Feel slightly annoyed with the GP for suggesting sertraline to my teen

[Mumofone200]

My 18 year old son says he has been suffering with anxiety. Heart palpitations and worry about his future mainly during lockdown and up to now. He has attempted to start 3 college courses at different colleges but has dropped out after a short period of time. He now spends a lot of time at the gym working out; sometimes with friends and time on his Ps5; he’s not that active as in Going out. We had a heart to heart and i suggested that he maybe talk to the GP which he did tonight. I feel slightly annoyed with the GP offering sertraline and not encouraging him to change his routine etc as a starting point. I know doctors prescribe medication to heal but isn’t 18 just too young to start medication for something that could be improved by therapy or a change of lifestyle. He is currently not engaged In Education employment or training and this is also a worry. I’ve e tried sitting him down to job hunt and have even applied for jobs on his behalf but nothing is changing. I really think he is. It stimulates hence the mental health decline. I’m really worried. Any suggestions

@GADDay

Be aware that you might not know the extent of the issue.

My DS (same age) was self harming (secretly), the doctor prescribed meds to address the anxiety and depression related to that.

Our teens have a lot going on and can be selective in their disclosure.

for you and your DC.

I’d taken myself to A&E on two prior occasions because my self harming wouldn’t stop bleeding and needed stitches. Prominent and not in a place easy to hide, either. Still have terrible scarring 30 years later.

I was also smoking, and drinking excessively every chance I got.

There were things going on that my parents didn’t know about, and still don’t know about now.

I’m just a concerned parent and can’t switch off. I sent him to the GP as I really don’t know what else to do with him. I’ve suggested he contact healthy minds or similar agencies but he just doesn’t listen to anything I say. He is still living in my home rent free etc so I really can’t just allow him to sink without trying to help.

You have no idea how your son is really feeling or what he said to the GP. If his anxiety is preventing him from changing his routine then he needs to address that first. Telling your adult son he can fix his mental health by pulling himself together basically and he doesn’t need medication could be incredibly damaging. Support him in whatever decisions he makes.

I know meds might help, they might not. I’m just really sad seeing him be sad too. I don’t know much about sertraline but will do some research

@Mumofone200

I’m just a concerned parent and can’t switch off. I sent him to the GP as I really don’t know what else to do with him. I’ve suggested he contact healthy minds or similar agencies but he just doesn’t listen to anything I say. He is still living in my home rent free etc so I really can’t just allow him to sink without trying to help.

He did listen, he went to the GP! But you arnt happy with the result of it, that’s your problem, how is addressing his anxiety by following the GPs advice ‘sinking’, give him a chance.

Sertraline can be very helpful. It can reduce the intensity of anxiety enough to enable the person to then access talking therapy or engage in simple activities etc to break the cycle.

My dd has experienced extreme anxiety (associated with her autism) and has been prescribed several different ADs over the years. She's been on a low dose of Sertraline for quite a while now and she wouldn't be able to identify what it actually does for her, but I think it just reduces her base level anxiety enough to engage with life. She's 17. It's nothing to be ashamed of neither is something that needs to be discussed with others if he doesn't want to.

Sometimes the medication is what's needed to enable you to start on the right path. It was for me (I'm on sertraline too) and has made a massive difference to my life.

I agree that he should also be offered therapy. His anxiety seems to be preventing him from pursuing education or work though and medication might allow him to make some changes.

@Mumofone200

I’m a believer of resorting to medication as a last resort. I just think if he tries other things first to see if they work then medication if it’s really needed. I’m scared that once he’s on it the dose will increase and an over dependence at such a young age. His lifestyle needs to change work college etc then reassess. I’m not comfortable with the medication but understand he will make his own decision

Medication does not have to be a last resort, and frankly, as he's 18, it's up to him.

I was on Prozac at 18, followed by Sertraline. It's now over 20 years since I took any SSRI anti-depressant. For the last few years I've been taking beta blockers for anxiety.

There are so many combinations of factors that influence these things that there is no way anyone can say now whether he'll end up on medication for life, a few years or a few months.

The problem with how GPs treat mental ill health in young people is that tend to assume they all have a deficiency of seratonin, hence prescribing setraline.

My DD spent two years on it and it didn’t make any difference. Then she had a psych assessment, was diagnosed with ADHD and it was found her seratonin levels were fine. It was her dopamine levels that were out of whack - she got prescribed the right antidepressant for that and she is a hundred times more stable and happy.

WorriedGiraffe I would never tell him to pull himself together. I know how anxiety feels and I have learned to manage it following a year of cbt. I get that I’m a full grown woman so more capable of learning to manage things but I can’t help worry about him being on medication. I agree that the anxiety is most likely preventing him living a full life so yes o do feel bad he’s suffering like this

My DD was prescribed sertraline at 16 and it saved her life. No question.

Why was he only offered this? Surely it should be offered alongside referral for counselling etc?

YANBU

GP definitely should have addressed lifestyle factors rather than go straight to medication.

One of my parents is a neuroscientist and has always told us not to go on psych medication unless absolutely critical due to the fact that there is limited/no research on longterm effects.

NICE guidelines say a 2 pronged approach is the gold standard, so medication and a talking therapy such as CBT.
Sertraline can be very helpful for anxiety and there are studies to back that up, if your son has started 3 college courses and had to drop out he may need medication to be able to do the self help stuff.

Warmduscher Are there tests for dopamine and seratonin levels? I’d prefer if he would consider taking bloods to see what the deficiency is before committing to medication. I know he’s an adult but he’s still my child and very much dependent on me financially emotionally etc I have a right to guide him

I understand your worry but they are your beliefs not your sons. Let him trust his Dr without your questioning
He should be free to make his choices without judgement

I started sertraline at exactly the same age after months of anxiety and depression. It put me on enough of an even keel to get myself sorted out and I came off them after about three years, haven't been back on them since. They are not the devil, they are not forever. If he wants to, let him give them a chance and see if it makes a difference. If not, try something else. I'm afraid there isn't a quick fix for mental health.

@Mumofone200

Warmduscher Are there tests for dopamine and seratonin levels? I’d prefer if he would consider taking bloods to see what the deficiency is before committing to medication. I know he’s an adult but he’s still my child and very much dependent on me financially emotionally etc I have a right to guide him

Yes, my DD had blood tests.

I've been taking venlafaxine since I was 18 and I'm pretty sure I'd be dead by now if I hadn't taken it.

It's not really a GPs job to suggest college courses etc. They would likely suggest either medication or counselling, and counselling is like hens teeth these days.

Surely your DS chose to agree to the prescription. A Dr couldn't force him to take it.

At 18 I'm afraid I think you need to leave it to him.

There is nothing wrong with using medication to get you past a difficult time. Just because he's taking it now doesn't mean he'll be on it forever. He just needs it to help get past this difficult time.

For Gods sake let him take his medication and get better. The doctor didn't prescribe it for no reason.

In the kindest gentlest possible way, you don't know what was said in the conversation with the GP. The GP will be aware of the different ways of managing anxiety and the outcome of their consultation is sertraline.
I also am a "medication is a last resort" person but when I suffered from crippling anxiety sertraline transformed my life. I just wasn't able to make the small adjustments in life that you probably think your son could do, I couldn't engage my brain enough to consider anything. A few weeks in I was able to, it was the medication that enabled me to make the other changes.
Give it a go and support what your son and the GP think is best. You sound like a caring mum so he is lucky to have you on his side.

YANBU but unfortunately so many people are hooked on ssri pills as GP'S dole them out like smarties.... But don't care about the long term impact, or the reliance, and really the avoidance of actually dealing with the nitty gritty of mental health to be able to find a path and sort out life as the alternative. That's too expensive an option.... And the anti depressants make pharmaceuticals lots and lots of money.

@Oblomov22

Why was he only offered this? Surely it should be offered alongside referral for counselling etc?

That’s the ideal but there is such a long waiting list for talking therapies most GPs don’t even bother referring.

We paid for DD to see a psychotherapist. I appreciate that’s not an option for some people but we knew she would never get to the top of the waiting list for the NHS service.