I’m scared to tell my anxious child about my Zoloft

I’ve never been troubled by the idea of taking an SSRI, but suddenly I’d rather do anything to avoid telling my son. Perhaps because he seems so much like me.

Photo: iStockphoto

Every parent, whether they’re the anxious-type or not, has fears for their child. Illness, injury, incarceration—these worries can play out like the private screening of a horror movie. My chiller starts, as many do, in the bathroom. It’s already late-ish on a weekday morning and I’m leaning over the sink when my five-year-old son walks in. I barely notice, even when he squeezes behind me to take a pee. I reach back to the cabinet over his head to exchange tweezers for my pill box, and as I’m fishing a yellow and white capsule out of the Tuesday cell, I hear my son’s wee voice: “What’s that?”

Now, I feel zero shame in telling the world it’s Zoloft—medication I’ve taken for 15 years to alleviate chronic anxiety. I’ve never been the least troubled by the idea of taking an SSRI, but suddenly I’d rather do calculus naked in front of an audience than tell my son. Perhaps it’s because in some crucial ways he seems so much like me.

From the very beginning, he’s been sensitive. I’ll never forget endlessly circuiting the neighbourhood at night while this tiny baby thrashed in my arms like a fish out of water. As a toddler, he developed obsessions with things like the sinking of the Titanic and the Hindenburg airship disaster (“May 1937 at Lakehurst, New Jersey”). Like others, I was charmed, but I also recognized the need to purge nervous tension. Whatever his interest, whatever his mood, there was such intensity.

He adored caregiver-and-tot gymnastics, for instance, but at age 4, when the kids graduated to a drop-off situation, we met with an impenetrable force field of resistance. We continued to show up, but never made it off the sidelines. When people see you struggling with a clingy kid, they say that if you rip the bandage he’ll be fine in no time. But for the first year after my mat leave we’d had him in home care and every morning was as bad, or worse, than the first.

Looking ahead to kindergarten, we were worried. Did we—did he—have a problem? The spectre of anxiety was officially looming.

Turning the light on
There’s a lot of talk these days about the rising rates of clinical anxiety in kids. Smart phones and helicopter parenting are commonly blamed—Donald Trump can’t have helped. I’ve seen the trend referred to as an “epidemic,” which always has the desired effect. But in fact, the rates of anxiety disorder among children and adolescents have not increased significantly in decades , according to Stanley Kutcher, a psychiatrist at Dalhousie University who has studied the epidemiological evidence.

“It’s the rates of self-reported negative emotional states and stress that are increasing, likely as a response to mental health awareness without mental health literacy,” he explains. In other words, kids are confusing the language of mental disorders with the description of normal negative emotions (“OMG, when I lost  wi-fi, I had, like, a panic attack!”) Kutcher also blames the “impact of the happiness/wellness/stress-free life industry driving sales of products”—the uncomfortable feeling of alarm is only made worse by a culture that doesn’t allow for it. So maybe what the numbers show is not an increase in anxiety but in our fear of fear.

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6 ways to calm your anxious child

This rings true for me. When my anxiety was at its worst, I was having panic attacks about having a panic attack. The slightest physiological shift suggesting alarm could trigger an unravelling, like a mummy being spun from its rags. Besides the loss of control, I was terrified of what might lie beneath. I hated feeling so vulnerable, and, in spite of many improvements in my mental health, I still do.

It’s partly what drew me, looking for help with our son, to the “Neufeld approach,” a way of leading children to emotional maturity developed by Canadian psychologist Gordon Neufeld. Our Toronto-based parenting coach, April Quan, explained that kids instinctively crave physical and emotional attachment to the adult responsible for them. It makes sense: they’re vulnerable and need us there to feel safe. When that connection is threatened, alarm and frustration signal there’s a problem.

This is tried-and-true attachment theory, but it has also been bolstered by what has been called a revolution in neuroscience. Evidence is mounting that emotion—and not cognition, as we have long believed—not only drives behaviour, but, if it is nurtured, serves our needs. This is already well established enough to have not only produced some best-selling books (Descarte’s Error, The Emotional Brain…) but also a Disney movie, Inside Out, in which Sadness saves the day.

Quan urged us to see our son’s behaviour as a signal of his separation alarm, and so we applied for a spot at an alternative public school that allows parents to cross the sacred threshold and walk their kids into class. I stayed maybe an hour for the first few days—no fighting, no cajoling, no promising, no pretending, just being there, inviting him to feel whatever he needed to feel. And the transition was seamless. It probably says something about my persistent discomfort with fear that I hoped we’d never face this again.

Put down your weapons
My son was an early and inventive talker. He once memorably called me a “thinkative girl,” but I could say the same of him. He wants to understand everything, perhaps especially abstract things like death, which he grappled with, often very emotionally, through JK. He’s also big-hearted. Sometimes he feels the feelings of others (he’s the one who cries when his sister scrapes her knee). He’s rarely hit anyone when agitated, he’s too empathetic, but by SK, he was sometimes turning his feelings inward, which somehow seemed so much darker. Once again we were asking ourselves if he had a problem and how to fix it.

The gold standard for psychological treatment of anxiety-based behaviours is cognitive-behavioural therapy, and there are various applications for kids my son’s age. Toronto’s Sick Kids Hospital has piloted a study that would teach him cognitive strategies that they call “weapons to tame ‘Sneaky Fears.’” Along with age-appropriate exposure exercises, Anxiety BC’s Complete Home Tool Kit for children emphasizes the usefulness of identifying worry feelings, or “naming the bully.” Taming the Worry Dragons, a program and training manual created out of BC Children’s Hospital in the 90s, teaches kids “to trap the worries that are ‘bossing them around.’” Each set of guidelines includes a disclaimer that some amount of anxiety is normal and adaptive, but the pervasive language seems to reinforce a fear of fear.

Deborah MacNamara, a clinical counsellor in Vancouver and author of Rest, Play, Grow, a Neufeld-informed manual for parents, says that while she is trained in CBT and supports it for certain patients, she doesn’t use it herself. She considers it a way of managing anxiety rather than understanding it. “You have people who say yoga has been their lifesaver, others who can’t get out of the house without medication,” she explains. “Practices may be helpful, but if you don’t make sense at the root level—what’s driving the problem? is it indeed a problem? and in what way?—you’re shooting in the dark.”

At five years old, our son is still forming his psychological roots, and because he’s so emotionally transparent, we’ve got a pretty decent view. So, for now, when he’s beating himself up, instead of focusing on elimination of the troubling behaviour, we’re trying to understand it. What’s the feeling behind it? What purpose does it serve? What kind of support does he need from us? And while the answers aren’t always obvious in the moment, we’re at least creating a safe space for him to get to know his own fear and the chance to develop its antidote, courage—all part of the repertoire of the mature, “healthy” adult we hope he will become…

Now cue the record scratch as I pop my pill.

Whose fear is it, anyway?
What I’m worried about is that the little yellow pill I take each morning says the opposite of what we’ve been telling my son about fear—that it’s OK, useful even. The medicine says fear is a sickness, a pathogen, the boogeyman. It says fear fear.

Of course, the subject of mental health is infinitely more nuanced than that, the line between endurable and unendurable suffering is neither clear nor universal. But try explaining that to someone who, thinkative as he may be, still doesn’t understand when “yesterday” was, couldn’t begin to grasp how I might not feel as strongly as he about Pokémon, simply cannot wrap his head around the fact that the Scooby-Doo monster is always a hoax! What a range of health care professionals I consulted told me—unequivocally and universally—is that I shouldn’t.

“We always think that kids are more curious about us and can handle more information than they really can,” said Lynn Miller, esteemed former president of the Canadian Anxiety Disorders Association of Canada. “Parents are bending over backwards explaining about death or relationships or whatever, and kids are like, ‘Blah.’ They just can’t. They ask the minimum and we should give the minimum.” Quan reminded me that even if my son asked about my medicine, I needn’t recite a detailed health history. MacNamara made the solution sound obvious: “Is it appropriate for a five-year-old to have a relationship with your anxiety? The answer is no. Your job is to lead him through his. So take the pill where he doesn’t see it.”

She understands why I might be feel conflicted, though. “You’re caught in a time warp,” she says. “The new neuroscience is colliding with an old way of looking at emotion. It’s like what happened with formula versus breast milk.” Maybe when he’s older, she adds, I could tell him that it’s what I needed “at that age and time,” and I imagine she’s referring to not only my own emotional short-circuiting, but an era in which emotional avoidance affected society more broadly. Quan says gently, “It’s like someone who needs a prosthetic. Everyone would much rather have their own foot, but that’s what you need to walk down the street.”

It dawns on me slowly as the interviews veer into therapy that maybe my anxiety about my son finding out I’m on medication is a red herring, or, more constructively, a red flag. Because, of course, what we want for our kids is so often about ourselves. Maybe what I’m really struggling to reconcile is my history of anxiety and treatment with the new way of looking at emotion.

So I guess it’s time to take another look at my prosthetic. Does it still fit? Could I also still learn how to accept—to feel—my fear? That’s my work to do, and it’s separate from the work of parenting my son. One of the most important things I can do for him is to remember that his story is not necessarily my story, that just because he’s sensitive doesn’t mean he’s going to experience the kind of chronic anxiety I have. That sensitivity may in fact turn out to be his greatest protection.

Read more:
Raising a drama queen
4 tips for managing anxiety in preschoolers

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