"The night before school, I would have panic attacks. I would start feeling really sick in my stomach. I would get headaches. I would wake up in the morning, and physically, my body would feel like I had the flu," said student Julia Landan, 16.
At first, Landan didn't know she had a problem. It started in junior high, worrying about not doing well in school, even worrying about asking the teacher a simple question. By high school, it got worse.
"There's many aspects to it. It's not that if you yell at them enough or are strict enough, it's gonna work. It doesn't work that way at all," mother Peggy Landan said.
Experts say anywhere from 5 to 28 percent of children will exhibit what's known as "school refusal." They say in the past, it was better known as truancy or school phobia. It's considered a symptom rather than a disorder. But, chronic absenteeism can be an important signal that something is going wrong.
"The more the kids internalize their anxiety, the more it gets worse, and the more they avoid what makes them anxious, and that's when the spiral starts," said Jackie Rhew, lpc Therapist, Alexian Brothers Behavioral Health Hospital.
Specialists say children seem to be at a greater risk during transition, such as changes at home, starting a new school, especially middle school. Signs include severe emotional distress, crying, complaints of headaches, stomach aches or constant excuses to leave school to go home. Another sign is when ailments tend to disappear magically on weekends.
Researchers estimate in about two thirds of cases, a psychiatric problem is the cause.
"Often times, we see this happening with going to school, will be the trigger of how an anxiety disorder might start," said Patrick Mcgrath, Ph.d., clinical psychologist, Alexian Bros. Behavioral Health Hospital.
Avoiding the issue may make it worse. Therapists say kids with unresolved anxiety or depression may try to make it better with drugs or alcohol. They may develop eating disorders or physically harm themselves.
Alexian Brothers Behavioral Health Hospital offers a specialized treatment program for school refusal. The idea is to help the whole family learn how to cope with school stress. What makes the program unusual is the student is placed in a classroom setting that includes everything from physical education to textbook assignments and group, as well as individual, therapy.
"We actually role play and put people into the scenarios they are afraid of and teach them to cope and handle it," Mcgrath said.
The Landans tried forcing their daughter to go to school and even sought counseling. They say none of it worked, but last spring, they discovered the Alexian Brothers program. Their daughter was diagnosed with severe anxiety and started medication. She also learned how to work through her fears.
"She's the Julia she was meant to be. She's been able to develop emotionally and mentally be stronger," said Peggy Landan.
"Don't hide it. That's what I did for the longest time, and that doesn't help. That makes things completely worse," Julia Landan said.
Julia Landan is back in public school and says she is doing well.
Some mental health professionals say not all children need a specialized program to resolve their issues. They say the first step for concerned parents is to get a medical assessment of their child.
For more information:
Alexian Brothers Behavioral Health Hospital
1650 Moon Lake Blvd.
Hoffman Estates, IL
Anxiety Disorders Association of America