anxiety

Anxiety: When Intervention Is Needed (Part 2)

We often think of interventions as surprise meetings where family and friends gather around the person of focus, inform them they’ve gone off the rails and insist that change is needed.

That’s not always how interventions go. Intervention is defined as “action taken to improve a situation.” They can be subtle. Our first action was taking Mary to the doctor. We were disappointed with the result.

The doctor met with Mary alone. Afterwards, the doctor met with me. She acknowledged that Mary’s weight was low, but I could tell she wasn’t as worried as I was. My guess was Mary had come across as pretty level headed. Because she is. The doctor asked me about my concerns. I told her. I focused on the fact that Mary was denying herself everything she loves. That she limited herself to salad for dinner, despite having just finished 90 minutes of soccer practice. We’ve been going to this doctor since Mary was born. She knows I’m not one to overreact. We agreed we’d come back in four weeks.

We got in the car after the appointment, and I asked Mary what they’d talked about. Mary said she gave her a list of healthy snacks she could try – Yogurt and granola, a bagel with peanut butter. “She told me to add one of these a day.”

One snack? That was it?! I was perplexed. There was no way adding one snack would make the difference Mary needed. But I was also hopeful. Maybe we were overreacting. Maybe things are okay. I wanted things to be okay.

Over the next four weeks Mary ate her snacks. We returned to the doctor’s office. She’d lost more weight. I also learned she’d stopped having her period.

What happened next is a bit of a blur. I asked Mary what she remembered about the order of events. She didn’t remember either. She did remember this: “You and Dad told me I had to go see a psychologist. I did NOT want to do that.”

Ah, it came back to me. Chad had found a family treatment center for teenagers with eating disorders. It was a multi week program, three afternoons a week. We’d presented it to Mary.

“What about soccer practice?”

“You’ll miss practices. This is more important than soccer. This is your long-term health.”

Missing soccer was, in Mary’s mind, not an option, but she could see we were serious. We gave her one more choice.

“Mary, we’re willing to take you to a nutritionist first. But we’ll need to see some changes in your eating. Otherwise, we’re enrolling you in the center.”

“Okay.”

The first appointment with the nutritionist started with all three of us together. Her name was Michelle. She asked each of us to share our thoughts about Mary’s health and why we were there. She listened as Mary shared her eating regimen. To our relief, Michelle immediately acknowledged that Mary wasn’t eating enough. She said it without judgment. It was an observation.

Before we left, she talked Mary through a new regimen that included three additional snacks every day. She told Mary to eat before every soccer practice and then again afterwards. She supported Mary’s desire to eat healthy food – she added things to the list that were healthy and also contained fat and protein. Michelle made it clear – Mary’s dinner salad wasn’t enough. We stopped at the grocery store and picked up some of the foods Michelle had recommended.

We watched Mary everyday. She was taking more snacks to school. Her mood slowly improved (she wasn’t starving!). Four weeks later, we returned to see Michelle. Mary had gained weight. It was the first time in months. She’d only gained a few pounds, so she was still well below her ideal weight. But this was the first time in months that she hadn’t lost weight, and it was worth celebrating.

They say it takes a village to raise children, and we engaged ours. We told our family and our closest friends what was happening, including the parents of Mary’s best friend. We knew they’d be supportive and respect her privacy. When the opportunity arose, her best friend provided encouragement, “Mary, that looks so good! You should eat more!” Her soccer coach checked in regularly. “You okay to play?” “You want to come out?” Of course, Mary always said she was fine to play and never wanted to come out. But, by asking he acknowledged her situation, he was subtle about it (show of respect) and he made space for her – if she needed to step away, she could.

Over the next few months Mary’s weight went up and down – mostly up. She wasn’t always eager to eat six times everyday. And sometimes she didn’t. But she inched towards her ideal weight and, once she reached it, stayed there. Her period started again.

Looking back, Mary acknowledges that she had anorexia. She’d looked up the symptoms – tendency towards obsessive behaviors, maintaining an excessive, rigid exercise regimen, refusing to eat certain foods, strong need for control, menstrual irregularities. It hasn’t gone away. She’s aware of it and makes conscious decisions to keep herself healthy.

“Mary, what got you through it?” I asked, as I got ready to write this post. I was truly curious – hopeful she’d give me “the” answer. Her response was non-committal. She wasn’t sure – she thought it was several things. She didn’t want to see a psychologist. Her eating was negatively impacting her soccer (she found herself so tired she didn’t want to go to practice). She learned what and how she should be eating from Michelle. She also learned about eating disorders – that she’s not alone. They’re common. Especially among young women and female athletes. I noticed a new podcast in our family feed – Real Pod with Victoria Gerrick.

Victoria is a former D1 athlete who had an eating disorder, and she speaks openly about her experiences. She shares how damaging the environment for athletes can be – physically and mentally. She brings guests on the show who share their experiences. Not always about eating issues. Anything that proved challenging. Through that, Mary learned the pressure she was feeling was real and others experience it too. She learned that her instinct to moderate her eating and follow the crowd might be unhealthy. She learned that eating yummy treats is okay and even encouraged (thank you, Victoria, for being part of Mary’s village).

In August, Mary will start college in Chicago. I asked her if she’s thought about what might trigger her anorexia. Will the stress of the new school, the soccer team, studies, create a desire for control? Will she revert back to her old eating regimen? She answered honestly. “I don’t think so.” For Mary, her eating isn’t triggered by events. She’s got a new regimen that keeps her healthy, and she’s committed to it. I’m hopeful, and I’ll keep watching.

Talking to Kids About War Is Like Talking to Them About Sex

Okay, so it’s not.

Talking to kids about war is not like talking to them about sex. However, the approach I’m using is similar. Stick with me.

When Mary and Payton were in Elementary School our PTA had a speaker come and talk to us. The topic: How to talk to your kids about sex. It was one of the most highly attended events. Everyone was eager to learn yet…uncomfortable. We’d all grown up with parents who either avoided the conversation altogether or took us through a horribly long, awkward conversation where they never named a body part. Instead they used nicknames. Penis was more comfortably referred to as “pee pee.” Apparently some parents referred to “broccoli.” Yikes.

Two things stuck with me. First – name it. Vagina is vagina, penis is penis and so on. Avoiding the names of body parts, she pointed out, makes them seem like something we should be ashamed of, embarrassed about and ultimately, something we shouldn’t talk about. The second thing that stuck with me – ditch the 2-hour conversation. Instead, have 200 one-minute conversations. One long, awkward two-hour conversation is something you get through. 200 one-minute conversations give kids the sense that it’s safe and comfortable for them to come to you when they have questions.

So, what does this have to do with war?

On February 23, 2022, Russia invaded Ukraine. After it happened, several experts admitted they were surprised. It was a bold move motivated by Putin’s desire to take back what Russia once had. This is the first time since WWII that an invasion like this has happened among the Western countries. I want my kids to understand the gravity of the situation. But I don’t want to terrorize them.

We learned Russia bombed a building marked “Children.” Ukrainians had intentionally labeled the building so Russian’s would know civilians were there. “Don’t bomb us” was the underlying message. Russia did anyway. When talking about it, I find myself wanting to replace “murder” with some other, less disturbing word. But then I think about the advice we’d been given – Name It. It was murder, and I should say it. Sugar coating it with less intense words doesn’t explain the reality, and it’s an injustice to the Ukrainians.

Hearing about and talking about murder and atrocities of war day after day is hard for me as an adult. Adding that to the thoughts of anxious teenagers could be twice as intense and possibly crippling. When 9/11 happened, I remember my doctor telling me how traumatizing it was for kids to see news stories showing the planes flying into the World Trade Center buildings. Younger kids, she pointed out, didn’t realize it was the same scenes being replayed. They thought it was happening over and over, across the U.S. There were terrorized. Specialists started encouraging parents to moderate how much news they watched.

Learning from the past, we manage the frequency and depth of the news and conversations we have about the war. The news is on the radio in the morning and evening. We want to know what’s happening. Chad and I highlight information we believe is important for them to hear. But we keep the conversations short.

Mary came home one night after soccer practice. She’d filled up the car with gas and was shocked at the gas prices. “The price of gas is $4.65 per gallon!” Chad and I nodded. We knew the war was having an impact on gas prices. Chad took the opportunity to explain this to Mary. While the war might feel far away, there are ripple effects. War impacts all of us. He didn’t go into a deep explanation of how gas prices are set. A one-minute (okay, maybe two-minute) conversation.

During a news story one morning, a reporter shared what Russia was broadcasting to Russian citizens. Apparently they’re claiming Ukraine is bombing itself. “That’s absurd!” I blurted out. “Why would anyone believe citizens would bomb themselves?” The kids were making their lunches. I wanted the kids to hear what I was saying. “You have to think about what you’re being told. If it doesn’t make sense – ask questions. Something’s wrong.” We talked briefly about the Russian press and the importance of a free press. Then they continued getting ready for school. Another 1-minute conversation.

Figuring out what to say to your kids requires a fine balance. You want them to be informed, to understand what’s happening in the world. But you don’t want them to be afraid. As I navigate these conversations, the advice I was given to help me talk to my kids about sex feels relevant and useful as I try to talk to my kids about war. Hindsight will tell.

Mental Health Days Are Worth Their Weight in Gold

On Wednesday, Chad came into the kitchen and quietly warned me, “Ellie’s really tired and is saying she might not go to school tomorrow.” He’d just brought Ellie and her twin sister Emily home from Ultimate Frisbee practice. Telling me she’s tired is his way of warning me – she’s feeling sensitive. Careful what you say and how you say it.

Ellie, like any teenager, has her sensitive moments. Hers tend to be a bit more….intense. She can have strong reactions to things that seem fairly mundane. Every week I go to Bakery Nouveau and buy pastries. One week I brought Ellie a cheese danish. When she saw it she went silent. She closed the box and walked away. She wasn’t rude. It was like she knew she couldn’t say anything nice, so she didn’t say anything at all. Two days passed. She’d been really quiet around me. We were in the car together, and I asked her, “are you okay?”

“Yeah. I was just really looking forward to the loaf cake. And I don’t like cheese danish. I was just really disappointed. I’m over it now.” And that was it. Episode over.

Sometimes Ellie feels down. That’s the easiest way to explain it. You can see it. She’s quiet. Her energy is low. She doesn’t engage with the family (not even to roll her eyes at Chad’s silly Dad jokes). She goes off to quiet parts of the house, away from the rest of us. We’ll ask if she’s okay, and she’ll shrug. As if she’s not sure. She’s not trying to be difficult. I don’t think she knows how to describe how she’s feeling, let alone why.

Today was one of those days. After taking a shower, she came downstairs, cut up some radishes and went back up to her room (she rejects cheese danish but snacks on radishes. Whose daughter is she? We’ll unpack that another time). The rest of us sat down to eat dinner. We weren’t sure if she’d join us. We let her be.

Chad tentatively asked Emily, “Do you know what’s made her sad?”

“No, but I think she’s tired.”

“Maybe a day off would be good for her,” Chad considered out loud.

Emily agreed, “I think she needs it.”

We’ve never let our kids stay home from school for feeling sad before, but none of us hesitated. We could all see that Ellie wasn’t herself. She wasn’t acting sad to seek attention. That would have required energy she didn’t have (and would have required a completely different response).

In his book Permission to Feel, Marc Brackett taught me there are degrees of emotions that we rarely reveal because we use so few words to describe how we’re feeling. I pulled out his book, knowing there must be better words than “sad” to describe what I saw in Ellie. I looked at his Mood Meter. It’s a grid with four quadrants and emotion words within each quadrant. I focused on the lower left – the low energy, low pleasantness.

Apathetic, sullen, disheartened, tired, bored, lonely, morose, glum, alienated, depressed, desolate, spent……

Combine sullen (Miriam-Webster’s definition: “dull or somber in sound or color; dismal, gloomy) with “spent.” From the outside looking in, that summed it up.

Ellie eventually came downstairs. She ate a little dinner and curled up in one of the chairs in front of the TV. Per our usual, we were watching a British mystery. In between episodes I looked over at her.

“Ellie?”

She looked up.

“If you want to stay home and take a mental health day tomorrow, you have our support.”

“Okay” was all she said. But I think I saw a tiny hint of relief.

We didn’t say anything more after that. Everyone went to bed. The next morning, Emily was up and ready as usual. Ellie was still in bed. Chad emailed the school, “Ellie isn’t feeling well today, so we’re keeping her home.”

When I was growing up, not feeling well required a cough or fever or some physical symptom. I think my Dad would have laughed at me if I’d said “I’m feeling spent and down, can I take a day?” He would have responded with something along the lines of, “We all have tough days. Get up and get yourself through it. You think I want to go to work everyday?” To be fair to my Mom, I think she would have been more open to it. She had a knack for sensing what people needed and was open to the idea of taking a break as a form of recovery. But I never asked her.

I work from home, so I was able to see how Ellie spent her day and watch how she was feeling. She woke late, then made herself a small breakfast and curled up in the same chair she’d sat in the night before, wrapped in her blanket.

“What are you going to watch? You can choose anything you want!” I said it intentionally. I didn’t want her to feel like she had to act sad all day to justify staying home. I wanted her to spend the day however she needed to. She gave me a small smile.

Just before lunchtime Ellie came upstairs and closed my bedroom door. My desk is in my bedroom, and I was on a call. I thought I was being too loud. My kids have told me I sometimes yell into the computer. I assumed that was it. When I came downstairs later, I apologized. “Oh, you were fine. I wanted to vacuum and I was afraid it would be too loud for you.”

The family room floor was freshly vacuumed.

In the early afternoon, I was on another call. Ellie came in and handed me a freshly baked muffin.

‘Ooooh”, I exclaimed. I looked at Ellie. She smiled before quietly retreating. Her light was coming back.

Ellie joined us for dinner that night. I asked her, “did you get what you needed today?”

“Yep,” she replied. And she smiled.

Mental health days are worth their weight in gold. And we have the opportunity to make them acceptable, normal. If we’re going to keep demanding so much from ourselves and the people around us, we also need to give ourselves and each other space to rest and recover when we need it.

A Tough Decision Made

On Sunday, Mary declared, “I need another college conversation.” “Okay” we replied and, at about 5pm Mary came marching downstairs with the dry erase board.

These ‘college conversations’ are Mary’s chance to tell us her thoughts about her college choices. Mary had applied to nine schools. She’d been accepted to several. She was having trouble deciding…which one should she accept?

During the first ‘college conversation’ Mary and Chad sat at our kitchen table while I made dinner. We told Mary to tell us everything she was thinking about her college options. Chad wrote down key points and themes, organizing them on the board (Chad and I have project management backgrounds…this came very naturally to him).

Mary went through every school, with diligent detail. We asked clarifying questions to make sure we understood. We shared observations.

After her and my trip out East, it seemed like University of Rochester and University of Vermont were at the top. Both schools are situated in beautiful surroundings and the architecture is classic – brick and/or stone buildings surrounding grassy courtyards. But over the past several weeks she talked more about soccer. And as she went through her pros and cons of each school, she said clearly, “I want to keep playing.”

“Soccer sounds really important to you. What if you accepted IIT’s offer today?”

This was the question Chad and I had been asking ourselves. Mary had been recruited by the coach at IIT, and Chicago was one of the cities she wanted to be in. She’d had other college coaches reach out, but they were in geographies she wasn’t interested in – like the entire West Coast. The IIT coach had been talking to Mary since the summer. Mary and I made a trip to Chicago, and he’d given Mary a tour of the school and told her about the team.

She shared two concerns – the cost. IIT was more expensive than the other schools. She’d have to take out more in student loans. It was an amount we knew she could handle, but is astronomically more money than she’s ever thought about.

The majors. IIT, as expected, has more tech focused majors and she didn’t have quite as many options as the other schools in her area of interest, environmental science.. “What majors does IIT have?” She listed them. There were several. Enough to keep it on the list.

The environment. It wasn’t a concern, but it was a variable. IIT architecture was designed by Mies van der Rohe between 1938 and 1960. It was designed with a modern influence which, during that time, meant a lot of concrete. Compare that to Loyola, which is right on Lake Michigan, has white stone buildings and a student center with a wall of glass overlooking the water. Easy to imagine studying there. And to the University of Rochester where the library felt like Hogwarts. Mary has been taught to consider every college as if she wasn’t playing soccer. Even if she went to IIT and played, what if she got injured? Would she still be happy there?

Loyola would be cheaper. But she didn’t have an offer to play soccer. Rochester would be beautiful but it would be the most expensive. Even more than IIT. She could walk on the soccer team. But it wasn’t a given.

At the end of our first ‘college conversation’ we had no closure. The only thing that was clear was that Mary didn’t know. She’d need more time. The hardest part was that we couldn’t do anything. There wasn’t any information we could dig up. No more spreadsheets we could build (Chad had created a spreadsheet outlining the cost of each school). All we could do was be available to talk and……wait.

Mary was tense. We all felt it. She’d wonder aloud what else she could/should do. What if I could play soccer at Loyola? Should I email the coach? What if I go to IIT and find I don’t like the major options? What if I choose my school because I can play soccer…is that bad? What if…….?

When she announced she was ready for another conversation, it was a small relief. We were eager to hear her most recent thoughts. She spent several minutes updating the board.. Then she said, “Okay, I’m ready.”

Mary proceeded to tell us all of the reasons she believes IIT is the right school for her. I won’t go into them here. It doesn’t matter. What mattered was seeing her confidence. She had made some decisions about her priorities and IIT hit the mark. She seemed satisfied. Content. Happy. I felt intense relief. And joy. All we wanted was for Mary to be happy, and we could see she was. “What do you think?” she asked.

“I think it’s great.”

Chad agreed.

I clapped and cheered.

Mary smiled. Then she emailed the coach. The next day he responded, “welcome to the team.”

And that was it.

Anxiety is showing up in moments I wouldn’t have expected.

Recently I was out of town, attending a work offsite. During the happy hour I received two phone calls from an unfamiliar number. The only people who call me are my family. Friends text, even if only to ask if I have time to talk. Calls from unknown numbers tend to be junk, so I ignored them.

Later, during dinner, I realized I had a third call from the same number. The persistence made me wonder, then I noticed the voicemails. Spam callers don’t leave voicemails, so I got up from the dinner table and listened. It was the Seattle Public Schools Contact Tracing Center. They said Ellie had been in contact with someone who’d tested positive for Covid-19. They told me to call the number and talk with them before she returned to school. It was Tuesday at 9:30pm. I called my husband. We agreed I’d try to call the number in the morning. If I couldn’t get a hold of anyone before 7:15, when the girls leave to catch the bus, we’d keep them home. Ellie and Emily are twins. If Ellie is exposed, Emily is too. Better safe than sorry. The girls were already asleep, so he’d tell them in the morning.

The next morning I called at 6:30, no one was there. I called at 7. No answer. I texted Chad. He said he’d keep them home for the day. My job done, I sat in my cozy hotel room (it had a fireplace!) with a cup of coffee and the newspaper. A bit of quiet before the day’s meetings began.

At 8:15 they called me. The woman said we’d need to keep Ellie home “since she’s not vaccinated.” I was quick to correct her – both Emily and Ellie are fully vaccinated. “Oh, then as long as she doesn’t have any symptoms, she can return to school anytime!” It was too late to send them to school that day (they attend an alternative school that’s an hour bus ride each way), so we let them stay home.

When I got home that night, Chad warned me. The day we both assumed would have been a delight for the twins was met with tears and anxiety. We thought the girls would relish the idea of being at home. A day of watching movies or binging on Netflix. But, Chad had noticed Emily sitting on the couch, sitting still, looking down. Something was off. He stopped what he was doing and walked over to her. He asked if she was okay. Her shoulders started to shake. He put his arms out, she stood up, and he gave her a long hug. After a bit of a cry, Emily told Chad the last minute change in plans stressed her out. She wouldn’t be able to take her Spanish test. She’d been looking forward to her Career Connect class. And they’d have to take two buses to practice, instead of the one that goes straight from school to the field where they play Ultimate Frisbee.

None of these seemed worth stressing over. The Spanish test would be there the next day. Sure, two buses instead of one was inconvenient, but was it worth tears? For me or Chad, maybe not. But for the kids, it was.

When I picked Emily and Ellie up from Ultimate practice that night, I asked the usual, “How was your day?” Emily didn’t hesitate. “It was stressful having our plans changed at the last minute.” She was also quick to say, “I know it wasn’t your fault.” She wasn’t complaining. Her tone was matter-of-fact. Like she was declaring – this happened, it stressed me out, it wasn’t anyone’s fault, and I’m dealing with it. Then they both laughed a bit as they said the show they’d picked to watch was a bad one – it hadn’t helped their stress at all.

She was okay.

Anxiety isn’t something we’re very familiar with, yet. Chad and I will be learning as we go. Looking back on this situation, I’m so grateful Chad picked up on the queues that something was wrong and that he paused. Afterall, she was just sitting there. He could have walked right by. He could have realized something was a bit off but kept walking to his office so he could make his work call (he and I both have been working from home since Covid-19 started). But he didn’t. He stopped, sat with Emily, and gave her a shoulder to cry on and an ear to talk to. He made sure she was seen and heard. He didn’t judge her for being more anxious than he might have been in the same situation. He didn’t try to fix anything (like make a dramatic effort to drive her to school). He just let her be as she was at that moment.