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Monthly Archive for December, 2008
Dear Jennifer,
My daughter is is seventh grade and she is refusing to go to school. She feels sick on school mornings. This started about 6 weeks ago. She has always been a good student and liked school. I don’t think anything happened, although she did seem to have a panic attack during PE a few weeks ago. Could this be anxiety and what should I do?
Dear Writer,
While a diagnosis of any anxiety disorder is impossible without meeting your daughter, the timing of her sickness does suggest it may be anxiety-based. Stomach aches and headaches are common symptoms people have resulting from anxiety. If she doesn’t feel sick on weekend mornings, and if when you let her stay home she feels better after an hour or two, that is further evidence of anxiety. If this is anxiety, a couple things pop into my mind. One is social anxiety which often occurs at this age. With social anxiety, the individual feels extreme self consciousness, as though people are looking at them and criticizing or judging them. They fear doing or saying something embarrassing. It is a type of performance anxiety, but the performance can be the simple act of walking on campus, eating, or starting a conversation.
Another possibility is the beginning of panic disorder. You said she had a panic attack in PE. Panic attacks can be very frightening and sometimes people develop a fear of having another one. She may be avoiding school because she associates it with panicking. Her fear of having another panic attack makes her more susceptible to having one.
One other possibility is separation anxiety, although this usually appears in younger children. Separation anxiety is the fear of being away from one’s parents. If she has not demonstrated this kind of fear before, it is unlikely separation anxiety.
Cognitive-Behavioral Therapy (CBT) is an effective treatment for social anxiety, panic disorder and separation anxiety. To read more about these anxiety disorders, you can go to adaa.org and click on Anxiety Disorders.
It is important to get her back into school as soon as possible. Easier said than done, however, the longer she avoids going, the worse her anxiety will get. Working with a CBT therapist to help develop a plan to get her back in school would be a good idea .
It is important to rule out any physical cause of her feeling sick, so she should see her pediatrician. It is also important to explore further if something upsetting happened at school that may need to be addressed.
Warm Regards,
Jennifer