A nervous girl

L. is the daughter of immigrant parents, the kind of girl who is always there for her parents, interpreting for them with words way beyond her emotional maturity. But today it is L. who has an appointment, because she, at age 14, has not slept for a week and is crying and has headaches. "I worry all the time" she explains. She is the worrier, the overachiever who gets a perfect 4.0 average, who spends all of her time doing homework, as if she is going to save her parents from the stifling factory work that is the only work they can get as non English-speaking parents. But now it is going beyond perfectionism. Now she is crying and having panic attacks. She is having mixed anxiety and depression. Fortunately, her parents are both understanding of the situation -- in fact her father is under my care for generalized anxiety and her mother is being treated for depression. She will get a low dose antidepressant and start seeing a children's therapist. She is very intelligent and she will do well. She smiles and says good-bye to me in Spanish. She has a sparkle of hope in her eye.