To ask for anti-depressants for 15 year old boy

[Toetoetoe]

I have appointment booked. I think my DS mood swings and anxiety are causing physical symptoms like nausea (especially in the morning) and now such bad fatigue after normal exercise that he is falling asleep and not able to get up for school and sleeping all day. It causes headaches and rapid mood swings.

I think it is biological and needs to be medicated - all the talking therapy in the world won't change that. I think it is genetic as my DD and another family member had these exact same symptoms, that were subsequently vastly improved with anti -depressant medication. This was after years of trying other things.

Am I being unreasonable to ask the doctor for anti depressants for someone still very young?

I don’t know if it’s only where I live (Wales) but the GP can’t prescribe antidepressants for children here. Have to be referred to a child psychiatrist or similar.

I have been on antidepressants on and off since I was 11. The side effects when I was a child were at times truly awful. Don’t assume medication will make this better. It really does work differently (or not work/make it worse) on children.

You can’t just tell a doctor what to prescribe surely? I think you should suggest to your son that he go to the GP and take it from there.

You'll need to see a consultant psychiatrist to get anti-depressants for an under 18.

You need a CAMHS referral, most waiting lists are unfortunately years long. GP's and acute paediatricians aren't allowed to prescribe mental health medications for under 18s unless they've been started by a psychiatrist. In most parts of the country you are looking at a few years before he can get medication unless you go private.
Sorry.

I think it's unlikely your doctor will prescribe off the cuff.

Many GPs are unwilling to prescribe ADs to under 18s, indeed many ADs aren't licensed for this age group. Their side effects can be lethal. When DS2 was a teenager only child psychiatrists were approved to prescribe them where we lived. My son got them because his depression was so profound (he had a life threatening chronic disease).

GP can't prescribe in England either AFAIK
Which is a good thing because antidepressants don't work the same way on teenagers and they are much more vulnerable to the negative side effects of them, including suicidal ideation. Is he getting any emotional support at school? Could you afford to send him to counselling or ask for some through NHS? As much as antidepressants can be very effective for some people in treating depression, at the same time a lot of depression is circumstantial and actually dealing with the causes and circumstances can help to alter that persons brain chemistry as much as medication.
Does he exercise? What's his diet like? Does he get a lot of good quality day light, especially in the morning? Does he take a vitamin D supplement? Does he get a lot of screen time? What is his sleep hygiene like?
If he has an issue with falling to sleep it may be that he is not producing melatonin effectively at the right times or is suffering from delayed sleep phase disorder (common in teenagers but often resolves itself). In which case that would cause him to struggle to fall asleep, he would be suffering with a sleep debt, and his morning times would feel effectively like being woken up in the middle of the night so make mornings difficult and make him not hungry yet. In which case sorting out sleep hygiene and possible melatonin supplements could be considerably more effective than antidepressants.

Agree that GP won't prescribe them. There have been cases where teenage boys (far more than girls) have become suicidal on them and actually followed through. No-one is sure why, but it's been enough to stop them being prescribed easily.

It is a very bad idea for teens to take antidepressants unless as a last resort and within 24-hour monitoring as some teens get an extreme adverse reaction from them. As in, some slightly depressed teens feel overwhelmingly suicidal as a side effect of anti-depressant medication.

Do everything you can to help ease his mood. Check that it isn't exacerbated by things like Vit D deficiency, B-complex deficiency etc by adding these supplements to his diet. Vit D spray is more easily absorbed than tablets. Get a B-complex and maybe a herbal-based iron supplement for him (better than standard iron supplements as it doesn't make you constipated as a side effect.)

Encourage him towards activities that help lift his mood, even for a moment, such as funny TV shows, cute animal videos, nature walks or runs, exercise in any form, video gaming so long as it's not addictive/non-stop, meet ups with friends, maybe in your own home - pizza and film nights, easy stuff. Not that these cure depression but they can help distract the mind temporarily and those brief distractions can add up to significant breaks from feeling low.

If he is amenable to it, he could also try online affirmations, visualisations, meditation and CBT/DBT/EFT tapping etc.

He should be able to access 6 online CBT sessions free on NHS via self referral.

EFT techniques can be self taught using youtube videos.

DS2 has depression and I have kept him away from medication as he is still in his teens. he uses all these techniques and they really help him minimise its severity.

I have seen posts on mumsnet of mums posting that their teens really benefitting from them but obviously I would rather there was a more natural approach. I just think that medication is necessary in certain cases.

He gets more than enough exercise. His eating was affected by the depression and he was not eating all day, so that could be better. Although he does eat.
He gets a lot of fresh air at school and plays football at break and lunch and does loads of walking as it is a massive school.

He is having a mentor come in once a week from a charity. The school arranged it for him. As they also noticed the change in him after puberty.

I would be willing to pay to see a Psychiatrist privately for a diagnosis of what is wrong. He has always been quite sensitive but he has lots of friends, enjoys his sport and is quite clever (although he does the bare minimum at school now and doesn't try as hard as he used to.

I will see what the doctor says, as we have already been before as this has been going on for about a year.

The reduction in stamina etc, it could be depression or could also be a physical condition causing fatigue. I would want autoimmune screening and Vitamin testing as a minimum. If he is doing so much sport and activity is he getting enough nutritionally to support that? If he has been off his food then that could also be contributing to low energy, it can be a bit of a vicious cycle with under-eating, but the combination of lots of sport and being a growing teenage boy he could easily need double the calories he did at 10y.

I hope that your lad gets the help he needs, op. I struggled for years to get help for my boy, but due to CAMHS being ridiculously underfunded and overstretched and the GP not prepared to help he had to suffer untreated. It was only when he seriously self-harmed that he finally got the help he needed. He was prescribed ADs and for him they have - literally - been a life saver.

They did a full blood screen as I asked for him to be tested because we have a family history of thyroid issues. The doctor said that everything was fine. I asked for a copy of the tests, but I don't know what I'm looking at!

The autoimmune thing is interesting as he has been complaining of his eyes burning and he is always stuffed up. He was given some medication for hay fever type symptoms but it has worked. He has also just been put on antibiotics for acne which I know can affect the gut.

The appointment is in a couple of hours with a new doctor at the surgery. My DS just said I will tell her all my symptoms.

His eating has improved a lot. He is very quite short but slim, muscular and athletic looking so he certainly looks like he get enough calories.

I had them at 16.best thing ever.
therapy did not work.

Thank you Fireblanket - I am glad your son got relief from them. Some things are simply biological and nothing to do with circumstances - like Diabetes is managed with insulin.

Memtselfandfood thank you for your first hand experience is is really helpful.

Ultimately it is up to the doctors he sees I guess.

Antihistamines can make you drowsy and acne meds can be bloody nasty and have all kinds of effects, including making people feel depressed. I would consider looking at the meds he is already on instead of adding in more. IME once people are put on antidepressants, instead of looking for other issues that might cause or contribute they are often just titrated up and down or added more mental health meds forever. I was on antidepressants at a young age and made some attempts, so the Suicidal ideation is not to be dismissed lightly. I don't take any psychiatric meds now, but would not have been diagnosed with my other health conditions had I been on psychiatric meds because my symptoms were either ignored because I was mentally ill (must be a hypochondriac as I have anxiety), attributed to my mental health (fatigue, heart palpitations) or believed to be side effects of the meds. I would really advise about ruling out other factors first, especially if he had recently started taking two medications and this is a relatively recent mood change.

If you post the results then we may be able to help you work out what they mean. A lot of the time NhS say results are fine when they are actually borderline

AngelaRayner

Totally agree, especially about the borderline results (that happened to me).

The depression and anxiety has been going on for long before the antibiotics and antihistamines however.

My DS said it was triggered by his first proper girlfriend dumping him a year ago in the Summer holidays. He doesn't like the summer holidays as he feels lonely and out of routine.

The doctor has referred him to CAMHS but said he is doing everything he can to combat the low mood from what he told her today. She started to talk about ADs but is a junior doctor and when she checked with her supervisor he told her about young boys becoming aggressive on ADS and having suicidal ideation etc. She said a psychiatrist will have to assess him.

She said the only thing he didn't have was a Diabetes test.

So basically we are waiting for Cahms or going private for a diagnosis.

He does have fatigue and heart palpitations but the supervisor said that the blood test 6 months ago showed nothing so he doesn't need another one.

Sorry I named changed

DD age 15 wanted antidepressants and the GP wouldn’t do it. Camhs pointless as not actively trying to kill herself. Got propanalol which didn’t help and a referral for a anxiety zoom course which was aimed at complete idiots who’d never read a book so was useless. All very frustrating.

My son got anti depressants at 15 from his GP who consulted with a psychiatrist

It was set in motion not by a self harm incident but by a major safeguarding concern picked up by school

so many things made sense when the medication kicked in

Between 12 and 15 was absolutely horrendous for him and he protected us (his family) from it to his own detriment

thank God for that GP because my son now successfully lives away from home, holds down a responsible job and I don’t worry about him every minute of every day

he struggles socially and needs scraping off the ceiling every so often though

Anyfucker I am sorry to hear that. Sounds like he was courageously living through hell. So glad he found relief in the end. Peace of mind for you too.

Cat lady - I know it can be useless. I found things for anxiety utterly useless and I tried so hard.

I will post his results when I dig them out tomorrow. As I agree with AngelaRayner borderline results etc are considered absolutely fine even though it can massively affect you.

Good luck, op. Teenage boys can be so difficult to help.

I found the old adage you can only be as happy as your unhappiest child absolutely spot on

I would change places with my boy a million times over and I hope he knows it

Given that 50% of mental health conditions are established by the age of 14 I think the GP's role in diagnosing and treating young people needs to be rapidly rampedup. Especially with CAMHS being so notoriously slow, some kids are waiting years and suffering horrendously. The ineffectiveness of treating mental health issues in young teens is a huge crisis in this country.
So I say yes, go to your GP, advocate for your child as persistently as you can. We should all be making a noise about this. Mental health services in the UK are appalling.

My 14 year old DS takes antidepressants. They were prescribed by a CAMHS doctor last year. I have found CAMHS to be inconsistent with who they will/can help. We are one of the lucky ones and he’s been in CAMHS since he was 6. Before he was prescribed antidepressants he had many tests to check there wasn’t a physical cause of some of his symptoms.

For us the antidepressants have been very helpful with no noticeable side effects. His appetite has increased slightly and he will occasionally engage in conversation. He sits downstairs with the family and he’s attending school most days. Prior to antidepressants he wouldn’t leave his room or talk.

www.nice.org.uk/guidance/ng134/chapter/Recommendations#steps-4-and-5-managing-moderate-to-severe-depression

Here are the NICE guidelines. They are just guidelines, not absolute rules.

They do state that for under 18s, prescribing antidepressants should be done only after assessment by a psychiatrist.

I think this is why most GPs won't prescribe in this age group.