Q I have an 11-year-old daughter who still cries often when I take her to school. She expresses a lot of worries about other kids and what they might think about her or say about her. She tells me that she is sick to her stomach almost every morning before school. Sometimes she will even vomit. She tends to avoid social situations and has only a very few friends. She was bullied enough the past 2 years in school that we changed schools this year. She seemed okay for the first couple of weeks, but now she is displaying the same anxious behaviors before schools. She has started having bad enough nightmares that she wakes up screaming 2 or 3 times a week. Should I have her evaluated for an anxiety disorder?
This is an excellent question. Yes, I do think you should have your daughter evaluated for an anxiety disorder, because you are describing a number of symptoms that sound both distressing and continuous. For instance, your daughter is expressing concerns about what other kids will think about her, which are likely heightened by the fact that she was bullied. Also kids very often express their anxiety through body-related symptoms such as feeling sick to their stomach. In the absence of an actual medical condition, the fact that she sometimes vomits shows how anxious she is. It sounds like her sleep is disrupted as well, meaning that anxiety is intruding into what should otherwise be a restful time. Likewise, school is supposed to be a place that feels safe — a place where kids can concentrate on being a student and learning, and also being a friend and having fun.
Getting an evaluation should be your first step because a diagnostic assessment will determine what kind of anxiety your daughter is experiencing. Considering how much stress she is feeling, she may also be feeling depressed, and an expert could assess whether she needs help for that.
In case she does need treatment for anxiety, you should know that cognitive behavior therapy is usually the treatment of choice for anxiety disorders. Also called CBT, this therapy teaches kids to understand and even change their thoughts and manage their anxiety with a repertoire of effective coping strategies. Cognitive behavior therapy is evidence-based and a really great tool for helping anxious kid.