Anxiety/Depression and the Decision to Medicate

[Indianamom2]

I realize this might be a sensitive topic, so right off the bat, if you have experience with medicating a child for anxiety/depression and don't want to share the details on this public board, please feel free to PM me if you want.

Ok, so DD is 8.5 years old. Since birth she's been anxious. I don't say that lightly. She has struggled mightily and we have done all sorts of testing and doctors and ruled out medical stuff and tried therapy...you name it, we've tried it....except meds for anxiety/depression because frankly, the cons terrify us.

DD has an extensive family history (particularly strong on one side) including two parents that struggle with anxiety and depression between us. While she hasn't been formally diagnosed with depression, she has shown some mild signs and she definitely has wildly high anxiety. I'm thinking that these two things are progressively getting worse and she's progressively growing up and not always telling us everything until she just loses it over whatever has been worrying her. When she loses it, it can be over very bizarre things (most recently, that when we were eating out at a restaurant that someone might have been poisoning her food, and so she wouldn't eat and was in tears and what is weirdest is that she was hungry and really excited about eating at this particular place because it was the first time we had been able to get in without having to stand in a line outside!)

Dh and I are kind of at a loss. We really want to help her, but two vastly different experiences with therapy have been less than helpful and several respected doctors have repeatedly told us that good (or even decent) child therapists/phsychologists don't really exist in our area. So that leaves us with the possibility of trying meds (which both DH and I and some of our extended family members take for both anxiety and depression.

When I asked DD the other day (we were having a girl's afternoon out) if she was worried a lot, she said she worried all the time. I asked her what about, and she said mainly about things that could hurt her, getting sick, getting shot at school (a direct result of hearing about Sandyhook through accidental exposure). I know she struggles with being impulsive, sometime very aggressive and lashing out. Sometimes it's from anger, sometimes from impulsiveness and sometimes I think from true fear. It's interfering in our lives and relationship. She's definitely what I would consider quirky and most likely somewhere very high-functioning on the scale (likely some Aspergers' markers).

So all that info to say, if you've gone the meds route with a young child....did it help? Did it make things worse? What meds were recommended? Who prescribes them? Were there side effects....you know....all the regular questions! I plan to bring all of this to our pedi asap, and I think she is great at listening and referring and being cautious, but I feel like we've spent her entire life trying to make things better for her and it's getting to all of us and I don't know what else to do, but I am truly scared to take this step.

Thanks for any advice you might have.

[maiaann]

Your DD sounds a lot like I was as a child. I struggled with horrible anxiety, but I was afraid to really let anyone how much I suffered because I was embarrassed. Even as a child, I knew half the stuff I worried about was senseless. But... anxiety is what it is and you can't control it. When it starts to consume you & control your life, there is absolutely nothing wrong with seeking treatment - even for a child. It wasn't until I was an adult that I sought treatment for myself. I wish my parents had gotten me therapy/medication as a child. I think it would have made my life so much better - I was miserable. I see signs of depression/anxiety in my 11 year old DD, and it just breaks my heart. If it ever comes to the point where I think DD needs treatment, I won't hesitate to help her. (((HUGS)))

My advice would be to try and find a specialist you trust & take it slow.

[egoldber]

I understand all your fears and concerns. BTDT. But honestly, meds completely changed older DD's life. She is so much happier now. We are so much happier now. Our DD was about a year older when we went to meds, but I think the need was clearly there about a year earlier.

We see a psychiatrist who specializes in anxiety/depression in children, which I realize is not always available everywhere. We started with generic Zoloft and it was a disaster. We knew after about 2 weeks it was a bad choice. Then we went to generic Prozac and she has been on that for 2 years now. We had her on 10 mg initially, then after 6 months or so we went to 15 and then again to to 20 mg after a growth spurt. She has been there now for about a year.

I decided not to really read much about the side effects because for her the meds have made such a huge difference in her quality of life.

[JTsMom]

Our situation is a little different, as DS's primary issue is ADHD, but for a while, his anxiety was rivaling it.

The very first thing we did was to try 5-HTP (an OTC supplement), and that actually worked reasonably well for quite a while. When it no longer reduced the anxiety enough, we started seeing a psychiatrist We tried an ADHD med first, which he had bad side effects from, then decided to switch gears and treat the anxiety first. We tried Prozac, which didn't help, and had several side effects. Next we tried Zoloft, which was much worse than the Prozac. If you scroll down, you'll see a post that details the issues we had with both.

Next we tried Intuniv, which is a non-stimulant that also helps with mood, and the anxiety 100% disappeared, which I was not at all expecting. Unfortunately, he was having some really big meltdowns when he'd face any type of frustration. After taking him off of that, I ended up having a really long discussion with the psychiatrist, and he suggested trying Tenex, which is what we're using now. It's the same type of medication as Intuniv- guanfacine- but Intuniv is an extended release version, Tenex is not. I hate to jinx myself, but it really is helping. The anxiety is gone, the hyperactivity is about a thousand % better, and his focus is somewhat improved. He is not having any side effects at all.

Had he and I not been desperate, we might have given up b/c it felt like we'd never find the right drug, but we *might* have done it. It's still early, so it's hard to say for sure. I absolutely understand being afraid to take this step. Jason has a serious heart condition, and ADHD meds have a black box warning on them for heart kids. I did everything I could to try to avoid going there, despite numerous specialists recommending this route, b/c I was terrified.

When he went off of the Intuniv, I can not describe to you how much worse life became. Even though the rages were gone, the intensity of his ADHD issues make life hell. He is really off the charts, and just cannot function. I was so happy when the new meds kicked in! If she, and you, are really struggling with it, I would absolutely consider meds. If you don't like the side effects from one, try another. There are a lot of options. If you can find the right match, life might look totally different for you and her.

[hillview]

I had severe depression as a child -- I was considering killing myself when I was 13. I KNOW I had signs a lot earlier, my parents were reluctant to get me any help (nothing could be wrong with their child) for a while. I think if I had gotten help earlier my teen years would have been a lot easier on me. I went on meds at age 13.

[Indianamom2]

I really appreciate everyone sharing their personal experiences. It is very helpful to hear the challenges and a realistic description of the benefits as well as the side effects and trial and error. I think that I have a good idea of how meds can affect DD because I've tried several meds and DH has tried at least as many different ones and we've both had successes and failures and side effects that ranged from mild to intolerable. At least we will be able to say, hey this is just the medicine and it will likely get better or....ok, I think it's time to try something different.

It's also really helpful to hear the stories of those who struggled with depression/anxiety as a child. I didn't have any anxiety issues until my twenties and no real depression (some PPD, but that's it). Dh has struggled with both his whole life and still does to an extent. My greatest fear is that my fear of the meds would cause her to suffer so much without them that something terrible would end up happening anyway. So I think I'm going to go ahead and make the call to her pedi and get the ball rolling (again) to try to see if we can help DD.

Thanks again for all the advice.

[pinkmomagain]

I have chosen medication for two of my children for their anxiety. The two things that really affected my decision was: 1) seeing how much they were suffering, especially comparing their experiences with more typical kids, and 2) seeing how it was getting in the way of them expressing their potential. I just wasn't going to let anxiety win.

Medication is not necessarily the answer for all. And in nearly all cases, therapy in conjunction with meds really is the best route. But I have found -- in my very limited experience -- it takes alot of work and motivation to be in therapy...and I've yet to see a therapist work with kids or teens with lasting results that did not involve medication in some way. Again, just my limited experience.

I would work with a psychiatrist or psychpharmacologist on getting meds right. That in itself can be a long complicated process. Best to work with someone who prescribes all day long and understands the nuances of these meds.

[Katigre]

I really relate to your dd as I have dealt with obsessive thoughts/anxiety throughout my life. I would keep meds as an option. The next few years will be volatile hormonally which can exacerbate mental illness struggle.

I would say this - during my last pregnancy my anxiety was really disruptive, the worst is ever been except during one semester at college, and this led me to seek counseling for it which I had never done before (even though looking back I needed intervention at other times). Through a lot of daily mental exercises I was able to manage it, but it took a lot of WORK and ENERGY and if I slacked off for even a day or two the anxiety overwhelmed me.

During that pregnancy I also switched our family's diet to paleo eating (which included cutting out all grains and eating a lot more vegetables, especially greens). Within a month of doing this my anxiety disappeared. It was totally unexpected and shocking in a good way. That was last spring. Now a year later (so this wasn't just some temporary lull but sustained long term improvement), I can say that my anxiety has stayed about 10 percent of what it used to be - totally manageable when I get an anxious thought, much more "normal" vs over the top.

I didn't even get intense postpartum anxiety like I have with my other two kids. I had a few anxious thought that I could handle by talking about it with dh (contrast this with postpartum after dd where I was sobbing on the couch about how electrical outlets were going to give my baby brain cancer and I was fearful to sit near one for weeks).

Whenever I eat non-paleo food (grains, high sugar, processed foods) for a few days the anxious thought come back and I feel gross mentally. This has made sticking to it fairly easy because I want to feel calm, reasonable, non-anxious, non hypochondriac, and non obsessive about worst case scenarios in daily life.

I don't understand how this diet works or why grains are so bad for my brain chemistry (or why greens are all important for my brain chemistry) but I have known at least half a dozen people who have had this same "side effect" from going paleo.

I truly feel like I've got my life back eating this way and have never felt so good.

In your shoes I would try the diet first while continuing therapy and then if it doesn't help try meds. There's no harm in a 30 day trial of different foods and it could really help.

I would also ask to have her tested for vitamin levels. Many people who deal with anxiety/season are unable to process b vitamins correctly (what you need for a healthy brain) and there are rx supplements that hugely help with this. http://www.deplin.com is amazing and has really helped my dh.

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[Indianamom2]

Katigre,

Thanks for the info. If I thought for even a moment that DD would eat anything on the paleo diet, I would try it, but compounding our issues are definite sensory issues that include oversensitivity to tastes and textures and extreme pickiness. The child will hardly eat one fruit or one vegetable no matter what we try.

As for vitamin deficiencies, she has been pretty throroughly tested. They found her majorly deficient in Vit. D, but otherwise, she was good...amazingly given her diet. I'm certain vit. B was one that was checked, but the info is something to still keep in mind, so I appreciate it. I'll look more into it and address it with her pedi (not the dr. who did the testing).

And I am going to call tomorrow to talk to her doctor about meds and what next. The mere thought that she is right around the corner from major hormonal upheaval is terrifying and something that is a major concern of mine, as I know that can't help the situation. I would much rather that she know that we did all we could to help her than wish that we had done more.

We were watching an old home video of DD at Disney when she was 4 and she was so joyful and happy and spirited (still had issues, but definitely not sad) and DH and both commented this evening that we don't see that anymore. I think we need help.

[Katigre]

I would ask your dr about the Deplin. It is prescribed in tandem with psychiatric meds and makes them work better. So she might need a lower dose of a medication if taken with deplin (potentially).

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[Indianamom2]

I would ask your dr about the Deplin. It is prescribed in tandem with psychiatric meds and makes them work better. So she might need a lower dose of a medication if taken with deplin (potentially).

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I just took a really quick look at Deplin and it certainly sounds intriguing....I will definitely ask about it. Thanks. I've never heard about that before.