear and anxiety,” Lujan Rickerman says.“ Younger children might cry. They might throw temper tantrums, they might freeze or not move, or be clingy, regress or act younger than they really are. They might have trouble sleeping at night, complaining about stomach aches, headaches or a sore throat. It’ s easier for a kiddo to say,‘ This hurts,’ which elicits a response from a parent, rather than say,‘ I don’ t want to because I’ m scared.’”
Parents should look for patterns, suggests Tucker: Is a child worried or trying to avoid school on mornings when there’ s a test or presentation, or is it every time there’ s gym class or music? Evaluate what day it is, what’ s going on at school and over time to see if the child’ s reaction occurs around a specific event.
“ Parents can help children learn their unique somatic signs of anxiety, so they can begin to recognize,‘ When I feel hot and sweaty and my heart is beating fast and my throat is dry, that’ s me feeling anxious, not sick,’” Tucker says.
CASE STUDY NO. 1
KASHA COOPER’ S * DAUGHTER Saraya * exhibited signs of intense anxiety at a young age and would often withdraw, shut down or become mute. Saraya insisted on being early to family outings, sports practices and games for fear of being judged. She had a phobia at school and would vomit for weeks before a new school year began, eventually developing a habit of vomiting every morning before school. In her teenage years, it became more dominant, often paralyzing, affecting every aspect of her life. She put excessive pressure on herself to achieve academically, but it became so acute that she eventually withdrew from high school completely. She never graduated, and now at twenty-three, still struggles to meet and maintain friends because she fears their judgment, suffers debilitating self-doubt because she thinks she’ s never as good as them, and can’ t be proactive because she fears failure.
“ She wasn’ t going to school. She wasn’ t coming out of her room, she wasn’ t eating. She wouldn’ t answer text messages or phone calls because she was overthinking everything,” Cooper says.“ She didn’ t have the coping skills, thought therapy was dumb, and just didn’ t want to put the work in. No one knew how to help, and everyone thought she was just quirky.”
Cooper says layers of treatments have worked for Saraya over the years, including therapy at Newport Mental Health, behavioral assessment at Butler Hospital, and now mood-stabilizing medications.“ Patience and compassion are essential when dealing with a loved one with anxiety,” she says.
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