Please Don’t Make My Students Cry

One of my after-school students recently came home from his school in tears.  His third-grade class had watched a documentary about underwater exploration, and the idea of being stuck in a submarine had given him anxiety.  After the movie, his teacher said something about the class taking a field trip in a submarine; I wasn’t there, but I think she was trying to encourage the students to imagine going in a submarine.  My student misunderstood (probably because he was already anxious) and cried out, “Do we have to go in the submarine?”  His teacher apparently responded with something like, “[student], why are you always so scared of everything? You’re going to ruin the activity for everyone.”  According to my student, the teacher was very annoyed with him.

Again, I wasn’t there, so it’s possible that my student misinterpreted his teacher’s feelings.  He might be wrong about what she said or how she said it.  I hope he’s wrong, because the idea of an adult–a teacher–speaking that way to one of my students is very upsetting.  The idea of a teacher speaking that way to any anxious student is upsetting.  See, I would hope this teacher would be sensitive to my student’s feelings since she obviously knows that he struggles with his fears.  What she doesn’t know is that he has Generalized Anxiety Disorder (GAD), a condition “characterized by persistent, excessive, and unrealistic worry about everyday things.”  In fact, it’s very likely that this teacher doesn’t even know what GAD is; unlike depression and Obsessive-compulsive Disorder, GAD isn’t typically discussed in pop culture, and most teaching programs do not require training in psychology.

My student’s family has not disclosed his condition to his school.  They have chosen not to pursue accommodations for their son because they worry about stigma and discrimination, very real risks.

This incident inspires several questions.  First, should parents report their children’s mental illnesses to their school?  Second, was my student’s teacher out of line in her criticism of my student?  In considering that question, assume she really said what my student believes she said, and that she exhibited some amount of anger when she made those statements.  Finally, and most importantly, should all teachers be required to complete some amount of training in psychology?  Teachers are increasingly knowledgable about learning disabilities and the Autism spectrum (not knowledgable enough, many parents will say, and I agree), but childhood mental illness is largely ignored in both certification and continuing education programs for teachers.

Please share your feelings in the comments, and stay tuned for posts about disclosing your child’s mental illness and psychology training for teachers.

All stories about my students are shared with permission from the student and her/his family.

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When a Cold is a Catastrophe

I’m sick.

Over the weekend, I got a fairly nasty cold, and I’m still recovering. To an adult who has control of her anxiety, a cold is an annoyance. For anxious children, however, even minor illnesses can be terrifying.

Children prone to catastrophic thinking are often extremely creative in their fears, especially if they don’t have a good understanding of relevant anatomy.  Sinus pressure is likely to make an anxious young child worry that his head is going to explode, but it may also make him worry that worms have crawled into his nose in the night.  As long as you’re respectful and compassionate, I think it’s okay to sometimes poke gentle fun at your child’s most adorable fears.

To keep things playful instead of traumatizing, acknowledge the child’s fear, explain that the fear itself is a symptom (of anxiety or an anxiety disorder), and make sure the child knows you are on her side and will protect her.  Most importantly, keep even gentle teasing one-on-one; a beloved teacher or parent joking about nose-worms could be comforting and sweet, but additional participants may intentionally or unintentionally humiliate or bully the child.  Also, be careful about joking about plausible consequences of symptoms, such as an ear infection leading to a ruptured eardrum.  Most anxious kids won’t find that sort of “joke” funny.

Below is a list of common cold symptoms and the fears they may inspire in anxious children and adolescents.  Some of the fears are silly, but it’s important to realize that intelligence does not necessarily protect children from anxiety.  A child or teen who knows her fears are unfounded may still be plagued by them.  If your child or student complains of one of the following fears, explicitly disprove his unfounded fears (“sinus pressure will NEVER make your head explode, no matter what) and deemphasize any real risks that don’t require action.

Being able to predict some of your child or student’s fears may help you to better remove those fears.  Just make sure you never inadvertently suggest a new fear: “Ooooh, ear pressure? Don’t worry, I’m sure your eardrums won’t explode!”

Symptom Possible Fears
Cough Suffocation, lung cancer, internal bleeding due to violent cough
Headache Tumor, concussion, meningitis
Pressure, ears Eardrum rupturing, deafness
Pressure, eyes Eyes “popping out”/exploding, blindness
Pressure, sinuses Head exploding, tumors, burst blood vessels
Sore throat Losing the ability to speak
“Stuffy nose” Suffocation, anosmia
Swollen glands Hodgkin’s lymphoma

Parents, note that many over the counter and prescription cold medicines can cause anxiety or panic in individuals with anxiety disorders.  Talk to your pediatrician for more information.  Curious about alternative cold remedies? Read this informative article from Mayo Clinic.

Antibiotic Safety Information
Colds are caused by viruses, NOT bacteria.  Therefore, antibiotics will NOT help prevent, mitigate, or cure a cold.  The misuse of antibiotics helps create resistance strains of bacteria (such as MRSA), and taking antibiotics when you don’t need them can sometimes hurt you. Your body is full of “good” bacteria that helps you digest foods and fight off infection. Children and adults should only take antibiotics when they are prescribed by a real medical doctor.  Always take antibiotics exactly as prescribed.

Is Royce White the Victim of Sexism?

I’m not a big fan of professional sports, but I’ve been enthusiastically following the story of NBA rookie Royce White. White, who was drafted by the Houston Rockets, has Generalized Anxiety Disorder (GAD) and phobia of flying. Because he cannot board a plane, the Rockets pay for ground transportation for White.

White is extremely open about his anxiety, and his candor has drawn attention to anxiety disorders. White frequently shares brave and heartfelt insights via twitter, inspiring many of his supporters to tweet their own anxiety-related diagnoses.

Recently, a critical article by respected sports journalist Adrian Wojnarowski questioned White’s dedication to the NBA and accused White of using his anxiety as a bargaining tool to get more playing time. White denies the allegations. I don’t know White, Wojnarowski, or anyone associated with the Rockets. I don’t know what White’s motives are, and I don’t know anything about his negotiations. I have no guesses as to the accuracy of the article.

Here’s what matters to me: Royce White’s tweets have made him a hero to children with anxiety disorders. And many twitter users have responded to that heroism with horrifying hatred. To raise awareness, White retweets some of his most cruel and ignorant attackers. These attacks are not about White’s dedication to the NBA. They aren’t about whether he’s using his anxiety unfairly. These tweets are pure hate, the kind of fanatical hate you might see directed at a political or religious figure. Again, I don’t know Royce. I don’t know if he’s smart or nice or if he kills puppies. But this is a man who has made it to the NBA in spite of crippling mental illness. To me, that’s pretty neat. Why are so many tweeters, who know exactly as much as I know about White, so deeply offended by him?

I wonder if it has to do with sexism. The Anxiety and Depression Association of America (ADAA), who I like to cite, claims that “[w]omen are twice as likely to be affected” by GAD. However, sex disparities related to mental illness are sometimes blamed on differences in reporting. In other words, it’s possible that women are simply more likely to report GAD symptoms. The idea is that men (and boys) may hide their anxiety in order to avoid being seen as weak. (A discussion about why women are allowed or encouraged to be weak is beyond the scope of this blog.) Is the hate directed at White a biological reaction to an NBA player acting, according to antiquated concepts of gender, like a girl? Do some of White’s haters worry that his anxiety somehow detracts from their own manliness?

While our culture’s ubiquitous low-level sexism about weakness is clearly relevant to White’s case, I’m not insisting that sexism is the most important part of the problem. (I’m certainly not accusing Wojnarowski of sexism. Again, I’m not talking about him.) People are always weird about mental illness. Every mentally ill person has (probably) been told to “get over” their disease. Many people simply can’t understand mental illness. Many people are offended by the terrifying idea that you can be betrayed by your own brain. As painful as it can be to interact with such people, I hope that White’s twitter bullies are offended by mental illness in general, not just by men with anxiety disorders.

I have known and worked with several boys diagnosed with anxiety disorders. These boys have been brave, intelligent, adventurous, and strong. (Just like the girls I’ve known and taught!) If I heard someone bully one of my students the way people have been bullying Royce White, I would go full mama bear. I want my students to be able to share their diagnoses and get the help they need without fear of discrimination or attack. Royce White claims to be a warrior against stigma and ignorance, and his tweets reflect that. So I think he’s a hero.

Unless it turns out he kills puppies.

Magical Thinking in a Hurricane

When I was thirteen, I was struggling with severe Generalized Anxiety Disorder and Obsessive-Compulsive Disorder, neither of which had yet been diagnosed. (I was diagnosed with Separation Anxiety Disorder in first grade, and at thirteen, I still worried excessively about my mom.) I hated school and already felt burned out by the second Tuesday of the year so, as I stepped out of my dad’s car in the morning, I wished that school would be cancelled for the day.

Wishing, even in my own head, was strictly prohibited by the torturous rules enforced by my OCD. But I was exhausted by months of acute anxiety—summer had always been difficult for me and puberty seemed to be exacerbating all my emotional struggles—and the thought slipped through. I did my simplest undoing ritual, which involved whispering “shut up shut up shut up,” and then I dragged myself to class…where a punky girl in an army surplus jacket informed me that the Pentagon had been attacked and New York City was, she thought, being bombed.

I knew I didn’t cause 9/11. I knew the attacks had to have happened hours before I even made that awful wish. I knew that it was disrespectful and narcissistic and absurd to feel responsible for something so horrific. But, in the panic of that day and the consistent anxiety of the following year, I returned again and again to that stupid careless wish.

Magical thinking, the fallacious association between unrelated events, is a significant cognitive symptom of OCD. Humans have evolved to seek out patterns: people who eat this red berry become very ill. Unfortunately, the patterns imaged by sufferers of OCD are typically very frightening. And, although magical thinking is a fallacy, intelligence doesn’t seem to offer much protection. (Imagine any of the many smart people who indulge a few superstitions.)

For healthy adults, a bit of magical thinking can be harmless or even fun. Magical thinking is ubiquitous in young children and rarely causes significant distress. However, anxious children and mentally ill individuals of all ages should avoid magical thinking. If you have an anxious child, be careful when encouraging even benign superstitions. (The weighted risks and benefits of teaching superstition is something that requires its own post.)

Crises like this hurricane can be scary for kids. If your children or students are prone to anxiety, reassure them regularly, shield them from sensationalist news, and show them that your family or school is prepared. Model calmness and optimism. And, if they recently wished for a few days off from school, make sure they know that this hurricane isn’t their fault.