Teen Anxiety: Teens Need to Know They are “More than This”
by Sharon O’Donnell
As the school year begins, I’m helping to promote an event in our area that focuses on teen anxiety, which is so prevalent these days. I’ve seen it all around me. And as the mom of three sons, now ages 27, 14, and 18, I’ve seen it in my own home. Parents have to be aware that some teens are more prone to severe anxiety due to their brain chemistry; it is not simply stress or worry, although those can be triggers. Those with OCD tendencies sometimes have 'stuck thoughts' that make it incredibly difficult to get past.
It was back in 2010 when the insidious anxiety came into my home quite unexpectedly.
When I picked up my middle son David, a 16 year-old high school junior, from basketball practice that October day in 2010, he looked awful. His face was pale, and he looked thin, but I assumed those were side effects of the ADD med he’d started taking that week. But I wasn’t prepared for what he said when he got in the car. “I’m feeling really depressed, Mom. I don’t know what’s the matter with me.” I couldn’t believe what I was hearing; David had never been depressed and had so much going for him: he was smart, handsome, athletic, had tons of friends, and a sweet girlfriend of almost a year. My disbelief quickly turned to panic, but I tried not to let it show on my face or in my voice.
We drove home, and since it was almost 5:00, I set up an appointment for the next day with our pediatrician who’d treated David and his two brothers -- Billy, 19, and Jason, 10, -- their whole lives. I told David he needed to go to sleep early. “But I have a chemistry mid-term tomorrow,” he told me, his eyes empty and sunken. He studied some but soon went to bed because we knew his sleep was more important than grades or exams at this point. I couldn’t sleep at all and kept hearing his words from the car in my mind, and when I awoke that next morning there was a split second of peace before I remembered. My husband, Kevin, took David to school on his way out of town on business. I was hoping David’s feelings were just from the stress of exams and the physical exertion of basketball. He’d be fine, I tried to reassure myself. An hour later, David texted us a message: “Get me.” I felt the urgency of David’s words: it wasn’t ‘Can u pick me up?’ or “Need to come home”-- it was simply ‘get me’ like he needed us to catch him as he was falling.
I drove to the school with a burning sensation in my stomach, a feeling that would become all too familiar. On the way home, David said he kept having repetitive thoughts he couldn’t get out of his head. He’d had mild anxiety before but nothing like this. The doctor’s appointment was scheduled for after lunch, and David slept until then.
That afternoon, while waiting for the doctor to come into the exam room, David revealed something else. “Mom, I’m not just depressed,” he explained in a weary voice that was almost inaudible. “I heard one of the school counselors say she was teaching a suicide prevention class, and since then I can’t get the thought of suicide out of my head.” I heard his words, but once again I couldn’t believe them. This couldn’t be my healthy, happy son saying this. But it was.
I assured David we’d get help, that things would be okay, but I felt completely devastated because I didn’t know what to do and because I was hurting so much myself. When the doctor heard the gravity of David’s thoughts, he discontinued the ADD drug and put David on an anti-anxiety medication, although it would take two weeks to begin working. He prescribed a tranquilizer for David in the meantime and told me to monitor him day and night. Kevin was still out of town on business, a five hour drive away, but I wanted him with me, needed him with me. I called him and said, “I don’t know what client you’re meeting with, but I need you here.” Then I told him what David had said in the doctor’s office. He started for home right away. Our youngest son, Jason, knew something was wrong, but I couldn’t bring myself to tell him about his brother other than to say David was depressed. Somehow Jason knew when I needed a hug the most, and even though he didn’t totally understand what was going on, his hugs got me through some rough times.
Luckily, school was out the next day, so David had a three-day weekend. On Saturday, things hadn’t improved, so Kevin and I took him to the Duke Medical Center emergency room. After a five-hour evaluation, the psychiatrists determined that David had a type of anxiety called Obsessive Compulsive Disorder, which manifested itself by intrusive thoughts that ran continuously in David’s mind. The doctors said they considered David’s thoughts just that – thoughts – and even though the topic of suicide bothered him, they didn’t think he would ever act on those thoughts. This still didn’t alleviate our concern; our son had gone from a happy, active teenager to one who was sad and tired and who slept a lot to avoid dealing with ‘the thoughts.’
Although doctors said that David had underlying tendencies for anxiety, I felt overwhelming guilt that we’d started him on an ADD med to help him focus, which evidently exacerbated the anxiety. Sometimes ADD and anxiety symptoms overlap, making it difficult to prescribe the proper treatment; David’s inability to focus, which we thought was ADD-derived, had probably been anxiety all along. I even recalled a time when David was in middle school and couldn’t sleep for several nights after some coal miners died in a mine in West Virginia; the initial report had been that the men were alive, but it proved to be false. David had followed the story on TV and told me after the awful news came out that he felt like he was ‘down there with the miners.” At the time, I thought David was just a very compassionate boy, but looking back, I know that had been anxiety.
When we got home from Duke that night, our oldest son, Billy, came home from his college dorm and stayed at the house that night because he felt, as I did, that we should be together. David's girlfriend came over too. We attempted to go out to eat to get David out of the house, but after ordering our food, David said he had to get out of the restaurant, so we got take-out boxes instead. Sunday was Halloween, and I walked with Jason through the neighborhood trick or treating; yet, in my mind, I remembered all those years of going trick or treating with David and Billy. David had been so carefree, so happy as he ran around from one house to the next, delighting in gathering as much candy as he could, especially Reese Cups. My heart ached thinking about his smile. Down the street was a group of teenage boys who were out trick-or-treating, but they were cutting up a bit, singing Christmas carols at each house. Their songs and laughter rang out, the voices of 15 and 16 year-olds, still struggling to adjust from higher pitched boys’ voices to the deep voices of men. Tears began to flow down my cheeks as I wondered if I would ever hear David laugh again.
The doctors at Duke said that the worst thing David could do was to give into the anxiety and that it was vital to keep him in his routine -- which meant he needed to go to school. My husband and I dreaded Monday morning and having to enforce this. I was emotionally exhausted and doubted my ability to be firm enough to go through with this monumental task. The shrill blaring of the alarm clock on Monday morning jolted us out of a restless sleep. While I lay in bed praying and wondering how to face the day, Kevin somehow had the strength to get David up, ready, and out the door to school. As I said good-bye to David that morning, I wanted to hold onto him and not make him go, but I knew he needed to go. I sent emails to his teachers, coaches, and counselors, alerting them to the situation. Later, I met Kevin at the school, and we actually sat in our car in the school parking lot for the entire school day; in case David needed us, we wanted to be right there. One of our friends from church was a teacher at the school, and she – bless her heart – got reports from David’s teachers about how he was doing and texted me. “Very weak and pale but chemistry teacher says he made it through” said one text.
The Pursuit of Normal
After a week and a half, the anti-anxiety med kicked in. Amazingly, December through February went relatively smoothly. In March, a student at David’s high school committed suicide, and even though David didn’t know the boy, he was of course, affected by his death. It was during this time that I discovered that three of the novels David’s English class was reading that semester involved characters committing or attempting suicide. I truly believe that English classes would make a positive difference if more of the assigned books were uplifting rather than so depressing. David’s meds still kept the thoughts at bay most of the time.
In mid-April, our family went to Washington, D.C. on spring break and did some sight-seeing. We stayed for a few days and then went home so David could play in a spring break baseball tournament. He had a good game, but afterwards as we walked to the car, he told me it’d been hard to focus at the plate because he was having repetitive thoughts again. I felt sick on my stomach. The anxiety was back. This time it was about Arlington Cemetery, which we’d just visited in D.C. “All those graves, Mom. Life just seems so random.” Despite the thoughts continuing for the next two games, David made the all-tournament team, a testament to his trying to battle through it.
However, over the next two weeks, the thoughts got so disruptive that David took himself out of two games because he couldn’t focus and was afraid he’d hurt the team. His compassionate coach knew this was a much bigger issue than baseball. David also skipped an SAT exam he was scheduled to take for college admission. Doing well on the SAT used to seem so important, but anxiety certainly put everything in perspective. I just wanted my son to be happy and healthy; I didn’t care what his score was on the stupid SAT.
Since the anxiety began, I’d spent countless hours on the Internet, searching for possible solutions. David’s words after the tournament about life being random sent me back to the Internet, where I found that much of what David was experiencing was existential anxiety. Everyone thinks about their existence and the meaning of life from time to time, but with OCD, the thoughts are never-ending. Luckily, we found wonderful local doctors to work with David -- a psychiatrist and a psychologist who worked in tandem. David also talked with one of our ministers, which helped tremendously.
The psychiatrist increased David’s anti-anxiety med in mid-May because the thoughts had not decreased. But two days afterwards, David hit rock bottom. He wanted to sleep all day, and he missed school on Monday, saying the thoughts were worse. Tuesday my strapping 17-year-old son lay in a fetal position on the floor, saying, “I’m never going to be normal again.” He held his head between his hands, his fingers on his temples, totally perplexed as to what was going on inside his mind. My heart ached, as I looked at him and imagined him as a toddler gazing up at me with his big blue eyes, trusting I’d take care of him. Now, I had no idea how to take care of him anymore.
His psychiatrist feared that David was suffering from serotonin syndrome, which is too much serotonin in the brain. He took David off the medicine immediately since the situation was dire. We opted to keep him off of any meds and continue with the psychologist’s therapy and also tried a natural supplement. Within a few days, David was much better. I began once again to do research on the Internet; during the months since David’s first flare-up of severe anxiety, he had been my complete priority. Of course, I kept up with my 10-year-old’s school work, checked in with my oldest son, and sometimes cooked dinner, but it was like I was in a fog. David’s world became my world as I read, took notes, & contacted doctors and teachers. There were a few times I tried to write a blog or work on a book – to try to return to my life – but then something would happen to David and bam! – I’d be right back in his world, aching for him, praying for him, on the Internet. I couldn’t focus on anything else because nothing else mattered. I was consumed by his anxiety.
Two weeks after David went off the meds, he seemed to be his old self. American Legion baseball season was beginning, and he was feeling good. I felt extremely blessed – even though I realized the anxiety could come back. There is a sporting goods store in our city with a women’s spa located above it. Over the years when I’d go to buy athletic items for my sons, I’d gaze at the stairs to the spa and dream of the day I’d go up those stairs for a massage rather than downstairs to buy sports stuff for the guys. That week David needed a new batting helmet, and I drove to the sporting goods store to buy one. I saw that spiral staircase leading up to the spa, but this time I didn’t yearn to go upstairs. Passing by the stairs to the spa, I walked toward the sporting goods store instead, smiling because my boy felt like playing baseball again.
But our respite was short-lived. In early July, repetitive thoughts were bothering David again. He went to play basketball at the park with friends to try to get his mind off ‘ the thoughts’. While he was gone, I went back on the Internet, looking for solutions that didn’t exist. A few hours later, I heard David come inside. I got up and went around the corner. David stood in the foyer staring at me, a basketball under his arm. “Mom, there’s just no hope,” he said, shaking his head slowly. I slumped against the door frame in despair, meeting his eyes. “Things just aren’t any better,” he added. I was so damn tired of this roller coaster. When was this blasted anxiety going to leave my son alone? When would it leave us all alone? It had taken the whole family hostage, turning our lives into a dark, foreboding place.
“Okay, David,” I replied, my voice quavering. “I’ll call the doctor. He’ll know what to do.” His psychiatrist told me to take David to the UNC-Chapel Hill adolescent psychology unit for an evaluation. On the way, I reached over and put my hand on top of David’s and prayed out loud. I thought he might flinch or pull his hand away, uncomfortable with praying out loud for him, but he didn’t. He seemed to soak it up, thirsting for comfort. Having to leave him there that night was almost more than I could bear, but we both knew he needed to be there. At UNC, they put him through a week of extensive tests and got him back on an anti-anxiety drug – a different one than before. Miraculously, David was feeling much better in a short time. The bill for that week was around $10,000, and I wondered how people who need extended help can ever afford to get it. Some of the kids we met there that week had been there for months.
The following week, David was able to play with his American Legion baseball team in the state tournament. His team fell short of the championship, which was disappointing. But they still came in third, and David played well, including a fantastic sliding catch at first base. There were many games being played at this tournament, and we watched some other games even though our team wasn’t playing. In one of those games between two other teams, a player in the outfield suddenly crumpled to the ground. Since it was a hot summer day, most of us immediately assumed it was due to heat exhaustion. The coaches gathered around the player, and medical personnel attended to him. A few minutes passed, and they carried him off the field. As the game began again, people in the stands were concerned and wondering aloud what had happened to the player. Then a man walked over from the field and delivered the news with a smile on his face: it was “just anxiety.” Everyone seemed relieved. A chill ran down my spine as I heard people relay those words throughout the stands -- ‘just’ anxiety.
At the beginning of David’s senior year in high school, he got involved in Young Life, a Christian-based organization that helped him and his peers examine some of his questions about life’s meaning. He still had some ups and downs during the year -- particularly during a promising senior basketball season that quickly took a nosedive due to self-confidence issues stemming from the negativity of the coach. This coach had been supportive the year before when the anxiety first started, but it seemed he had run out of patience in dealing with David's anxiety and was not very nice to him -- even though David had some good games. But the anxiety was nothing as significant as before. During that trying basketball season, David began taking a pre-metabalized folic acid tablet to help the anxiety med absorb into his system better; that seemed to be a God-send for him. That spring, in a tournament championship baseball game, David hit the winning double and was carried off the field by some of his teammates. It was so fitting that David got an opportunity to have that moment. But the burning feeling in my stomach remained, and when the phone rang and David’s name showed up as the incoming caller, I still would often get uptight. I knew the threat of anxiety always hung in the air, like a predator after its prey. It was bittersweet to think of David as that little boy with the big blue eyes and tousled hair, how protected he was in those innocent times before anxiety came and changed our lives so suddenly.
David did well in his freshman year of college two hours away from home, taking on responsibilities and doing well academically. It was tough for Kevin and me to have David go to a school that wasn’t within quick access in case he needed us, but we knew it might also be a step he needed to take. He suffered no anxiety flare-ups, and the time he used to spend practicing and playing two sports in high school was instead used to focus on studying. David’s freshman year GPA was high enough that he was able to transfer for his sophomore year to his dream college that is only 15 minutes from home. He did well doing well there, graduated with honors, went on to get a Master’s degree, and has a great job in our hometown now. There were some anxiety flare-ups here and there along the way, but David has learned how to deal with his anxiety better and knows what to do to alleviate the triggers. He is still dating his girlfriend since 10th grade (almost nine years), and they have both been in demanding graduate programs. He also exercises (usually running, basketball, or weightlifting), and that has helped combat his anxiety tremendously. I can tell in his eyes and in his voice that he is happy and excited about life.
All this gave me a new understanding of mental health struggles, particularly how easily and quickly such a problem can arise. Anxiety is an epidemic among teenagers, and society has to somehow offer them hope amidst all the bad news they hear 24/7 and all the pressures. Teens have to truly understand that they are not defined by their GPA’s, SAT scores, batting averages, physical looks, future job prospects, or other accomplishments; they are so much more than that.
Our family feels extremely blessed that David’s OCD has responded positively to medication and therapy and that he is excelling. His struggles have made him more mature and emphatic and a stronger person than he would have been otherwise. He knows what’s important in life.
And I have been able to move ahead as a mom and as a writer, getting a humor book published this year and writing lyrics for a local teen artist, Brooke Hatala. She and I worked together to write a song called More Than This about teen anxiety. Brooke will be singing this song at the Teen Mental Health Summit in Chapel Hill, NC on October 6th.
This school year, be aware of the increased competitiveness level, of the AP courses, the expected extracurriculars, social media pressures, the unblanced hormones, the lack of sleep, the uncertainty in this world & nation, and the threat of violence in our schools. Some people are more prone to being bothered by such things and internalizing them and overthinking them until it affects their very ability to function. It is an imbalanced brain chemistry that makes most of these young people predisposed to this. It’s not ‘just’ anxiety.