teachers, what do you do with year 11 child who leaves classroom and won't attend school due to panic attacks?

[papayasareyum]

my year 11 daughter is experiencing this. Acute anxiety, meaning she has panic attacks and has to leave classroom and work in another room. She's having lots of time off school due to this. I encourage, persuade, do everything to try and get her into school, but how can I make a fully grown 15 old get in the car if she's engulfed by panic and wont go? She's got lots of friends at school, absolutely loves school, but feels trapped in the long lessons and it makes her panicky...no issue before year 11, I suspect she's internalising GCSE stresses, perhaps unconscious stress. She's having counselling and has beta blockers for anxiety, but the problem is still there. It doesn't help that I strongly suspect the school feels she isn't trying hard enough to get in every day and that they're not happy about her leaving the lessons and doing the work elsewhere (the work is always done and she's on course for top grades) What do you do in your schools with children like this? I've got another meeting at the school next week (which I've requested) and I need to think of some ideas to get her through the next few months and wonder what happens in other schools? Any advice?

It’s a really tough one, and it sounds like you’re doing all the right things. Obviously if the severe panic attacks are persisting then you need to keep going back to the doctors to monitor her dosage, is the counselling helping?
Other stuff - relaxation techniques, looking at a meditation app, making sure she gets plenty of exercise. I would also strongly recommend deleting social media if you haven’t - Y11s can be overwhelmed by their peers going on about how stressed they are, how much revision they need to do, college applications etc etc, on top of the more usual teenage anxieties.

Has she sat mocks yet? The school should be looking at putting her in a small room for exams, (medical recommendation may be needed).

In lessons, she needs to be able to feel that she can leave whenever she needs to - my school would send an email round to ensure that she is sat near the door and has a card to leave lessons. Does she have to go somewhere else to work or could she go somewhere else to calm down and then go back to lessons?

What about interhigh? It's an online classroom, where you still follow a curriculum, get up for classes etc, except it's done from home from the PC. It does cost though.
Always a thought.

noble giraffe, the school have done most of those things. They called me in for a meeting a few weeks ago though and said that they felt that she could make more of an effort to stay in the lessons. She's really embarrassed when she has to leave the classroom, so she's not doing it for a laugh. Since they said this, it's been a bigger struggle to get her into school, as she thinks the teachers think she's taking the piss and can't be bothered to stay in the classroom. I can see where the school are coming from, to some degree. She can sometimes spend half the school day in a separate room (like a pastoral support/thrive area where she can do the work) and I understand why that's not ideal. I don't know how we force a very panicked teenager to stay in a room she wants to run screaming from, though? I've tried the softly supportive approach and the firm but kind approach and the firm firm approach and it doesn't alter anything. I know its not ideal, as its year 11, but not sure what else we or the school can do, except maybe let her have a reduced timetable or work from home and turn up for the exams in May? I'm really at a loss and the school just keep saying that I need to 'get her in' as if I'm not trying this already! I've looked at Interhigh and it's too expensive for us, sadly.

as she thinks the teachers think she's taking the piss and can't be bothered to stay in the classroom

I know students who take the piss and can’t be bothered to stay in the classroom, and they are not top performing students who take themselves off to work elsewhere and keep up with the curriculum. It is unfortunately common for high achieving girls to fold under stress in Y11 and teachers would be quite used to this, so I’d expect individual teachers to be quite sympathetic.

It’s awful that the school have said that she could make more effort to be in lessons - was she present at that meeting? There is such a focus on mental health in schools that it’s bizarre that a pastoral team isn’t more clued-up. I think you need to be more forceful with them that this isn’t a choice for her - the doctor, the medication she is on etc demonstrate that it is something that needs to be taken seriously - they wouldn’t tell a kid on crutches that they need to make more effort to do PE.

they wouldn’t tell a kid on crutches that they need to make more effort to do PE

I'm going to use that analogy in the meeting, thank you.
I've been processing what they said since the meeting. I know teachers have a tough tough job and dealing with obnoxious parents is probably the worst aspect of the job (or one of them) so I always try to be reasonable to the point of bovine compliance when I deal with teachers, as I don't want to add to their stress! But it does need to be said, I think. Thank you.

I’ve had students who have used the technique on this link - might be worth looking at with your dd
www.getselfhelp.co.uk/stopp.htm

It's also not uncommon for 'panic attacks' when 15 to be actually just a normal response to stress which they don't quit understand. This may be what the teacher was alluding to (not to say this was actually the case just possibly what the teachers are thinking).

She needs counselling to help her process the anxiety because we all know life can get a lot more stressful...

what I’m finding challenging right now is getting her to school when she’s crying, shaking, sobbing and point blank refusing to get in the car. The school tell me to “just get her to school” but when she’s in a state of panic and won’t budge, how do I physically get her from home to the school?

You cannot physically bundle a sobbing teenager into a car and the school shouldn’t be expecting you to. You need to deal with the panic attack, using whatever techniques have been shown to help.

Have you discussed the process of getting to school with your DD? What does she think would help head-off the panic attack before it gets to the point where she can’t move? What has helped on days when she has made it into school?
Can she distract herself? Headphones? Music? Watch something on a tablet to take her mind off the actual process of getting to school?

Does she know that panic attacks won't hurt her? As overwhelming awful as they feel (fellow sufferer here), they're not dangerous. The impulse to flee is much more manageable knowing that they'll pass and you'll be totally unscathed. Can you buy her some nice stationery so she can doodle, wordsearch etc as a distraction technique whilst it passes. I use to actually write out "this can't hurt me" over and over. Check out the Linden Method, you can do it from home.

Cognitive behavioural therapy can be very successful with panic attacks. One of the things it teaches people is that if you go with it, a panic attack does actually get better. Also 7-11 breathing helps with panic attacks.
But I wonder if she is actually having a panic attack? Crying, shaking and sobbing is being very upset. A panic attack is breathing too rapidly so that you take in too much carbon dioxide which causes short term physical symptoms.

This matters because how she can best deal with it is different depending what it is.

Dont whatever you do move her to working from home as suggested above. When someone has anxiety they need to keep fighting it. Giving into it tends to mean that the anxiety gets focused on something else instead e.g. going outside the house at all.

Can't offer any advice I'm afraid but this sounds similar to my year 10 daughter. Not refusing to go to school yet, but I can see we could easily be in the same situation in a years time. Seeing the school councillor regularly has helped my daughter. She won't talk to me about it but does talk to her friends. I just wanted to let you know you are not alone.

@abacucat I completely agree and know that when she is attending her mental health is better, but often I can’t budge her through the door at all. She sometimes won’t even get out of bed, despite me cajoling, encouraging, pleading, begging and then yelling. I just don’t know how to force a very headstrong, unhappy child who is shaking with anxiety out of bed and in the car? I think she’s becoming depressed now too as she says she wishes she wasn’t alive (although she says she isn’t going to kill herself) I think the stress of loving school but now this anxiety meaning she can’t stay in the classroom, along with the fact that her teachers don’t seem convinced that she’s genuine (her counsellor actually suggested she lets them see her cry, ffs) is creating a perfect storm

I wonder if anti anxiety medication might help her short term to get out of bed and to school?
This article gives some advice to parents of school refusal kids.
www.psychologytoday.com/gb/blog/worry-free-kids/201710/how-help-child-overcome-school-refusal

I would highly recommend this helpline. Both you and your DD can ring it.
www.sane.org.uk/what_we_do/support/helpline

All the advice says it needs a team approach to tackle, but the teachers don't seem on board with this. I wonder if you need to push the school to be much more supportive and work with you on this.

Also given her age it might help to look at the advice and guidance for adults with anxiety that makes it hard for them to get out of bed.

She has to want to get over the panic attacks so that she is the one managing them -you can’t do that for her. I used to get them frequently and had some success with the following; moving - staying still whilst having one meant that I felt both panicked and paralysed - even sequential finger tapping helped a bit. Nature sounds. - especially running water sounds on my phone used to bring me out of it quite fast. Juggling bean bags (or trying to - because you have to concentrate really hard). Sitting near the door - so I could go if I needed too. Telling people about it - so they understood. Not fighting them - accepting it and looking for something else to focus on. Beta blockers didn’t nothing to help. I am also a fan of aromatherapy oils especially frankinsense for panic attacks.

Eldest ds had similar issues during a levels which I appreciate is slightly different as its past compulsory attendance age but he came out the other side. He refused to take medication but did engage with counselling both through the GP and school. He had overwhelming feelings of being trapped and controlled. Teachers micromanagig (with the best of intentions) Sent him into a panic. He never felt good enough. Anyway things which helped were; listening to him, it often felt like the conversation went round and round but it put things into perspective. Having someone he could go to in school if he needed to and somewhere to go if he needed to, like a safe space. He stopped going to the lesson which was triggering it the worst and self taught in library or at home. On really bad days nothing helped which was heartbreaking but slowly the really bad days got further apart.
He ended up getting the grades he needed and is now at university and doing well. He is acutely aware of his mental health and wellbeing and knows how to keep himself in check with only minor wobbles. On reflection I think on occasions I was enabling his anxiety but who knows if that would have made much difference. Good luck and I hope your dd can find her way through soon.

thank you all @3teens2cats do you mind me asking what you think you did to enable it? I sometimes think I should be more forceful in making her go to school, but when I do force things, it seems to make her more anxious and then it has the opposite effect (she's off school more), I feel constantly guilty and as though I'm making the situation worse not better. But I've tried pretty much EVERYthing and none of it seems to alter the fact that when she's anxious and won't go school, she's anxious and wont to to school!

@papayasareyum I think my own worry could have fed his iyswim. One of my brothers took his own life and I am terrified of my sons feeling like they can't talk or overcome their feelings. I would constantly ask him if he was OK and possibly just gave his anxiety too much attention. I didn't give him much chance to work through his feelings without jumping on it and trying to make it better. Obviously being there was the right thing to do and dismissing his feelings would have been totally wrong but I often wonder if I should have given him more space to work through his own feelings without trying to fix him all the time. It's only since seeing how well he is coping on his own at uni that I can see it.