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Dr. K
Dr. K, Psychiatrist
Category: Mental Health
Satisfied Customers: 358
Experience:  15 years clinical experience in all areas of psychiatry. Holistic and practical approach.
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My 17 year old son, Cameron, is experiencing what I can only

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My 17 year old son, Cameron, is experiencing what I can only describe as anxiety about going to school in the morning. He's a good student, involved in jazz band and band. We switched some of his classes to online, but he still cannot get himself to go to class. I have been working with the school counselor and his teachers, but he is really struggling. "Why is this happening to me, mom, I don't understand," he said to me this morning. His teachers are concerned, I'm concerned. He doesn't want go to counseling because he isn't comfortable talking to someone he doesn't know, but at the same time won't talk to my sister or stepmom, both women he trusts. I don't know enough to be much help beyond what I've already done and the situation seems to be getting worse, not better. I am going to a counselor, myself, in large part so he can see that it's okay. I need some tools, ideas?
It's great that you are going to counselor to model for him...also consider the idea of family counseling to send him the message, "Let's work on this as a team" instead of "You are broken & need to be fixed."

Anxiety is best treated holistically by trying to balance one's life. Remind him that some anxiety is a normal part of being human, but some people's "anxiety thermostat," so to speak, goes off quicker than it needs to to.

Medications can be helpful for some people. I almost always recommend 1) psychotherapy with a live therapist, and 2) learning some formal relaxation therapy. Also, by formal relaxation therapy I mean yoga, meditation, or similar methods. Having relaxing hobbies is also important, but not quite the same as formal relaxation therapy.

Maybe try telling him that these last 2 treatments I mentioned are proven by sophisticated studies using brain scans (CT, MRI, EEG, pet scans) to improve brain function. That might encourage him to pursue the therapy. Or you guys could take a yoga or tai chi class together.

And remember you can't separate emotional health from physical health, so exercise & nutrition are vital.

There are also several self-help books you can read which can help including: 1) The Seven Spiritual Laws of Success by Deepak Chopra, 2) The Feeling Good Handbook by David D. Burns; 3) The Relaxation & Stress Reduction Workbook (New Harbinger Self-Help Workbook) by XXXXX XXXXX, 4) The Shyness & Social Anxiety Workbook: Proven, Step-by-Step Techniques for Overcoming Your Fear by Martin M. Antony and Richard P. Swinson , 5) The Anxiety & Phobia Workbook (New Harbinger Self-Help Workbook) by Edmund J. Bourne, & 6) "Panic Attacks Workbook" by David Carbonell.

Since he's a good student, the books could prove to be very valuable.

I hope this helps. Let me know if you need more feedback. Good luck & take care.
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Please let me know if you need more information. We can continue the dialog until you are satisfied. Once you are happy with the answers don't forget to hit the ACCEPT button & provide expert feedback. Also remember that this is not an official doctor patient relationship and not a substitute for a full live psychiatric evaluation. Thank you for using justanswers.com
Customer: replied 5 years ago.
This kid is pretty buttoned down. He's meticulous about how he does things, he makes lists to get things accomplished. He reacts with irritation to common place interactions. For example, if he feels like I am looking at him too long, he get's irritated. I think part of the anxiety is he has unrealistic expectations of how others should act, and unrealistic expectations of himself as well. Is this also part of his anxiety?
Okay, so 1st, anytime I see a live patient for an evaluation I tell them the following: I don't always try to come up with an exact diagnosis when I 1st meet a new patient for several reasons: 1) our modern diagnostic system isn't perfect, 2) thus, many patients do not fit typical "text-book" diagnoses, and 3) I don't want my patients to feel labeled by a diagnosis (rather, I want to learn about & help them focus on their strengths that they have to overcome their symptoms & problems).

Next, it's even harder (and somewhat unethical)to try to come up with an exact diagnosis for a person on justanswers.com (and even harder when the source of information is a mother like yourself & no the patient).

With that being said, when you mentioned meticulousness & making lists, it made me think about OCPD (obsessive compulsive personality disorder)...which is very different from OCD (obsessive compulsive disorder). For lack of a better description, people with OCPD are "anal retentive." It's often a "functional" syndrome which doesn't bother people (e.g. many professionals aren't bothered by their OCPD b/c it basically helps them to stay highly organized & work difficult jobs like law and medicine). Here are 2 links to help describe OCPD:

http://www.nlm.nih.gov/medlineplus/ency/article/000942.htm

http://www.sciencedaily.com/articles/o/obsessive-compulsive_personality_disorder.htm

OCPD often goes hand in hand with perfectionism; I recommend all my patients with perfection issues read the book "Too Perfect: When Being in Control Gets Out of Control" by Jeannette Dewyze and Allan Mallinger.

Irritability can accompany either anxiety disorders, OCPD, or perfectionism...but it can also by a symptom of mood disorders (like major depression or bipolar).

The unrealistic expectations are very common in OCPD or perfectionism (but could also be a part of mood or anxiety disorders).

I hope this helps clarify. Let me know if you need more info.
______________________________________________________________________
Please let me know if you need more information. We can continue the dialog until you are satisfied. Once you are happy with the answers don't forget to hit the ACCEPT button & provide expert feedback. Also remember that this is not an official doctor patient relationship and not a substitute for a full live psychiatric evaluation. Thank you for using justanswers.com

Customer: replied 5 years ago.
Interesting. So I could be dealing with something much bigger that just anxiety here. I will take your advice for reading and going to counseling together and see if I can get him in a place where he's comfortable in that environment and can "see" himself working on these issues with a therapist. I will also have my sister and his stepmom for encouragement since they are aware of what he's going through. Is there anything else I should be aware of?
The main other thing I would say is that from the brief glimpse you have shared with me, I do see hope for your son (also, I am a straight shooter...I don't sugar coat things just to make people feel better).

The strengths I see which make me think your son can do better include:

1) He's a good student & has other talent (e.g music can be very healing).
2) Research shows patients with loving & supportive family do better & obviously you are in his corner.
3) He hasn't really tried any treatment methods yet. I have seen patients with very severe issues who have tried various treatments for years...and it is more challenging for me to brainstorm & help them.

And lastly I want to reiterate that I truly believe in formal relaxation therapy. Yoga, meditation, tai chi, etc. do not have to have any religious context. They are powerful healing tools for mind & body. In fact, more & more research in Western medicine is focusing on the health benefits of these treatments. For example, one type of helpful psychotherapy is called CBT (cognitive behavioral therapy)...and now people are practicing & researching MCBT, which is CBT which adds a focus on mindfulness (another form of relaxation therapy).

That's all I can think of right now...take care.
______________________________________________________________________
Please let me know if you need more information. We can continue the dialog until you are satisfied. Once you are happy with the answers don't forget to hit the ACCEPT button & provide expert feedback. Also remember that this is not an official doctor patient relationship and not a substitute for a full live psychiatric evaluation. Thank you for using justanswers.com

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