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

In fact many of the professionals who say psychiatric medications should be first line treatments are being widely (and publicly) challenged about this "treatment method" now. And many more people are are coming out and stating that what is often termed a "relapse" when people are coming off the medications, and thus they restart, is actually withdrawal.

It took me 20 years to concede that I needed Sertraline. I so wish I had done so much earlier. What a waste of life that was.

Therapy waiting lists are long at best, years at worst, and therapy is no guarantee. I tried therapy before drugs and while the counsellor was very good, it made very little overall difference to my anxiety. Sertraline, however, kicked in within 3 days (which I wasn't expecting) and has made a huge, immediate difference. Don't rule out the ADs on some vague feeling of them being a last resort (or weakness, in my own case).

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.

Lot of misinformation here. SSRIs are not addictive, and they cost absolute pence as most are off patent now. A months supply of sertraline costs 92p

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 don't think most people can be expected to have a comprehensive knowledge of causes and treatment of depression and anxiety. SSRIs tend to be first choice these days. GPs aren't going to be routinely prescribing tricyclics or SNRIs.

SSRIs can come with horrendous withdrawal symptoms, and there was until recently very little research in these, or their dependency rates.

Although you have referred to him as 'my teen' he is technically an adult now at 18 and it seems perfectly reasonable to me for a GP to prescribe sertraline to an adult.

I was put on a similar medication when I was just 14 due to severe anxiety, and looking back (now in my 30s) I am so pleased that my mum was supportive of me taking the medication. It doesn't suit everyone but I would certainly encourage him to give it a try for a few months as it might be a great help to him.

My 23 year old is on setraline plus another I can’t remember name of - for adult diagnosed ADSD. He sounded a bit like your son- except he was in work (good work too) but did have anxiety and impulsive behaviour and a lack of motivation at times. This drug worked well for him .

Id be mad too, at 18 he should be offered other treatment with medication as a last resort.....

Think you are being U for the nicest possible reasons. You don’t want to medicate your child and that is so understandable. But in the gentlest way.. maybe if he starts a low dose he will get the confidence to be able to change his routine. It’s hard; and with COVID etc even more so. I’m old and had issues before COVID but I needed a hefty dose of AD before I could get myself out of a rut. Encourage him to do the other things.. talk therapy etc (although I hope they are better than in my area where I was told I had too many problems I needed to sort out before the therapist could help me…) but don’t discount some medical help too.. it doesn’t have to be forever.

Id be mad too, at 18 he should be offered other treatment with medication as a last resort.....

That's not what NICE advises. That's not how therapy works.

Please keep an eye on him. The first few weeks on sertraline are horrendous and make anxiety worse. Apparently it’s even more horrendous for teenagers

Sertraline isn't 'horrendous'

I'm so confused about what you expect the doctor to do???? You wanted the doctor to tell him to change his lifestyle? You think doctors go through decades of training so they can tell you point one on Buzzfeed's 10 ways to have a good day? And that people who make the big decision to go to a doctor would consider that in ANY WAY helpful when they have a serious medical issue?

So you're now discouraging him from getting the medicine he needs, pushing him away from medical help. Do you think you are a good or a bad influence when it comes to his health? How long do you want his life to go down the drain until you'll let him get the medical help he needs?

I needed anti depressants to get me in a stable enough place I could access further treatment. I put them off for years when I could have been on the path to recovery.

Ds is younger than your son but also on setraline. It’s a vital step to help him

@BarrowInFurnessRailwayStation for many people (especially younger people) the first few weeks of sertraline are awful. I’ve taken them on and off for around 20 years and every time I have started taking them I have been a nervous wreck

Yanbu OP. Having been in your teen's position and now as a mother to a very volatile preteen I agree that changes to lifestyle and therapy should be explored before offering medication, particularly sertraline.

The initial side effects of sertraline can be physically and mentally brutal and go on for weeks before you see any effects. The side effect section of the sertraline leaflet is as long as your arm - literally. Then it takes months to come off it. Some people get such horrendous withdrawal symptoms (NB not relapses) that they are resigned to be on this medication for life.

YABU. If a GP believes that his MH requires medication then why wouldn’t he take it? Would you advise against medications for say asthma??
CBT and other therapies can be helpful.

If you want him to change his routine why did you send him to a stretched overworked GP? GPs are medical doctors - they are going to prescribe Medicine if they feel there is a clinical need. It sounds as though you should have sent him to a life coach or similar if you wanted non medical suggestions.

Flowers500 I don’t want things to escalate and I’m out of ideas so sent him to the go so they can do an risk assessment! What’s wrong with that.
And yes I say “my teen” as eight”teen” is a teenager !

YABU but perhaps just through lack of understanding of mental health conditions? Just as with physical health conditions, medication is often needed when the brain isn't functioning as one would wish. It's not simply low serotonin/ dopamine levels - it can be about availability, receptiveness vs resistance, genetic predisposition- so many complex interactions. There isn't a simple blood test for depression.

I have also seen anti depressants save the lives of teenagers - far more lives endangered by the never ending waiting lists for talking therapy, particularly at CAMHS age.

This may help with some information

www.youngminds.org.uk/young-person/medications/thinking-about-trying-medication/

@Mumofone200

Flowers500 I don’t want things to escalate and I’m out of ideas so sent him to the go so they can do an risk assessment! What’s wrong with that. And yes I say “my teen” as eight”teen” is a teenager !

And they did their risk assessment and decided medication was best at this time and yet your now complaining about that?

If nothing else your risking sending very mixed messages to your son and making things even tougher. Let the GP do his job.

He needs medication. Severe side effects are rare. Also he’s 18. Support him.

I don't think you have a "right to guide him" @Mumofone200 - you can offer guidance but its not a right..

I do understand where you're coming from. However, my experience with my now 18DD was that her prescription for fluoxetine allowed her the headspace to even contemplate battling the underlying causes (in her case understanding what was driving her anorexia) Without the fluox she was an exhausted, anxious zombie and consequently the anorexia could exert more influence.

best wishes to you and your DS

Meadowblossom As said above the overstretched GP is trained to risk assess.

This thread is proof that the stigma against bad mental health is still there.