When Your Child Needs Professional Help To Manage Their Mental Health

by Whitney Casares, MD
Originally Published: 
woman hugging daughter
Scary Mommy and Terry Vine/Getty

I’m sobbing. It’s like 8:46 am and I’m sobbing. It’s for the silliest reason.

I just dropped my kids off at school and, as per usual, they got to pick the soundtrack in the car. It’s usually some Disney tune or another. This time, Moana won out. We can’t just listen to a few songs, either. Nope, they wanted that sucker to play from start to finish. By the time the last one hopped out of the car, a few songs still remained and, again as per our usual, I forgot to turn it off. I found myself humming along absentmindedly as I wound my way through the surface streets and over to the freeway toward my pediatrics’ office.

Finally that song, “Know Who You Are” comes on – the one where (spoiler alert!) Moana restores the heart to the lava monster, Te Ka, revealing the beautiful, hidden island of Te Fiti.

“I have crossed the horizon to find you,” Moana croons.

“I know your name.

They have stolen the heart from inside you

But this does not define you

This is not who you are

You know who you are.”

Like I said, I’m sobbing, big fat tears running down my face as I try to concentrate on the road.

I’m sobbing because, for the longest time, it was hard to see who my oldest daughter really was. She suffered from severe colic as a baby (and I followed suit with postpartum depression right behind her). She struggled with potty training, she had the hardest time sleeping. She tantrumed through her toddler years. She lashed out whenever she was emotionally dysregulated. She suffered from the very first month of her life under what I know now was an extreme level of anxiety.

My husband and I consulted her pediatrician and mental health experts. We had labs drawn. We tried occupational therapy. We had her tested for autism. We went to multiple parent coaches and child psychologists. It seemed like we were working so hard to keep her together and to keep our lives together, too.

Sometimes, it felt like her anxiety defined her, no, consumed her – and our family. There were moments you could see glimmers of who she really is: a creative force who feels deeply and cares immensely; a brilliant mind who loves reading, imagining, and expressing. In her best moments, she is a light to everyone – happily singing and dancing. She cuddles in close for hugs and stories. She joyfully leads her sister in plays and dress-up performances. But those moments were often hard to come by, and could be shrouded by worry and fight or flight-fueled reactions in the blink of an eye.

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As a pediatrician, I know all kids have trouble regulating their emotions and can be complete jerks, especially when they’re tired or hungry or scared, but this was something completely different. There were so many nights when all I could do was sit against the door inside her bedroom as she raged over an unpredicted turn of events (“No, we can’t go if Matt won’t be there! I don’t care if he’s sick”) or over worries that wouldn’t let her be (“What if I make a mistake in dance class? I just can’t go! Everyone will laugh at me”). I sat, and held my baby girl, unable to reason with her, and hoped beyond hope that someday she would be free of this force that so clearly kept her captive.

It seemed like time and age only heightened it all. Suddenly, her three-year-old sister became more emotionally mature than she did, comforting her with, “It’s okay, sweetie, it will be okay,” and patting her gently on the shoulder. Finally, after working with a young family in my own clinic who started anti-anxiety medications for their six-year-old, we turned to a psychiatrist for help. I don’t take prescribing medications for any child lightly, but taking the plunge into the medication world for own my little one felt even more daunting. At the same time, though, I knew we couldn’t keep on going the way we had been for so long. We were too tired and overwhelmed for that.

It took about two weeks for the medication to fully kick in and, although she was still six (and acted like it regularly), the lows weren’t quite as low. Her outbursts weren’t as grand. Her mountains (even meeting a friendly mascot at a local baseball game) were more like the mole hills other kids faced.

Slowly, we chemically brought her back in balance, working with her therapist to maximize rewiring her responses to everyday obstacles. And it was as if — after all that determined, heart-wrenching searching across the horizon for the one I knew was out there — I got to place the heart in my own fiery lava monster and she literally melted, relaxing into the true beauty I’ve always known she was. She became the exquisite (yet still quirky and sensitive) island I always knew was waiting to be unveiled.

We still go to therapy for her. We still do all the hard work to support her. Bedtime is at 8 o’clock sharp. She doesn’t miss a meal. We don’t pick activities we know will send her over the edge and now, thank goodness, she’s able to more logically explain that attending a holiday performance with multiple set changes makes “her heart buzz and her tummy feel funny” versus screaming and hitting me as we enter the lobby. I can help her now because I know what she needs.

Maybe as you’re reading this, you’re going through a tough time with your sweet child who doesn’t appear so sweet to you at this moment. Maybe it feels like you’ve lost them to colic, or to a really hard developmental stage, or to a group of friends you don’t like, or to some bad behaviors they’ve taken on or to or… you name it. Remember, mama, that’s not them. It doesn’t define them.

Keep searching across the horizons to find them. If they’re young, first get the support you need to weather through it. Take care of yourself while you’re trying to take care of your little one. Then, collect data and get help from professionals (a pediatrician’s office is a good place to start). If they’re older and it’s a behavior you’re seeing that isn’t in line with the character you know they have, learn how to have choreographed conversations with them to get at the “why” behind what they’re doing.

Remember, our kids are always waiting and hoping for us to reveal their true selves. They’re waiting for us to tell them, “You know and I know who you are.”

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