To be terrified - please help me.

[WhoisRebecca]

Dd, 15, has started taking sertraline after being prescribed it by a private psychiatrist. She took an overdose last year and school refused towards the end of last year.

She is now behaving erratically- running into classrooms at school shouting that she’s going to kill herself, but then laughing - her teachers think she seems very hyper and ‘excited.’ She’s running off when teachers challenge her or swearing at them. She was never like that before this year.

At the weekend she went for a walk and texted a charity helpline, saying she had no bed and was going to jump on the train tracks. We had taken her bed apart because a new double bed was coming on Monday. There was a spare bed upstairs for her. Dd knew this. The police arrived and I was able to show them dd’s location - she had tracking on her phone. They quickly assessed that she had a safe home and did, in fact, have a suitable bed. This was a reaction to being told off because she had bullied a student at school.

She was put in isolation at school for a nasty incident towards another student. She can sometimes be loving and calm. At other times she is very very high and erratic. School had to send her home today. She struggles to attend lessons. I don’t know where to go from here and feel utterly desperate.

My son has bipolar mood disorder and is on sertaline among other psych drugs and it's helped a great deal but every child is unique and reacts to medication differently. I sincerely hope the doctors can help your daughter. Best of luck

@WhoisRebecca

I also wondered if it could be bipolar.

I was also thinking this too

Hi Op
Great that you have a psychiatrist to see tomorrow definitely sounds like she may need a medication change.
I would go super low demand for home and school, don’t push her to do anything she really doesn’t actively want to do.
Keep school involved but add and you decide if she is fit to go daily, don’t let pressure from anyone cloud that judgement.
Solidarity and a mumsnet hug from me, I have a 10 yr old with ASD and anxiety on fluoxetine. Things are much better now but I remember how terrifying it is in the eye of the storm xxx

Sertraline can precipitate extreme behavior particularly at the start of treatment e.g. mania, suicidal tendencies etc Everyone is different. She needs to be reviewed by the private psychiatrist, could be a dosage thing, or the meds just don't suit her; it's often a matter of trial / error.

What you describe does sound an awful lot like a manic episode. They can be very uncharacteristic, and generally end with a crashing low so do keep an eye for that. I'd keep her at home myself, she isn't well enough to be in school. Please don't stop the med's, as that can have serious side effects as well - they need to be tapered properly, under supervision. She's suffered severe trauma on top of depression and that is going to take some effort to untangle. I'm sorry to say this but drugs aren't always helpful as they numb you to a large extent. Psychotherapy can help her work through these things, process it in a healthy way and set herself free. If you have insurance have you considered a short admission to get her stabilized?

I'm so sorry for you both, it's so hard.

Hi OP. I have name changed for this to not be identified, but I have dealt with a child similar to this, I won't say in what capacity I was involved though. Firstly, definitely get her medication reviewed.

The child used to use suicide as a manipulation initially, but this escalated to serious threats and attempts. Under CHAMS etc etc. Was eventually advised to be taken to A&E at every threat, this happened but child seemed to enjoy the attention, would be very pleased to be collected from school to spend and afternoon in A&E for them to basically say there was nothing they could do.

School would need to be very on board with this approach and it may not be in the best interest of your daughter, you would need to carefully consider it. There were meetings between school, parents and CHAMS etc to agree this strategy before hand and it was very clearly explained to the child that should they make a threat at school that school would phone 999.

Child then made a serious threat and attempt at school. School rang 999 for police and ambulance. It ended in child eventually being restrained and taken away by ambulance after having to be actually chased around school for an hour. It was absolutely horrific for all involved but something then made them click at the seriousness of what they were threatening, the realisation that it wasn't a game or an empty threat. It was still a long road to recovery with lots of careful unpicking of issues from both home and school, but that was the real turning point.

How much sertraline is she on? I find it interesting because the instructions with sertraline is its only for children under the age of 18 if they have OCD. It can also make there anxiety worse before it gets better. But her behaviour is sounding very ADHD and as you said she has been diagnosed with this.

She's really young and has suffered a traumatic event. I don't think diagnosing serious and enduring mental illness by internet is very helpful. OP is understandably worried but as extreme and alarming as it is, this behaviour is pretty understandable under the circumstances.

Young brains (and older brains) don't necessarily react well to strong psychoactive drugs. She might be neurodivergent. She's been sexually assaulted. She's a teenager with all the hormonal changes that brings.

Let the professionals decide whether any labels are useful.

Have you considered her seeing a psychotherapist who specialises in adolescents as well? Who is not attached to the school.

She’s on 100 mg which I have now reduced to 50 (on advice). She hasn’t yet been diagnosed with ADHD- she’s on the pathway.

I will look into psychotherapy. She’s not a great talker though and won’t always engage.

It sounds like a manic episode from the sertaline.

I had one before and it was terrible.

How did the appointment with the doctor go today?

If things get bad don't hesitate to take her to A&E.

@WhoisRebecca psychotherapy is a marathon not a sprint. It takes time, but a good one will help her open up/engage.

If you're on face book there's a very good supportive group called 'parenting mental health' that you could join. There are stories in there worse than your situation so I'm sure you'd get some good advice etc.

Surely the first thing to do is get her to stop taking the sertraline? The most likely cause is a reaction to it, not a sudden onset of bipolar, surely? And it's the most easily ruled out.

Very likely a reaction to the Sertraline if she wasn't like this until starting the medication. Hope it goes well at the psychiatrist tomorrow.

@WhoisRebecca

This isn’t just poor behaviour, is it? It’s definitely a mental health issue.

I completely agree with you. Don't send her into school. She is in mental health crisis.

See your psychiatrist and if they are not on board get a second opinion. This needs looking at urgently, it's not behavioural by the sounds of anything you've said.

You poor things. Such a hard thing to be going through.

Get her a private adhd assessment asap. Out cost 700 then started adhd medication. Totally changed child. Went from defiant about everything, refusals, running off, doing dangerous things to a calm child who was so relieved their brain was whirling like a top

I will look at getting a private ADHD assessment.

Dd was calm tonight. The psychiatrist thinks I should pursue an ASD assessment- I’m going to go private as we’ve been on the waiting list since December with no word. She’s happy with reducing the sertraline dose but we are going to adopt a wait and see approach.

Social care contacted me today and they are going to put Dd in touch with a youth worker and a youth group that can help her with relationships skills and managing emotions. They are going to check in with school to see if they can keep an eye on my other dc to see if they need any pastoral support from school (they are both v well adjusted and happy, but I think it’s worth just keeping an eye on them).

The psychiatrist supports rewards rather than sanctions and ignoring negative behaviour. She thinks a holistic approach is beneficial so we are going to sort some psychotherapy this week.

I’m keeping Dd off school next week and then she’s back in for her mocks the week after.

She was wary of stating adhd medication if Dd is diagnosed, given that it’s a stimulant and Dd has possibly reacted badly to sertraline.

It’s got back to my mum that my aunt has been telling people that Dd is bad and out of control and I’m not a good parent…

That sounds positive on the whole. How are you feeling? Your aunt sounds incredibly unhelpful. Can someone in the family that she will listen to have a strong word with her and ask her to pipe down? She's making the situation worse which won't help your DD.

I’m feeling a lot better. I actually don’t think I’m a bad parent. Dd2 and ds are both highly academic, in school council and chess club etc - so why is my parenting judged because one of my dc has difficulties that are from trauma, MH issues or disability?

OP you really need to insist that the psychiatrist winds down this medication and get her off it. You cannot possibly assess what has just happened if you don’t rule out it being purely iatrogenic.

Is this is her or is this simply the pills.

If not, further assessment will be muddied by uncertainty.

The psychiatrist doesn’t think that this is just medication. DD’s behaviour is not completely new, it’s just never displayed itself at school or to this extreme before. I am reducing the dose and keeping a watchful eye. If things aren’t getting better we have a repeat appointment in two weeks. I don’t think we should do anything quickly at this point.