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

He’s not keen on medication for mental health either. I’ve not enforced my views on him but told him to think carefully about whatever he decides. I have told him therapy is another option though

I too think medication should be a last resort but if you were worried about him enough to see the gp and he’s not working or in education then it’s pretty serious.

I would assume the medication is only temporary to improve his mood and then once he’s got a job and got his self confidence back the doctor will wean him off it.

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.

Absolute crap.

I've been where you are and know how hard it is to watch a young adult go through a difficult time.
It might be helpful to you and DS to think about it in a different way:
He's ill. If he had an infection you would of course encourage him to take antibiotics, wouldn't you? This is just the same, and remember people are far more clued up about mental health issues now (so there is no shame or stigma in it).
He might not be ready to engage with any other kind of therapy at the moment (and mental health services through the NHS are pitifully under-funded). That time may come, when he feels it might help.
But for now, he has had tremendous courage in speaking to his GP.
It's a difficult path to walk as a parent. My advice to you is to leave him be, but also let him know (gently) that you are there to help and support him - he only has to speak to you about what he needs.
It goes without saying that you will continue to keep an eye on him to monitor how things are going. There are lots of medications out there, and sertraline might not be the right one for him (my DC was prescribed fluoxetine, I've taken citalopram in the past), but any medication is not a life sentence - people can and do stop taking this type of medication.
I really hope things work out for your DS.

I avoided medication for 10 years. Then I finally accepted sertraline at 30 and I honestly wish I had not rejected going on meds in my early 20s would have saved me from anxiety filling every corner of what was actually a really special period in my life and making things so much harder.
I’m now the friend that would always recommend trying meds if hesitant alongside other therapies as well.
Some of these meds can make you feel a little worse before you feel better but I’m not a doctor so make sure you understand all those risks too

I’m worried about side effects. What if it makes his mental health worse for a while. I just couldn’t take it. I know there’s no magic wand for this. It’s a very complex situation.

YANBU.

Maybe had the GP offered other things besides the drugs, but it was unreasonable, though completely typical, to just offer the one.

Lots of young people (and adults) are suffering from anxiety triggered by the effects of the covid pandemic. That's an environmental cause, and medication isn't going to change that. There needs to be a reframing of the situation for many and also changes in activities, pinpointing what triggers are. Additionally things like a lot of gaming are often problematic in that they give immediate relief from symptoms but in the long term make them worse.

Advise him to take them ar night for a couple of weeks then side effects will be minimised. Sertraline generally doesn't cause too many problems and it's well tolerated.

Also I’m those 10 years I really did try myself multiple therapies including private talking and nhs cbt. Was never able to even make a dent into my horrific GAD. I also felt more ready to tackle the therapies and issues again and the meds helped and I very easily came off them when I decided to TTC.

Thanks for the kind words and advise. It’s so hard.

I had a similar experience to @UnderTheMoonlightWeDanced
Sertraline has helped to regulate my moods. I struggled on for years 'not resorting to medication' but it's been great for me. Perhaps it's worth a try with strict supervision for a few months?

I know it's hard, but honestly, these medications can transform people's lives.

@Mumofone200, I totally get that it's hard for you to watch him go through it (the situation with my DC nearly brought me to my knees, so to speak).
But, he may well take some time to adjust to the medication - it doesn't mean it's not going to help. It might be difficult for you, but if you can help him through what may be a difficult time, you will both get the benefits that will follow.

I will see what he decides but yes strict supervision will be a definite must. Might even need to see GP about my own mental health as terrible nightmares the last few nights! I think his situation is triggering mine

YANBU
The problem is there is such a long wait for talking therapies drs often do this so they are seen to be doing something. I think what drs also don't always do but should is check for physical problems first like thyroid, anemia ect. The only thing you can do at the moment is watch and wait to see how he is over the next few months.

In the kindest possible way YABVVU.
I work with adults of your DS's age in mental health capacity.
These are uni students whose lives were spiralling out of control, attempted to take their lives etc.
They are all in uni having had the support of GP's, Psychiatrists etc and are working towards successful futures whilst still being unwell. and on medications
I would encourage open conversations and honesty about the meds, reassurance that if these don't suit then there are other meds/avenues that can be explored but to be honest about it (side effects etc without panic)BUT please don't discourage because what you may fail to see is what a massive step forward this is for him, to open up and just how brave he is.
Please also reassure him that mental health issues are nothing to be embarrassed about and are really part of a huge amount of peoples lives.

I agree there’s no shame in taking medication that helps make your mood more stable so you can focus on getting better.

I just wish GPs wouldn’t assume everyone is deficient in seratonin. It’s great if that’s what the problem is and that SSRIs work for you.

But in my DDs’s case it wasn’t what the problem was so she wasted two years feeling even worse and wondering what could possibly be so wrong with her that anti-depressants didn’t work. She had no idea there could be another reason for her depression because that was never explored.

I've tried pretty much every therapy going and none of them has made a blind bit of difference. Sertraline has kept me as a functioning member of society. So what if he becomes 'reliant' on them? Would you say the same about a diabetic that needs insulin?

Anxiety and depression can be caused by a chemical imbalance.

Yabu

Medication of course has a case in some treatment plans, particularly in crisis, however I agree with you OP.

Withdrawal from psychiatric medication can be absolutely terrifying and dangerous.

Can you self refer to IAPT in your area? Have you helped him find some resources as well, or had a discussion about what else may be available apart from medicatoin?

I’m getting the impression that lots of people think SSRIs are the only anti-depressant available and that seratonin deficiency is the only reason for depression.

I think him going to the Dr is a massive step forward. I’ve been on sertraline for 2 years: I’ve had major anxiety all my life (now early 50s) and wish I’d started taking it sooner. I still feel like myself, but it’s ‘taken the edge off’, IYSWIM. I passed on so many opportunities in my youth, due to my anxiety. Obviously we’re all different, so eep an eye on your DS … but this could make SUCH a difference to him. I don’t feel bad or sad about taking medication: it’s saved my sanity. My BIL is diabetic and has to take meds: I try and look at it in a similar way. His body needs help to function properly: my brain needs help to function properly. And I wouldn’t get too hung up on therapy or counselling… IME the effectiveness can vary vastly, depending on the individual you’re assigned. Hope things work out for you and DS x

I think some of these replies are quite harsh towards op. Her Ds is 18, yes he's an adult but 18 is still very young and as a mother she is worried.

I have a sibling that had very serious mental health problems at that age and medication helped him live a normal life. That being said, any mood altering medication prescribed and managed solely by a GP without specialist training should be treated with caution. If he needs medication, it should be prescribed and managed by a psychiatric consultant and I doubt he’ll get a referral for low mood. Rethink and Mind the mental health charities are a good starting point for advice.

Pumpkinstace Totally Understand but why not differ a blood test to find out! I just don’t agree with medication before exploring any other deficiencies. Hormone imbalance anaemia or thyroid etc like someone suggested.