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.

I do understand how meds can be thought of as being scary and, well, 'too much' and there's no denying that sometimes they're over used.
However, sometimes they're absolutely the right option, I've certainly needed ADs in the past, and also they can really help in helping therapies like CBT and talking therapies be even more effective.
Anyway, I do agree that having a critical view of meds is probably sensible, although also being open minded to their benefits is good also, and seeing them as something to have in a toolkit of treatments to help ppl

@Imustbemad00 i was 15 when i was diagnosed with depression, 16 when i started medication! It changed my life and now I'm a happy healthy 20 something year old, iv been of meds for 5 years and haven't had any episodes x

Honestly thankyou to the people that have shared their experiences. It’s helped me see a completely different perspective.

I think my view of them is maybe a bit outdated. Although I’m still very worried.

My main concern now is what happens at the end of the 12 weeks. And if the therapy (and it is IPT for the person that guessed earlier) is supposed to work in 12 weeks, then why the need for medication. If it doesn’t, there needs to be a plan for ongoing therapy, not being put on another waiting list.

I would be over the moon if she started medication and I saw an improvement like some have described.

Would you say the same about insulin or cancer treatment if your daughter needed those? Depression is an illness and it's no different. As a PP said: 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.

This is exactly it. I'm not me without medication. I'm bogged down by an impenetrable fog of doom and futility, I can't think straight or motivate myself to do anything but lie around wishing I was dead. Antidepressants make me feel normal. I'll be on them for life, because I wouldn't have a life without them.

And if the therapy (and it is IPT for the person that guessed earlier) is supposed to work in 12 weeks, then why the need for medication.

It sounds very much as though her clinicians think she needs the meds to make her functional enough to engage with the therapy. It won't work at all if she is mired too deep in depression to engage with it.

Therapy is unlikely to cure the depression in 12 weeks, if at all. While it can make a big difference to understanding it and altering negative thought patterns, it is not a cure, it's to provide you with the means to cope with being depressed. For some people it doesn't work at all because their mind set is so skewed by depression. Therapy and medication in tandem is likely to be much more effective. I've had therapy numerous times over the past 15 years - for longer than 12 weeks at a time - and it has never taken my depression away. It allows me to 'out-think' it sometimes, but without being on antidepressants it would be next to useless.

I am wary of meds for teens as well, but 12 weeks of therapy is unlikely to be sufficient. If the doctors are recommending meds, I would at least consider them.

Oh and a very low dose of medication can actually be enough to help the patient see the problems more clearly. So a little bit of help might make therapy much more effective.

Not read the full thread so don't know if anyone has posted this but there was a BBC programme a while ago that showed that only 1 of the AD's available actually worked with teenagers. Many of them actually made things worse to the extent children were committing suicide.

It was called The Dr Who Gave Up Drugs.

I have suffered depression and I have been on ADs. I do research in the area of depression.

While it isn't reasonable to dismiss ADs in any particular case it genuinely isn't reasonable to compare them to Insulin.

ADs are effective in around 45% of cases. This compares to placebo that is effective in 40% of cases. CBT is also effective in around 45% of cases...and you only get up to a more reasonable sort of number for the combination of CBT and ADs which is 55-60%.

This is not because AD's or CBT aren't particularly effective...its because they work for different people in different ways.

If Insulin was as effective as ADs there would be a huge number of dead diabetics around.

The OPs DD may need AD's to engage in therapy...though she may get enough of a boost from sugar pills to get her engaged with therapy. She may find therapy effective or useless.

There is no way to tell (that the NHS fund anyway - we are testing some experimental questionnaires if anyone's interested) what will work for her.

The key thing is not giving up if the first treatment or combination is unsuccessful. Not all therapists are equal. Not all ADs are equal. Writing anything off at this point would be a mistake.

www.google.com/amp/s/www.bbc.co.uk/news/amp/uk-scotland-42917452
A BBC article from 2018 makes for interesting reading

cherie having read that article and some of the papers it refers to, I have to say that if it was my child, I'd be trying therapy first before trying ADs.

The key thing with the CBT is whether or not you are capable of following the advice. If your therapist says you should aim to get out the house and meet with friends twice this week...and you simply can't do that with your current symptoms...then yes - take the ADs to see if that boosts you up to the point you can engage in behavioural change. If you can already engage in the behavioural changes without the drugs then there's no point taking the drugs....

It’s incredibly common for young people with SEMH struggles to self medicate with alcohol, drugs or risky behaviour.

Far, far better to have her under the care of a doctor and taking something to restore the chemical balance in her brain properly, hopefully allowing her to engage in therapy properly.

The end of the 12 week therapy course may signal the end of CBT, but shouldn’t necessarily mean CAMHS close her case. It should be reviewed and a plan made appropriate to how she is doing.

I'd definitely ask on what basis they are suggesting ADs. If it is a blanket first treatment line then I'd be skeptical. If the answer references her specific case I'd be inclined to take it more seriously.

Another possibility to consider, that ADs are being prescribed because she will be discharged after the therapy has finished. I know it's not what you want to hear, and in an ideal world it would not be the case, but CAMHS is so overstretched that they're arranging medication now because you won't have the option in the future.

I hope it's not the case, but it's something to be aware of. It's unlikely CAMHS will be involved in the long term.

I don’t have experience with this, and as a consequence I think I’d have almost the same approach as you OP.

That said, I’d educate myself thoroughly, on drugs and therapy and my child and her doctors and.....everything. I’d become a goddam expert. You sound as though you’re in the dark, guessing about stuff, going by suspicion and outdated information.

Get yourself into NHS websites, reputable internet resources, book an appointment with a private doctor to talk to for just an hour to learn things, speak to your DD’s professionals, speak to people who’ve had experience, try every resource available. Piece it together, and do as much as you can with your DD.

I’m so sorry you and your DD are going through this.

School is often a big reason for depression.
Unschooling could be the way to go

I would seek a second opinion. My mother suffered from depression and was eventually put on anti depressants. I won’t go into details but they didn’t work out for her. Anti depressants can be miraculous if correctly prescribed but three sessions seems a bit quick. Although in the other hand hers may be a case where the benefit is so obvious that it makes sense. I wouldn’t trust NHS clicians though. They aren’t treated well to begin with but I think a lot of decisions end up being rushed because of the constraints they find themselves under.

Cherie the BBC article you linked to is based on the opinion of one person (Prof. David Healy) and his interpretation of the research, which is disputed by the Royal College of Psychiatrists and other experts in the field. Talking therapy is not for everyone. Some young people simply don't benefit from it, refuse to engage with it or cannot cope with it for various reasons. In cases where depression is severe they may need medication to help them to access therapy in the first place. It may be appropriate in some cases to try therapy before considering medication but this has to be determined on a case by case basis and OP's DD's CAMHS team are in a far better position to determine whether the risks of medication outweigh the benefits in her particular case than any of us.

I would seek a second opinion

She hasn't really had the first opinion yet. Unless I've misunderstood the OP they haven't actually met with a Psychiatrist yet. For all we know, he/she might assess OP's DD and decide medication isn't needed at this point afterall.

IME medication and talking therapies work together. The meds pull you out of the hole enough so your brain is clear enough for the talking therapy to penetrate. When I was unmedicated the councelling did fuck all; I was too emotional and sensitive and catastrophising.

I have just read the article. Maybe thinks are different in Scotland but in England a GP is not allowed to prescribe antidepressants to someone under 16.
Antidepressants are contraindicated for bipolar but bipolar would not normally be diagnosed in someone at the age of 12.
On two occasions my daughter stopped taking the antidepressants to punish herself. She didn't initially tell me but both times I guessed because she was becoming increasingly irrational.
They have nor solved all her problems (she has been an in-patient) but as others have said they have helped keep her alive.

Op, The NICE guidelines state that medication for under 16's should be offered alongside therapy.
if you decide to have medication make sure the psychiatrist is aware that the therapy should run alongside it.

my dd15 has tried Sertraline and fluoxetine, unfortunately neither are suitable for her due to side effects (acute gastritis) so her insides need to heal and she will try a different type of anti depressant.

she also has weekly CBT with a psychologist at camhs

Even normal meds (paracetamol or other general stuff) I don’t take unless I really really have to. It just feels so unnecessary.

My (lovely overall) mother thought just like you. I suffered in my childhood for no good reason because she was afraid of medicine. As an adult I happily take if I think that I need it. Please don't let your own anxiety about meds stop your daughter from getting the hell she needs. Also, at age 13 You might want to take her own opinion into account. She is the one feeling it.