Every other week, Sonali Gupta draws on more than 10 years of experience as a clinical psychologist to answer readers’ questions about parenting, family dynamics, relationships, mental health, and more.

Can’t Let Go: I have a 4-year-old who is extremely attached to me. She has just started going to school and she wants to play with other children, but wants me to be always around her. She has not been able to make new friends, although there are no other complaints. She can also be quite stubborn.

Sonali: I can understand how this can trigger anxiety for you and your daughter. The emotional bond that children share with their parents is a stability zone for them. They derive their sense of security and comfort from knowing their parent is around. That’s why the transition to school can sometimes make some children clingy and crave attention. Let me assure you, that this is a normal phase of growing up. Some children make the transition very easily by 3 or 4 years, others may take a while longer to make friends or adjust. (Read more about separation anxiety on The Swaddle.)

What helps is acknowledging your child’s feelings and making small, gradual changes that help her steer toward independence. You could try setting up a play date at home while you are physically present, but not in the same room. This will help her feel comforted yet able to enjoy her freedom. Also, try scheduling smaller periods where you allow her to play independently.

You can also encourage your daughter by talking to her about school in a positive manner, focusing on the fun she can have with friends and guaranteeing you will meet her immediately after school.  Speak to your daughter’s teacher, so that he or she can reinforce your daughter’s achievements, but also create fun rituals that help her adjust. I once worked with a 5-year-old who had difficulty adjusting to a new school until the duty of being the Door Monitor gave him a purpose and enabled him to start having fun. A buddy system, wherein the teacher pairs your child with another classmate, may also help ease the transition.

Finally, remember that how we feel as a parent also has an impact on a child’s anxiety. Children are perceptive and can pick up on your own concern or stress. So be patient with her learning process and try not make comparisons with other children.

—

How Much Is Just Aging? My mother in law is around 70 years old. I have been staying with her for the last one and a half years. My husband says she was highly active and social throughout his childhood and teen years, though a decade ago she was diagnosed with depression and has been on medication for such ever since. She was social till about year ago, when she had to undergo hip replacement surgery. Since the surgery, we’ve been concerned about many changes in her, including wanting to sleep excessively, reluctance and difficulty communicating with family members, lying, poor hygiene, verbal and physical abuse, picky eating, and poor memory. What could all of these things mean?

Sonali: Thanks for writing. It sounds to me that you are concerned with the change in her behaviour, lack of orientation and cognitive decline. It is very difficult to be conclusive about the diagnosis, without seeing the client. From what you are describing, there could be a possibility of Postoperative Cognitive Dysfunction. A lot of research focuses around how surgeries in old age may trigger cognitive decline. You must consult your physician about this.

Another diagnosis could be pseudodementia. Pseudodementia is when a person who has depression also has a cognitive impairment that looks like dementia. The term pseudodementia does sound like a misnomer, but it’s a real illness, requiring treatment and medication. There is also the possibility of this being an early stage of actual dementia. It is important to note only diagnosis by a trained clinician would help your mother-in-law access the medication and psychotherapy that could help her in this case.

Remember these are hypothetical diagnoses based on the limited information provided. A combination of neurocognitive tests and a psychiatrist’s evaluation along with a neurologist’s judgment would point to a clear way forward. I strongly urge your mother-in-law to consult both a neurologist and a geriatric psychologist.

I can understand as a caregiver it can be a difficult time for the family. A proper diagnosis and understanding of her illness would help her live a better life and you adapt better as a family.