Internalizing disorders

I had actually intended on writing something else today, but this has been at the forefront of our lives for quite awhile, so I think this is the post for today.

Both of my boys are heavily internalizing.  This presents many challenges on many fronts.  One of the biggest issues that face my boys is others (including therapists and psychiatrists) not understanding what is really going on.  Internalizing tends to not be “believable”.  By that I mean, when others don’t “see” it, they assume it doesn’t exist.

When psychosis, processing deficits, anxiety and other traits are present, there is a good chance all of that will be internalized rather than externalized.  Many kids have a combination of both internalizing and externalizing behaviors, but those who are heavily internalizers do not often present as “behavior disordered” in public settings, generally.  They reserve all of that behavior for the safety of home (and family members).  One of the reasons that the family dynamic is so difficult for those with bipolar disorder/schizophrenia and the like is that most of the chaos and bad behavior occurs at home.  This also leads to “blame” in the form of others criticizing parenting techniques, manners, etc.  The reality is that when kids are able to “hold it together” in public, it ALL comes out at home.  This stress on the family is overwhelming for the parents, siblings and the child with the issues.

Imagine this scenario: Child A with X illness has had a “wonderful” day at school.  According to the teacher they displayed “model” behavior in the classroom, had fun at recess, ate their lunch appropriately and did all of the required classwork.  Perfect.  Then, said child comes home.  You ask how their day has gone and they say, “fine.”  Little brother walks into the room and says, “Hi, Child A!  Look what I made for you with this play-doh!”  Child A turns around and sees the creation and pushes little brother over, screaming, “Why did you use that Play doh!  I was going to use it to make something special for Dad!”  To a parent of a child without a disorder, it looks like just absolutely unacceptable behavior.  While I won’t say that the behavior is acceptable, I have had experience with why this occurs.

What the teacher didn’t know, or see, was that Child A had a very difficult day.  The classroom, at a certain point, was very noisy and it induced some sensory overload.  It took an inordinate amount of concentration to keep Child A focusing on their work and not reacting negatively to the excess stimuli.  When a small argument broke out with two classmates that took up quite a bit of the teacher’s attention and distracted the class from a favorite exercise, Child A’s frustration was rapidly growing.  In order not to become a behavior problem too, Child A ripped a piece of paper over and over into pieces to keep calm.  When another child having a bad day was frustrated and crying excessively, Child A’s anxiety grew and it took a large amount of energy to keep calm and not start crying as well.  During practice in one of their more challenging subjects, Child A’s processing issues were making it hard to do the work properly, which made Child A angry.  Instead of showing the teacher anger, Child A said they had a stomach ache and spent a large amount of time in the bathroom.  During recess, Child A couldn’t find anyone to do the same thing they wanted to do, so Child A spent time alone on a swing and felt very lonely and sad.  On the bus ride home, Child A was so tired they fell asleep and the bus aide got angry when it took too long to wake Child A up.  Child A arrived home thoroughly done with a very trying day.

Children with internalizing disorders often have days like this. Sometimes, every day.  When they are non communicative or non verbal, it makes it all the more difficult to be helpful.  This is a perfect example of, “what you see is not often what you get.”  There are educators, professionals and administrators out there who refuse to acknowledge that this exists.  I know because I spent months and a lot of money battling some.  I have spent the better part of eleven years dealing daily with internalizing disorders in my family.  It is chaotic, overwhelming, sad, difficult and exhausting.  What families need most is support and to be heard and understood.  This is not always readily available or an easy task.  Online forums available for families of children with mental health challenges can be helpful.  Sometimes just having a willing ear is enough.  Other times, respite is necessary.  Some mental health agencies have mentor programs which are very helpful.  Local NAMI agencies have groups to attend that are helpful, and is a great forum to relate with other families going through similar challenges.




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