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

@PlantBasedPlatypus

And the new (drafted) NICE guidelines do say that a range of treatments should be discussed and offered before medication is considered...

Yes, my GP did this, in my area the waiting list for any help apart from medication was four months. That four month wait was actually for a phone call to book you in, after that phone call the wait for an actual appointment was around 13 months.

If you were still even alive for your face to face appointment you would be allocated no more than three sessions, one of which would be taken up with booking in etc.

FYI I would have been dead well before 13 months, the only reason that didn’t happen is because I could afford to go private.

If NICE think those with mental health conditions should wait months and months for treatment, I do hope they apply this to all illnesses so the mental health stigma brigade can experience what its like for us.

YANBU. I would feel the same.
However, I don't think a GP should not be the first go to in this case. They are stretched and the reality is, they are trained in medicine. Not holistically diving in to why a teen is anxious. They have short consults and a prescribing book. Its no wonder they end up just prescribing medication - its all they really have time to do..
I'd arrange counselling first with a good psychologist. Or maybe send him travelling (backpacking to Australia for a year?). Medication is, for me, a last resort when everything else has failed.

Or maybe send him travelling (backpacking to Australia for a year?).

Oh, does the body produce hormones at different levels in Australia?

If he hit the diagnostic criteria for moderate or severe depression, then the GP will prescribe antidepressants. They only suggest watchful waiting if you're scoring mild on the diagnostic criteria.

I read all your posts OP but please think more about this. Your DS could but hasn't made routine or lifestyle changes. If he can then great, but part of depression is demotivation, feeling overwhelmed, socially withdrawing and anhedonia (inability to enjoy things you used to) which comes from changes in brain chemistry.

Your DS will be influenced by your views, so he may repeat your view he doesn't want to take medication. Please ask yourself if you are doing him a disservice? His GP will only prescribed any antidepressant with short reviews at start to see how he responds and if it helps.

YABU. The Doctor is doing what he feels is mist appropriate. I suffer from severe anxiety & several months ago.it got so bad I couldn't get out of bed. I couldn't face work I was so stressed.

After speaking to my GP she prescribed Setraline. It took about 6 weeks to work but what a difference it made. I feel so much better and able to face things

If taking setraline helps him I canf see why you're so against it. You say seeing him sad makes you sad, so setraline will help him

There's no shame in taking meds if needed. Dont advise him, support him

@PlantBasedPlatypus

Yes, and *@Ready2020* you cannot speak for everyone either.

I had a horrendous time with medication as well - it is not "dramatic" to say how it is for some people. It absolutely needs to be talked about, and thankfully, as shown by the change in NICE guidelines and all the pressure from psychiatrists, it is now being talked about and people are being listened too.

I'm not speaking for everyone. Just giving my experience like you. The point is until you try them then you won't know how they affect you.

@Simonjt

Or maybe send him travelling (backpacking to Australia for a year?).

Oh, does the body produce hormones at different levels in Australia?

You mock, but I know of at least 2 young anxious, shy teenagers who went travelling to Asia/Australia for a year when they were floundering after finishing school, with the encouragement of their parents.

It was the making of them. They all returned to the UK with far more independence and confidence. All are doing well now.

My gps tried different things with me, it took years to get to a psychiatrist and get medication. Years of crippling anxiety. Never depression, never suicidal. Thankfully. Or who knows.

If you would take meds for a sore throat or heart or stomach, you’d be a hypocrite not to take them for your brain. (Referring to other posters here) and I can’t imagine my child having anxiety or depression, and advising that instead they should go backpacking over the other side of the world for a year in a pandemic too

Anxious and floundering when finishing school and being riddled with anxiety including palpitations etc might be very different things.

@Halfabag

Anxious and floundering when finishing school and being riddled with anxiety including palpitations etc might be very different things.

True. But the OP says he goes to the gym and out with friends. So he is active and can leave the house and function around people. To me, it reads that he is anxious about the future and doesn't have clear direction.

YABU if your son needs medication he needs it a change of lifestyle won't fix everything

YABU by pushing your own ideas on your son. Let him decide as an adult.

In my experience GPs prescribe antidepressants in collaboration with the patient. So it’s a decision GP and patient take together, both have to agree to it. The doctor won’t have just chucked the pills across the desk and gone ‘take these, now fuck off’.

The GP should also be keeping in touch every month or two, to make sure he is getting on OK with the medication and to check there aren’t any major side-effects or problems. Onboarding with sertraline — any SSRI, really — can be a bit tough and it takes a while to start working so it’s useful to keep in touch throughout this part of the process.

Just because OP’s son works out and meets friends doesn’t mean he isn’t anxious (or depressed). I was working out several times a week — in part to mitigate my depression — when I was prescribed sertraline. Some people ‘mask’ their depression and anxiety symptoms which is especially problematic as it can mean no one knows they’re struggling.

And a GP will absolutely know the difference between ‘lack of direction’ and actual depression and/or anxiety.

OP I hope your son finds a way through this and gets the help he needs.

YABVU.

Medication is often needed to improve the patients MH to the point where they can think about making changes and attending therapy.

Don't judge what you don't understand. Your son is an adult and would have agreed to go on sertraline when he attended the appointment - GP's don't just give you a prescription without discussing it first.

I wish my DS had been prescribed something. She had periods of anxiety and depression starting at 17. Doctors didn't take it seriously enough. She killed herself at 37

My child, who has recently started on ADs due to depression and anxiety, has had issues mainly focused on school / college work. They regularly meet friends and seem normal and happy when with them, but they say all that is just a distraction- covering, not eliminating the bad feelings. So socialising isn't per se an indicator all will be well if only they could get over X issue. My child saw a psychiatrist who explained how the brain gets into cycles re serotonin levels that can't just be easily changed by positive thinking etc. The brain is an organic part of the body like any other.

Worth reading lost connections. Debunks the myth that depression or anxiety are a result of a chemical imbalance in the brain. Studies show sleep is 3 times more beneficial than antidepressants. They also are largely beneficial for people for the placebo effect. Worth reading all the studies. Whilst the benefits can be huge the side effects are very real too.

Three college courses started and dropped is him trying to make the lifestyle change but finding it too hard. Some people need a leg up to get over difficult things, this is his leg up. Obviously you can be there to keep an eye.

Having an anti-medication attitude can be very damaging though. Mental health problems are every bit as real as physical ones. No one should suffer a headache/a chest infection/anxiety, when they don’t need to.

@Simonjt

Or maybe send him travelling (backpacking to Australia for a year?).

Oh, does the body produce hormones at different levels in Australia?

Actually exposure to enough natural sunlight to improve vitamin D levels and regular exercise outdoors will help most people with depression and anxiety.

Sertraline helped my Teen's anxiety which helped him integrate back into life but it caused wild mood swings, including dark thoughts and he stopped taking it, which in itself was a pretty horrid process. What really worked best for my DS was therapy which we paid for privately.

I needed sertraline to break the cycle and allow me to start my life. Before it everything was too overwhelming, too big. I took sertraline which then later allowed me to engage with cbt.

I’d encourage him to make his own decision. I’m not being unkind / but he is 18 now, and you have to start to step back.

FWIW a small dose of an SSRI could make a big difference and let him start to do all the things you mention.

No one wants to take medication- but sometimes you just have to.
If my mother had helped my brother get medication for his anxiety 30 years ago - he might have had a happy life. Instead he’s used alcohol to cope with his anxiety, and his life is crap.

My point is don’t project your beliefs on to your son. He has his own life to lead, and what’s right for you isn’t necessarily right for him.

The doctor is an expert on mental health. Allow the NHS to help your son. You should not be encouraging him to disregard medical advice.

I think people have the wrong end of the stick. I do not put my views into my son. I’ve kept them to myself, simply shoring how I feel on here! I’ve never been a parent to do that. People are getting the wrong end of the stick.

Of course I believe in medicine and natural remedies. I’ve managed to control blood pressure with medication and lifestyle diet changes. I’m not silly enough to not recognise when medicine is necessary. I also have never discouraged my son from doing anything in his life.