Disclaimer: I am not a child therapist, psychologist, or psychiatrist. The content below pertains to our personal experience. All queries concerning your child’s mental and general health should be directed towards your medical professional. This article is only meant as an informational source based on our personal experience.
A little over a year ago our pediatrician handed me a phone number and said “it’s time”. The phone number was for our local Mental Health Access team, and she was referring my daughter for further assessments. At the time my eldest was only three years old, but we had known for a long time that she had many behaviors that pointed towards anxiety.
I have personally suffered from anxiety for as long as I can remember, but as with many aspects of parenting you often question yourself a million times before openly bringing up the topic with someone else. Our eldest was extremely high needs as a baby, and developed controlling behaviors as she moved from baby to toddler to little child. Some behaviors, the clinginess for example, could be explained as “normal” or “age appropriate”, but as she got older they didn’t disappear but progressively got worse.
Luna was diagnosed with a Congenital Heart Defect at three months old, and from that moment onwards she developed a huge fear of doctors. Even a routine check-up would result in refusal to let the nurse take her measurements, terrified screams, and basically a lot of heartache for all of us. As she grew older and began to speak and understand the world around her, she would start to have real panic attacks that would result in vomiting. If I told her we would be going to the doctor for a check-up she would start repeating the same questions over and over again, start shaking, and then inevitably vomit all over the place. Needless to say, these events were traumatic for everyone. Meltdowns also led to vomiting, and would start because of the most random thing: a tag on a t-shirt, having to watch a TV show that she hadn’t chosen, or even a piece of toast not being cut exactly as she wanted it cut.
Anxiety is notoriously difficult to diagnose, especially in children. It also appears in so many different shapes and forms, and can often be confused with symptoms of other issues. I know that a lot of people dismissed my concerns, and as Luna was my first child I wondered if I was oversensitive to some of her behaviors, and possibly overreacting. This didn’t stop me from mentioning them to her pediatrician, and when we moved to California in early 2016 I found a doctor who took my concerns seriously. After a year of observing Luna she referred us for further assessments, and possible treatment.
The initial onboarding period took a while. I had to provide an overview of Luna’s symptoms to the Access team, who then referred us to the children’s mental health team at a local hospital. After that we rapidly received a call from a therapist who made an appointment to meet for in-home assessments. The assessments took about a month in total (4 in-home visits of about 90 minutes each and a lot of paperwork containing tests and multiple choice questions for me to answer). After this our therapist informed us that while they do not officially diagnose such young children with anxiety, Luna demonstrated a high level of controlling behaviors, as well as other challenging behaviors that were disrupting our household and causing distress in Luna’s everyday life.
We then went on to complete 9 months of Parent Child Interaction Therapy (PCIT) with our therapist, and Luna graduated from the therapy a few months ago. While some of her behaviors have morphed into other controlling behaviors, and she still sometimes has panic attacks, she is a lot more confident. She has also learnt a lot of coping techniques, and as parents we have also learnt ways in which we can help her better, especially when she displays moments of aggression and defiance. Obviously I know that anxiety is not something you can cure, but our goal was always to ensure she had healthy coping techniques from an early age, rather than the very unhealthy ones I developed for myself.
Depending on where you live and what type of insurance you have, it may be harder or easier to get help. I was very persistent in order to make sure that this wasn’t brushed away. California also has an excellent state-run mental health access system in place, as long as you can figure out how to navigate it – but you have to do a lot of the initial work yourself. We were also really lucky as we established a real bond with our therapist, and Luna trusted her from the get-go. This is what really helped us, because Luna didn’t hide any of her behaviors, which she had a tendency to do in front of people she wasn’t sure about.
Here are some of my own personal tips when it comes to seeking mental health and wellbeing treatment for a very young child:
- Keep a log of frequent behaviors that concern you. Many people will tell you that it’s normal for two year olds to have meltdowns, but there is a HUGE difference between a tantrum and a meltdown that affects your child for days. These behaviors can include things like sensory issues, picky, controlling eating habits, and a need to only wear certain clothes amongst many others.
- Write everything down before you go to the doctor or have a first meeting or phone call with a therapist. Look for a reputable childhood anxiety checklist online and see if any of the items seem familiar to you, and then write down what and why.
- Talk openly to your child’s doctor and push for a referral if they don’t seem to be concerned enough. You know your child better than anyone else, and it won’t hurt anybody to go through the assessments. Pediatricians do tend to wait until the child is about three years old before they deem behaviors worthy of a referral though.
- Talk openly with the therapist during the assessment period, and don’t hold back. I brought up a lot of my own personal childhood traumas as I was worried that I may be overcompensating with Luna at times due to what I had been through as a child. Everything matters, even if it may seem insignificant to others.
- Ditch the guilt. If I had had access to the same therapy as Luna did when I was a child I think I may have developed better coping habits as an adult. We all feel guilty, but we can’t let it stop us from seeking help when it benefits the whole family.
Luna will be starting pre-school soon as we think she is now ready. She also finally agreed to be potty trained this summer, something that she had been fighting for a very long time. She still tries to control certain aspects of her life, especially when it comes to her interactions with me, but little by little her strong, independent spirit is telling the anxiety to relax and let go. Some weeks it feels like we have made three steps forward and two steps back, but in the grand scheme of things we have made huge bounds ahead in the past 12 months.
Jade Anna Hughes is a writer, poet, mother of three, immigrant, and activist. You can find her work and portfolio over on her website.