Anxiety

The Merriam Webster Dictionary defines anxiety as:

1. apprehensive uneasiness or nervousness usually over an impending, or anticipated ill.

2. medical: an abnormal and overwhelming sense of apprehension and fear often marked by physical signs (such as tension, sweating, and increased pulse rate), by doubt concerning the reality and nature of the threat, and by self-doubt about one’s capacity to cope with it.

An anxiety or panic attack begin all of a sudden without any warning. They can strike at any time and the cause or reason for them may not be known.

Symptoms of an anxiety or panic attack, can include all or some of the following:

Fear or loss of control, flashing vision, hyperventilation, palpitations, chest pain, headache, sweating, shaking, breathlessness, chills, nausea, abdominal cramps, dizzy feeling, and numbness.

We were on a family trip traveling down the Oregon coast, all of us remarking on how beautiful it was and thoroughly enjoying the experience. Out of nowhere Ryan exclaims, “pull over, pull over, pull over!” He was completely hyperventilating and trying to get out of his seat belt, and had an absolute look of terror on his face. I asked him what was wrong and tried to tell him to calm down, which only seemed to make things worse. We finally were able to get the car to the side of the road and got him out of the car. Once we were able to calm him down, we asked him what happened. All he could say is that he didn’t know. He was scared and felt a sense of doom.

This was Ryan’s first of many anxiety attacks that he developed as a teen. We have no idea when or where they will occur and they seem to happen for no apparent reason at the time. However, he had always been an anxious kid. Excessive worry over the smallest things was his MO from a very young age.

Anxiety is one of the many comorbidities of ADHD. (I will address comorbidities in a later post). In brains that are going a million miles an hour, with a lot of input from external and internal stimuli, it’s no wonder that someone like Ryan has difficulty regulating his thoughts to any sense of normalcy. We noticed when Ryan was young, that when he was overstimulated with information, he would “freak out”. He liked things to be clear cut and black and white. He wanted to know what and when we were going to do something, and if anything fell out of that order he would have difficulty expressing himself in a calm way.

With the help of Ryan’s developmental pediatrician and behavior therapists, it was decided that in order to help Ryan manage his anxiety, his father and I had to plan and schedule as much of Ryan’s life out as possible. Doing things on the fly were no longer an option. This worked well of course during the school week and generally on the weekends. But when it came to vacations or summertime, it was very difficult. Even going to Disneyland with friends, he would want to know what rides we’d be going on the next day, and in which order. We did our best to help Ryan understand that not all things could be planned out. Sometimes he was OK with changing directions and other times he wasn’t. And we never knew what would set him off.

As Ryan grew older, his anxiety changed. He learned that he needed to hold in his verbal outbursts around his friends and at school. So when he came home, it ALL came out. Sometimes, his frustration about something didn’t raise its head until the day after something happened. Or he would be upset about something so small, that we had to figure out what really was going on. Sometimes his anxiety was about his schoolwork, or something a friend had said to him. His verbal outbursts at home were so disruptive and painful, that it was difficult being in the same room with him. It was also having an affect on his sleep.

So we went back to the drawing board with his doctor and therapists.  We had him start taking melatonin for sleep and a small dose anti-anxiety medication when Ryan became a teenager.  In family therapy, the therapist helped Ryan and us  to learn tools to help manage his behavior, and also therapy alone for Ryan so that he had someone to talk to without judgment.  Ryan has learned to go with the flow a little better, which is especially helpful in dealing with college life.  And he seems to be handling his anxiety better.  On the other hand, his mother has her own anxiety about her son’s being away at college, but that’s another story all together…….