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Seperation Anxiety in 6 year old on Lexapro

I have been reading the articles on your sight.  I have not found a situation similar to mine.  I have a 6 year old in Kindergarten who is experiencing severe separation anxiety.  We have been to two physicians both wanting to put him on meds.  We are in our 3rd month of school and it's not getting any easier.  My child still crys every morning and throws up at some time during the day almost every day.  We don't want to put him on meds unless absolutly neccessary.  The Doctor's say he will need to be on meds at least a year.  Depending on relapses after he comes off will determine if this will be needed for life.  Is there any other treatment besides meds?  We have tried positive reinforcement.  Stern and firm love when leaving.  Nothing seems to be working.  How long would you recommend for for this to go on before we give up and just take the Lexapro?  What are the odds that he'll be able to come off the meds after a year and stay off?  I am desperate for another opinion, even of parents.  We have been to the only Doctor's available for Pediatric Pys.  that's on our PPO list.  I want to be absolutly sure that meds are necessary and that there is no alternative before we start this regimen.
Thanks
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rcw
Hi.  I know you may feel like your child is the only one going through this, but believe me, he's not.  My daughter is in the first grade now.  In kindergarten she used to cling for dear life and have to be pried off of me.  Now that she's in first grade she is still having a little trouble but not as much.  At the beginning of this school year, she also was crying every morning and throwing up every morning.  She would not stay buckled in her car seat and I'd have to stop the car and buckle her back in.  Whatever you do, DO NOT let your child stay home unless he is actually sick with a fever.  Don't give in.  If you give in and let your child stay home, he will try to stay home and it will take more time for him to adjust.  I know it's very hard on you and your child.

What I do is walk my daughter to the cafeteria every morning where all the kids wait before being let into the classroom.  She does not wait with the kids.  I take her to an ESE teacher who is always in the cafeteria, and she takes my daughter and a couple of other little girls to their classes right away.  That way my daughter knows what to expect every morning and is not in the loud cafeteria.  It's also helpful for my daughter to be one of the first ones in the classroom and be situtated and helping her teacher.  This makes her feel important.  In addition, I believe with my daughter she would feel more overwhelmed with her feelings if she were coming into a classroom that was already filled with kids.  Her coming in as one of the first ones in the classroom also gives the teacher an opportunity to welcome her into the classroom before she gets so busy with the other students.

Up until a week and a half ago, my daughter was throwing up in the morning, either on the way to school or once we pulled into the parking lot.  I just made sure I had a bucket in the car and wipes and a bottle of water.  These were out of her sight though until she actually needed them.  If she began to say she was going to throw up, I'd hand her the bucket.  Be very nonchalant about it, very calm.  Don't make a big deal out of it.  When she'd throw up, I'd wipe her mouth and let her drink some water.  Then we'd continue on into the school.  I talked to her doctor and he prescribed Zantac, a stomach medicine, which prevents her from feeling nauseous in the morning.  I would certainly try that and see how it goes with your son.  She hasn't thrown up in a week and a half and she's been in a good mood going into the school.  If he does take Zantac, make sure to give it to him right at bedtime and as soon as he wakes up, because it lasts for 12 hours and it may take a half-hour to an hour before becoming effective again.  So be sure to give it to him as soon as he wakes up.

Try to keep everything as calm as possible in the morning and the night before, making sure your child is getting plenty of sleep.  Try to inject some fun into the morning, and if your husband can be involved in goofing around or having fun while getting your child ready in the morning, that would also be helpful.

What I also do is give my child a quarter for going into the school well and a quarter for dressing, or at least letting me dress her without a fuss, and a quarter for eating.  This rewards her along the way, and on the weekend she can take her money and buy what she wants.  I've also made a chart with these categories too.  What I've read is that children can sometimes be overwhelmed with feelings and anxiety that they do not understand, and we just need to be patient and calm.

My daughter is an excellent student.  She reads higher than her grade level.  I'm told she does very well once she gets past the mornings and she has made some nice friends in her class.

One book I would recommend which I checked out from the library is "School Phobia, Panic Attacks and Anxiety in Children" by Marianna Csoti.  The other one I recommend is "Family First" by Dr. Phil McGraw.  One more is "Raising Your Spirited Child" by Mary Sheedy Kurchinka.

Do things that your son can look forward to, such as a game night on a certain day of the week, an ice cream day.  We have ice cream day one day a week right after I pick my daughter up.  It's something for her to look forward to.  Believe it or not, little things like this seemed to have helped her.

Whatever you do, the mom has to stay calm.  By the way, I'm the one who is taking Lexapro:)  It is very mild.  I just started taking it a month ago because I wanted to stay calm for my daughter so she would stay calm.  Gook Luck and I hope to hear how it's going with you!
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Avatar universal
rcw
Hi.  My daughter had a substitute all of last week.  She started the throwing up again in the morning before school during that week.  This week her teacher is back and no throwing up so far.

I did take her to see the pediatrician last week, no diagnosis made, just advice given, nothing I hadn't heard before.

She and I went to a classmate's birthday party at an ice skating rink this weekend.  She loved being there but it took 2 hours after being there until she was ready to try ice skating.  That's just her.  She just takes a while to warm up to something new.  She was very proud of herself once she got out there.  I didn't push her to do it.  We kept her ice skates near us the whole time.  She kept track of them to make sure we didn't lose them.  Then when she was ready I put them on her and she went out on the ice.

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Avatar universal
rcw
Hi.  I'm glad you wrote back.  I wouldn't say my daughter is overprotective of her little brother, but she does not let her friends be mean to him.  She did have a problem with field trips last year.  There were 4, and she only went on one.  She was scared to ride the school bus because she never had before.  The first field trip she really wanted to go but she threw up the entire day before the field trip.  I thought she was really sick but come to find out, it seems that it was just the anxiety.  By the way, I was supposed to be one of the chaperones on that field trip, but I wasn't allowed to ride on the bus, and my daughter was not allowed to ride in my car.  If she went, she had to go on the bus.

So far I've heard of no field trips for this year, but if there is one, I'm going to let her decide whether she wants to go or not.

My daughter definitely does not jump into anything new.  It takes her a while to warm up to anything out of the ordinary.  She'll observe for quite a while and hang around me until she's ready to join in.  We went to the mountains in the summer to a train park where they had a nice regular-sized train to ride on and also a smaller train plus other amusement park type rides.  She would not go on any of them.  Her 3-year-old brother was on these rides by himself.  After a few hours of being there, I picked my daughter up and walked onto the small train.  When the ride was over, she wanted to go on it again.  I knew she'd like it; otherwise, I wouldn't have done that.  

She also feels more comfortable in a small group playing rather than a large group where she doesn't know a lot of the kids.  Ever since she was small, she's always been clingy.   She has only  thrown up from anxiety with school or school-related activities.

Reading the book "Raising Your Spirited Child" will explain the type of child you have and how to react to him.  It will explain not to push your child to do something before he is ready.  I would ask my daughter what she did in school, but she would never answer.  So I stopped asking, and before long she would bring up little things about her school day.  I was surprised!

Something else I would recommend would be to find something your child likes to do to raise his level of self-confidence, something he is good at or enjoys, such as taking photos, getting him interested in a particular series of books.  Taking him to the park where other kids are, with you nearby to watch him, might be good for him also.

I've been getting my daughter outside more where other neighborhood kids are so she can ride her scooter.  She's outside while the other kids are there but not necessarilly playing with them.  This helps her become comfortable around other kids.  We also go to the pet store where she can pet the dogs which she loves to do.  

Don't get discouraged if one week seems great, then the next seems like you're going backwards.  It will get better again.  I still do not know from one week to another what to expect, but I do know we are making progress!  Good luck.  Feel free to write back if you'd like!

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242606 tn?1243782648
MEDICAL PROFESSIONAL
If your son was acting entirely in a normal fashion pior to his entry into kindergarten, and if his functioning apart from the school issue is also entirely normal, you can be very comfortable persisting for now without medication. It sounds like you are handling the situation well, insisting that he go to school and leaving him in the hands of the school staff. Does he calm down very readily after you depart the school? Does he participate in the ongoing activities in the school? The main reason to use medication now is to help him be in less distress and thereby able to cope better with his adaptation to school. The medication should help somewhat with the anxiety, though it will not entirely change the situation. The choice of medication is something you might want to examine. For example, you might ask the prescribing doctor why he would select Lexapro or Celexa (a sister drug of Lexapro) over Prozac. But either would be a sensible choice. At the bottom line, you wouldn't be making an error in judgement if you proceed with medication, but it is by no means a mandatory route to go, either.
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Well we made it through Thanksgiving break return without any relapses.  I was really afraid it would be like starting all over.  I hope he does as well after Christmas.  I have stopped volunteering at his school.  I have discovered on days that I'm there for any reason, even if I'm not working in his class he gets teary eyed at lunch and clingy during the day.  It appears that the tougher and unattaching I am the better he does.  It's almost as if he feeds off of my concern and tenderheartedness.  I am still loving just taking a few steps back.  Hope all is better now that the sub is gone.
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Avatar universal
Oh my gosh!  Reading about your daughter is like reading about Kade.  They are so similar!  We have the same rules with the bus ride/parent on field trips.  So far Kade has ridden to the place but I have always checked him out so he could ride with me home as a reward for being brave on the way down.  All the other times you described were exactly the way he has acted since a toddler.  Have you taken your daughter to a medical Doctor?  Did they give her an official "diagnosis"?  It is so nice to talk to someone who is walking on the same path.  If I don't immediatly respond to the posting don't think I've ran away, I don't always check every day.
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Avatar universal
Thank you so much for your thoughts and input.  It really does help to know that there are others out there going thru the same thing.  Kade is doing better right now.  I ended up not putting him on the Lexapro because the Dr told me if we started it he would have to stay on it at least a year before we could try coming off.  I really wanted to give him a little longer and try some suggestions (like the reward system and saying good bye quickly while his teacher was giving him a special job to do to destract him)  So far, in the last 2 weeks he is improving and settling down some in the mornings.  I'm going to check out the books you mentioned also.  I was curious to know about your daughter.  When I took Kade to the Dr he told me Kade showed other areas of anxiety such as:  watching over his little brother really closely, hating changes like substitutes at school, or field trips, he doesn't like the big inflatable slides or anything new to try.  Does your daughter have the problems too or is her anxiety centered around just school?  I was hoping he would grow out of this by next school year.  Maybe I won't be asking the Dr anymore questions in the first grade too.
Thanks again!
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Avatar universal
Well I'm no doctor or anything, but I would suggest that if you are worried about it being hard to get your son off medication after a year (let's say)of medication,I would not let him know that he is on medication. If give him the medication without him knowing it, I believe it will be less hard to deal with him once off the medication.
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