Anxiety & School Refusal - Please help!

[Namastayinbed87]

Hi everyone, I am desperately seeking advice regarding my 9 year old son.

From around March this year, my son has been suffering from extreme anxiety, it seemed to come out of nowhere. No changes in our home life, no issues at school or when he is in class etc... He started refusing to go to school and struggling to settle at night. I called the GP who referred him to CAHMS Scotland. After a while we received an initial choice appointment where I discussed my concerns around my Son. Since that appointment, we haven't gotten any further with them and they have advised the waiting list is up to 2 years.

Things have gotten progressively worse, he is completely refusing to go to school and won't settle at night unless he is in my bed with me there, even then he will take hours to drop off to sleep and is awake again a few times through the night. He is also showing signs of separation anxiety from me, but he seems to be absolutely fine if he stays overnight at my sisters.

The school are trying to help the best they can, we have had a family engagement officer try to assist us by coming out to our home and encouraging him to go to school. As soon as he opens his eyes in the morning, he starts to refuse to get up and go to school. He can spend the full morning in tears, throwing himself to the floor saying he's hurt or cannot get back up himself. He is also in a cycle of negative thinking, and from the bottom of my heart, I have tried and said everything I possible can to help him. I have spoken to 4 GP's who have advised they cannot help because of his age and refuse to refer him to a pediatrician.

I was made redundant a few months back where I had a WFH job, and since then I am struggling to commit to a job as I can't seem to get him to go to school and he can be upset and having panic attacks for a full morning. I am now struggling financially and falling behind on bills. He seems to refuse any methods of relaxation or breathing as he gets so upset it's like he doesn't even hear me trying to help him. I am at a complete loss as to what to do now and the school can only do so much to help. They wont provide funding for therapy in school until he is actually attending. I am absolutely heartbroken seeing my little boy go through this and at the same time it is really starting to affect my physical and mental heath as everyday is a struggle. I'm having alot of chest pains and I feel so worn down.

Has anyone went through a similar situation and can advise if there are any other help outlets available? Due to my financial situation I can't afford private counselling for CBT. Thank you in advance.

Sorry to hear you're going through this.

What do the school say? How was he doing - socially/academically in school?
Did he seem to be struggling at all? Falling behind with e.g. reading/ homework, or reluctant to do homework?

Although not on the same scale, we had anxiety/ school avoidance issues with DS2 from a similar age. It turns out he had dyslexia and although he was just about keeping up enough in the classroom so as not to attract attention, it was hugely stressful for him. He realised he didn't 'get' stuff as quickly as others, and some of the other students had called him 'slow' 😡
Could something like this be going on perhaps?

Thank you for your reply!

He was doing great at school prior to this, his teacher always said he was a hard worker and enjoyed learning. The only issue was to slow down with handwriting. He was always coming home proud with his wee certificates 😔

I keep in contact with the school daily, they just keep saying to try and get him in, even for a few hours but it's not easy at all. I can't even get him to get dressed, he just refuses. He's quite a tall and strong boy. Not that I would, but I literally couldn't force him to get ready if I tried.

Sorry you and your son are going through this. This is something called EBSA (emotionally based school avoidance). Unfortunately CAMHS are very hit and miss when dealing with any kind of mental health related issues in children (IMHO). Speak to your GP again and see if you be given a letter stating that your child is experiencing severe anxiety and it has created a barrier for him getting to mainstream school.

The LA/school should be putting steps in place for him to have an appropriate education whilst he is unable to physically get into school. Once he has been away from school for 15 days then the onus is on them to provide it.

There is more information on the IPSEA website of steps you can take.

Wishing you both much love.

Thank you for your advice.

I have asked the school to provide work that he is missing out on, but they said that if they do that then he will get used to that and will continue to not come to school 😕I was quite surprised at their response

If it came on very suddenly after a strep infection it might be worth investigating PANS / PANDAS.

Oh dear, that does sound difficult 😥

There isn't an option where you could volunteer for an hour or so to do reading/crafts etc as a parent helper so he goes into school with you and settles?

I appreciate that this might not be possible if you're looking for work though.

What does he say for his reasons that he doesn't want to go? There's no possibility he is being bullied/picked on by another child is there?

Do not go to Sam and Martin Robbin’s program whatever you do!!! They change their name incessantly so it’s hard to know what they’re going by now but they used to be Young Vibes and they were also stop anxiety now I think. They changed their name all the time because they keep getting in trouble because they’re not formally trained. They refuse subject access requests. They have been in trouble with trade standards. The BBC did a story on them. https://downloads.bbc.co.uk/rmhttp/fileon4/PAJ_2707_PG13_Mental_Health_Profiteers.pdf

there are several people who make suggestions for free organizations, but I’m not finding them right now but they are on the post post about Young Vibes. Also look at Connections in Mind and also look at Dr. Becky Kennedy.

At what time of morning/day do you sort of give up on the coaxing and he eventually settles down? I'm assuming once he realizes too much time has passed and he's secure in the knowledge that he's not going in that the anxiety/panic stops?

What are his main worries/concerns that will happen while at school, is it that he worries something bad will happen to you or that something bad will happen to him and you're not there as back up/reassurance?

I am not sure of the systems with you being Scotland; but here in the midlands we have a team of teachers at the County Council who teach children who are medically unfit for school. I work for them and a lot of my students have severe school anxiety. We work therapeutically and try to reengage them slowly with education.

Does he complete work at home? Is it purely the school environment and potential social anxiety or is it the work as well?

What does he do whilst he's at home? What is behaviour like in general?

What are his friendships like?

IPSEA isn’t relevant since you are in Scotland. Have a look at Enquire instead.

We went through this with DS at a similar age as yours. Ours started in lockdown when he developed terrible anxiety and OCD. It came out of nowhere as well. We got an urgent referral because he had developed suicidal thoughts and of harming us. He became extremely distressed due to these and more which led to not eating, not sleeping, tears all day, loss of interest in all hobbies and fun games.

The referral came quickly and we were appointed a clinical psychologist who did video calls with DS and I, offering CBT. I honestly feel they weren't massively helpful. But she did listen to my concerns that DS needs an ASD assessment. She made the referral to camhs and I do believe it was fast tracked as a result. Within 4 to 6 weeks the MH practitioner made contact and we had online appointments weekly. She began the assessments but whilst this was ongoing he had a relapse and the OCD and anxiety came back with a vengeance so offered weekly CBT sessions alongside the assessment ones. These massively helped. Lockdown was over. He was now expected to attend school but felt he was unable to. Thankfully with the CBT he started going in. He was in year 6 at the time. Bullying started towards the end of year 6 and so did the school refusal. With the bullying we nipped it in the bud but anxiety has never really gone away. Hes now in year 10 and we have had EBSA on and off over the years, CAMHS didnt want to know as they say he is autistic and anxiety etc is part and parcel of that. They did signpost us to some local charity after I broke down on the phone to them, now this charity offered talking therapy to DS - a child who is selective mute, who struggles to vocalise what he's feeling, who has always needed me to advocate for him. But I wasn't allowed to sit in on these video sessions. So that was a waste of time for everyone. And I did overhear her once say to DS 'well if you're not going to talk then what is the point of sitting here'.

Anyway this was our experience with DS. I'd try and get the camhs referral fast tracked in any way I could because the longer the EBSA and anxiety go on, the harder it is to treat.

I'm in Scotland too. Enquire are very good if you call them as regards to your rights and supports in law.

It is difficult to know what's going on with the info to hand. Is he ok with friends - will he still go over to pals' houses, play out, have friends over?

Does he still engage and get involved with friends? Is he ok going to cubs, beavers, any other groups?

Is this definitely just school?

Does he seperate well from you to go to other activities?

Sometimes kids school refuse because they are worried about YOUR health - that something awful is going to happen to you. This is the kind of age kids become aware that parents can die.

Has anyone at school had a parent die recently or become very ill? Any child at the school very ill or passed?

Any health concerns in the family? Grandparents?

If all that is ruled out and he goes off to other activities with the same friends, you need to look closer at the school environment.

The teacher.

The toilet situation.

The class control.

Next - you mention handwriting. How are his other motor skills? His pen hold? Getting changed for PE? Tying laces?

Some teachers put a lot of pressure on to do things fast and if your boy is dyspraxic, he will struggle to process verbal info fast and slowness getting changed, messy handwriting, poor organisation still gets some teachers really angry. They shout at the kid which causes anxiety and poor self esteem.

Anything like this needs an educational psychologist involved and an IEP in place.

Other clues to poor motor skills are a dislike of ball games, messy eating, clumsy, might have an unusual gait when running - arms out maybe. Balance can be poor and might be scared of heights, avoids rough and tumble type games.

In fact any learning prob needs the ed psych.

Emotionally based problems (worries re home, friends etc in the absence of a learning prob it's clinical psych)

Clinical psychs are nhs based and chances of seeing them next to nil. You would need to go via gp or private.

Ed psych are education service - school can refer.

Start with Enquire. They will point you in the right direction

You have my sympathy OP. I’ve a 9 year old daughter displaying them same anxiety.

They tend to call it EBSA (emotionally based school avoidance) rather than refusal just because refusal implies a conscious choice is being made rather than it being the result of MH issues like anxiety.

It is incredibly stressful. If you’re on FB there’s a great page called Not Fine In School. It has lots of great advice and also families who are going through it too.

Our child struggled with EBSA aged 9 and was ultimately diagnosed as autistic.

They are attending school now but it took a long time to get there. We tried to understand what specifically made them anxious about school. For us it was being asked questions unexpectedly, anything where they were the centre of attention, any kind of show/sports day/play and the practicing for these and assemblies.

The school essentially assured my child that they would never have to do any of these things, made a little certificate of this promise and laminated it. All of the teachers are aware of this but my child also carries the promise around with them to show a teacher if they're ever asked to do any of those things accidently.

School can still be a tricky place for them and they can get very emotional about any interactions with peers that aren't 100% positive, or if they feel the teacher is being unjust in some way. Obviously we can't prevent those things from happening and they do cause major wobbles and the odd day off still.

But understanding what specific things triggered the anxiety and the school flexing to accommodate their needs has meant that school attendance is now much, much better.

This is a long but very insightful thread that you might find helpful:

https://www.mumsnet.com/talk/chat/5003192-the-ebsa-support-thread-emotionally-based-school-avoidanceabsence?page=26&reply=138397460

I know it isn't ideal but could you look into benefits that might support you and reduce some or the pressure on the whole situation? Would you be entitled to carers allowance?

No Matter what you do, avoid Sam and Martin Robbins. They have been called Young Vibes, Stop Anxiety Now, Peaky parents, Themumsnet (bonkers) and now Anxious to Awesome. They will promise you the world, but they have no formal training or experience and they have no ability to deal with any child with neurodivergence. They have been in trouble with the trade standards. They refuse subject access requests they will make your life so much more stressful. A lot of people recommend Charlie Waller Trust.

The neurotransmitter in the brain that helps with anxiety is serotonin. Research it. I’m not a doctor, but there is a supplement called five HTP and that is a precursor to serotonin. We take it in our family to help produce more serotonin to have that feel good relaxed feeling. It’s over-the-counter and you can get it from the natural dispensary shipped to you out of Stroud. You do want to just start a low-dose like 50 mg and make sure it has B6 with it or take it with B6 for metabolism. Also do not take them if he’s on an antidepressant because you don’t want serotonin syndrome.

but whatever you do avoid like the devil and the plague Sam and Martin Robins because they will make your life even harder.

Was there any traumatic episode leading up to it? Could anything have happened to him? It sounds like whatever’s happening as the neurotransmitters in his brain or way out of whack so his dopamine serotonin and norepinephrine are way out of whack. I’m not a doctor, but I’ve had to study this with my own kids because my son had OCD, but if you look up all the symptoms of low serotonin or low dopamine or low norepinephrine see if any of that sounds familiar. Low motivation and pain tolerance and memory could be dopamine and norepinephrine…which you can use Wellbutrin. Never relaxing could be seratonin and either 5 HTP or lexapro. Study neurotransmitters to see which symptoms he is showing . Sometimes psychotic episodes are too much dopamine.