To consider anti-depressants for my 16 year old?

[Mumofboth]

Just that really. She’s had a lot of crap to deal with and is really struggling. We’ve referred her for CBT but the waiting list is long and I can’t afford to go private. She’s regularly suicidal although she also has good days where she feels she can cope. This makes me wonder if she has a hormone imbalance. From my understanding, the tablets make you “numb” almost and therefore unable to feel extreme emotions, this equally terrifies me and sounds like it might be good for her. I hate the idea of medication but I also hate the constant worry that one day it won’t just be suicidal THOUGHTS. She’s my world and I hate to see the sadness in her eyes. Any advice appreciated.

I think it’s always useful to remember that when someone posts anonymously on a forum purporting to be a healthcare professional a) you have no idea if that’s true and b) an ethical, responsible healthcare professional does not give medical advice to patients he/she has not assessed on a public forum.

Your daughter needs medical advice from professionals who can assess her thoroughly. The GP is a good start.

Suicidal ideation is no less an emergency than acute asthma.

As pp have said, at her age it won't be a simple case of the GP prescribing. You should definitely take her to see the GP though, for general check-up and possible CAHMS referral. And though a 16yo needs tactful handling you do need to know if she is on antidepressants, to keep an eye on her the first weeks. Hope it goes well for you. Be prepared that unless it is something clearly physical (like iron deficiency), it will probably take time.

My 18 year old is on 5htp for mental health as far fewer side effects.

FFS the OP isn't contemplating mixing anti-depressants into her unknowing DD's food.
She is worried about her child and is being an involved and supportive parent.
And there's many a GP i would not trust to advise a teenager on MH issues.

OP - I wouldn't advise a teenager to take AD. As pp said, encourage her to have blood tests - everyone in the UK should take vit D tablets and she might need vit B supplements.

Get her out walking if you can (I know, easier said than done with a teen )
Download Ruby Wax Sane New World - Taming the Mind - which will help her understand her brain and introduce her to mindfulness.
Encourage her to join a gym, go to a Pilates class.

Look at changes to her diet - reducing sugar if need be- and cook some healthy, nutritious meals together so she starts to take responsibility for her well being (I'm not suggesting you are currently feeding her crap btw!)

Help her to take charge rather than relying on a prescription.

@Mumofboth I’m sorry your DD is going through this.

As the others said; exercise is great, healthy eating (even when it’s the last thing you want!), checks on vit D.

For cbt she should have kept a diary or notes on how she’s feeling - it’s worth looking to see if her period and hormones influence her mood - my cycle is a big part of my mh, but it’s been hard to find a dr who is sympathetic.

"OP - I wouldn't advise a teenager to take AD."

May I qualify this a little?

I absolutely agree that ADs should never be the first port of call for teenagers, but there are teens who need them, either because other treatment isn't working or because they are too ill to focus on any treatment such as CBT without them. My dd was one of them. There was no way she could take charge of herself or anything else, she was struggling to eat or get out of bed. CAMHS tried everything and nothing made any difference until she went on the medication. I fully understand why they tried everything else first: they did right given her age, but it was a scary time.

She is now a thriving young adult, still with MH problems, but under control. Far from being numb, she has become the lively, bubbly, enthusiastic young person she was obviously meant to be. She says herself that the illness made her numb and the ADs have given her back the connection to her feelings. She is studying on an extremely demanding course (physical theatre) and despite physical disability is coping extremely well with any setback. She uses the CBT techniques she learnt from CAHMS all the time, takes plenty of exercise and eats healthily, so it's not just a question of popping a pill to avoid doing those other things.

She tried to come off the ADs a year ago, but became very ill again. She now accepts that she would rather be alive on medication than risk suicide without it. Because for her, that is basically the choice. Not ideal, but better than what would be the alternative in her case.

If I had refused to let her go on them or talked her out of it, I fully believe she would be dead by now.

So I would say, I would support the doctors in exploring every other avenue first. But if nothing else works, and if they think ADs are the way forward, then I would support that too.

One of my dc went through this, and OP I know exactly how you feel. Literally sick with anxiety yourself/up-the/walls
Our GP refused to prescribe AD’s for a teen, as is common practice here.
CBT helps some kids, therapy helped ours. That and changing schools. Her hobby. She’s out the other side now 95%.

Hang in there.

The thing is OP if your DD has a reason for feeling sad-you say she has had a lot to deal with-then her depression isn't clinical, so AD's wouldn't necessarily be the correct road to go down for her. I think therapy is probably the way to go in her case, but if you are seriously worried that she might harm herself then of course you should get her to the doctor's to discuss more immediate help for her.

From my understanding, the tablets make you “numb” almost and therefore unable to feel extreme emotions

SIGH I really wish people would stop spreading this myth because it makes people worry unnecessarily about taking drugs that would probably be helpful.

Most modern antidepressants do not make you feel numb, zoned out, dopey or apathetic at all. If your daughter was prescribed antidepressants they would almost certainly be SSRIs, not the sedative-type antidepressants that were prescribed years ago, and they typically do not make people feel 'numb' at all. In fact, when people say that SSRIs made them feel numb, the numbness was more likely to be a symptom of their depression, not a side-effect of the SSRIs. There can be side-effects, of course, but they are usually manageable - the main side effects I suffered were mild nausea for a few weeks which usually went away when I ate something like a slice of toast and a bit of fidgetiness for a couple of weeks. The only side effect I had that remained throughout the whole time I took the tablets was that they made an existing sleep disorder a bit worse, and also a tendency to see things out of the corner of my eye - not hallucinations or anythng like that, just that thing where you think you catch something moving in your peripheral vision and just think 'Wait, what's that? Oh, it's nothing' for a split second.

If your daughter is suicidally depressed then I strongly suspect that carefully prescribed drugs could help her, if she is comfortable with taking them and the GP feels it's appropriate.

I really wish someone had prescribed them for me when I was sixteen because when I was finally prescribed them at 18 they actually helped me hugely and have continued to help me on many other occasions throughout my life.

Don't wait. Get her to the Gp for a prescription

very unlikely a GP will prescribe, the risk:benefit balance is finely tuned at that age as antideps in teenagers can risk suicidality. Most GPs would not initiate at this age but would refer to psychiatry, which will usually be a wait of several months, unless acutely suicidal in which case crisis team will see you.

Antideps are not a short term fix, they take 4-6 weeks to work and you need to take them for at least 6m - 1y in the first instance and longer if using them for a second time.

Antidepressants definitely don’t make me feel numb. Just normal.

There are some real misconceptions on this thread. There is a good reason why the immediate couple of weeks after starting antidepressants is high risk for suicidal behaviour. It’s not because the antidepressants make you feel so awful that you just want to escape it. It’s not because side effects are more severe in younger people.

It’s because when starting antidepressants, people’s motivation tends to increase first, before their mood lifts. So when people are very depressed, the lack of motivation and inability to plan and think coherently stops them being able to carry out their suicidal thoughts. As they start to feel better, they are motivated and think more clearly. This is a time of high risk, until their mood lifts and they no longer feel suicidal.

This is higher risk in teens because teenagers are more impulsive than adults as they haven’t fully developed impulse control.

What does your dd think? I would encourage her to try medication if she were my child. I wish my parents had, then I might not have spent my twenties in a psychiatric hospital.

It really isn’t unlikely that a GP would prescribe.

Hi Mumofboth.
Sorry your DD is going through a bad time.
I have some experience with this as my DD started self harming aged 13 and after a year of CAMHS (1 to 1 with a psychologist every week) she asked to go on AD's and was prescribed Citalopram. She is still on them two years later and for her they have really helped. She suffered no side effects and said (still says) they have been a life saver.
I think we were lucky to get an appointment with CAMHS so quickly, but please keep her talking to you and anyone else in the meantime. Do anything that allows her to open up and keep trying. Make a nuisance of yourself if necessary. Fight for the help she needs. Talk to school, helplines, charities.

Good luck x

@Proseccoinamug a safe GP won't initiate antidepressants in this age group in primary care

I’m not a medical professional. I did develop anxiety in my late teens.
I’m studying nutrition and want to specialise in this area. Absolutely take advice from your GP.

There is increasing evidence that many deficiencies can be behind anxiety and depression. Ask the GP to test for vitamin D, ferritin levels. I would consider seeing a BANT nutritionist who can look at other possible issues such as B6. Balancing blood sugar in the day. A very good probiotic as a disrupted microbiome in her stomach will affect her mood. You could even just get a good B complex supplement yourself. Finally, upping her omega 3 and good fats could reduce inflammation which can also be behind low mood. It’s a massive area but so much can be done - in conjunction with a supportive GP.

I don’t agree with those saying “you’re wrong” and “they don’t make you numb”
as that’s exactly how my ds describes it , he said he doesn’t really feel anything since starting them and he’s 19 ,been on them since 18 .
You cannot tell others how they will feel on a medication, it’s all so individual

We can say "they don't make everybody feel numb" though, can't we, Fizzy? Also, "if one form of Ads doesn't work for you, depending on age, you may be able to swop".

Yes of course but that wasn’t what a couple of pp were saying , I just wanted to point that out

The thing is OP if your DD has a reason for feeling sad-you say she has had a lot to deal with-then her depression isn't clinical

Not true.

I spent most of my adolescence feeling sad alone depressed - lost a decade of my life. If someone or something had helped me it would have been good for me . I am on ADs and I feel stable now. It's doesn't numb me at All. Just stopped my mood volatility.

Is the self-referred Mental Health Services the same as CAMHS, OP?

My 16yr DD went to the GP (she allowed me to sit in with her) and the GP wouldn't prescribe anything due to her age. The GP did refer her to CAMHS and after 4 months, she was assessed. But it took another 2 months before she got to see a CAMHS psychiatrist - who did prescribe anti-depressants. DD started on the lowest dosage, upping the dosage after the first month when she showed no side effects.

We've yet to see an actual positive improvement, but she's keen to carry on in the hope that her mood will improve on these.

DD has been very desperate and suicidal, we (the parents) are terrified that she might act on her suicidal impulses. As well as being distraught that she is so unhappy, and that we can do little to make her feel better. I'm so sorry that any other parents are going/gone through what we're going through, and especially sorry that their young person is so unhappy.

We have reassessed our finances and decided that we must pay for private therapy (extremely lucky that we can) in the hope that that will help our DD.

It's incredibly unfair that we as a society cannot/do not fund mental health services enough, especially for our young. I acknowledge it's unfair and we're lucky in so many ways that we're able to look outside of the system, none of this is good.

OP, what does your DD think about anti-depressants? They're not a solution IMO, but can be a useful tool to get you to a less negative place. Will your mental health service prescribe? Can they? Perhaps go back to the GP and push for more help

I'm in my 30s and my life unraveled last year. if my parents had got me medication and support when I was 16 I would have had 2 decades of living rather than existing

I don’t often post but wanted to share my experience of trying to help dc who has ha down mh problems for the past few years.
Be wary of giving ADs to a teenager, their hormones are not balanced and the effects aren’t necessarily the same as they would be in adults. I think most studies have shown they’re not a good idea for teenagers.
Dc took a low dose of Sertraline and it was alike a miracle, they really did improve but then the dose was increased and they became suicidal, self harmed (never done this before) and developed bulimia and insomnia. They also told me they felt completely numb, then went cold turkey and were almost sectioned.

After a break they tried 2 other types of ADs, neither worked, both caused insomnia and eating problems.

We also tried CBT, alongside the ADs and things just got worse.

The only improvement I’ve seen was with private therapy but they then refused this,
.
Mental illness is a devastating illness, dc’s illness has almost destroyed our family,p. They’re now under Adult Services which I have found to be 100 times better than CAHMS. We still have a very long way to go. Funding is really lacking in this area.

Also from my experience the psychiatrist at CAHMS said it was definitely my decision whether to try ADs when dc was under 18 and they wouldn’t have prescribed without my consent, so the parent does get to decide until the dc turns 18.

There is no quick fix and no one size fits all but I’d definitely use ADs as the very last resort for a 16 year old. There is a reason they’re not recommended for use in under 18s as studies have shown they don’t work.

dietcokemum, that possibly depends on the area you live in.

Here, they certainly do. Fluoxetine only. Anything else they refer to secondary care.

CAMHS here won’t take a referral for a sixteen year old, they go to adult services. Unless already engaged with camhs before their 16th birthday, in which case they remain with camhs until 18.