Friday, July 22, 2011

Separation Anxiety Disorder and Agoraphobia

Separation anxiety is a normal stage of development in babies.  The exact age of its onset and resolution vary with different sources, but in general, it begins at around 8 months and ends at about 18 months but can sometimes last until 36 months of age.

Separation Anxiety Disorder is not the same thing as the normal separation anxiety of babyhood.

Separation Anxiety Disorder is a psychological disorder that involves intense anxiety when the person is separated from home or from someone with whom they have a strong emotional attachment (usually a parent or grandparent).  By “intense anxiety” I don’t mean they simply feel anxious, or fearful at the beginning of the separation.  I mean that the person feels terrified, nauseous, and disoriented by the thought that something may happen to the person they are attached to while they are absent.

My daughter, Laura, has suffered from Separation Anxiety Disorder for as long as she can remember.

Separation Anxiety Disorder affects about 4% of children and about 7% of adults.  The cause is unknown, but is frequently preceded by a traumatic event.  The recommended treatment is cognitive behavioral therapy. 

Anxiety disorders can also be associated with other disorders, as has been the case with Laura.  I reviewed one of these in my post about Tourette Syndrome.

One of the most common manifestations of Separation Anxiety Disorder in children is school avoidance.  Laura struggled with attending school from pre-school through grade school.  We participated in numerous counseling sessions with her over the years that were based on cognitive behavioral therapy, and finally, in middle school she began enjoying going to school.

Yes, that’s right, it took a full 8 years for her to not only be able to attend school without feeling nauseous and scared, but to actually enjoy school.  During those years she underwent numerous hours of counseling, cognitive behavioral therapy, and eventually found some relief with the aid of prescribed medications.  She had a wonderful eighth grade year and was looking forward to high school.

Her anxiety disorder returned with a vengeance during high school, and at the beginning of her sophomore year, she just couldn’t bring herself to attend classes any more.  There was nothing we could say, offer her, withhold from her, or do to convince her to go to school.  She wanted to finish high school and earn a high school diploma, but she insisted that she somehow needed to do it from home.

Online school was just beginning to be an option at that time, and we found an accredited online high school with a good curriculum.  We enrolled her and she began what became a very long journey as well as an emotional roller-coaster.

I won’t go into all the details and timelines, but her experience included not just separation anxiety disorder, but also panic attacks, depression and agoraphobia.  At one point, she couldn’t stand to be more than two blocks from home. 

She continued seeing the Child Psychiatrist that had been treating her since diagnosing her with Tourette Syndrome when she was younger and who monitored and adjusted her medications as needed.  Laura also regularly met with wonderful licensed clinical social worker who was a tremendous help to her.  The counselor started seeing Laura when the agoraphobia was at its worst and was willing to come to our house until Laura was able to travel the few miles to her office.

Unfortunately, the medications had side effects, including weight gain and a lack of interest in accomplishing anything.  Apparently, the medications that lessen her anxiety also reduce her ambition and her drive to achieve.  Completing online classes without set deadlines for submitting assignments became a huge challenge.  (Note:  many public schools now offer online classes that follow the same schedule and deadlines as regular classes)

But Laura kept working at her schoolwork little by little, sometimes just one class at a time, until spring of this year when she finally finished the requirements for her high school diploma.

We are so proud of her! 

She’s taking a break from school now and working on her artwork and her Etsy business.  This has been some really personal stuff, and I want to thank Laura for allowing me to share these experiences.

Cindy

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