When discussing Selective Mutism, it is important to not only focus on the lack of speech aspect of SM, but also all of the anxiety that comes along with it. There is a lot more to SM than not being able to talk. Many people are not aware of this and tend to focus all of their attention onto the speech, when really it should be the anxiety that is dealt with first and then the speech.
One of the issues that many people with SM deal with is health anxiety. You may notice that either yourself (if you have SM) or your child tends to become a lot more anxious during the cold/flu/stomach bug season than any other time of year and there is a reason for that; health anxiety. For many people, a simple cold is not that big of a deal, it’s just a cold that’s going to go away in a few days. When you have extreme levels of anxiety, it is often not as simple as that and many people can become so anxious that they may genuinely believe that their symptoms are actually symptoms of something that is a lot more serious even if they are reassured that it’s just a cold over and over again. This anxiety can be particularly extreme if they are the first to become sick because since no one else has caught it yet, that can add to the worry that it is not just a bug that’s going round, but actually something really serious.
This is not to be confused with being overdramatic. It is not an attempt to be an attention seeker, they are genuinely suffering from really high levels of anxiety and to them the worry that their symptoms are a sign of something serious is very real. Comments such as, “Everyone else is just getting on with it and not complaining, why can’t you do the same?” will only add to their frustration of their belief that no one around them understands. Since their anxiety is so high and their belief that they are experiencing symptoms of something really serious does feel very real to them, making a comment like that will not make them instantly snap out of it. What will help is helping them to reduce their anxiety and doing things with them so that it will help distract them and take their mind off it a bit.
For me, it is not just becoming sick that has given me health anxiety over the years, but also injuries. For example, if I was to bang my head, I would become so convinced that I’d caused myself a life threatening injury even after being reassured by others over and over again. Of course everyone around me knew that it was only a slight knock, but I would often beg to be taken to hospital to have it looked at because I was so convinced I’d done myself some serious damage. Being told no would make me feel extremely frustrated and distressed. If you are a parent of a child with SM or even any kind of anxieties, please do be prepared for many meltdowns during times such as this.
If you suffer with health anxiety, you may find that like me, you will most likely become very well known at A+E/ER, walk in centres etc. The problem with this, is that after so long, even if you do go in with something that actually isn’t down to just health anxiety, but is actually a problem that does need treatment, you may begin to be taken less and less seriously. As a result, I often try not to mention that I have anxiety (since I am usually able to talk in doctors/hospital environments so long as no one I can’t talk to is around) because I do find that once I mention that, they may start to think that whatever I have is actually just high levels of anxiety. Not only can anxiety make you believe that your symptoms are something serious, but also the stress/anxiety that that causes, can actually make the problem seem worse than it actually is. For example, if you have a headache, the stress/anxiety can make the pain of that even worse.
I would like to point out that I don’t go to seek medical advice unless I genuinely do believe it really is something really bad, I don’t go every single time something goes wrong. There have been many times when I have spent a lot of time at home with severe levels of anxiety thinking that something is really wrong. However, when I do go, the problem is often put down to just anxiety and so this often becomes the first thing that is discussed during a visit. I do believe that this is what contributed to doctors believing that the severe headache I was experiencing last year was down to high levels of anxiety, even though I instinctively knew that it wasn’t anxiety and it turned out that I was right; I had viral meningitis. I had to seek medical attention 3 times over the course of 3 days and was even turned down to be taken to hospital in ambulance for one of those times. This does not make me feel frustrated with the doctors, but it does make me extremely frustrated with my anxiety as it means that since most times the problem usually ends up being down to anxiety, the doctors will then just presume that it’s going to be anxiety each time. I really do wish that I didn’t have such high levels of health anxiety because it would mean that I may be taken a bit more seriously when I do go in.
However, having said that, high anxiety is an issue that you should seek medical attention for if it’s unmanageable for you. Even if the problem does turn out to be high levels of anxiety, that is a problem that does need to be dealt with and sometimes if that means being given reassurance that the problem isn’t something serious, but it’s actually anxiety, then it’s worth going to get that reassurance. Also, having someone to talk your issues over with (or someone to talk to you if you can’t communicate with them) and to perhaps figure out some kind of treatment plan for your anxiety can be something that can help too.
More than anything, I don’t mean to be a pain when I do seek medical attention for things that many people would see as ridiculous, it is more a cry out for help with the severe levels of anxiety that I am dealing with. Sometimes having that extra reassurance or having someone to talk to about things can be enough to help at least take the edge off the anxiety a little.