I struggle with how to describe my children’s mental issues to the professionals (teachers, doctors, therapists) who are supposed to help them. Saying “anxiety disorder” is easy, and for some professionals it is sufficient. They instantly understand the adaptations my son needs in order to function in their space. In fact, I’ve had some teachers who adapt so automatically that I don’t even have to have the anxiety conversation at all, they automatically create an environment where my son feels safe and can function. But if the words “anxiety disorder” don’t instantly garner comprehension, I’m left trying to describe how this nebulous thing impacts every minute of my son’s life. Sometimes I’m required to demonstrate the level of disorder, how far outside the norm my son is, and why “all teens have some anxiety” doesn’t cover my son’s experiences. I hate having to prove disorder because it forces me to confront the extent of the impact anxiety has on my son’s life. It rips away the illusion of normality. It requires me to re-process my guilt and insecurity about how I handle his anxiety. It makes me grieve again.
I am fortunate in that this son is my youngest. Most of the professionals I’m dealing with have already worked with me for one of my other children. These professionals have developed a level of trust in me, my competence, my assessment of what is needed. I don’t get nearly the push back that I used to get when making requests. However this has also created some disadvantage for my son that I’m now trying to rectify. I already knew about so many resources that I picked whichever was most convenient. His diagnosis was done at a university clinic. His medicine is managed by a primary care doctor. His therapy was done at a different university clinic. His schooling is partially done at home with heavy involvement from me. The diagnostic picture is scattered and, as we face high school next fall, it needs to be consolidated. He needs a psychiatrist who will use professional expertise to look at the whole picture and help us see what we need to do to help this young person navigate his way into adulthood.
So I called the psychiatrist who helped me with two other children. And I was halted by the gatekeepers at the front desk. “We’ve had such an influx of people who should really be seen by their General Practitioner, so now we require a referral from a GP first before we’ll make an appointment.” Sometimes I can talk my way past this sort of barrier when I’m certain it shouldn’t apply to me. Not this time. The receptionist was “happy to pass a message to the doctor (my ally) to see if he’s willing to waive the requirement.” Which leaves me making an appointment with the GP and hoping that the psychiatrist’s knowledge of me will cause him to knock the gates open from the inside.
And it leaves me worried that perhaps they’re right, perhaps I’m blowing this anxiety thing out of proportion, perhaps he behaves as he does because I enable it rather than getting strict to force him to overcome it. Then I remember his reaction to small life events like having a book confiscated in class or having an unexpected assignment, and I am reminded that it is not normal to react to such incidents by curling into a crying, shaking ball of stress.
My son and I have worked hard to untangle these behaviors. He’s gotten so much better at cooperating with me to analyze why his reactions happen. We hope that is a step toward making it not happen. Because when he can’t make himself face an assignment, when facing the assignment begins to trigger panic, he withdraws and begins reading in class, which looks like laziness or lack of engagement. Him reading in class creates challenges for teachers when they have to tell other kids to pay attention. And the work piles up because his brain represses it out of existence. I function as an outside check/enforcer to require him to face what made him anxious. But it can take us multiple days to dig down and figure out what is blocking him from doing an assignment. (Things that block an assignment: if it has creative writing in it, if it requires synthesis from reading instead of regurgitation, if it requires a group to complete, if it requires presentation in front of others, if it requires drawing rather than copying a diagram, if he is upset or anxious because of some other event, if he doesn’t feel well, if he is upset from forcing himself to confront a block on an assignment. Basically 3/4 of all assignments have some sort of block in them.) Given time to walk away from an assignment and come back to it, he can almost always overcome the block and do the work, but it means that assignments pile up. And I know some of the teachers get frustrated/baffled about why he won’t do them. (If he can do it after school today, why couldn’t he just do it in class yesterday?) Then we reach the last week of the term (this week) when he has to plow through work or he will fail classes. The pressure of the deadline helps him break through blocks. It also raises his ambient stress level so that any disruption to the “get the work done” plan results in full blown panic.
Which is why this week is the week I remembered that it is really time for a single professional to re-examine the entire diagnostic picture. And I make phone calls. Because I can’t run interference for him forever. And he while he could possibly build an adult life with no writing, drawing, or group work, he can’t build an adult life with no stress or unexpected events.
I don’t have answers. I wish I did. This kid of mine is so courageous every single day, in ways that look (from the outside) like he is being obstinant, disrespectful, or not trying. I know some of the people in his life get to glimpse the courage and humor inside him. Most just get to see the top of his head because he’s reading, not meeting their eyes, and not speaking. Today I go to our GP and have a conversation which will likely be short and end in a referral, but there is always the chance that a longer explanation and justification might be required to convince the GP that what I think is needed is actually needed. I have to remind myself that these outside checks are good, that having someone outside with a different perspective can be valuable. That’s why we go to professionals in the first place. But I hope that the conversation will be short, and that I won’t spend the next few days spinning in self doubt over how I’m trying to help my son.