Care and Feeding

My 10-Year-Old Stepson’s Mother Is Medicating His Panic Attacks Without Professional Supervision

His dad and I want to help him with his anxiety, but pills seem premature. How should we intervene?

A boy holding his forehead, looking anxious
Photo illustration by Slate. Photo by Getty Images Plus.

Care and Feeding is Slate’s parenting advice column. Have a question for Care and Feeding? Submit it here or post it in the Slate Parenting Facebook group.

Dear Care and Feeding,

I have been a stepmom to two amazing kids for the past five years. I love them like my own, and I have always had a very involved role in raising them. Our 10-year-old is a sweet, funny, sensitive kid. He’s creative and musical, and I love that about him. But for the past several months, he has been an anxious, terrified mess during his weeks with his mother. He supposedly has “anxiety attacks” regularly while there, seems stressed to be around her, and talks about having scary thoughts. He does not seem to have these problems when he stays with his dad and me.

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To make matters worse, he had an episode at school about six weeks ago where he got dehydrated and had to go to the doctor. He was shaken from feeling bad, so the doctor prescribed him some Vistaril to help calm him down that evening, with the instructions it was only to be used in emergencies. He kept saying over and over that he has anxiety and that he wanted medicine for his concern—not even sure how he knew that was a thing—before looking at me and asking, “What’s anxiety?” Upon returning to his mother, she administered that medication four times in just three days after getting the prescription and continues to do so any time he has a “panic attack” when he’s at her house.

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This concerns me very much. I think she is reinforcing the idea that something is wrong with him and that medicine is the only way to deal with life when you’re stressed. I worry he’s not learning proper coping skills, and I’m even more worried that these episodes are only happening at her home. My husband and I have both tried talking to her about helping him with coping skills (reading, journaling, drawing, exercise, deep breathing, guided meditation) instead of immediately plying him with medication that was only meant to be used on a one-time basis anytime he feels stressed. I’ve also tried to share some parenting books with her that I’ve found to be helpful in hopes this would help her to try something else to help him. I’m at my wits’ end.

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I’m worried about our kid and want answers as to why he’s feeling that way when he’s around her. To give a tiny bit of background, she has been through two messy divorces and is currently seeing a new partner who has stated he has no interest in raising someone else’s kids. I don’t agree with a lot of her personal choices, but she’s still their mom, and I want to respect that. I know they aren’t my biological kids, but I’m so worried about them, especially my son. It’s so hard to see him struggling and feeling like we can’t help. He was supposed to see a child psychologist next month, but I fear that may be delayed due to the COVID-19 crisis. Any advice?

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—Stepmom Is Shook

Dear SIS,

It’s great that you and your husband have taken efforts to try other coping mechanisms and responses to stress, and terribly unfortunate that his mother has refused to even give them a try, but what your son seems to need desperately is some sort of consistency. Also, I didn’t miss that you mentioned being worried about both children, which totally makes sense considering that Mom’s new partner doesn’t have any interest in them (absolutely gross) and that the eldest seems to be having a really rough time there, and only there, on a regular basis.

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While there are a number of kids (and many adults) who successfully manage anxiety and other such issues with the aid of medication, it sounds like your son is being medicated without regular care from a mental health professional, which is deeply concerning. I’m also curious to know if his bio mom is dosing him correctly and what, if any, challenges he may face if he’s getting a significant amount of this medication while he’s with her, but little to none while with you.

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In the immediate future, you need try and figure out a telemedicine solution of some sort to get your son to a professional. Perhaps there’s more to the story of the dehydration and doctor’s visit, but it doesn’t sound like either household knows exactly what is going on with this young man, and he can’t get effective support from you all until you do. Furthermore, if you all aren’t able to agree on some fundamental levels about how to address the ongoing issue and particularly challenging incidents alike, you may be running the risk of exacerbating his anxiety or discontent.

Once you have the insight of a professional (or two, if you are able), you and your husband will be better equipped to speak to your co-parent about how the three of you can manage your son’s issue. If she remains committed to what sounds like questionable medication dosing and/or if there continue to be other red flags surrounding your kids’ time with her, it may be time to speak to a lawyer about entering mediation, changing the terms of the custody arrangement, or otherwise relying on outside help to create some reasonable standards for both households to follow. I wish you all the best on this difficult dilemma and hope that your son is able to find peace in both homes sooner rather than later.

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Dear Care and Feeding,

My almost-2-year-old loves music. I mean, LOVES it. She gets up from a nap and is swaying in her crib, asking for it. We currently listen to music on our family’s laptop, mostly musicals. The problem now that we are all home together is twofold. First, listening to music all day is distracting and annoying to my husband and me, who are working from home and parenting in close quarters. We need quiet at various points. Second, my daughter is very particular about whatever the song is. We have a playlist of about 150 songs she has liked, but it can take upwards of listening to the beginning of 10 songs before she approves it. At any point, she’s done with a song and insists on the next one. I want to buy her an iPod at this point. Is she too young? During the quarantine, she’s been watching an episode or two of Sesame Street probably twice a week and FaceTiming with relatives about three times a week. We have kid-friendly headphones meant for future plane travel. Am I crazy for wanting to get a toddler an iPod?

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—Mama Needs Some Silence

Dear MNSS,

You are hardly alone in turning to a screen to make Pandemic Parenting a bit more bearable. There is nothing crazy about investing in an iPod—which is not a terribly expensive investment these days compared with when the devices were the gadget to own—to help provide the comforting music your little one needs to entertain her when you two cannot. You’ve already got special headphones, which I assume limit volume levels with regard to keeping little ears safe, so head on down to eBay and find a used iPod and let your daughter play DJ (or FaceTime a grandparent, or watch an episode or two of her favorite show) without costing you and your husband your ability to work! Just be sure that you’re monitoring exactly what she has access to on there, as even a nearly-2-year-old could easily be tech-savvy enough to download some things you wouldn’t want her to have.

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• If you missed Tuesday’s Care and Feeding column, read it here.

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Dear Care and Feeding,

Under what circumstances would it be appropriate to have our nanny return to work? My wife is struggling. Our kids (4 and 2) are quite clingy with her, no doubt due to general stress in the air and a forthcoming baby in July. Of course I want to help my wife, but I’m not convinced our nanny will help. She can’t take the kids to the park, playground, or museums—they’re closed. She can’t take the kids to visit friends. She can take the kids for walks, which is something, I guess. She can also play with the kids inside, which might distract them from my wife for a little while. On the other side, our nanny is another vector for coronavirus. She lives with her spouse, mother-in-law, and two teenage kids. Who knows what they’re exposed to? And I’d hate for us to indirectly infect her family. We’re being careful, but that’s no guarantee we’ll avoid the virus. Let’s ignore economic considerations; we’re paying her normal wages and can do so indefinitely, thankfully. Also, the nanny has said she’s eager to come back to work. Are there any CDC recommendations that would help us minimize the risk of having another person around?

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—Needing Nanny

Dear NN,

The Centers for Disease Control and Prevention has issued no recommendations that I have been able to find that support your desire to have this woman return to your home. Your pregnant wife is struggling with two small, clingy children, which is understandably frustrating, and it would be one thing if you were seeking out live-in help or someone who is otherwise capable of essentially limiting their contact with other human beings to your family and your family alone. However, your actual nanny lives with her partner, children, and mother-in-law. The risk to both households is too great.

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I think it’s wonderful that you are still paying your nanny, and while I understand that it may be difficult to justify doing that when she is willing to return to work, her willingness is not a substitute for safety. You are describing a situation that could be dangerous to all involved, including a likely elderly mother-in-law and a small baby who is still in the oven. I implore you: Please don’t break the social distancing rules for this—it’s too risky. Best of luck to you all, and warm wishes to your wife for a safe, comfortable delivery.

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Dear Care and Feeding,

My teenager snuck out last night and spent hours in the car vaping with a friend. Putting aside all the reasons this was such a terrible idea, we are not sure how to handle this possible exposure to COVID-19. Is it reasonable to keep him in his room for several days and have him use a private bathroom? Do we need to wear masks around him?

—Stressed-Out Parent

Dear SOP,

Ideally you would keep your son as isolated as possible from the rest of the family for the 14-day period that is recommended for self-quarantining by folks who may have been exposed to the coronavirus. That is, of course, a very difficult task for anyone, let alone a teenager who is headstrong and irresponsible enough to sneak outside and take a break from the miserable but important steps we have been asked to take in order to stay healthy.

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In lieu of that, it is totally reasonable to remand him to his room and a private bathroom for as much of that time frame as possible, which can be a great “Scared Straight” moment as well (and hopefully one that ends with him returning to the rest of the household without so much as a sniffle). Meals and other necessities can be left outside of his door. Wear masks when in his presence and keep everyone 6 feet away from him. Punish him to the full extent of your household’s rules, and do whatever you can to ensure that he doesn’t make this same mistake again. Make sure that you monitor him for any symptoms, and try to obtain a test if he displays any of them.

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Sorry that you’re dealing with this, and I’m sorry for him too—for all of us. Being stuck in the house like this is an absolute nightmare, and I can only imagine how hard it is on a teenager. But remind him that kids have died and will die of this menace, and just because that happens rarely doesn’t mean he should tempt such a fate. Furthermore, by exposing himself, he compromises the health of everyone in the household. Please lay the thickest guilt trip on this young man that you can summon up. Best of luck to you all. Please try and stay safe!

—Jamilah

More Advice From Slate

A few months ago, I began therapy for severe depression. A few weeks later, I met a man who (he said) had just been through a nasty divorce. We bonded over mutual misery, and for the first time in my life, I began a “friends with benefits”–type relationship with him. Flash forward to last week: I ran into him and his wife at a grocery store. It turned out, I know his wife—she’s my therapist. I held it together at the store but made sure later that he knew our “relationship” was over. I have ignored all subsequent contact attempts but have saved the messages and texts while I decide whether or not to tell her. So my question: Should I?

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