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teens and antidepressants


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ok first off i have to say i've worked myself into such a state about this i'm finding it hard to fess up. i've held it in for seven days now and i can't take it anymore even though the shame and guilt of admitting this is killing me. i tried this morning not to take a clonazepam (i'm trying to wean back off), and i can't even do that because my heart is racing and i keep crying. this will be really really long so unless you have an hour please read something less cumbersome heh.

some of this is overreacting because i'm depressed (e.g. the panic attacks and the crying). some of this isn't. some of this i think any parent would freak about. but i have to check what someone else with a teenager(s) thinks.

my kid is a 16 (almost 17) year old girl/woman/child. after this year, she only has one more year of high school to get through. up until about six months ago, she was a considerate, attentive, and charismatic child. she laughed a lot and had an active social life (she was - and still is - actually quite popular despite her freakish appearance and loud bisexuality). she's never had a real sex life (is terrified of pregnancy), she's never done drugs (that i know of), she's never come home drunk or late or lied about where she really was.

about six months ago, things began to change. she didn't want to go out with her friends much anymore. she began spending more time in her room/online. her core group of friends varied a little - she made fast friends with three other girls who are MI and on medication... and are also allowed special privileges academically because of said MI (as should be the case). her best friend went from one longtime friend to another girl (also a longtime friend) with huge issues and a tendency to be verbally abusive.

;) she began playing with cutting. i knew she was doing it (know the telltale signs) and at first i said nothing, because i knew she was playing with it. she was taking pictures of it and saving the blood for other people to see. this is a cry for attention, not a way to cope with pain, in my opinion (as a former cutter myself). eventually i told her i knew, and that she'd have to figure out how to stop that one on her own since there wasn't any way i could force her to do something else (the terror on her face physically slid away when i said that). i also told her that if she felt like she needed to do it, if she was ever feeling overwhelmed or in pain, that it was always okay to tell me or someone safe, even if it seems stupid or unimportant... because the short-term solutions never get you anywhere but in more trouble, just like drugs (something she understands very well). she was pretty quick to get upset that i knew about it at all, and in so many words said it didn't have anything to do with being in pain. she wouldn't elaborate. so now maybe it's turned into something else altogether. :)

she began having panic attacks, or what she described as such, at school and couldn't go to/perform in class (only certain classes, not others). she says she cannot concentrate. she goes to school in the morning like i'm sending her to a coal mine, but she comes home talking about whatever social events happened that day like a regular kid. until i ask her about aforementioned classes. then suddenly she remembers she's anxious and says she couldn't do anything today so she just sat there. she refuses to make any plans to deal with this whatsoever. i told her teachers myself what was happening. some of them have been easier on due dates and things, others don't care.

she's had one or two days where she hasn't bothered getting out of bed until around four in the afternoon. she says she's too depressed to bother. then she'll have a week where she's up before the alarm goes off in the morning. curiously, these events coincide with whether or not she's fighting with the new best friend.

she tells me about the current best friend - everything. i show her a checklist of abusive relationships and ask her to tick off what the friend does. the results were astounding. i told her she would always feel like crap if she chose to spend her time with people who treat her like she was crap. i told her she did have every reason to use her boundaries and stop allowing this in her life, and that it would upset anyone to be treated this way by someone they loved - it's not okay for someone to treat her like that. i told her i understood how hard it would be, and how much she'd miss her, and that it would hurt for awhile... but the hurt won't be any worse than how said friend makes her feel every day. she totally agreed, and even took steps to do just that, and has since been so much less depressed/anxious it's amazing. not perfect, but a world of difference. more good days than bad.

somewhere in between all these incidents, i asked her if she'd like to go see a therapist to talk to. she agreed (enthusiastically). i meant someone to TALK TO. we went through the ridiculous waiting period, i did a two hour intake interview over the phone, kiddo did an hour interview over the phone, and then the interviewer recommended the appropriate tdoc and gave us an appointment date.

that date was last week. the tdoc interviewed kiddo about her own history, family history, the usual stuff you talk about in the first 90 minute session (not really getting into therapy per se, but helping the doc know what you might need). the doc's recommendation was that kiddo (a) get on antidepressants immediately - to help her concentrate (wtf?) at school, and (b) go to a teen anxiety group that's an hour away. then she told her that her gp would prescribe something for her and she'd give him a call - the SAME GP that had me on one wrong med after another for TEN YEARS of my life until i got a pdoc to finally let me have a mood stabilizer. i cannot say enough times how big an IDIOT this man is when it comes to psych meds... i mean he's done everything from take me off meds cold turkey (potentially causing life-threating seizures) to giving me incompatible psych meds to getting the PI sheets WRONG about dosage amounts. i've bitched about this quack here before.

the gp's office called me with an appointment today, it's next monday. it's before the next therapy session. back up lysergia. the day after kiddo's session, i called her tdoc and requested to speak with her regarding the med decision. she told me i could come next session with kiddo (next thursday). so the prescription will be in hand before the meeting whether i like it or not.

there was no mention of trying any talk therapy before meds. NONE. and this is a tdoc, not a pdoc, not someone with a medical license. this is someone who had to call a gp who knows NOTHING about my child because she's never freaking sick, and neither of them have any decent training in psych meds.

i tried talking to kiddo about my concerns - that i was panicking about her jumping the gun with the meds, and that i really (really really really) believe that she needs to TALK to someone, that she has a lot of issues past and present that need sorting out - and i listed them all right there (boy was she agape - i hit the nails all on the right heads, she said). i said i was worried that meds would mask all that and she wouldn't want to work on anything anymore, and that her future life would suffer for it. i told her i'd never ever taken or heard of an antidepressant that helped anyone concentrate within the first two months (which is all that's left of the school year)... that more likely she'd be more tired and it would be harder to concentrate and that she'd probably see more side-effects than benefits during that time period anyway. i begged her to at least think about it. at least wait until the school year is over - it's not like she's failing (i get to see her school stuff every day online).

she emphatically told me NO. that her therapist had informed her that since she's 16, she has the legal right to make her own medical decisions. it's true. she can, legally, whether i like it or not. and she said she has EVERY intention of taking them as SOON as she can get them... and she doesn't even know what's being prescribed yet.

i don't know what she told that tdoc. my own therapist (wisely) reminded me that the tdoc may not be a quack... my daughter may have gone in there with the full intention of getting meds, by whatever means necessary (including reporting symptoms that aren't there). we had even talked (the session before) about kiddo spending so much time with other kids who identify with being their illness (and boy do they EVER), and whether she wanted to fit in with them.

it's possible that things really are worse than i think, that she really is that ill right this minute. but i've been talking about her behaviour to my partner, my family, my best friend.... ever since this started happening, and these are people who know kiddo (and her self-admitted drama queen ways) very well. they all freaked and had the same reaction i did when i told them about the tdoc's decision. and they all know intimately about my med struggle for the last ten years, and none of them believe that psych meds are "bad" inherently. so it's not that they're anti-med people.

so now i'm counting down the days until monday, when i see the gp (oh yeah i managed to get the secretary to put me in for ten minutes right BEFORE kiddo's ten minutes (which are as long as the appointments last, if not less). i can tell him what i'm afraid of until i'm blue in the face and he might not listen. then i have to wait until the following thursday, when i can find out what the hell that tdoc was thinking when she put that idea out there.

i have a tdoc appointment tomorrow that hopefully will get me into a calmer place so i don't go off like a crazy lady and either lock my child in her room to keep her away from the pills, or leap across the desk at either doctor with a letter-opener (okay for all you folks out there who think i'm abusive/dangerous and might do it? i'm EXAGGERATING. no calling the cops necessary, mkay?).

i just need to know what y'all would do. some of you know me better than others, you know how much i love my child, how close we've always been, how much alike we are, how our home is the one all the kids want to be in because we never fight with each other... i feel like all that's gone and i'm devastated. i'm terrified this is the end of her thinking my advice ever means anything.... and it DOES, i know it does, i've been so many freaking terrible places in life and in retrospect i know how not to get there again. she used to value that, and ask me questions about it, even at 16 when she was supposed to be hating me or ignoring my ass! she used to tell people her mommy was her therapist and all her friends' therapists too, heh... that's how much she told me about her life, once upon a time (not that long ago!). now a tdoc who doesn't know her and a brand new social circle might take her to those terrible places, too. or that's what my depressed and anxious brain says. and there's nothing i can do. or is there? how on earth do i let this happen if they don't allow me, her own mother, a choice?

okay i'm done i'm sorry this was so long but i am so tired of crying today i had to finally write it all down and make it real. i don't think i'm dealing with this very reasonably. or like a sane person (hahahahaha yeah that's funny). if you got through all that and have any words of wisdom i'd really appreciate it.

- sniffly rita

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I read your whole post and I can tell that both you and your daughter are in a lot of pain. My 17 year old son has been diagnosed with varying degrees of anxiety/phobia/depression/dysthymia since age 9, so I somewhat know about the meds and moods, but I've never experienced a rapid change of personality in him like you have with your daughter. I have, however, heard of it happening quite frequently in our local high school - with girls.

I'm not sure where you are located, because I'm relatively new here and don't know you, but I'm wondering if you have a choice of tdocs, pdocs, or even gps. I'm lucky to live in a major metropolitan area where these docs are on every corner, and many many take insurance. I'm assuming you don't have that luxury or you would be trying to find a new doc for her.

I agree that rushing into meds is just that - rushing, however it is done very frequently with friends I know. When my son was 9 he was prescribed zoloft without any therapy. And I have to say it was a godsend, an amazing change. However, we may be one of the few lucky ones where it worked so well so quickly.

And due to the fact that it did work so quickly we noticed a change in school performance right away as well.

Please please please do not think I am telling you to put your daughter on the meds. I just want to pass along our experience. I know others have totally different experiences with meds and talk therapy.

It does sound like your daughter feels that the new group she is hanging with is so glamourous with their MI and their meds. I guess there is no way to know what is really going on in her head, and hopefully the talk therapy will get to the root of it. Its a hard age, and I'm sure she feels good to have a group to fit in to, even if its not a good group. The fact that her relationship with her best friend can dictate her moods so extremely seems to be a sign of depression. All kids get upset about issues with friends, but they usually can still get out of bed and go to school.

So I think you are doing the right thing by taking her to therapy. It also sounds like you know a lot about meds, so you will have a good idea of what to expect and whether the gp is giving her the correct meds at the correct dose.

I hope your tdoc can help you also. I'm sorry you are going through this, after 16 years of happiness it must be hard to deal with what is basically a "new" child. But it sounds like you are so supportive and that's what she'll remember.

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Hi, Rita.

That sounds like a horrid situation. Good for you for pointing out healthy and unhealthy behaviors.

In general, teens/ADs make me very nervous. I'm very biased, as I come from a long line of manic-depressive folks, all of whom presented as depressed in their teens.

ADs have not helped my family's situation much, as a group. That's an understatement... but the acceleration has been remarkable. On the other hand, the ADs have helped with diagnostic clarification.

On the other hand, a good AD and some skilled therapy are just fantastic in OCD in adolescents.

So I don't want to paint with too broad a brush.

But going in, and discussing your own mood disorder history, and your own problems with ADs - yeah, that seems like a darn good idea.

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I'm gonna come back and write more later (have to go out the door like 10minutes ago) but just wanted to mention the fact that a gp shouldn't put anyone (esp. a teen) on any AD before first doing a few blood tests (thyroid, etc. you know?) that might give you a week inbetween when you think the med will be prescribed. just wanted to write the down while I was thinking of it.

will be back, I might have a thought or two from your daughter's perspective.

it'll work out, and alll that you have with your daughter is not going to be erased by this tough patch. those roots and trust and love go a lot deeper than the opinion of one doctor, so try to have some faith in that in the meantime, k?

be back ltr.

m

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Meg has a really good point about ruling out thyroid issues, etc.

As a teen, I was a "classic" case of depression, and I wished I could take an antidepressant. I'm not sure about your daughter, though. I had no friends in high school, so your daughter's social travails perplex me a bit.

I'd definitely want her seen by a specialist--or at least not by your current GP. There's no way you could change doctors?

I mean it's possible that the first med he prescribes her will work, but he sounds kind of scary based on your description...

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thank you so much everyone. it really helps me to validate that i'm not overreacting as much as i think i probably am (well in behaviour if not in thought anyway heh).

that's an excellent point about checking for physical conditions. we did do that at first about six months ago when the symptoms started presenting (everything was normal, and i especially insisted on thyroid tests because of my own family history)... but i could definitely argue another look is in order and (though i know the tests will probably still be normal), it'll buy me some time.

i tried again to talk to her about it last night with no luck :) . her mind is still made up. i said please, please take until monday to consider waiting until after exams. i'm trying to find a way not to challenge her independence while getting her to see some options. i'm driving myself insane in the meantime. i'm having a hard time waiting to FIX this. good thing i have tdoc this afternoon huh :) .

thanks again. i am going to breathe a little now ;) .

- rita

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i waited for a long time feeling like crap before i got help (at 17), and started on valproate for bipolar - then i totally totally crashed and took prozac, which made me psychotic before i came off it a few weeks later. later i was on lithium, then added edronax... now i'm on lamictal.

anyway, my point is that i'm 18, and antidepressants havent helped so far. I dont have the same issues as your daughter but i do know that they dont help when your real issue is just needing to talk and work out issues.

I'm on my way to finding a good psych, because i know that even if i choose antidepressants again, they wont 'fix' things. i chose meds without my parents knowing. the side effects and they way they can make you feel can be shocking and once you've started its quite hard to stop.

i hope your appointment with GP was helpful. best of luck for you and your daughter.

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thanks berry. it really helps to hear from someone who went that route at that age, and how it turned out (though i know everyone's different). good for you for looking for talk therapy. it really is the harder choice for most people i think, although it's not always the total answer (for me it's both). i wish you luck in finding a good tdoc!

the GP appointment is today. kiddo's therapy appointment is thursday. i'm so anxious i think i am going to explode. but no matter how i feel i am doing this. i would never forgive myself if i didn't fight for what i thought was right for my daughter. even if it turns out i couldn't help at all (anxious anxious anxious anxious), i can at least know i tried really hard.

i'll come back and tell how it went today, unless i have a total meltdown or something because she came home with a script for something ridiculous (anxious anxious anxious anxious).

- rita

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As for the general question, IMHO, the three meds that I would feel most comfortable (or least uncomfortable) for a teen would be, lithium, bupropion and lamictal.

As for your particular case, it would be wise to keep in mind that what worked for you has a higher probability to work for your daughter.

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As for the general question, IMHO, the three meds that I would feel most comfortable (or least uncomfortable) for a teen would be, lithium, bupropion and lamictal.

As for your particular case, it would be wise to keep in mind that what worked for you has a higher probability to work for your daughter.

thanks Glen. i kinda thought that maybe what works best for me would be the better suggestion (if we have to go that route at all)... but then i wonder is our body chemistry similar enough for that? i mean i have/had grave's disease (thyroid) since childhood, and she doesn't... that kinda changes my opinion a little (since it runs in my family). but then again, our physical development and physical appearance are so much the same... i dunno. i agree on your med choices definitely though. absolutely no mood stabilizers, and no wellbutrin and no paxil and no effexor and no cymbalta (gee rule out much?). just too much risk of both side-effects and/or dependence for me. you can't give those drugs a quick fling to see how they work. they take too long to get there and take too long to get off them, if you can at all. well except for wellbutrin. which would no doubt drive her anxiety through the roof so i would hope any gp would know that one.

i'm rambling again because i'm still nervous... a little over two hours to go yikes!

- rita

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I GOT MY WAY I GOT MY WAY I GOT MY WAY I GOT MY WAY!!!!!!

;):) :) ^_^

no meds until she's had four group sessions and at least three more CBT sessions.

YES!!!!!

where the hell is the virtual champagne around here.....

the squeaky wheel got the grease. goddamn.

:P:( :( :(

i'm sorry i can't stop smiling!

- rita

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Isn't Paxil the only antidepressant approved for depression in pediatric patients?

But it's great that you've managed to stave off the meds for now... (BTW, how did you manage that? It seemed like your daughter was hell-bent on getting them.)

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i have no idea what's the standard now for pediatric anti-depressants. truthfully i've never known anyone with children on ADs (just APs and stimulants). that probably contributes a lot to my fear. i would think that there would be a range of ADs that may/may not work with kids - i mean aren't they as individual as adults in that way? i dunno. i have a bazillion year old psych degree (not really a bazillion, but twelve years out of the loop is a long time in treatment standards), but i steered clear of the child psychology classes (now i know they were too triggering, back then i thought i just hated child psych heh).

okay this is what happened:

battle number one: monday - went to see GP. my appointment was first (needed new WB sample packs, damned insurance). i told GP kiddo was next in line and what was coming, and how vehemently i was against meds as an immediate treatment in this case (and why). then it was her turn to go in, and i made her go alone. GP talked to kiddo for two minutes then called me in to join them anyway hehe. turns out she IS exaggerating symptoms, and because i said it was a possibility, GP wanted to check what she said against what i saw (brilliant idea coming from this fuckwad doctor). kiddo told GP she was failing due to lack of concentration, that she couldn't sleep, and that she had lost weight. on top of her poor mood over time, sounds like depression, right?

lie #1: she isn't failing, and her marks weren't great to begin with due to poor study habits (that she's had forever). the poor concentration makes that worse, but it is NOT the reason for her lack of A's. if she does fail, it will be because she went out of her way to do so - i'm not even kidding. i know what her marks are. they keep them all online after every unit/test/project.

lie #2: she sleeps when she WANTS to sleep. she doesn't WANT to sleep at midnight even though she knows she has to get up at 7:30 - so she doesn't. then complains she can't. this has been going on for years. it has never once prevented her from going to school - EVER. no matter how she feels or claims to be feeling. if she does sleep until four in the afternoon, it's on the weekends when she's probably just so sleep-deprived from staying up late that she needs to catch up (not because she's too depressed to get out of bed).

lie #3: she is not losing weight. she has gained twenty pounds in the last year because she won't get off her ass and get any exercise whatsoever (also chronic for her - she HATES physical activity, but it's only now catching up with her). and i know this for sure - she outgrew all her pants and i had to buy her new ones.

soooooo.... GP says hmmm well why don't we wait until mom talks to tdoc on thursday. kiddo is MAD but she says fine she'll wait (thinking she'll get her way in the end anyway no doubt). she has an appointment scheduled with the GP next tuesday to tell him how that went and if meds are going to be in order.

battle number one down - i bought more time without meds.

battle number two was thursday - went to see tdoc with kiddo. tdoc was VERY surprised to hear our contradictory versions of these issues (and a few others). she asked kiddo very directly who was right, and kiddo didn't lie (she just squirmed an awful lot). she asked kiddo if this was part of the drama-creating issue, and kiddo said yep probably and shrugged (typical teen). tdoc asked her if she still wanted meds. of course kiddo said yes. tdoc asked what are you hoping meds will do for you - she said she didn't know (same Q&A we had the day before at home!). then i told her about the med glamourization issue, and she had NOT been let in on that part of the equation. after hearing that, she decided that yep, we're going to wait on those meds and stick to group and CBT for at least two months first.

how do you spell relief? MED-FREE CHILD. ;)

oh yes she is mad at me for interfering. but she's not being pissy with me. i think she's considering "proving me wrong" and fighting therapy... it sounded an awful lot like that yesterday. but the tdoc sees enough teenagers to know THAT one real well and i'm hoping they can work that one out themselves. this woman sounded like she really knew what she was doing, and wasn't going to take any excuses from kiddo (yessss!!!!). but in the end, she has agreed to wait on the meds, go to group (which she's dreading, except for the possibility there might be some hot emo kids there (her words not mine!)), and go to her one on one sessions.

so in the end? i didn't have to do any real fighting - all i had to do was tell the truth to the right people and, thankfully, they believed me (it would have gone SO haywire had they ignored me).

and i'm just so happy knowing her tdoc is good and that she's planning to do CBT and focus on present-day functioning NOT on ruminating over how she got this way. it makes me feel really positive about her future again. even if she's mad at me in the meantime :)

thanks for listening to all that!

-rita

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I just wanted to add, I'm 19 and I have been hospitalized times. Mostly with teenagers. I've seen tenns in there for running away, and feeling depressed.

I think that medication is push on teens too much.

A lot don't even need the medication, they just need therapy.

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I just wanted to add, I'm 19 and I have been hospitalized times. Mostly with teenagers. I've seen tenns in there for running away, and feeling depressed.

I think that medication is push on teens too much.

A lot don't even need the medication, they just need therapy.

thanks tanya and berry ;)

what a different world it is today than when i was 16. i "ran away" at that age, and nobody put me anywhere (i'd like to call it moving out, since i took the time to pack and everything heh). my sister ran away at 14 and even the cops wouldn't go get her to bring her home, let alone to the psych ward.

i guess back then (only twenty-some years ago!), 14 was considered old enough to make one's own decisions. damn! now doing that will get you the whole shebang of authorities on your butt i guess.

- rita

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I'm glad you've convinced your daughter's doctors to try the therapy route first. I wish I'd had that opportunity as a teen.

It is Prozac that's approved for use in children. Paxil has not been approved for use in children under 18 years old.

Prozac has an extremely long half-life, so it's much more forgiving if a dose is skipped here and there. Paxil has brutal discontinuation effects for up to 50% of its users, and tends to lose effectiveness when stopped and started.

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  • 3 weeks later...

Im 21 And Let Me tell You When I Heard I Could Get Anti-Depressints I Was Like YA!!! Because I Hurt like Hell And was Desprit For Any Help, Im Not A Cutter But Ive Tryed It Mostly Just To Get Attention Sortof A Silent Cry For Help I belive Shes Strong Willed To Just Get That Pill That Will Make It All Go Away But In My Experence It Takes Months For Them To Take Affect, I Mean Whats It Gonna Hurt Her Getting Meds I Know You Love Your Daughter Dont Let this Escalade In Painfull Silence To Suaside, Not trying To Pressure Just Trying To Help ;)

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Isn't Paxil the only antidepressant approved for depression in pediatric patients?

I think it's Prozac that's approved in the under-18 group. I've got an under-18 kid on it so I'm sure hoping I've got this straight.

You're right of course. I've never taken either, and I got the "P" SSRI's mixed up.

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