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Anxiety: Panic In The Classroom

The first day of school can be terrifying for kids with Anxiety Disorder

Part 27 of our award-winning series “Our Children’s Health

Every morning was the same: Brendan would get up for school. He’d put on his clothes and eat his breakfast. His mother, Ashley, would make sure everything was in his backpack. As the time inched forward, he thought about getting on the school bus, walking into the classroom. His stomach tightened. His nerves grew frayed. He became silent. And then, before he would leave his house, Brendan had to do one more thing to start his day.


He went to the bathroom and threw up.

Brendan suffers from anxiety disorder, an umbrella term for many other challenges faced by children and adults when confronted with some of the elements of everyday life. Brendan’s story is not uncommon. Some research has said that as many as one in five children suffers from some form of anxiety disorder, which can affect grades, social interaction and other aspects of the life of a child.

It did not end at vomiting for Brendan. Once he was out of the house, he dealt with his anxiety in another way. He said nothing, a condition of his selective mutism, a disorder that many children deal with. At home, he was a talkative child. Out of the house, and especially at school, Brendan was unable to speak above a whisper, if he even spoke at all.

“He did that practically every day until third grade,” says Ashley.

If he raised his hand in class, he could not ask his question or offer his answer. At Cub Scouts, when he wanted to respond to the Scout Master, he would whisper into his father’s ear and his dad would answer for him. And so it went. Ashley says that when he was younger, the kids would rally around him and help him out. They would speak to the teacher for him. During class concerts he would nervously tug at his clothes. One year, at the annual moving-up ceremony at school, the kids had to read from journals they had authored during the year. They stood in a line, side by side. As Brendan’s turn grew near, Ashley felt his panic. At last it was time for Brendan’s piece. A girl next to him took his journal from him and read it to the room.

Ashley says she cried. She had done what she could to be there for him, including be a lunch monitor so he would see her and the teachers would get to know who she was.

Other kids would take him as their friend. One boy who lived nearby became his closest friend, and in that role Brendan’s mouthpiece as well. He would speak for him whenever necessary. But as Brendan got older, the kids got a little meaner. They called him names, like “Mute Man.” It wasn’t getting easier. Ashley says Brendan went to therapy for years. But, she says, “I don’t think it helped him very much.”

A new course of treatment was established for the quiet young boy. Brendan began receiving treatment from Dr. James Snyder of Great Neck-based Long Island Psychiatry about two and a half years ago. Brendan has since undergone consistent psychotherapy and takes the powerful antidepressant Zoloft every day.

“We resisted using drugs for a long time,” says Ashley. “But if you have diabetes, you use insulin. Brendan needed medication to treat his problems. Once he started [taking] Zoloft, there was continuous improvement.”

The treatment worked quickly, says Ashley, and by the end of third grade, Brendan was making great progress. He is 11 years old now, and will enter middle school this fall. As Ashley speaks, Brendan is outside, playing with a friend who had slept over the night before. He speaks at school. Loves baseball and soccer. He does not scream and yell like the other kids, though. Even so, he is light years from the days when speaking to anyone other than his mother or father ranged from difficult to impossible.

“Things are pretty normal,” says Ashley.

This year is a new test for Brendan. A jump from elementary to middle school is big, and such changes can be panic triggers.

“Any type of transition can trigger panic,” says Dr. Suzanne Main-Wegielnik, who specializes in school and clinical psychology at the Orchard School at the Andrus Children’s Center in Yonkers. “School beginning, school ending, a vacation—any of these things can result in a panic attack.”

Those  panic attacks manifest themselves in physical manners, says Snyder, and they are painful and unpleasant.

“Kids will develop headaches, stomach aches, many different maladies,” says Snyder, who regularly treats children suffering from anxiety and panic disorders.

Dr. James Snyder treats dozens of kids with anxiety and panic disorders.

Dr. James Snyder treats dozens of kids with anxiety and panic disorders.

The first thing to do, of course, is determine if any such physical reactions are indeed the results of psychological issues.

“Always make sure the child is examined by their primary care physician first,” says Snyder. Anxiety can cause kids to refuse to go anywhere, especially school. And forcing them to go somewhere is not the answer, he says.

“Parents need to be trained. It is very frustrating for them. When their kids are suffering, they are tortured, and it is hard to understand why their kids would have these feelings,” says Snyder.

Of course, lots of kids hate going to school. But what about a family vacation? Should that cause such issues?

It did for Frank.

One of two children, Frank is about to start his sophomore year in high school. He has no real anxiety issues these days. Still, for years there was almost nothing that would not throw him into a fit of anxiety. Instead of taking comfort and refuge in a week away with his parents and sister, Frank became unable to function.

“He was always nervous,” says his mother Frances. “When he was about 9, it was at its worst. Leaving the house for anything, especially school and vacation, was torture for him.”

Frank suffered from anticipatory anxiety. As the hour approached, Frank would get sick. Very sick. He would vomit. As the family prepared to take a flight, he would have to visit the men’s room and throw up. His stomach would twist into a knot. He would not be able to eat for the entire vacation.

“He would play with the other kids, go swimming and be smiling, but his stomach was tight,” says Frances. “And he just could not eat.”

Frank began to see Dr. Snyder. He went on Lexapro, another anti-depressant. Each year he got better. When he got ready to go to camp one summer, he took Klonopin—a drug used to treat epilepsy and panic attacks—for the initial anxiety and the first day of camp. But he was all right after that.

He continues with therapy and practices relaxation techniques. The problems will always be there to deal with, says Frances. It has also affected his social life.

“He does not have a lot of friends,” she says. But if he is invited somewhere, she makes sure he attends. When he was younger, he could not even sit in a movie theater, but Frances says she and her husband turned it into therapy and took him until he became more comfortable with the surroundings.

“He has to confront these things and deal with them. It’s just something he’ll always have to do,” says Frances. “Life has to go on. We want him to enjoy it.”

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