School Refusal

Does anyone have any advice/experience with a child having anxiety attacks when going to school? My almost 9 year old daughter just started this last week. Her grades are amazing. I have had in depth conversations with her teacher and counselor and there is nothing that happened at school to cause this. She is my “last” child so I have babied her and I don’t think this has done her any favors. I have ADD and anxiety/depression. I have previously taken Lexapro but have successfully weaned off that and currently take Vyvanse which is working for me. My daughters pediatrician started her on Lexapro with Vistaril PRN. I have enabled her by keeping her out of school. My pediatrician and therapist feel she needs to be in school but because I understand what she is feeling I don’t feel right about traumatizing her anymore than she is doing to herself. I don’t know anyone else who has a child going through this and I am at a loss. I feel like my psych issues have been put on blast and I feel guilty for potentially “giving” this to my daughter. I am accepting of my mental issues but I do not know how i feel about hearing I “caused” this for my daughter.
I am open to hear any advise or suggestions to help with my daughter. She has a close attachment with me so I think there is some separation anxiety underlying. She has mentioned feeling like she “cannot get out” of the school and what she means is when her stomach hurts (anxiety) the nurse won’t call me since it is nothing worthy to go home.
As I have said I have anxiety and I am stressing out. I would love any suggestions. Thank you so much.

Can you volunteer to work in the class to see for yourself what is going on? can the school do a homebound program or just send work home while you work with a therapist to help her fears?

My daughter went through that in 5th grade, and she ended up inpatient in the hospital for 3 weeks. They started her on meds and she had therapy. She actually wanted to hurt herself. She has anxiety, depression and adhd. We had to search for the right pediatric unit for mental health because of her age and we found an excellent one and we were lucky. It doesnt matter if you did or did not influence her behavior. The mechanics of anxiety are mental health related and she needs help for it.

I don't have any suggestions for this. But I thought I would mention a resource for kids with disabilities & educational concerns. I don't know if this will be useful to you. But it's worth checking out. If they don't have anything to offer they may well know who will:

PACER Center - Champions for Children with Disabilities

Also, here's a link to an article, from PC's archives, that discusses how to handle panic attacks in children:

What to Do When your Child is Having a Panic Attack

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

The other thing is (and I do not recommend it for you but it is a thing) -homeschooling. You would have to be very disciplined to do it and it wouldnt make your child's anxiety any better for dealing with life outside the home.

If you want help homeschooling PM me. It's not like a home version of school.

Hey Steph,

another thought for you about your daughter being home from school. I think by continuing to keep her home, or even trying home-schooling, you could unwittingly send the message to her that anxiety is something we must submit to...i.e you're afraid to go to school so you need to stop going to school. This would likely extend to other aspects (anxiety just tends to grow and grow unless we manage it) such as "there is someone not very nice in my swimming group so I'm not going to go swimming anymore" etc etc

I think of school for a 9 year old as their occupation in a sense. Later this gets replaced with work and/or university. Children learn more from the school environment than just academic knowledge. They learn about socializing and managing conflict with peers. They learn how to be self-disciplined and respect authority from differing personas...every time there's a new teacher there's a new way to respond. Later, there's a new boss to work with and adapt to. These are all important skills to learn as a foundation for working as an adult. Adults can't stay home when work provokes anxiety...well maybe a few sick days if they need a break...but ultimately they need to learn how to manage work stress. So, even at age 9 your daughter needs to learn two important pieces:

1. anxiety is something that happens sometimes...it's like a message from body or mind that we need to make some changes in order to get back to peaceful balance. We don't need to panic about the anxiety itself. All feelings are temporary. The anxiety will pass with active support and time.

2. I need to go to school. That's where I belong with the other children my age. If something is wrong at school, we need to talk about it and find ways to make it better. Staying at home will not make it better.

I watched my parents' worlds get smaller and smaller over time because they dealt with their intense anxiety by submitting to it. So the anxiety continued to grow and extend to all areas of their lives.

That said, of course as Mama Bear you love her so much and it must be very painful for you to see her panic. I hope my thoughts are helpful. As i said before, she reminds me so much of myself when i was younger. If I knew her in the non-PC world I'd reassure her that these tough times can get better. I wish when I was a little girl, that someone had tried the strategies I sent to you in my first message. Though thankfully at age 15 I started having CBT with a very kind therapist. She was wonderful.

I have heard of yoga classes for little people....would your daughter enjoy that? Very soothing.

Sending a big safe to you and your little one. Take good care. As someone once told me: "Try not to freak out that you're freaking out!" Perhaps there's a way to say that in terms your daughter can relate to.

One more thought for you Steph since this school anxiety issue is close to my heart...

if you think it could help your daughter I would be willing to write a note here on PC sharing how I struggled with feeling sick before school and had panic attacks. I would emphasize how I was able to move beyond that. I could post such a note right here on the thread for you to read or in a PM to yourself. You would of course review it and decide if you'd like to share it with her. In my first career, I worked with children (I now care for adults) so I think I can write it at a level that makes sense to a 9 yr old. I also have a niece who is 11 and she has a lot of anxiety about school due to relational aggression from some girls in her class. Though I realize that does not sound like your daughter's specific problem. My goal would be to give her hope that she will not always feel overwhelmed by panic.

Just an idea for you Steph. No offense taken if you don't think it's a good idea.

Good luck!

Did you make any decisions yet? The law is not on your side where truancy is concerned. Are you able to get her to counseling asap?

—-I so agree with your remarks. I was very anxious as a child, stomach aches being the main symptom, perfectionistic, teachers pet, and extremely introverted. Learning tools for coping with anxiety would have helped tremendously. I cant stress that enough. Anxiety disorder and depression occurred in the family, so I wish that had been monitored. Vigorous exercise is vital, even walking a dog might help if she doesn’t like exercise. Since the social aspect is so important, I wouldn’t home school without creating a wealth of social opportunities.