Parenting, Uncategorized

Acting Normal in Abnormal Sitautions

Part of my role as the Program Coordinator of Abound Counseling at Lutheran Social Services of North Dakota, and a part I’m learning more about as I go, is to coordinate video conferencing events. We’ve started a series called the Brown Bag Lunch series where the Fargo based group of amazingly talented clinicians I am so privileged to work with, present on the topic of Mental Health.

As the coordinator of the events, I also get the added perk of sitting in on them. Not that it takes much. These events are free. 🙂 But I do like to make it sound like I’m getting spoiled a bit here and there. As most writers, I take the opportunity to exaggerate upon the truth. And in my line of work, in my previous line of work as a Daycare Director – nothing, nothing, sounds better than a free seminar focused on mental health in children. There needs to be more. Much more. Especially when it focuses on a topic you don’t often hear of. 

Post Traumatic Stress Disorder.

When you see those words, where does your mind go? Soldiers….new moms…adults that have gone through traumatic things. Do you think about children right away? I never did. Not until working where I do now. But it’s a very real disorder that many children, especially children in foster care, children living in abusive situations or children facing neglect, are suffering with.

And often times, it’s misdiagnosed.

I sat in this seminar today, listening to Sara Stallman, LICSW, one of the most talented women I know in the counseling field (not that I know many but even if I did, I’m sure she would still maintain my opinion) and halfway through it I was blindsided by a realization.

I’m not sure many of you remember this, but several months ago, I blogged about my three year old daughter being diagnosed with Generalized Anxiety Disorder. She was having horrible tantrums, tearing apart rooms, asking repetitive questions that would drive me absolutely crazy and not acting like her normal Mady-self. Granted she still has a good tantrum every now and then. She is her strong-willed mother’s child. But her behaviors were very out of the realm of normal from what I’d come to expect of her.

When diagnosed and provided with the option for PCIT (Parent Child Interaction Therapy) I felt sick and though I understood what the doctors were saying to me, it didn’t stop me from calling my mom and crying over my child having a diagnosis.

The realization that right-hooked me was that Mady didn’t have anxiety. Mady had been exposed to trauma. What symptoms she was presenting were exactly what you would expect with anxiety…but also how the trauma gets misdiagnosed, according to my amazing clinician.

Trauma presents itself in ways that really do provide that opportunity for a physician or specialist to look at the behaviors and say things like Anxiety, Depression, Oppositional Defiant Disorder, and Bipolar disorder. Sometimes symptoms can even be misdiagnosed as seizures. In some cases, children are put on medication for seizures (which, coincidentally do not stop the “seizures”) when what is actually happening, is the child is dissociating from the situation. They’re checking out. No more sir, thank you. It’s an extreme response to what trauma their facing. Their coping mechanism.

It was nearly a year ago now that things really started going downhill for us. We had gotten unexpectedly pregnant and lost the baby March 4th – 8 weeks into something both me and my husband were actually okay with and excited about. When the miscarriage happened, I didn’t handle it well. I put on that brave face and pushed myself through every day while being miserable on the inside. But we all know what the pro’s say. Kids can pick up on these things. You might think you’re hiding it well, but they can read you. They know something’s not right with mommy. The week after that, our dog Mack died. The girls went to bed and when they woke up in the morning, he was gone. They knew he was sick, but his death was very quick and there wasn’t a lot of warning. The week after that we got the call from my mom that my dad had cancer and we had to explain to the girls that grandpa was sick and he would be fine but he had cancer. Mady’s big question with that one, and with it so quickly following Mack’s death, was if grandpa was going to die. Very matter-of-fact, very much the way you would expect a three year old to ask that question…but she would still ask it constantly. And about three weeks after that, mommy lost her job. Which means Mady lost her friends, her consistent schedule and her daycare providers whom she loved.

In hindsight…I probably should have brought up a majority of this when we were talking to the physician. I think I did to some extent but put on that “brave face” when retelling the nastiness of the situation and perhaps downplaying it a bit.

Looking at all of that as an adult, it doesn’t seem like a “traumatic” experience on a level that would do enough damage to provoke a diagnosis. But, we’re adults. We know coping mechanisms and how to apply them. We’ve been conditioned through our lives on the correct way to respond to and handle trauma. Some of us struggle with it and seek counseling. We have that option. We understand that if there’s something not working for us, we can pick up the phone and call someone to schedule an appointment.

Children can’t do that. But they can react.

Here’s a breakdown of the behaviors in children often caused by trauma.

Sad Anger/Refsal Fear Agitation All of the Above
Frequent crying

Not “looking happy”

No spontaneous smiles or laughs.

Low motivation

Isolates

Sleep/food issues

Lack of seeking hugs or physical comfort

Self harm thoughts (as young as 7)

Mild to extreme tantrums

Destruction of property

Aggression

Need for Control

Defiance

No care for consequences

The hard to like kids.

Low eye contact

Spaces out often

Doesn’t seem to listen or respond to others verbally

“Zombie” kids

Bowel and Bladder issues

Vomiting/gagging without reason

Struggles to follow general routines

Possible seizures during extreme dissociative periods

Always on the go

Low attention span

Highly impulsive

“Race car with no brakes”

Exhausting for caregivers

Bowel/bladder issues

Often labled as “bipolar kids”

Extremely reactive

Never know what kind of day you will have with this child

Mood swings

Seems to forget different states of being

Extremely confusing for caregivers

Sensory issues frequently present.

The sadness can be misdiagnosed as depression, the anger – ODD, the fear – anxiety, the agitation – ADHD…and all of the above? Bipolar disorder.

I asked Sara, who knows what happened with Mady and what happened in our life at that time, if there was a good chance she could have been dealing with trauma and not have Generalized Anxiety Disorder. The answer – absolutely.

And it makes sense. Because with mommy being back at work, with stability brought back into her life through daycare and preschool, and with everyone settling into a more well-rounded routine…the behaviours have steadily disappeared.

It was, to be very honest, startling. I didn’t think a three year old could experience trauma, or PTSD, or depression. With a background in Early Childhood Education…I was ignorant when it came to this. The truth is, they can.

We, as adults, see their reactions to trauma as behavior issues. We label, we punish, we get frustrated. And more often than not, we see these behaviors as problems, frustrations. I’m ashamed to say I did.

What one of the clinicians I work with calls it is acting normal in abnormal situations. They’re reacting in a way that’s entirely normal to the situations they’re in – abusive, neglectful, traumatic. They’re acting in a way that is normal to them. And what needs to happen, instead of writing their reactions off as behaviors, is there has to be an understanding that there may be something deeper. That they’re struggling to deal with the things happening to them.

There isn’t much advocacy for trauma based therapy. Not that I’ve seen. I’m so hopeful that with the team I’m so blessed to work with, that this changes. I hope that more parents can look past behaviors, think about what’s going on in their lives, in their child’s lives, and realize that their child may need help sorting through a bunch of emotions that adults even have problems dealing with.

Think about any time you’ve faced the death of a loved one, or some unexpected depressing mess…and imagine having to sort through that as a child.

And Sara, I hope you don’t mind me using you for my blog fodder. 🙂 You’re an amazing woman and I’m so happy to know you!

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