There’s a look. We know it well. It’s one of anguish, fear, concern, and pain that is just short of physical.

It is the unwelcome face of anxiety. It is accompanied by both physical (a stiffened body) and behavioral (defiant, bordering on manic, activity and trouble sleeping) markers.

We’ve seen this look too much recently — a sign that Ryan’s life is careening up against the walls of the narrow path where he functions best. 

The possible causes are many. Schoolwork. Busy schedules. A San Jose Sharks losing streak. Hormones. Growth spurts. Medication tolerance. The general difficulty of figuring out middle-school life, augmented by a neurology that makes understanding social and non-verbal cues compete for his mental energy as much as studying for a test or quiz.

Some may read that list and think, a favorite team’s losing streak, really? Yes. Prioritization, whether of schoolwork or his emotions, has never come naturally for Ryan. He makes things work for him by applying order and structure to a chaotic world, but when things don’t follow that order (ie, the Sharks always make the playoffs, this year they may not) it’s a problem.

As his parents, we do our best to help Ryan manage is anxiety. We tell him it’s OK to stop studying or take a break from exercise. We go out of our way to not add to the pressure he puts on himself to succeed. We are well aware that managing his anxiety is the key to everything for Ryan, because when it gets to be too much, it becomes all-consuming.

But we’re also his parents, which means we’re familiar. Sometimes, the same message, but from a different voice — that of a doctor, therapist, or counselor — is needed. So it was lucky that we had such an appointment scheduled this week.

I listened as Ryan found the words to explain exactly what is making him worry to the point it affects his sleep. Even in middle of listening to my child describe his anguish, I paused to appreciate his ability to communicate his exact feelings. Getting there was not easy.

Ryan listened attentively to the plan that was laid out — an attempt to modify his daily routines just enough to allow him to restore his proper sleep, since without that the rest becomes exponentially more difficult. He did not question the authority of this voice (although he did later with us before relenting).

I did my best to explain to the voice how we have come to understand Ryan’s approach to life. He doesn’t do anything subtly or halfway. He’s All In, whether it’s studying (schoolwork or statistics), working on his hockey skills or adding strength. I tried to convey that we understand the drive that is a byproduct of this compulsive approach can lead to positive accomplishments in which Ryan takes pride. I was wary not to come off as on over-driven parent pushing a resistant child to academic or athletic achievement for selfish reasons. I’m not sure I succeeded. The voice listened, but reminded me of the need to manage the anxiety before it causes more significant issues.

I get it. With every fiber of my being, I get it.

What I was trying to explain was that narrow path where things work best for Ryan. Using all the skills he has learned to mitigate the challenges presented by autism, and by applying his obsessive drive to that which he wants to do, he has found achievement that brings with it self-esteem. But if he ventures too far towards the obsessive, he risks plunging down the slippery slope of anxiety.

It is our job to help him navigate that narrow path — on both sides. I do not want to stifle his drive and energy, because we have seen the positive effects of accomplishing that which HE sets out to do. At the same time, we understand that we must not add to the pressure that he puts on himself. We need to help him understand that pulling back a bit does not mean giving back that which he has gained. Ryan feels if he doesn’t study every free moment, he’ll forget everything he has learned. Likewise, if he doesn’t work out every chance, he’ll lose all the strength he’s gained.

It’s a fine line to walk, and a tricky one to keep up. There are no easy answers, miracle solutions or instruction manuals.

We will simply do what parents do. Monitor, advise, bring in outside resources when necessary. Do everything in our power to lessen the pressure he feels, while still encouraging him to pursue the things that matter to him and bring him the joy and satisfaction of achievement.

Treacherous on both sides, it is a narrow path, indeed.