To refused medication for DD

[Imustbemad00]

I’m just looking for advice of people with experience of similar situations and how things turned out. Without being rude, it’s a difficult time so please keep unwanted opinions to yourself.

My DD is suffering with mental health issues. She was referred to CAMHS over a year ago but due to the school cocking up the referral, she wasn’t actually on a waiting list. Finally got seen by CAMHS in a hospital in the summer, and it’s taken until now to actually start treatment.

She is severely depressed, anxious and has self harmed.
She was on a waitin list for cbt as they felt this was best. I called recently to see how long it would be and was told there was still a wait but there was another treatment option that was available ASAP.
I told them they needed to make the decision, as professionals, as to what treatment best meets her needs.

So she started the new treatment, which is more based around relationships and depression and I’m not 100% convinced it’s the best treatment.

On the first session, the (very senior) psychologist mentioned the possibility of medication.

Third session and the lady has said they want a doctor present next session to maybe start medication. This has been discussed with my daughter with no mention to me. I’m awaiting a phone call.

My issue is, shouldn’t they try all possible treatment for a period long enough for it to have an effect, before offering medication to a young girl.

Of course, I just want her to feel better, any which way, but I’m very apprehensive about medication. I admit I don’t know a lot about it but it scares me.

Why have we waited this long, to feel like we are just being fobbed off with medication on the third session.

Meds can help for some people. My DH tried CBT and other types of therapy and they don't work for him at all, medication does. He has tried both since he was about the age your DD is now.

I have another friend who uses a combination of both CBT and meds. He still has a lot of problems but it's better than when he wasn't on treatment.

And I work with another young person who is having therapy and no meds. It seems to be working for him, at the moment.

It's all down to the individual: the causes of their illness, their approach to therapy ... if your someone's MH problems are caused by a physical problem then a physical intervention to restore the balance (e.g. in serotonin levels) will be a good treatment.

There is such a stigma about mental health medication, and it’s really unhelpful. For me, the medication has always been essential to get me to the point where I can benefit from the therapy.

I have had treatment on and off for depression since I was 18. (Granted, older than your daughter is now)

I'm 27 and 3 months ago came off of my medication completely after taking meds for two years. This combined with counselling and cbt helped me get to the point where I actually feel better.

A decision to medicate shouldn't be taken lightly but it has been in my personal experience, literally life-saving. I'd sit down with the doctor and your daughter and have an open discussion about it, have a list of questions you both might want to ask etc. But I wouldn't rule it out.

Hope your daughter starts to feel better soon OP.

As hard as it feels, sometimes you have to put your faith in the experts. They wouldn't suggest meds if they did not feel this was for the best. I had meds and CBT, but I could never have fully engaged in the therapy before the medication. Once I had the CBT and learned how to deal with my issues I then came off the medication.

I took anti depressants for two years in my mid 20s (which I know is a lot older than your daughter). They didn't make me emotionally numb or flat - they levelled me, probably the best way to describe it. I was able to cope with every day things - going for a walk, shops, talking on the phone, generally talking to people. I also had CBT sessions.
They helped me after a few months to think about why I was ill and how to make changes, adjust, read myself more, see where I was going if that makes sense.

In hindsight I suffered from depression/anxiety from my teens I just didn't know what it was and I made some terrible choices from my late teens for a good few years. I wish I had sought help earlier.
I've haven't used or needed anti depressants for over 15 years now. I can appreciate how final a medication route can feel but I have a 13 year old daughter now, I can only go with what I would do from my own experiences I wouldn't rule out anti depressants.

I found anti depressants very helpful because they stopped the merry go round of intrusive thoughts.
They aren't addictive like a high, you have to come off them under supervision and gradually but it's not remotely like giving up booze or heroin. Not ime anyway.
What they can enable you to do is make the steps you need to recover.
They don't always fix everything but can be very helpful.
Chat to the experts and your daughter. Good luck

But the problem with AD is that I view them as addictive, hard to get off, altering moods to the point of making you emotionally numb

That really and truly isn't the case. Maybe once, when the medication available was very limited, but not now. I'm on antidepressants and they certainly don't make me emotionally numb- they just make me feel like "me"; it's depression that numbs me and makes me feel as though nothing is worth doing. Medication helps you to help yourself by making you feel capable again, and things don't feel so overwhelming.

I think it's useful to look at this situation as you would a physical ailment. If your DD had asthma or a broken bone you'd accept an inhaler or a plaster cast without question. Medication for mental health problems can often predispose patients to respond more positively to CBT when it becomes available.

My poor son with brain damage after a stroke in the NICU has severe anxiety and bipolar like symptoms-he suffered so much I would've done almost anything to alleviate it. I would've loved to have not needed Rx help but sometimes life just doesn't turn out as we want it (he did receive CBT) He is now 18 and he will never not have anxiety but he's stable and that's good enough for me

They dont and won’t “make her happy”. That’s not how they work

If my Dad hadn’t agreed to medication when I was a teenager I would have killed myself. I almost did - that’s when they started taking me seriously. It shouldn’t have had to get to that point.

These medications are life saving for the vast majority of people.

You do not want to walk in our child halfway to death because you refused her something that would help her feel better.

*Your child

Really tough one. I was on AD in my early 20s. I found they made zero difference and left me with a very dodgy stomach.

I also suffered from ante natal depression and went to see a councillor. I was really stunned by how quickly they moved onto the subject of medication and when I refused, they simply didn't offer me anything else...no talking therapy, just a promise to check in with me frequently.

But as some of the comments here have stated, and as some friends have confirmed, lots of people find ADs helpful in getting off the ground and getting into therapy or in making whatever steps towards change they needed to make.

Has your daughter shown any particular preference for how things progress? Can she take a herbal remedy like St. John's Wart with her ADHD meds (obs check with GP) it could perhaps be an interim solution while you discuss fully the pros and cons of clinical medication?

I had a friend who's mother took an approach to medication very similar to yours, as in it didn't work for her so her kid didn't need it also. She buried him at the age of 17. That was over 20 years ago and the memory is still incredibly painful.

You also need to learn how to play the system. You really need to wise up and learn quickly to keep pressing, from all angles.

you need to speak to your GP and the camhs and the mental health teams make it very clear that she should've already been on the waiting list for CBT as well as the current treatment.

And make sure some of your long term plans for her are already being actioned.

@Imustbemad00 you could easily google they are medications that a large proportion of the population are on for blood pressure, heart failure, and cholesterol but you missed my point, which I will labour away at - you understand a diabetic needs insulin to live because it is a physical illness. Because your daughter has mental health issues and there is still stigma round that, you dont think she needs medication, because you of course are far better trained than any professional. So you're quite happy to deny her medication which may make her better due to poor education and inbuilt prejudices.

I think it might be worth you looking at how current anti depressants work - depression can very much have a physical neurological basis that medication can help with
The best course of treatment could be this alongside proper counselling

Please don’t simply say no without properly discussing it with her team

AD’s have moved on a lot since first developed and have very few side effects unlike the earlier ones, which act completely differently on the body.

They may have to try more than one to get a good fit for your dd. So don’t be alarmed if this is the case.

Therapy is very demanding if done well and if the patient engages fully. It also may make your dd feel worse in the beginning. Taking these tablets will work both to prop her up and to leave her in the best place to benefit most from the therapy.

I have also taken AD’s a few times and come off them no problem. I think only having a 12 week course is difficult. If your dd needs more therapy I hope they turn refer her on to open ended treatment.

You could ask the therapists view of trying to access therapy through MIND but please be careful to ensure you get someone with relevant experience if they approve / you choose this route. Although idk if they work with children.

Sine she is under CAMHS and the therapist is suggesting a doctor it will be a child and adolescent psychiatrist who sees her and prescribes the medication.
What they are doing follows NICE guidelines - she has had some therapy and they are now proposing medication alongside therapy. This was what happened with my daughter.
If you have the same experience as me they will increase the dose gradually and monitor closely for side effects.
Medication helped me daughter to engage better in therapy.

I fought for years to get my dd medication when she finally went on it it changed her life.

You can try all the CBT and courses and techniques but if she can't engage in it because of how she feels it's pointless and a huge waste of her time. She'll spend that time feeling worse and worse.

This isn't about you and how you feel about medication it's about your daughter

"But the problem with AD is that I view them as addictive, hard to get off, altering moods to the point of making you emotionally numb and I guess I just want that to be a last resort."

I didn't find them addictive, or hard to get off. As for the emotionally numb, yes, they had that affect initially, but I don't think it was a bad thing. It gave me space to think about things calmly and somewhat what rationally.

I don't blame you for being wary, but if they're being recommended and if your daughter understands the risks and benefits of taking or not taking them and decides to take them you should be supportive of that choice. Given that she's 13, chances are the decision will be hers.

I'd be open to the meds in your shoes. It's VERY different to paracetamol for a headache...

If the recommendation came from an experienced psychologist I'd be listening and working with both them and the psychiatrist to get the meds right.

My experience is that the psychologist are less likely to support the use of meds as the first port of call. Let the experts guide you here as I think your views of the necessity of meds is clouding your judgment.

I would encourage you to do some research on how mental health medications work and the differences. SSRI medications for example operate as a mood leveller rather than making someone happy and operate to give a healthy baseline for someone to be able to engage and get the benefit of talking therapies

Anti psychotic are another ball game but it doesn't sound like they are an initial option here

I have a lot of respect for the fact you are recognising that your experience is different to hers because I am sure you can imagine the damage a view that you could do it without and so why can't she could do to her ? I think it's positive that you can see the difference to be honest

I do feel mental health services are insular and expect you to just know some information so do your research as much as you can to see what and why they are offering things as they often don't explain clearly enough why

It's worth seeing this as well slightly differently ,this is not a black and white...do this and it fixes x y or z situation , often therapy will highlight further aspects that weren't clear and increase the need for medication....think more of an organic treatment process rather than plastering a leg .

Depression is often caused by a chemical imbalance in the brain and the aim of medication is to correct that balance so she can engage in therapy.

I get that AD sound scary at 13 but so does sever depression and self harming.

I take long term ADs for anxiety. I’ve had all sorts of therapy aswell. They’ve not numbed me at all they just make me feel so much better and less worried about every little thing. Have you googled different kinds - there are so many now it’s not one size fits all. My theory is, we only used to know when people had extreme mental health issues, on medication, with more extreme side effects (with the then limited drugs) -because people would hide their problems if at all possible. People wouldn’t talk about it the way we do now as it was embarrassing. Men have higher rates of suicide because they are less likely to seek the help needed. I have been on 3 or types trying to get the right one. The most that happens coming off them has been some mild nausea for a few days. To cut a long story short... Don’t refuse the meds.

I thought therapy was supposed to work?

Hopefully, yes. But there are no guarantees unfortunately. If your DD's depression is "severe" as you say, then it's highly likely that it's causing some cognitive impairment (poor memory, lack of concentration etc) that may limit the effectiveness of talking therapy and make I difficult for her to engage in a meaningful way. Antidepressants won't "make her happy" (if only it were that simple), but they could take the edge off the physical and cognitive symptoms of her depression just enough for the talking therapy to have a real impact. People don't realise that therapy (especially CBT where effectiveness depends on the participants willingness to practice the strategies learned in therapy outside of the sessions in their own time) is bloody hard work. It takes a lot out of you and it's a real commitment. Not easy to cope with when you're depressed and everything seems pointless.

Also just to reassure you that modern antidepressants are not addictive and are generally very safe and effective for adolescents. Serious side effects are very rare and your DD would be started on a low dose and monitored as this is increased gradually. The Doctor who was mentioned to your DD will be a Child and Adolescent Psychiatrist (most likely a consultant) so will be a specialist in prescribing and monitoring psychotropic medications for children and young people. Having worked in Children's MH for many years I can honestly say that the vast majority of CAMHS psychiatrists err on the side of caution when it comes to prescribing medication, particularly to under 16's. If it's not necessary they won't advise it. But all they can do is advise, your DD doesn't have to take the medication if she doesn't feel comfortable.