We Need to Do Something Sooner

Note: Five years ago, I wrote a post in honor of Children's Mental Health Awareness Day. It's been on my mind a lot lately, and I considered simply re-sharing that original post. But enough has changed since then, both in my own life and in the world, that it seemed worth revisiting the topic as a whole, including some of the same stories while adding new ones based on more recent experiences.

A few weeks ago, I was sitting at dinner with a group of teacher friends, and the topic of student mental health issues came up. Our discussion included just how prevalent mood disorders have become, particularly among adolescents, and what has led to this growing trend. Given that the group had learned only weeks before that I face my own anxiety struggles, one of them turned and asked how long it had been for me. I replied that, officially, I was diagnosed during college, but looking back I was pretty sure I could have been diagnosed in 2nd grade. I don't really remember the initial verbal responses that followed - I just remember looking around the table at the shock I saw on each and every person's face.
I remember a time when I felt that same level shock when I looked at how long undiagnosed anxiety affected my life. The young age that I started experiencing symptoms of anxiety and the long time between my initial symptoms and my diagnosis have become accepted facts of life for me. It took a number of years, but I've come to accept, too, the number of times it seems that my symptoms should have been obvious to more knowledgeable adults in my life. But that doesn't make it right, and that doesn't mean that we don't need to work for change. 15 years passed between my first symptoms and finally receiving an accurate diagnosis. That's a long time to fight a battle by yourself, especially when it's a battle you don't understand or that you don't even realize that you're fighting. And I don't want any other child or teen to have to go through the same things that I did.

Because I wish I had known sooner.

When I reflect on my childhood, I think I started presenting signs of social anxiety when I was in 2nd grade. It was then that I struggled to make new friends in a class where I had none at the year's start, that I started growing pits in my stomach each time my teacher reprimanded any of my classmates, and that I discovered my identity at school, that as one of the "smart kids," felt threatened any time that I was anything less than perfect (the first time I got one wrong on a spelling pre-test was a truly scarring experience). I was lucky that year - I had a teacher who worked to help me the best that she knew how and that brought in the expertise of others to help me as well. Partway through the year, I started getting pulled with a few other girls in my class to be part of a "Friendship Club" with the school counselor. I thought nothing of it until adulthood when my therapist asked me if I'd ever been part of such a group. That year was the last time that my childhood school system did anything to help support my mental health as a student.
Third grade brought a less supportive teacher, worse problems with finding friends among my classmates, and many-a-Monday-morning where I "faked" sick to get out of going to school. And by "faked," I mean that I swallowed a bunch of air to give myself a stomachache so that I wasn't technically lying when I said I didn't feel good and wanted to stay home. This ended promptly when my parents brought me to the doctor thinking that something horrible was wrong with me at which point I thought I was about to get in huge trouble and decided to stop. Even after that, there were many morning meltdowns that led me to miss my bus and be brought to school late. Actually, there were many meltdowns at home in general because my childhood subconscious knew that home was the only safe place to express the turmoil I always seemed to be feeling. I knew that my parents would love me no matter what, so any lashing out I did was reserved solely for them. Even so, the meltdowns that appeared as tantrums and the general defiance that often followed lead to some family counseling that year. It helped my parents and me to function better with each other at home, but my inner turmoil remained.

I wish I had known sooner

A few years ago, I attended an annual mental health symposium and during one of the break-out sessions chose a seminar on anxiety in children and teens. As a part of his presentation, the childhood psychologist leading the session listed which mental health disorder should be suspected when children display mood disregulation during different age ranges. Next to the ages 7-12? Anxiety.
I don't think most people realize that. We think of anxiety disorders as things that set in when students experience the academic and social pressures of being a teenager, when they start using social media, when their whole futures are on the line and they start to feel like the weight of the world is on their shoulders. Younger kids sometimes have irrational fears, but they grow out of those, right? Anxiety and depression are only faced by bigger people with bigger problems, right? I was 7. I was throwing tantrums almost every morning because facing the neighbor kids, facing my teacher, facing my classmates, and trying to live up to their standards for me and getting nowhere near reaching those standards - those were all challenges that felt too much to bear. I presented mood disregulation when I was 7 years old.

I wish I had known sooner.

At some point, I began to internalize all my anxiety so that it wouldn't appear to cause such a problem - I hated having so many eyes on me. Perfect schoolwork was the only way to avoid the ridicule of my classmates. Perfect behavior in public was the only way to make sure that the adults in my life would continue to like and praise me. Perfect conformity to the images of the person my various groups of "friends" wanted me to be (sans compromising my core values) meant that I wouldn't have to be alone. This continued all the way through junior high. I can't blame anyone for not helping me then. My anxiety was high-functioning. I may have been crumbling on the inside, but on the outside I looked like a high-achiever. I looked like a leader. I looked normal.
Then high school rolled around, and while the outward levels of functioning remained high, the crumbling that had been happening inside started to show on the outside. This was triggered, at least in part, by spending my sophomore year dealing with the first hour class from hell. 4 out of 5 days on our modified block schedule, I started my school day in a hostile classroom environment led by a teacher who liked to spend their time bashing everything I believed in, every aspect of my identity. It was no wonder, then, that during my sophomore year I generally spent 2-3 days of the school week in tears for at least part of the day, if not the whole day. 2-3 days a week in tears, 5 or 6 classes a day, and only one teacher ever pulled me aside to ask what was going on - though my advisory teacher did once mention to my parents at conferences that he was keeping an eye on me.
Junior year brought not only an increased load of schoolwork but some unique challenges. While I no longer faced the anxiety-triggering class and teacher, the damage was done, and school had ceased to be a safe place, teachers were no longer to be trusted. I did find one sanctuary within my school day - choir. Choir provided a low-pressure escape where the hard work we put in was still fun, and some part of me deemed my choir teacher still trustworthy. And then that teacher committed suicide and sent that year of choir through the tumultuous emotions that come not only with grieving but with going through 5 different choir teachers in a year's time. I held my emotions in, though. I wasn't one of the inner-circle choir kids, so I felt like I didn't have a right to grieve. My parents thought that something was wrong, but I was in denial. They tried to schedule a meeting for me with my school counselor; she agreed but on the day she was supposed to meet with me, my parents were surprised to learn that she hadn't. The appointment was rescheduled, and once again she cancelled. She stopped replying to my parents' communication after that.
So I continued feeling the inner turmoil, believing that I'd grow out of my over-sensitivity, believing that my perfectionism wasn't a problem, trying to convince myself that everything I was feeling was normal. I never cried through as many school days as I did during my sophomore year, but during both my junior and senior year, I still spent enough days in tears that it seems like someone should have noticed. Someone should have said something. I never had a teacher during my junior year who pulled me aside to see if I was okay. I had one who did my senior year but I'm pretty sure that it was mostly because he thought his reprimand was the sole reason that I was in tears.
Through this whole time, I never sent up any of the big red flags. My grades remained extremely high (with 3.9 unweighted GPA by graduation). I had a solid group of friends and was able to make and keep some new ones. I stayed out of trouble. It took two D's on my second trimester 3-week progress report senior year to get called down to the office for the only conversation I ever had with my school counselor. She told me that she'd seen my grades come across her desk before and those D's were not normal grades for me; she wanted to make sure that everything was okay. I shared that I'd missed two tests when my family went on vacation leading into winter break and that I hadn't had the chance to make up those tests yet in the few days since returning but was scheduled to do so the following week. At that point she sent me on my merry way.

I wish someone had noticed sooner

There are still schools where the high-functioning students slip through the cracks. I worked at one of them. A place where academic success is placed at a priority over all else, including student health. Working with some of the school's highest achieving students, I saw kids who were carrying a higher stress load than any teen should have to carry. Kids taking 4 or more AP or College-Level classes beginning in their sophomore year. Kids who felt distraught over an A-. Kids who felt it necessary to go through the immense workload required for a test retake in order to bring their scores from a 98% up to 100%. Kids who dropped out of all their non-academic activities to keep up with schoolwork by the end of 10th grade. Kids who were consistently sleeping for 4 hours or less each night. Kids who I listened to my colleagues complain about at lunch for not being able to deal with stress "like a normal person." Kids whose data privacy mattered more than their mental health concerns at the single hour-long mental health training we were given as a staff (which got cut off at exactly the one hour mark, right about the time the only mental health professional who was presenting was finally being given a chance to talk, because heaven forbid we give up any of our remaining  7 hours of the day set aside for collaboration time to instead talk about student mental health, in a school that appeared to be careening headlong toward an epidemic of mood disorders).
That school system demanded an even higher level of perfection of its teachers than it did its students, and I left 3 months into my second year there, my mental health decimated, and I finished out the school year on a medical leave, trying to rebuild myself back into a person again. I couldn't last 2 years as a teacher at that school. I can't imagine spending 4 years there as a student. I recently learned that in that last 10 months that same school has seen 4 student suicides. And it still took students amassing over 1,000 signatures on a petition calling for changes in practice and education regarding mental health and the stigma surrounding it before school leadership started discussing real change.

They needed to do something sooner.

It took me a long time to piece together how I'd fallen through the cracks during my own school years, not learning some of the details of all that had happened until I was near done with college. Once I saw the bigger picture, I was mad at my childhood school system for a long time. Bitter about what had happened. Resentful of the many teachers who could have said something, who should have said something, and didn't. It's taken a lot of time to accept what happened, to give my teachers the benefit of the doubt, especially in light of the school counselor who told my parents she'd help me and then didn't. And I've had the chance to stay enough connected with the school district where I grew up to believe that things have changed for the better. When I think of the teachers I know who work there now, I feel like I can trust that most of them wouldn't let another kid like me slip through the cracks. I've forgiven. But I haven't forgotten.

Because I wish they had done something sooner.

I was diagnosed with Social Anxiety Disorder at age 22. I could have been diagnosed at age 7. That's a 15-year difference. 15 years of fighting a battle that I didn't even know I was fighting. 15 years of confusion that I couldn't handle life's stressors the way that my peers seemed to be handling them. 15 years of building unhealthy coping mechanisms. 15 years of thought patterns and memories to rewire in my brain. 15 years too late. Even now, 7 years after diagnosis, I'm still unlearning bad habits, still rewiring automatic thought patterns, still struggling to get myself to a place of continually functional anxiety management. And there are days I can't help but wonder what might have been different in my life, especially my adult life, if someone in the position to have the knowledge and training to see that something was wrong had seen something, said something, done something when my brain was a little younger, a little more malleable.

I wish someone had helped me sooner.

Living with an anxiety disorder is a big part of my life; dealing with my own struggles makes me hyper-aware of others that are like me. Not everyone carries the burden that I do, and I know that it's harder to feel like you can do something when you haven't lived the struggle yourself. But I urge you to be part of the changes that we need to continue to make to support children and teens in caring for their mental health. Educate yourself. Normalize mental illness by talking about it. Practice empathy in all interactions, including and especially those with people struggling with their mental health.

We need to do something sooner.

I can't go back and change my own past, and in some ways I'm grateful for it. I'm grateful for the teacher that my experiences as a student have made me. I try to keep an eye out for my students who struggle with mental health issues, offering a safe space and a listening ear the best that I'm able to, checking in on them when they appear to be having a rough day. I also try to be very aware of students who might be struggling. The students who cry through my class. The ones whose usually-upbeat personality turns sullen. The ones who start labeling themselves as "failures" or "worthless." The ones who stress out about getting an A- instead of an A on a single minor assignment or who insist on retaking a test to bring their score up from 98% to 100%. I listen to their struggles and work to find strategies that will help them cope. When relevant, I work to help their classmates understand their emotions and behavior, especially with my littles who struggle to verbalize what's going on. And I do what I can to make sure I'm not the only person who's keeping an eye on them, particularly if they don't already have a special plan in place. At the secondary level, I contact their counselor; at the elementary level, I check in with their classroom teacher. I contact parents. I make sure that my eyes aren't the only ones watching out for this kid because I can't do it alone.

We need to do something sooner

If you look only at the major indicators, you miss out on those of us who are high functioning - and there are more of us than you realize. It took someone who knew all to well what to look for to finally have a teacher who expressed her concern for me. She was the one who gave me a safe place through her class my senior year, even checking in with me once when she feared the classroom discussion of the day made me feel uncomfortable. It was through her that the rest of school became a slightly less scary place. And she continued to watch out for me after I'd graduated. When I was home over school breaks, we'd often meet for coffee. It was on one of such coffee dates that she revealed that she'd recently been diagnosed with an anxiety disorder herself. She shared how much of herself she saw in me and that she was worried about me. At the time I was too far in denial and pushed her warnings aside, but on the list of conversations I'm most grateful for, that one makes at least my top 3. That conversation gave me an opening for someone safe to talk to once I finally was diagnosed. She became a person I turned to for assistance in finding expert help when I needed it. It couldn't have been an easy or comfortable conversation for her to have, but it changed my life for the better, particularly in how I deal with mental health struggles.


More of us need to do something sooner.

I know that there are plenty of schools that have worked and continue to work to support students with mental health issues. That help to break down the stigma so that it's safe for students to share their struggles and ask for help. I've even worked at some of them. And I have plenty of friends who work at other ones. The school systems in particular have gotten a lot better over recent years, and the adults of my generation have grown up with a greater awareness of mental health issues that helps us as we work with children and teens facing those issues. It's easy, then, to get frustrated when someone tells you that there's work to be done. Or when the world is portrayed differently than we want to see it. I remember when the Netflix series 13 Reasons Why came out last spring and watching as nearly every educator I knew got angry at the creators for portraying the adults surrounding a teen's suicide as being clueless at best and willingly useless at worst. And then I think of my own worst experiences - both as a student and as a teacher - and I realize how important that portrayal is as a warning that there still exist environments where adults are clueless, where adults are useless, where adults willingly do nothing. It's a warning that we need to keep working for change.

We need to do something sooner.


It's hard to look at a young child who's dealing with bigger problems than someone so small should have to deal with. Most of my time as an elementary music teacher has been spent with children in grades K-2. I look at their faces and see the innocence of their youth. I see their hope and joy and imagination. But I look at some of my kiddos and see something else. I see them struggle to cope with experiences that seem small to me but are shocking to their systems. I see instantaneous meltdowns over minor slights. I've more than once had young elementary students who almost always came to music saying that everyone hated them and that they hated their life. My heart hurts for these students.
Some of these littles are already surrounded by lack of awareness and stigma. Some are cared for by parents who want to protect them from how the world might see them, parents who fear the labels and paper trails that may follow their children for the rest of their lives. As a teacher, it's hard for me to hear that parents don't want their children evaluated for greater levels of need. Don't these parents understand that we as a school want to provide support for their children? But as someone with one of those labels, I also understand. Because stigma is still real, still harmful. It even exists still in some teachers who, with truly the best of intentions, sometimes write off behavior without seeing or understanding the mental health concerns behind it. I don't want my kiddos to face the stigma either. But another school year down, and their struggles are the same - some are even worse - and I wonder how they will cope as they get older and life gets more complicated.
Then I look at some of my other kiddos - the ones whose parents see them struggling and look for help, either through the school or through medical professionals. The ones whose teachers say "I know they're not going to qualify for special services this year, but what interventions can I use to help them now because I see them struggling and worry that it will only get worse." Many of those kids still struggle, but it's awe-inspiring to see how they've transformed just since the beginning of this school year - to the point that it gives me chills, leaves me speechless, and makes me teary each time I think of how much they've grown. That kind of change only happens when they have adults who are looking out for them - who can see that something isn't quite right and know where to turn to get further assistance when they don't have the expertise themselves. These kids have people who are helping to provide tools for them to cope in the face of their struggles and who are cultivating environments where these kids are still accepted among their peers. They're the lucky kids. All kids should get to be lucky kids.

So we need to do something sooner.

On this Children's Mental Health Awareness Day, I challenge those of you who have children or work with children to be alert no matter what their age. Still watch for those big red-flag warning signs, but keep an eye out for the subtle ones too - things like perfectionism, constant apologies, negative self-talk, people pleasing, self-doubt, an inability to relax, chronic irritability, etc. These traits and actions may seem unimportant when a kid is getting good grades, is involved in lots of activities, is surrounded by a group of friends, is never one to get in trouble and is always an example for their peers - but high functioning doesn't always indicate absence of problems. I would know, I lived it. And I'm trying to make sure that no other child does. But I can't do it on my own.

We need to do something sooner.

We need to watch out for these kids. We need to educate them so that when they realize something is wrong they know that it's real and valid and can be fought. We need to educate their friends so that those who struggle with their mental health can find supportive peers who will stick by their side through the battle. We need to educate their families so that when those families see signs that something isn't right, they can recognize what's going on, know that their concern is valid, and know how to get help. We need to educate their communities so that kids are surrounded by empathy, not stigma. We need to be there for all these groups, and we need to be ready to listen, ready to help when they ask for it - and, in the times when it's necessary, we need to offer them help when we see the problem before they do.

I wish I had known sooner - and I can't help but think that there are still kids out there like me, wondering what's wrong, fighting a battle against an unknown enemy, grasping at all the wrong tools because they're the only tools to be found. I don't want there to be more kids like me. I want them to know what they're fighting and how to fight it. I want them to know that it's not their fault that they're fighting the battle. I want them to know that people won't desert them because they're fighting this battle, and especially not when they feel like they're losing it. I want a world where kids can find happiness and health even when they have mental health battles to fight. And isn't that what we all want for our future generations? So dare to step up and join me, to be part of the change. One more kid like me who slips through the cracks is one too many. We need to do something sooner. We can do something sooner - so let's start doing it, together.