Distressed and depressed by anxiety

Where only first names appear, names have been changed to protect the identities of the sources.

Nearing the Colesville Road parking lot, CAP junior Kirsten feels panic creeping up inside her. All she wants to do is run, hide or scream, take the wheel and turn back for home. As she pulls into the parking lot, tears leak from her eyes and stream down her face. Her hands begin to shake and her breath quickens. Frozen in the passenger seat, she is unable to force herself out of the car. She pleads with her mother to let her stay home, just this once.

Kirsten is not dreading a presentation, a bully, a mean teacher or even her final exams. She is experiencing a panic attack, the result of a clinical anxiety disorder she has coped with since third grade.

"You just want to die"

Kirsten's symptoms are only one manifestation of clinical anxiety. According to behavioral therapist Roxann Roberson-Nay, other forms of anxiety disorders include obsessive-compulsive disorder, fear disorder, agoraphobia (fear of entrapment), separation anxiety, generalized anxiety disorder and post-traumatic stress disorder. Clinical anxiety disorders, in some form, plague 13 percent of the nation's youth, according to an April 2001 article in American Family Physician.

Anxiety disorders stem from a chemical imbalance in the brain that makes stress unbearable, says Roberson-Nay. When this biological susceptibility to anxiety disorders coincides with high levels of stress, the result is some form of an anxiety disorder. The stress can be a result of schoolwork, trouble in social relationships or a specific trigger such as a phobia or separation from parents.

For Kirsten, this trigger is the thought of vomiting; at the height of her paranoia, she avoided eating certain foods for fear of throwing up. She stopped going to school and even going out at all, worried that she would not have an easy way out if she had to vomit. "I based my whole life around that tiny chance that I might throw up," she says. "I couldn't go anywhere that I couldn't escape from."

When she felt trapped, Kirsten's breathing escalated to hyperventilation and she was overcome with a terrifying feeling that it was "the end of the world." She saw death as a superior alternative to throwing up. "I didn't want to commit suicide," she says. "But at that moment, you just want to die."
Her panic attacks and resultant fits of distress were worse at night than during the day, often lasting for hours after her parents went to bed. They ignored her pounding on the door and her uncontrollable crying, she says.

The parents of former Blair sophomore Edward experienced a similar struggle with their son, whose social anxiety disorder prevented him from going to school. Every night Edward packed his backpack and made his lunch, hoping to go—but every morning he simply couldn't do it, regardless of any reward promised or punishment threatened.

Like Kirsten, Edward showed signs of "school refusal" at an early age, his father says. When he was in first and second grade, Edward's parents would "physically make him go to school," even in his pajamas, according to his mother. At the school doors, they dragged him into the hands of a teacher and had to walk away without looking back. "It just tears at your heart strings," his mother says.

Schoolhouse blues

To help ease his anxieties, Edward's parents enrolled him in a small private middle school. In the new setting, Edward could "command the environment" as a handsome, smart class clown, says his mother.

However, when he came to Blair, he couldn't feel comfortable around his new peers. The school year progressed, and Edward found his situation worsen. As his absences began to add up, so did the teachers' questions about his situation. Cut from the basketball team, behind in his classes and without close friends, Edward spent more and more school days at home in front of the TV.

For every day he spent home, Edward paid the price in late homework. Losing credit in all of his classes did nothing to motivate Edward, who will not only have to retake his classes but also factor failing grades into his GPA.

At a large school like Blair, it is difficult for guidance counselors to make specific accommodations for students like Edward. After a scheduling problem at the beginning of this year, Edward's parents decided he had to switch schools. "That was the end of what Blair could do for us," Edward's mother says.

For Juliana, a senior who suffers from obsessive-compulsive disorder, generalized anxiety disorder and separation anxiety, Blair has been a good place to blend in. "There are so many different kinds of people at Blair," Juliana says. "People can deal with it."

Road to recovery

Juliana is farther along in her recovery than most adolescents with anxiety disorders. After years of behavioral therapy, where she learned techniques for dealing with her anxiety, Juliana calms and controls her panic.

According to Roberson-Nay, the first step towards recovery requires parents not to allow kids to stay home. The longer a student is away from school, the harder it is to go back. "[The disorder] keeps taking over more and more of their life," Roberson-Nay says.

Edward is now attending a military academy, where he can find solace in a set schedule and his 20-man company. Such predictability and dependability, like that of a military school, are constants on which anxious students like him can rely.

To expose herself to her fear of vomiting, Kirsten pays weekly visits to the Maryland Center for Anxiety Disorders at the University of Maryland and attends a specialized school. She has not had a panic attack since April and plans to return to Blair on a half-day schedule in January.