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 think you should speak to your dd.
I Had medication at a young age, im glad i did.

To be clear she’s not having cbt, but IPT as it was available sooner than cbt. Because we accepted IPT it means she’s been taking off the waiting list for cbt.
Mi have met with the psychologist. We all met together to discuss if the therapy could work for her, I trusted her opinion that it could.

She had her third ‘alone’ session today where she was told a doctor would be present next week and we can all discuss putting her on medication. It was indicated at the first meeting but I was under the impression it would be if the therapy seemed to not be working.

I understand hey are stretched but I will not be happy about them discharging her at the end of 12 weeks if she is still unwell.

In terms of her being too depressed to engage with talking therapy, I don’t think I agree. She is very articulate for her age and actually quite good at explaining how she’s feeling, and is not shy about it. Although obviously a lot of the time she just doesn’t know why she is so unhappy. She does understand some of the experiences she’s had that have possibly triggered her depresssion and sent her down this path (issues with non contact parent, past bullying, stress at secondary school ect)

I ALSo feel I’ve a lot of people are replying to my original post and not reading any of my updates. I’ve said I’m willing and will do lots of research.

My daughter is/was very articulate but as others have said depression causes a sort of brain fog.
When she started taking them and they started to work she said she couldn't believe how much difference taking a pill could make and she didn't understand why she hadn't been given them years ago.
As I said they didn't solve everything (and she has since been on and come off other medication) but they did help considerably initially.
She has always had therapy alongside the antidepressants.

I ALSo feel I’ve a lot of people are replying to my original post and not reading any of my updates. I’ve said I’m willing and will do lots of research

That will happen. People want to help, but may not have time to read the whole thread.

Are you booked in for any sessions with your daughter?

You need to stop focusing on all this “at the end of 12 weeks”. It doesn’t work like that. What do you think think will happen? That after 12 weeks she’ll magically be better and won’t be depressed?

I’m 12 weeks she’ll acquire some of the tools to help her to feel better. Recovery takes far longer, and a shit tonne of hard work.

Please, as someone who has been depressed for as long as I can remember, if they recommend meds let her have them. The first time I ever felt “normal” was when I started taking meds. That was 26 years that I’d “lost”. If she was diabetic, would you hesitate to give her insulin? Or if she was epileptic, would you just let her carry on having seizures? Mental health is no different. She’s suffering and the team are trying to manage her symptoms. Trust them, it doesn’t have to be forever, but if it works then she’ll start to feel better.

I know it’s awful seeing your child suffer, and not having a deep understanding of mental health - well, it must be scary as fuck. If it were my boys? I’d be shitting myself, and I’ve been through counselling, CBT and DIT. And various medications. So even knowing what I do, it would still be scary.

But you have to do what’s best for her right now. And things may change - she might only need a short course. But please, trust the people who know what they’re talking about.

Anybody who took my SSRI (citalopram) away from me would be doing a great cruelty. It allows me to function at a normal level and enjoy things without crippling anxiety ruling my life.

Please don't refuse treatment for your daughter because of vague fears you can't articulate.

Just seen your update - I’m so relieved that you’re aware that things might not all be better in 12 weeks

@ohfourfoxache because that’s basically what they told me. They expect the 12 sessions to work. It might not be 12 weeks, they might make the gaps in between longer as time goes on but that is essentially what they told me and that’s why I’m worried, because I know she’s not going to be magically better in 12 sessions and I worry what will happen if they discharge her when we’ve fought so hard to get her there

I’ve been in a similar situation with our son. He was 15 at the time. I was initially anti meds but we took the consultants advice and within 6 weeks they started to help him.
The way I eventually thought about it was if it was an infection would I have refused anti biotics?
Whilst I understand your reluctance you need to listen to their professional opinion prior to making any assumptions
I hope things get better for you and your family xx

Unfortunately even with 12 sessions, it may be something that she always has to “work on”. The idea is that it changes your thinking and behaviour, so if you naturally “revert” to something, you’re likely to have to really work through things to think of them another way. It takes lots of practice, which is going to be needed for a while.

What support do you have for you? Watching your child go through something like this must be utter hell - have you got anything in place?

*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. *

NICE guidelines are just that, guidelines. There are cases where a period of time on medication with no therapy is appropriate.

She may get on better with the therapy once she starts feeling better within herself.
What areyou going to do if she isn't better after the 12 sessions though?

@Imustbemad00 I understand your worries about them discharging her before she is ready. I completed therapy last year and about half through the course some things were discussed which meant they extended my course of therapy. They saw I needed more time.

Once I was discharged I was advised I could refer myself again and I would have been back to waiting but assured the wait would not be as long considering my history. Between first referral and first session I waited four months. Once I referred myself again after initial treatment I waited three weeks.

Thing with mental health is it might not just go away so even after initial treatment is finished (because your DD is more stable and responding positively) doesn't mean she won't need a re-referral but as long as she is open and honest during her sessions then I can't see them discharging her is there are still issues to be worked through etc

My advice would be to exercise caution, especially with a 13 year old. My ds was given Sertraline by CAHMS when he was 17 and I can honestly say it ruined him.
To be fair the first does of 50mg did seem to work but he then wanted more and they kept increasing it, on 100mg he felt suicidal, on 150mg, he couldn’t sleep, became bulimic and self harmed and they then offered 175mg. I was reluctant to increase from 50mg and I wish we had never agreed to the increase.

The leaflet specifically states Sertraline should not be prescribed to under 18s for anxiety and depression but at the CAHMS we attended most of the kinds were on it. I would do a lot of research if this is what they offer you. My friends daughter is on 150mg and regularly attempts suicide.there was also a program on the BBC in the summer where teenagers had attempted and completed suicide on Sertraline.

After my son turned 18 and CAHMS released him in a much worse state than he was when he first went, my son decided to go cold turkey on the meds and almost ended up sectioned. Once the drugs were out of his system he actually started to improve though is in no way fine atm.

The 12 weeks isn't meant to work as in it cures your dd's depression, it's supposed to work in that it gives her the tools to manage it better.

I think your decision to seriously consider medication and do lots of research is a good one. I'm sorry if you've already said and I've missed it, but what does your dd think? Does she want to try medication?

Anti depressants can be a literal life saver and they are not a life sentence. They do not always work and the side effects are sometimes really unpleasant. Meds and therapy is probably the most successful combination when it comes to treating depressive illness, so unless your dd is really unwilling, I'd be in favour of at least giving it a try. I do understand your concern, but honestly, as someone who has dealt with depression on and off since my teens (and is currently re-starting anti depressants due to various stressors that I am failing to manage with just cbt) I would not rule anything out. There is an incredible relief if the meds work that is worth an awful lot.

We have met with the psychologist. We all met together to discuss if the therapy could work for her, I trusted her opinion that it could. She had her third ‘alone’ session today where she was told a doctor would be present next week and we can all discuss putting her on medication. It was indicated at the first meeting but I was under the impression it would be if the therapy seemed to not be working

But you haven't met with the Psychiatrist yet, so I would advise you keep an open mind for now and just see what they say. No Psychiatrist will prescribe a child meds just because a Psychologist thinks they should. They will do their own assessment and decide whether to offer your DD medication on that basis. If they do offer it (which they may not) it is just an offer. Your DD won't be compelled accept it and she can also take some time to think it over if she doesn't want to make a decision right away.

Be honest with the Doctor about your reservations. They will understand, it's perfectly normal and understandable to have reservations about your child starting medication. I think the important thing is not to rule it out altogether until you've heard what the Psychiatrist has to say.

Going cold turkey (rather than a phased withdrawal) is the very worst thing you can do

My son saw 2 psychiatrists at CAHMS (the first one left) and I can honestly and truly say therir only concern was giving and increasing meds. The second one only met with him for 15 minutes out of a one hour appointment before insisting on increasing the dose and at the follow up appointment offered a further increase even though my son had at least half of the top 10 side effects including, insomnia, eating disorders, self harm and suicidal thoughts.
If you can afford it I would recommend private therapy.
My son also had around 5 months of CBT alongside the meds with a psychologist and he got increasingly worse until, the psychologist left too.
Honestly in most areas CAHMS is under funded and staff turnover where we attended was ridiculous.
He is now having private therapy and no meds and is improving slowly

Ariadne I know and I begged him to reduce slowly but my son was 18 and refused point blank to put another pill in his mouth. He ended up hardly able eat, speak or get out of bed for 2-3 weeks. It was horrible but he is very stubborn and wouldn’t listen to anything:(

CBt will give her some skills to cope with her Mh. What to do when the intrusive thoughts start. Looking at why she's depressed and helping the person feel 'normal' and that you aren't alone. What's on offer afterwards depends. Since cbt I have had other therapies and councilling. At the start, they couldn't say what else would be offered afterwards because they didn't know the extent of the issues or if cbt would be enough.

I've been on and off meds since I was 15. Getting off them was relatively easy. At one point I woke up one day and decided no more and stopped taking them. They don't make me emotionally numb, although some days I wish they would. I'm still the same me, just that I can cope with the world and everything else better. I still have intrusive thoughts, but because of the therapy I have had, I have strategies in place to help. WIthout the mix of the two, I wouldn't be here now.

My daughter is younger than yours and on anti depressants. The waiting lists for therapy at CAMHS are horrifically long (2 1/2 years from referral to family therapy) and we couldn't stand nonchalantly by and watch her deteriorate.

It's made a huge difference to her; she's on an even keel, hasn't self harmed since November, she's attending school and she's started to give a shit about life. It was the right decision for us, not an easy one.

So you would rather she stay anxious and depressed all because you have an issue with the medication?

My perspective is from the point of view of being a mental health nurse working with teenagers.

If an experienced senior professional is recommending this, I think you should at least consider it. I think professionals are often slow to prescribe for children, so if they are recommending it it is likely for a good reason.

Generally only spoken therapy will be offered for more mild presentations, but for moderate to serious presentations the most effective treatment is medication alongside spoken therapy. I wonder if during the sessions you have had, the psychologist has become aware that your dd's presentation is more serious than she initially thought?

Yes the side effects can be horrific, but whilst still under psych care, it's easier to change them. I had some really horrible side effects. I refused to take that med again, not a problem and the meds were quickly changed. When I was under the gp for meds however, I was told to leave it a bit longer.