Looking for advice for a teenager on managing anxiety in the mornings
October 11, 2023 11:19 AM Subscribe
A family member aged 16 is having difficulty with anxiety in the mornings. They are newly at college so going through a lot of changes. They feel anxious getting up, during the journey to college and on arriving at college, to the point where they sometimes retch. Some of the usual strategies such as sitting with the feelings are hard to manage when they are in a rush in the morning. They have had some counselling already and are on a waiting list for more. What could they try? They may read responses to this question. Thanks.
during the journey to college
Long shot thought: how are they getting to college? Train? Bus? Car? I developed some train-based claustrophobia mostly out of nowhere several years ago, and it was its worst when I was commuting to work in a rush. My anxiety manifests itself through my stomach, which only compounded the I'm stuck on a train with no exit problem.
The school may just be a coincidence.
posted by phunniemee at 11:34 AM on October 11, 2023
Long shot thought: how are they getting to college? Train? Bus? Car? I developed some train-based claustrophobia mostly out of nowhere several years ago, and it was its worst when I was commuting to work in a rush. My anxiety manifests itself through my stomach, which only compounded the I'm stuck on a train with no exit problem.
The school may just be a coincidence.
posted by phunniemee at 11:34 AM on October 11, 2023
Do they have to be a full-time student for some reason?
I would just drop several classes and see if that doesn't solve the issue. This isn't a race, and they would likely learn better with a half time course load anyway. And that would still put them 'ahead' of the people on the more common schedule.
posted by SaltySalticid at 11:40 AM on October 11, 2023 [11 favorites]
I would just drop several classes and see if that doesn't solve the issue. This isn't a race, and they would likely learn better with a half time course load anyway. And that would still put them 'ahead' of the people on the more common schedule.
posted by SaltySalticid at 11:40 AM on October 11, 2023 [11 favorites]
It sounds silly maybe but you know how papers have crosswords and sudokus and jumbles? Doing them in the morning during a commute on public transportation was a total lifesaver for me when I was dealing with anxiety in college. For your family member, maybe something like a game with daily completion tasks, or a sudoku book, or the NYT crossword app might work. Also games like Tetris or more complex forms of solitaire could work.
Basically, you want to find something that captures most of your attention but that you can do while kind of still waking up in the mornings. Nothing that if you mess up there would be consequences, and something predictably available in a new form each day. It keeps your mind from ruminating and helps keep your breath more normal and your hands busy with something non-destructive.
I do also think that 16 for college is awful young, unless this is actually highschool and you’re using non-US terminology. College would have been an enormous challenge for me at 16, even though academically I would have been great (probably better than when I actually attended!) Are they still living with family? Some more structure and involvement from adults might be a good idea for the first year.
Think through breakfast - are they eating something or some way that triggers an upset stomach? Maybe they could leave a little earlier and eat a packed breakfast on campus, or try to eat more slowly at home. Small changes like coffee to tea can make a big difference too. I wouldn’t focus too hard on the food thing, since that can easily slide into anxiety territory all on its own, but if they don’t make headway on the anxiety angle, look to the digestive angle.
posted by Mizu at 11:45 AM on October 11, 2023 [3 favorites]
Basically, you want to find something that captures most of your attention but that you can do while kind of still waking up in the mornings. Nothing that if you mess up there would be consequences, and something predictably available in a new form each day. It keeps your mind from ruminating and helps keep your breath more normal and your hands busy with something non-destructive.
I do also think that 16 for college is awful young, unless this is actually highschool and you’re using non-US terminology. College would have been an enormous challenge for me at 16, even though academically I would have been great (probably better than when I actually attended!) Are they still living with family? Some more structure and involvement from adults might be a good idea for the first year.
Think through breakfast - are they eating something or some way that triggers an upset stomach? Maybe they could leave a little earlier and eat a packed breakfast on campus, or try to eat more slowly at home. Small changes like coffee to tea can make a big difference too. I wouldn’t focus too hard on the food thing, since that can easily slide into anxiety territory all on its own, but if they don’t make headway on the anxiety angle, look to the digestive angle.
posted by Mizu at 11:45 AM on October 11, 2023 [3 favorites]
Identitying exactly what they're anxious about can help. Specific classes, social stuff, general failure, etc. If they can identify it, it will be easier to identify strategies to counteract it.
If it's more a general sense of dread/ fear, with no specific focus, biology is more likely to be coming into play, as others have mentioned above. Food, caffeine, an uncooperative sleep cycle, a fast heart rate, medical issues, etc. are worth looking at.
posted by metasarah at 11:47 AM on October 11, 2023 [3 favorites]
If it's more a general sense of dread/ fear, with no specific focus, biology is more likely to be coming into play, as others have mentioned above. Food, caffeine, an uncooperative sleep cycle, a fast heart rate, medical issues, etc. are worth looking at.
posted by metasarah at 11:47 AM on October 11, 2023 [3 favorites]
I think the term "college" is probably not what US posters are thinking of when answering here. Since they are 16 and poster is UK, it is more like the end of high school years in US before they go to "university". So it may not have the same option (taking a lighter semester, having flexibility).
posted by maxg94 at 11:48 AM on October 11, 2023 [15 favorites]
posted by maxg94 at 11:48 AM on October 11, 2023 [15 favorites]
Regular exercise regulates anxiety, which is a long-term solution.
In the short term, I know from personal experience that a short, intense workout will calm me down and dissipate the stress hormones—it gives them something to do other than circulate in my bloodstream and drive me up the wall.
I’d suggest a short trial, like a week, of waking up and exercising (cardio, strength, walking, whatever floats her boat) 10-30 min in the morning and see if it makes her feel any better.
posted by telophase at 12:11 PM on October 11, 2023 [5 favorites]
In the short term, I know from personal experience that a short, intense workout will calm me down and dissipate the stress hormones—it gives them something to do other than circulate in my bloodstream and drive me up the wall.
I’d suggest a short trial, like a week, of waking up and exercising (cardio, strength, walking, whatever floats her boat) 10-30 min in the morning and see if it makes her feel any better.
posted by telophase at 12:11 PM on October 11, 2023 [5 favorites]
Response by poster: Yes, sixth-form college, thanks maxg94.
posted by paduasoy at 12:15 PM on October 11, 2023 [2 favorites]
posted by paduasoy at 12:15 PM on October 11, 2023 [2 favorites]
If I was 16 and had anxiety and I came to this thread, I’d have more anxiety.
Already there is the pressure of measuring up in terms of schooling and exams. Maybe the work is harder than it used to be. Maybe I feel like I’m failing. Now I come to this thread and see that I sleep wrong, eat wrong, exercise wrong, don’t try hard enough for counseling, and otherwise fail to measure up. That’s a lot!!
First thing this teen needs is love and support. Make it clear that it’s ok not to be ok and that you love them for who they are, not what they do. Do something fun, go on an outing.
Next, put your teen in charge. Ask them if they want to talk about this with you. Ask them if they even want you to help. If your offer to help is accepted, ask your teen what exactly it is about the situation that they’d like to change, brainstorm problems and solutions to that aspect, and discuss if any follow up is necessary. Your teen is in charge.
Dear teen: if you are reading, ask the poster to consolidate this narrative to a short bullet list of suggestions. Try one or two if you’d like. If you’d rather work on something else besides morning anxiety, or perhaps do nothing right now, that’s ok! You are loved just the way you are.
posted by shock muppet at 12:38 PM on October 11, 2023 [7 favorites]
Already there is the pressure of measuring up in terms of schooling and exams. Maybe the work is harder than it used to be. Maybe I feel like I’m failing. Now I come to this thread and see that I sleep wrong, eat wrong, exercise wrong, don’t try hard enough for counseling, and otherwise fail to measure up. That’s a lot!!
First thing this teen needs is love and support. Make it clear that it’s ok not to be ok and that you love them for who they are, not what they do. Do something fun, go on an outing.
Next, put your teen in charge. Ask them if they want to talk about this with you. Ask them if they even want you to help. If your offer to help is accepted, ask your teen what exactly it is about the situation that they’d like to change, brainstorm problems and solutions to that aspect, and discuss if any follow up is necessary. Your teen is in charge.
Dear teen: if you are reading, ask the poster to consolidate this narrative to a short bullet list of suggestions. Try one or two if you’d like. If you’d rather work on something else besides morning anxiety, or perhaps do nothing right now, that’s ok! You are loved just the way you are.
posted by shock muppet at 12:38 PM on October 11, 2023 [7 favorites]
For your family member, maybe something like a game with daily completion tasks, or a sudoku book, or the NYT crossword app might work. Also games like Tetris or more complex forms of solitaire could work.
Listening to music can also help me get background anxiety down to a more manageable level.
Breathing exercises sometimes also help. Especially if I've been practicing them in non-anxious times - they're easier to do in the peak anxiety moments then.
How do they feel the rest of the day, though? Do they like school? How do they feel about the other kids, the teachers, their academic performance, their social life, etc.? Do they feel like they can talk about it? Sometimes anxiety is caused by health stuff, which is worth checking out, but sometimes it's related to specific things going on in your life. Besides counseling (which, are there additional counselors whose waiting lists you can get on? Private ones for a quicker shorter wait?), are there any specific anxiety-producing factors in their life that can be changed or addressed in any way?
Do they have time to de-stress outside of school? How often do they get to do things they really enjoy? How often to they get to feel really relaxed?
posted by trig at 12:56 PM on October 11, 2023
Listening to music can also help me get background anxiety down to a more manageable level.
Breathing exercises sometimes also help. Especially if I've been practicing them in non-anxious times - they're easier to do in the peak anxiety moments then.
How do they feel the rest of the day, though? Do they like school? How do they feel about the other kids, the teachers, their academic performance, their social life, etc.? Do they feel like they can talk about it? Sometimes anxiety is caused by health stuff, which is worth checking out, but sometimes it's related to specific things going on in your life. Besides counseling (which, are there additional counselors whose waiting lists you can get on? Private ones for a quicker shorter wait?), are there any specific anxiety-producing factors in their life that can be changed or addressed in any way?
Do they have time to de-stress outside of school? How often do they get to do things they really enjoy? How often to they get to feel really relaxed?
posted by trig at 12:56 PM on October 11, 2023
You could be describing me in high school. My problem was being startled out of sleep and the resulting sky-high cortisol and adrenaline making me feel anxious and pukey. Having to rush to get ready for school and rush to get there didn’t help either.
See if getting up earlier than needed so they can have a peaceful morning would help, I need an hour padding to wake up gradually and unhurriedly but even a half half helps. Use a gentle graduated alarm rather than a heart-stopping startling one. Look into strategies for calming the nervous system they can learn and implement throughout the day to help them stay regulated.
And please don’t make them eat, I always threw up from too much cortisol and adrenaline and being forced to eat or drink meal replacement shakes just made me even more stressed out. Pack them some beef jerky or a granola bar and let them eat when their system has calmed down.
posted by stellaluna at 1:15 PM on October 11, 2023 [10 favorites]
See if getting up earlier than needed so they can have a peaceful morning would help, I need an hour padding to wake up gradually and unhurriedly but even a half half helps. Use a gentle graduated alarm rather than a heart-stopping startling one. Look into strategies for calming the nervous system they can learn and implement throughout the day to help them stay regulated.
And please don’t make them eat, I always threw up from too much cortisol and adrenaline and being forced to eat or drink meal replacement shakes just made me even more stressed out. Pack them some beef jerky or a granola bar and let them eat when their system has calmed down.
posted by stellaluna at 1:15 PM on October 11, 2023 [10 favorites]
What exactly is their anxiety about? Are they worried they will not arrive on time? Are they afraid of school work? Are they worried they will fail? Of messing up, of falling behind? Or is it about a fear of making a fool of themselves by doing something wrong in the new environment? Are they dreading a particular teacher or perhaps a bully? This is Step Zero of helping the teenager deal. You have to take the fear behind the anxiety seriously and actually try to solve the problem first.
Once you have done that, some level of free-floating anxiety still probably will remain, so you can try the following (written under the assumption that the teen's problem was a fear of failure or difficult classwork - modify as needed):
- with the help of a trusted adult like a parent or mentor, the teenager can be led through a visualization exercise imagining themselves going through the commute and the first few hours of classes, with the leader planting affirmations such as "whatever difficulties may arise, I am capable of handling it all". Do this repeatedly, once or twice a day, about 10-15 minutes each time, for a week or two and see how it goes!
- the teenager can be helped to practice breathing through their worries and anxieties, helped to notice anxious feelings in the body as they come up and deliberately focusing on inhale-exhale, leading to physical calm. (Which leads to emotional calm.)
- the teenager can be asked to talk through what's worrying them to a trusted adult such as a parent or mentor, who will take care not to let the teenager spiral off into anxious catastrophizing, but skillfully head the spiraling off towards reassurance and reminders of how the teenager has successfully handled these challenges in prior years
- maybe the teenager can be driven to school for a week or two by a parent, someone who the teen trusts? Just to head off the anxious build up during their commute, and help to reset the teen's experience of the beginning of their day with a few excellent starts to the school day
posted by MiraK at 1:34 PM on October 11, 2023
Once you have done that, some level of free-floating anxiety still probably will remain, so you can try the following (written under the assumption that the teen's problem was a fear of failure or difficult classwork - modify as needed):
- with the help of a trusted adult like a parent or mentor, the teenager can be led through a visualization exercise imagining themselves going through the commute and the first few hours of classes, with the leader planting affirmations such as "whatever difficulties may arise, I am capable of handling it all". Do this repeatedly, once or twice a day, about 10-15 minutes each time, for a week or two and see how it goes!
- the teenager can be helped to practice breathing through their worries and anxieties, helped to notice anxious feelings in the body as they come up and deliberately focusing on inhale-exhale, leading to physical calm. (Which leads to emotional calm.)
- the teenager can be asked to talk through what's worrying them to a trusted adult such as a parent or mentor, who will take care not to let the teenager spiral off into anxious catastrophizing, but skillfully head the spiraling off towards reassurance and reminders of how the teenager has successfully handled these challenges in prior years
- maybe the teenager can be driven to school for a week or two by a parent, someone who the teen trusts? Just to head off the anxious build up during their commute, and help to reset the teen's experience of the beginning of their day with a few excellent starts to the school day
posted by MiraK at 1:34 PM on October 11, 2023
If the 16 year old is having anxiety attacks to the point where they are throwing up, then this is a LOT more serious than some posters understand.
This is doctor level stuff, and you should take them out of school until you get in to see a doctor, and then advocate like hell for them. Do not minimize what is happening, there is no reason why someone should have to suffer like this at the beginning of their life, and I would go so far as to say that forcing someone to go to school while having a panic attack is abuse. Getting treatment for this is more important than school and that would be obvious to people if they understood what the stakes can be.
I started having panic and anxiety attacks at 23 years of age (including the sudden feeling like I would throw up), which is a little older, but it's not like that's when the problem REALLY started. Really I'd been "dealing" with it for years, on my own. If I had gone to the doctor in 1997 and gotten professional help then the trajectory of my life might have been much different. Instead, I thought that it was up to me alone to "figure out" what was wrong and/or hide it from everyone. Eventually I developed agoraphobia and didn't leave my house except to go to the liquor store for over 10 years.
The tragedy of that is that this is very, very treatable, there is no need for anyone to suffer from this, there is all kinds of help out there. I'm currently on a tiny dose of an SSRI and I do professional therapy about once a month now. I also have access to a community of people who have some overlapping experiences and with whom I feel safe. That was a very important piece of the recovery puzzle for me and helped me feel like I was not uniquely broken. I'm willing to talk with you about it paduasoy, or even with the 16 year old in question, just MeMail me.
posted by Horkus at 2:08 PM on October 11, 2023 [8 favorites]
This is doctor level stuff, and you should take them out of school until you get in to see a doctor, and then advocate like hell for them. Do not minimize what is happening, there is no reason why someone should have to suffer like this at the beginning of their life, and I would go so far as to say that forcing someone to go to school while having a panic attack is abuse. Getting treatment for this is more important than school and that would be obvious to people if they understood what the stakes can be.
I started having panic and anxiety attacks at 23 years of age (including the sudden feeling like I would throw up), which is a little older, but it's not like that's when the problem REALLY started. Really I'd been "dealing" with it for years, on my own. If I had gone to the doctor in 1997 and gotten professional help then the trajectory of my life might have been much different. Instead, I thought that it was up to me alone to "figure out" what was wrong and/or hide it from everyone. Eventually I developed agoraphobia and didn't leave my house except to go to the liquor store for over 10 years.
The tragedy of that is that this is very, very treatable, there is no need for anyone to suffer from this, there is all kinds of help out there. I'm currently on a tiny dose of an SSRI and I do professional therapy about once a month now. I also have access to a community of people who have some overlapping experiences and with whom I feel safe. That was a very important piece of the recovery puzzle for me and helped me feel like I was not uniquely broken. I'm willing to talk with you about it paduasoy, or even with the 16 year old in question, just MeMail me.
posted by Horkus at 2:08 PM on October 11, 2023 [8 favorites]
I asked this question that might help.
Over the years I've figured out some other elements.
It helps me to leave the house right away. Trying to treat the anxiety first and then start the day is a bad idea.
I have sleep apnea and now use a cpap, both of which play a part in anxiety after sleep. With sleep apnea I sleep with my mouth open and therefore swallow a lot of air, which is also part of using cpap and being pumped full of air all night. It took a long time for me to realize that part of my anxiety was related to having gas from all that air. The quicker I address that, the better.
Finally, I sometimes deal with sleep inertia, which is that period of feeling gross between waking up and really feeling awake. Because that time makes me anxious, I had been skipping coffee--but it turns out that having coffee to finish waking up is really helpful for those times.
Sometimes I think the hardest part is anticipating the morning anxiety / focusing on dealing with it.
NAD and ymmv, but those have provided some help with a cruel problem that affects a lot of people.
posted by mermaidcafe at 2:50 PM on October 11, 2023
Over the years I've figured out some other elements.
It helps me to leave the house right away. Trying to treat the anxiety first and then start the day is a bad idea.
I have sleep apnea and now use a cpap, both of which play a part in anxiety after sleep. With sleep apnea I sleep with my mouth open and therefore swallow a lot of air, which is also part of using cpap and being pumped full of air all night. It took a long time for me to realize that part of my anxiety was related to having gas from all that air. The quicker I address that, the better.
Finally, I sometimes deal with sleep inertia, which is that period of feeling gross between waking up and really feeling awake. Because that time makes me anxious, I had been skipping coffee--but it turns out that having coffee to finish waking up is really helpful for those times.
Sometimes I think the hardest part is anticipating the morning anxiety / focusing on dealing with it.
NAD and ymmv, but those have provided some help with a cruel problem that affects a lot of people.
posted by mermaidcafe at 2:50 PM on October 11, 2023
My kid has severe school avoidance anxiety and has managed a total of 9 days in school this year, although last year was much better. Our approach is: early sleep and early wake, about 3 hours ahead of the start of school. Routine is written down by teen and decided by them, not imposed. Mine likes to eat slowly with an iPad, then get dressed. Schoolbag is packed night before to reduce stress there. Going to school is either early or late to avoid other kids. I walk or commute with them.
Does that work? Partially. What really worked was an understanding school that allowed my kid to come in late with all teachers knowing to say nothing about it, but be blandly neutral (no praise, no criticism), a friendly security guard who was always cheerful so going into school was ok (mine required check in) and making sure it’s treated matter of fact and we do things as low stress as possible.
Also Xanax. I use half the smallest dose and it’s made end of year exams possible for my kid. Given with breakfast or a glass of milk. When her doctor first proposed it, I felt really hesitant because Xanax! But the dosage is tiny so it’s just a couple of hours where she feels calm enough to handle school. You can’t use it continuously so it is more for big days like exams and first days of term. Mine may use it on Mondays going forward until school feels more manageable.
Google school avoidance anxiety - if you’re in the UK there’s parent support specifically for this and your teen can chat with other kids who have this. It’s a specific form of social anxiety and the best treatments now are meds, therapy and an understanding school. Feel free to memail me.
posted by dorothyisunderwood at 4:48 PM on October 11, 2023 [2 favorites]
Does that work? Partially. What really worked was an understanding school that allowed my kid to come in late with all teachers knowing to say nothing about it, but be blandly neutral (no praise, no criticism), a friendly security guard who was always cheerful so going into school was ok (mine required check in) and making sure it’s treated matter of fact and we do things as low stress as possible.
Also Xanax. I use half the smallest dose and it’s made end of year exams possible for my kid. Given with breakfast or a glass of milk. When her doctor first proposed it, I felt really hesitant because Xanax! But the dosage is tiny so it’s just a couple of hours where she feels calm enough to handle school. You can’t use it continuously so it is more for big days like exams and first days of term. Mine may use it on Mondays going forward until school feels more manageable.
Google school avoidance anxiety - if you’re in the UK there’s parent support specifically for this and your teen can chat with other kids who have this. It’s a specific form of social anxiety and the best treatments now are meds, therapy and an understanding school. Feel free to memail me.
posted by dorothyisunderwood at 4:48 PM on October 11, 2023 [2 favorites]
Tiny thing, but, if they take morning vitamins, they could try taking them in the evening instead. Vitamins make me nauseous and being nauseous worsens any anxiety I'm feeling.
posted by nouvelle-personne at 6:35 PM on October 11, 2023
posted by nouvelle-personne at 6:35 PM on October 11, 2023
I'm late here, but this hits home for me, including the retching from anxiety. I (now much older) puked copiously before my first college interview (surprise, the interview didn't go so well). I think that it is hard for people to understand JUST HOW BAD the anxiety can be. This isn't "get in better shape and drink less coffee" kind of stuff, this is some serious illness that his honestly debilitating. Everyone experiences anxiety to some degree, but it can become malignant.
I know a lot of people hate psych drugs, and I resisted for years (just more willpower, just more meditation, just more exercise and I'd be FINE). Self-medication works for a while until it doesn't. I finally had a doctor (a neurologist, who I saw for unrelated reasons who could see the "amped-upedness" in my physical reflexes) say that I needed medication like a diabetic needs insulin. This was without anxiety having been brought up at all -- he noticed it in a physical exam, and of course my demeanor.
My life now is 1000x better. I still suffer from the anxiety, but I can manage it. I'm more present for my family. I'm more present at my job. Therapy works better when I'm not in constant high-alert mode. I can have a laugh once in a while
Don't hesitate to reach out, OP. I didn't "lose" anything, because whatever you experience is valuable, but I would have a much different, socially richer, much less uncomfortable, young adulthood with properly supervised meds. Although I would have read fewer books, so who knows... ;-)
posted by nixxon at 7:59 PM on October 11, 2023 [5 favorites]
I know a lot of people hate psych drugs, and I resisted for years (just more willpower, just more meditation, just more exercise and I'd be FINE). Self-medication works for a while until it doesn't. I finally had a doctor (a neurologist, who I saw for unrelated reasons who could see the "amped-upedness" in my physical reflexes) say that I needed medication like a diabetic needs insulin. This was without anxiety having been brought up at all -- he noticed it in a physical exam, and of course my demeanor.
My life now is 1000x better. I still suffer from the anxiety, but I can manage it. I'm more present for my family. I'm more present at my job. Therapy works better when I'm not in constant high-alert mode. I can have a laugh once in a while
Don't hesitate to reach out, OP. I didn't "lose" anything, because whatever you experience is valuable, but I would have a much different, socially richer, much less uncomfortable, young adulthood with properly supervised meds. Although I would have read fewer books, so who knows... ;-)
posted by nixxon at 7:59 PM on October 11, 2023 [5 favorites]
First thing I would do is make sure their sleeping area is well- ventilated and absolutely free of carbon monoxide — which could also be an issue during their ride to school.
Because if they have a lot of CO2 in their blood when they wake up, that will make it more acid, and blood acidity can trigger an anxiety attack all by itself:
Because if they have a lot of CO2 in their blood when they wake up, that will make it more acid, and blood acidity can trigger an anxiety attack all by itself:
Uncued panic may arise due to homeostatic imbalance in pH in the brain and internal milieu. Acidosis ‘sensed' by chemosensory mechanisms may be translated to autonomic, behavioral and respiratory symptoms of a panic attack.posted by jamjam at 8:01 PM on October 11, 2023 [3 favorites]
A lot of great advice above. A few other things to consider -- habitually avoiding the thing that causes anxiety reinforces the feeling of anxiety associated with that thing. It sucks doesn't it? I don't want to say that this is a "it'll just go away if they keeping going to school" kind of thing, but avoiding it doesn't help.
I sometimes re-frame my physical feelings of anxiety. I imagine that I am... some wildly confident person going on stage and that person might experience the same physical feelings as anticipation, getting excited, being amped up etc. etc. instead of interpreting them as anxiety/fear-related. This helps a little bit in recognizing the physical feelings for what they are, somewhat separately from the meaning I assign to them.
Sometimes I do some CBT-type techniques. What am I anxious about? I'll have a terrible day at work. What is the evidence that I'll have a bad day? Have I ever felt anxious but didn't have a bad day? Do I really know that I'll have a bad day? And even if I have a bad day, what is literally the worst that can happen? And, ok, if that is the worst that could happen, could I manage through that? I've found "The Worry Cure" to be a good book for this.
Lastly, I did find a WORLD of difference getting on prescription medication. The rest of the techniques were managing my physical feelings, but medication has been able to actually reduce the frequency/severity of those physical feelings, so it's WAY easier to do all the mental techniques b/c your body is not shouting at you at the same time.
posted by ellerhodes at 5:45 AM on October 12, 2023 [2 favorites]
I sometimes re-frame my physical feelings of anxiety. I imagine that I am... some wildly confident person going on stage and that person might experience the same physical feelings as anticipation, getting excited, being amped up etc. etc. instead of interpreting them as anxiety/fear-related. This helps a little bit in recognizing the physical feelings for what they are, somewhat separately from the meaning I assign to them.
Sometimes I do some CBT-type techniques. What am I anxious about? I'll have a terrible day at work. What is the evidence that I'll have a bad day? Have I ever felt anxious but didn't have a bad day? Do I really know that I'll have a bad day? And even if I have a bad day, what is literally the worst that can happen? And, ok, if that is the worst that could happen, could I manage through that? I've found "The Worry Cure" to be a good book for this.
Lastly, I did find a WORLD of difference getting on prescription medication. The rest of the techniques were managing my physical feelings, but medication has been able to actually reduce the frequency/severity of those physical feelings, so it's WAY easier to do all the mental techniques b/c your body is not shouting at you at the same time.
posted by ellerhodes at 5:45 AM on October 12, 2023 [2 favorites]
The last thing I would add on reframing the feelings is saying to myself -- things that are new and likely makes me grow as a person probably will feel a little anxiety-inducing b/c I am doing something new and meaningful and I want it to go well. The fact that I feel anxious is actually expected/normal and is a sign that I am on the right track.
posted by ellerhodes at 5:48 AM on October 12, 2023 [1 favorite]
posted by ellerhodes at 5:48 AM on October 12, 2023 [1 favorite]
I am sorry to hear about your child's struggles. I dealt with terrible anxiety from around the age of 10 till I was an adult. It was a chronic feeling of battery acid in my stomach, with occasional week or month long acute stretches (continuous nausea, retching and vomiting, loose bowels, dizziness, difficult concentrating, compulsive behaviours). On reflection, I think I had a clinically significant case of obsessive-compulsive disorder without any obvious behavioural component, so it wasn't picked up. There was less awareness about anxiety and childhood disorders at the time so not a surprise it wasn't.
I recall from an early age being very scared that there was something desperately wrong with me and that everyone else could tell. The actual thing I was worrying about wasn't particularly material. The real problem was this underlying feeling of being "wrong". Puberty only added to the number of things I had to worry about; more things to feel guilty about ("your sexual desires are wrong", "no-one will find you attractive", "other people are better than you", etc.)
As an adult, I have dealt with other psychological issues that cluster with OCD and anxiety (depression, alcoholism, ADHD). This has all involved a great deal of work.
I am not sure I have any easy advice on this. It took me a long time to deal with this. I have dealt with it, but I also have to re-deal with it on a daily basis. I am ok with that and find I am in a better position than those who do not do the work.
I have written down a bunch of thoughts below. Much of it based on things I learned since I was that age. A lot of it is probably me projecting. Some of it is easily actionable, some is more big picture. I hope that something in there is useful.
1. First, make sure you have tried to ask your child there is any specific, obvious underlying issue. Is someone bullying them? Is someone threatening them? Is someone manipulating or blackmailing them? Is there some specific problem they feel worried or ashamed or guilty about? I am sorry to say that terrible things happen to the most unassuming young people. Children can hide things if they feel they have to. Reassure them that there is nothing they could possibly do to make you love them less, and that you only want to know so you can help them feel better.
2. If there is nothing like this, I would then try to reassure them. There is nothing wrong with these feelings. These feelings are normal. There is nothing wrong with them for having these feelings. They will not last forever. Life gets better. Things get better. This is a difficult age, but one day they will no longer be troubled by the things that worry them, and they will be happy with themselves.
3. On the off chance that they are feeling guilty about something. I am reminded about something my therapist said to me when I was 15. "I have worked with a lot of criminals. People who do bad things aren't like you. They don't feel bad about it. Only the good people worry." I still take comfort from that.
4. I use tools from CBT and find them extremely helpful. There's a lot there but I find that recognising my "unhelpful thinking habits" in the moment will take the edge off the worst fears.
5. I am also particularly fond of the feelings wheel (there are many versions, I like this one because it focusses more space on the negatives). When emotions are intense and coming in a big jumble, they can be overwhelming and distracting. The simple act of breaking down and expressing what I am feeling helps me to process it. You can do it in your head just by looking at the wheel, but I like to combine it with writing.
"I am feeling [x] because of [y]"
6. When I was at school, I struggled on a social level. I didn't have confidence in myself, or my ability to engage with others. I did not realise that the point of living was not to be acceptable to as many people as possible. So I did not develop a strong sense of myself. I just knew that whatever I did, it would be unacceptable to someone. I said the wrong things, I was not dressed well, I had bad hair, I had the wrong ideas. Other people were a scary mystery. They all seemed to have been issued a secret handbook on how to be, and I had no clue.
7. What made it worse is that school was a small and intense environment where you regularly come into contact with people who might not like you, and who don't have the tact to keep that to themselves. At university and beyond, there is more opportunity to find your niche sub-culture and be your best self without judgement. But that is a very long way off when you are 16.
8. Everyone else may look like they know what they are doing. But I later discovered that everyone else was struggling in their own way. I did not need to compare my failures to their seeming successes; this was unhelpful and untrue.
9. I found developing my sense of identity helped. I am embarrassed to say that it took me until my 30s to jettison the idea that I needed to be acceptable to all people. I eventually worked out that pretending to be someone I wasn't was exhausting and anxiety inducing ("What if I am found out?"). Honesty served me better. So I began to focus on discovering and being myself. Developing a real sense of who I was and what I wanted made a huge difference. It was like placing a rigid structure within me, helping me finally bear the pressure from the world around me. So what if other people don't like me? I like myself. And it turned out, more than enough people liked the real me as well.
10. I started by exploring new things and following what I enjoyed. Others have mentioned exercise, and I found sport a great help. Something with a structure, a schedule, short/medium/long term goals. It was a healthy distraction, but also gave me a sense of pride and identity. It was also an opportunity to make friends with people who were interested in the same thing. Creative practices are also good ones for this (art, writing, music, etc).
11. One other thought: as a parent, it's great that you are taking an interest and trying to help. Just be mindful that there is a limit to how much of this you can fix for your child. Unfortunately, the project of being ok with oneself lasts a lifetime, and you cannot shoulder the burden for them, however distressing it is to see that your child is unhappy. We all have to learn to do this work for ourselves. So be a support, take an interest, offer whatever help they are willing to take, but whatever you do: try not to add your fears and anxiety about their wellbeing to their burden, and double check that you aren't trying to micromanage their inner lives. They are much more likely to come to you in due course if they feel you will respect their boundaries, particularly as they try to establish their own separate identity as an individual (rather than being an annex to the parent).
posted by Probabilitics at 6:23 AM on October 12, 2023 [2 favorites]
I recall from an early age being very scared that there was something desperately wrong with me and that everyone else could tell. The actual thing I was worrying about wasn't particularly material. The real problem was this underlying feeling of being "wrong". Puberty only added to the number of things I had to worry about; more things to feel guilty about ("your sexual desires are wrong", "no-one will find you attractive", "other people are better than you", etc.)
As an adult, I have dealt with other psychological issues that cluster with OCD and anxiety (depression, alcoholism, ADHD). This has all involved a great deal of work.
I am not sure I have any easy advice on this. It took me a long time to deal with this. I have dealt with it, but I also have to re-deal with it on a daily basis. I am ok with that and find I am in a better position than those who do not do the work.
I have written down a bunch of thoughts below. Much of it based on things I learned since I was that age. A lot of it is probably me projecting. Some of it is easily actionable, some is more big picture. I hope that something in there is useful.
1. First, make sure you have tried to ask your child there is any specific, obvious underlying issue. Is someone bullying them? Is someone threatening them? Is someone manipulating or blackmailing them? Is there some specific problem they feel worried or ashamed or guilty about? I am sorry to say that terrible things happen to the most unassuming young people. Children can hide things if they feel they have to. Reassure them that there is nothing they could possibly do to make you love them less, and that you only want to know so you can help them feel better.
2. If there is nothing like this, I would then try to reassure them. There is nothing wrong with these feelings. These feelings are normal. There is nothing wrong with them for having these feelings. They will not last forever. Life gets better. Things get better. This is a difficult age, but one day they will no longer be troubled by the things that worry them, and they will be happy with themselves.
3. On the off chance that they are feeling guilty about something. I am reminded about something my therapist said to me when I was 15. "I have worked with a lot of criminals. People who do bad things aren't like you. They don't feel bad about it. Only the good people worry." I still take comfort from that.
4. I use tools from CBT and find them extremely helpful. There's a lot there but I find that recognising my "unhelpful thinking habits" in the moment will take the edge off the worst fears.
5. I am also particularly fond of the feelings wheel (there are many versions, I like this one because it focusses more space on the negatives). When emotions are intense and coming in a big jumble, they can be overwhelming and distracting. The simple act of breaking down and expressing what I am feeling helps me to process it. You can do it in your head just by looking at the wheel, but I like to combine it with writing.
"I am feeling [x] because of [y]"
6. When I was at school, I struggled on a social level. I didn't have confidence in myself, or my ability to engage with others. I did not realise that the point of living was not to be acceptable to as many people as possible. So I did not develop a strong sense of myself. I just knew that whatever I did, it would be unacceptable to someone. I said the wrong things, I was not dressed well, I had bad hair, I had the wrong ideas. Other people were a scary mystery. They all seemed to have been issued a secret handbook on how to be, and I had no clue.
7. What made it worse is that school was a small and intense environment where you regularly come into contact with people who might not like you, and who don't have the tact to keep that to themselves. At university and beyond, there is more opportunity to find your niche sub-culture and be your best self without judgement. But that is a very long way off when you are 16.
8. Everyone else may look like they know what they are doing. But I later discovered that everyone else was struggling in their own way. I did not need to compare my failures to their seeming successes; this was unhelpful and untrue.
9. I found developing my sense of identity helped. I am embarrassed to say that it took me until my 30s to jettison the idea that I needed to be acceptable to all people. I eventually worked out that pretending to be someone I wasn't was exhausting and anxiety inducing ("What if I am found out?"). Honesty served me better. So I began to focus on discovering and being myself. Developing a real sense of who I was and what I wanted made a huge difference. It was like placing a rigid structure within me, helping me finally bear the pressure from the world around me. So what if other people don't like me? I like myself. And it turned out, more than enough people liked the real me as well.
10. I started by exploring new things and following what I enjoyed. Others have mentioned exercise, and I found sport a great help. Something with a structure, a schedule, short/medium/long term goals. It was a healthy distraction, but also gave me a sense of pride and identity. It was also an opportunity to make friends with people who were interested in the same thing. Creative practices are also good ones for this (art, writing, music, etc).
11. One other thought: as a parent, it's great that you are taking an interest and trying to help. Just be mindful that there is a limit to how much of this you can fix for your child. Unfortunately, the project of being ok with oneself lasts a lifetime, and you cannot shoulder the burden for them, however distressing it is to see that your child is unhappy. We all have to learn to do this work for ourselves. So be a support, take an interest, offer whatever help they are willing to take, but whatever you do: try not to add your fears and anxiety about their wellbeing to their burden, and double check that you aren't trying to micromanage their inner lives. They are much more likely to come to you in due course if they feel you will respect their boundaries, particularly as they try to establish their own separate identity as an individual (rather than being an annex to the parent).
posted by Probabilitics at 6:23 AM on October 12, 2023 [2 favorites]
I apologise if this is me perhaps overidentifying with your family member. I too developed very severe anxiety when I hit sixth form college. Looking back, I am entirely sure that much of it was due to losing all the support structures that allowed me to cope with my undiagnosed ADHD. While CBT, medication and time helped a great deal, being diagnosed with ADHD and getting medication was life changing. I went from dropping out of university with suicidal ideation to getting a first class degree. Perhaps an assessment for any learning disorders would be worthwhile? The college should be able to help with that.
posted by In Your Shell Like at 7:34 AM on October 12, 2023 [2 favorites]
posted by In Your Shell Like at 7:34 AM on October 12, 2023 [2 favorites]
Hello family member. I struggled a lot at school and college (UK). When people asked me the normal triage sort of questions (‘is anyone bullying you?’ etc, as above) I was confused and distressed because there didn’t seem to be anything wrong, I was just broken, I wasn’t functioning in the way people expected of me, and I couldn’t explain why.
I’ll be honest, I don’t know what would have helped me at the time, except for not being punished so much by staff at school and college for not being a good student. This is of course a story of ‘yes, when I was in my 20s and 30s I was eventually diagnosed with ADHD and autism’, because there are lots of us now. You’re young so you might be getting helpful clues from TikTok about what might be going on with you — or you might have no idea.
I think the main thing I would like to say is you are a whole person and the difficult experiences you are having are really real and should (and I hope will!) be taken seriously as something painful you are going through. I’m glad you have a family member who wants to help. I hope people can work together to find ways for your life to be more bearable right now and in the future, because that is what you deserve. Honestly.
posted by lokta at 4:57 AM on October 13, 2023
I’ll be honest, I don’t know what would have helped me at the time, except for not being punished so much by staff at school and college for not being a good student. This is of course a story of ‘yes, when I was in my 20s and 30s I was eventually diagnosed with ADHD and autism’, because there are lots of us now. You’re young so you might be getting helpful clues from TikTok about what might be going on with you — or you might have no idea.
I think the main thing I would like to say is you are a whole person and the difficult experiences you are having are really real and should (and I hope will!) be taken seriously as something painful you are going through. I’m glad you have a family member who wants to help. I hope people can work together to find ways for your life to be more bearable right now and in the future, because that is what you deserve. Honestly.
posted by lokta at 4:57 AM on October 13, 2023
Response by poster: Thanks for the responses. They are going to keep a journal for a while to see how the anxiety is in the mornings, and to try some of the things people have listed and see how that changes it. Their parents may also drive them to college more often, as that seems to help.
posted by paduasoy at 11:19 AM on October 13, 2023
posted by paduasoy at 11:19 AM on October 13, 2023
Another tiny, weird thing that might be in play...
I have serious anxiety issues, and was very unhappy at school. When I was in the sixth form, I started suffering from nausea on school mornings... which turned out to be because I had abruptly stopped being able to tolerate anything sweet first thing in the morning. (Still the case, thirty years later. I also can't drink tea on an empty stomach.) Switching to something savoury for breakfast obviously didn't do anything to make school any more bearable, but it did at least stop me feeling sick for the first hour.
posted by ManyLeggedCreature at 7:28 AM on October 16, 2023
I have serious anxiety issues, and was very unhappy at school. When I was in the sixth form, I started suffering from nausea on school mornings... which turned out to be because I had abruptly stopped being able to tolerate anything sweet first thing in the morning. (Still the case, thirty years later. I also can't drink tea on an empty stomach.) Switching to something savoury for breakfast obviously didn't do anything to make school any more bearable, but it did at least stop me feeling sick for the first hour.
posted by ManyLeggedCreature at 7:28 AM on October 16, 2023
Response by poster: Just had a reminder to update this. Short version is that family member is doing much better at the moment. We went through the answers with them. Their parent is driving them in on Mondays, as that is an especially difficult day. They have had the first session with a new counsellor and feeling positive about it. They were very keen to change A level subjects; the college would not allow that (too late in the term), but they are managing their feelings about that. They can be up and down, but are having some good times as well as some harder ones. They are hoping hormonal contraception will help with moods.
posted by paduasoy at 4:01 PM on November 10, 2023
posted by paduasoy at 4:01 PM on November 10, 2023
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posted by heatherlogan at 11:27 AM on October 11, 2023 [2 favorites]