Oh Steph, what a tough situation for you and your daughter! She sounds like me! A long time ago. I'm in my 30s now and a professional...there is hope!! Hope it's okay to post from my perspective...I am not a parent.

I tend to take a problem-solving approach to things. So she needs her education but you of course don't want your little girl to feel traumatized every time she goes to school. I used to feel like that every day when I went. My body was tense. And like your daughter I got top grades and yet I worried about everything all the time. My mother and father both (in my opinion) were living with untreated depression and anxiety. They honestly didn't know what to do with me. It was a different time and place and there were no therapists etc. I just had to force myself through it every day and couldn't wait to get home again...from age 4/5 until 15 when I was finally diagnosed.

So, for you and your daughter here are my thoughts...

how would you feel about teaching her to meditate? Not as complicated as it sounds. There are simple motoric guided meditations out there or some beautiful ones involving imagining a soothing place/guardian etc. Some are designed for children. There's even a beautiful one for helping little people gently fall asleep at night when they are anxious.

You can search with your daughter on YouTube and choose a voice/style/image/message which she prefers. Even 3 minutes in the morning before school and (if her anxiety is bad enough) you could call her at lunch and talk her through another short meditation over the phone and then repeat at home. Practice/repetition is key. Meditation truly is a research-based method for reducing anxiety and depression.

Mindfulness sounds important here. Start asking her to pay attention to her thoughts, feelings, and body sensations when she is anxious before school. One by one you can help her unpack those thoughts. Sometimes we need even a small tangible comfort when anxiety upsets the stomach etc such as sipping some ginger ale or hot ginger and lemon tea...very soothing.

If you think separation anxiety is part of it...is there something of yours she can bring to school with her in a way that is age-appropriate and won't provoke peer-teasing? Such as a bracelet or a blanket wrapped up in her backpack or even an umbrella or a fragrance you wear? To continue the connection to you from a distance.

With anxiety, especially panic, I think it's really important to address root cause. At her age you could try an exercise at home (when she's more relaxed). Piece of paper and pen. "When I think about going to school I feel _______ and _________ because ____________." "I would rather be at home because at home I feel __________ and __________." "Something I like about school is _________." "Something I do NOT like about school is ___________."

As far as keeping her at home, it sounds untenable and not ideal but I understand that you don't want your child to suffer. How about this? A form of desensitization. If she's been home, then try "tomorrow I'd like you to go to school for one hour." and prepare her mentally with some meditation and deep breathing before and after. Then the next day try 2 hours. Then gradually build in hourly increments each day until she slowly manages to tolerate a full day at school. Give lots of reinforcement for her efforts whether they go well or not. Small things which make her smile each time...even a sticker system with a sticker each day she goes to school and a small reward after a full week etc.

Does she have any buddies she likes to pal around with? In or out of school? Hobbies? We all need balance, right? if she's a high-achiever, perhaps there is not enough fun or play in her life?

Hope these ideas help. I really empathize with both of you. I absolutely hated school until I was older and went to university because then I felt in control. Control is key. Humans are most anxious when they feel their sense of control is lowest. Something about school is making her feel that she has no control. Whatever you can do with your daughter to help her feel a sense of control before and during school...that should hopefully help. Maybe she needs daily phone check-ins with you for a while during the school day...not to ask to go home but to hear your voice or decompress with a short meditation exercise.

If the school is rigid, you can point out that these alternatives are much better than her just staying out of school indefinitely. Maybe this sounds like a stupid Q and sorry if you already mentioned, but have you asked her why she feels so anxious about going to school? I bet she knows. On some level. She's a smart little 9 year old and her spirit or mind is trying to indicate a problem which she's not sure how to deal with. Ask her to elaborate on "I can't get out." If it feels essentially like a prison to her, ask why? What is it about school which feels suffocating to her...with time I think she will tell you. I also think that if you come from a problem-solving perspective you may feel less guilt or fear about what's going on with her. All parents have troubles, right? It doesn't mean they cause their children's problems. She could certainly be picking up on your anxiety but there are ways to deal with that. Find something calming to share together...whatever that may be.

I would respectfully discourage you from going down the medication route with her. She's only 9 and her brain is still developing. By the time I was 15 my anxiety and depression were really bad. The doc had me try so many different meds over many months...they just made me sick and didn't help my mood at all. Therapy saved my life. Truly. I gave up on meds years ago.
It's one thing for adults to take them if they feel they help but I honestly do not agree with giving little people psychiatric meds. These are just my thoughts, you're her mother and you will decide. It just seems less than ideal for a 9 year old to be taking pills in order to function or get to school each day. I say that without judgment but care and regard. I would also be concerned about the long-term effects of the meds on her developing brain. One way or another she needs to learn practical ways to reduce the anxiety...that will serve her well later in life. Do you see what I mean? I often think meds mask our emotions rather than helping them. There are cases where they are needed of course...bipolar, schizophrenia, psychosis. But those don't fit with how you described your daughter. Again, sorry if I missed a piece.

There are so many ways to manage anxiety, particularly with a young bright child, without meds. If she is not afraid of needles, you can take her for acupuncture. It really helps me with anxiety and my TCM doc also cares for children. If not the needles, then acupressure can be just as useful. It can calm the nervous system. I wasn't sure if you are both talking to a therapist or just yourself. Since she is so bright, I think she would likely respond well to CBT from an experienced pediatric psychologist. I would go holistic with her, talking, acupuncture, meditation etc etc

Peace to you and your little one