Antidepressants for 15 year old? Terrified

[BeethovenNinth]

My 15 year old…. Lockdown floored her, didn’t settle in secondary, anorexic. Self harm and dropped out age 13. Hasn’t been at school for two years. For six months was house bound

her mental health was very poor. We have tried talking therapies (waste of time), hypnotherapy (limited), exercise and diet (helpful). Her mental health is now pretty good - she eats albeit limited foods, she now sleeps well, self harm gone. She has slowly worked up to going to a choir once a week and even seeing a friend. She has gone from not managing to leave the house to being able to visit a busy city, take buses etc (with me) and attend family parties. Slow but good progress

we are in Scotland so there is absolutely zero help. They don’t care she isn’t there. We have looked at private schools but she is too scared to get there each day.

she wants to try antidepressants as thinks it’s a magic bullet. I’m happy to find a private psychiatrist but feel it’s a massive step. My friends son committed suicide last year and he had just started to take an SSrI. My real real worry therefore is suicide ideation.i could give up work and check on her constantly but if someone wants to commit suicide it’s very hard to stop them

should I really medicating a child who mentally is well and slowly improving just so she can attend a school system that doesn’t suit her?

if not what else can I do? Thus has now massively affected my own mental health. The whole family is broken by it.

ps no point mentioning autism. She doesn’t want a diagnosis and even if she did there is years wait up here and no support once diagnosed. She doesn’t see herself as autistic - highly anxious.

thanks for any insight

So sorry OP must be really hard. My DD15 struggles with her AuDHD.

Does she acknowledge the private school might work well for her?

Is there a baby step process you can work with her on in terms of the journey there and back?

I don't think SSRIs are good for young people sorry OP.

What are your other options?

OP I don't think there's a clear answer to this. Antidepressants could help her massively, could do not much at all, or the side effects could make things worse. It's very hard to know what category anyone will fall into. I wouldn't say it's something to be terrified about though. I'm not sure about prescribing guidelines for a 15 year old. Normally a patient is seen and monitored regularly as they titrate up to a therapeutic dose. It is worth speaking to the GP about your concerns. This all should be done under the guidance of a GP so they can keep a close eye on her and what dose she should be on at her age.

I would be mentioning briefly potential severe side effects so that she is aware of them but also let her know it is unlikely to happen so she knows to alert you asap if she does experience anything.

I don't know fully what the guidelines are regarding antidepressants and young people, but it might really help her. It's hard to know unless she tries.

I don’t think they are either.

i suggested beta blockers for now. I’m not sure how we get those.

I am a musician and take them for performance anxiety and they work well for me. My DD’s issues are much more extensive though.

i am out of options. We have tried volunteering but she freezes.

In England a child of that age would not be able to be prescribed anti depressants by a Gp and she'd need to see a specialist.

She shouldn't take them to try to fit into a school system. They may help her improve but it's hard to know until she tries them.

I'd echo what Starsay says, but I'd also like to say well done, OP - you've done an amazing job to get your DD to where she is now. I know first hand what a struggle it is.

You might find some better support on the teen ED boards, the mental health boards and the neurodivergent teen boards (the latter even if she won't countenance an assessment).

Good luck. X

It's not a magic bullet - discuss it with your/DD's GP initially rather than a private psychiatrist who is going to benefit from ongoing consultations and prescriptions?

A friend had similar experience when her DD was about 14 (the ADs, not long term school refusal/eating disorders).
They helped, not sure how long DD took them for, in now mid 20s, now has a good degree and career.

Also, OP, as someone who is both ND and a long term user of antidepressants, I think I'd try other routes before ADs if I could go back in time.

I’m so sorry your daughter, you and your family are going through this OP, it sounds really tough. Well done to you all for getting this far, some really big improvements here.

Can I ask what talking therapy DD tried? I do think there’s a big variation out there and also “clicking” with the individual therapist is important. Do you feel there weren’t enough sessions offered, that the therapist wasn’t right, wrong type of therapy? Something else.

It’s tricky as she is making great progress, but I know how hard these wins are. As a PP said, SSRIs can make a big difference for some, do nothing for others, and everything in between. There are some potentially horrible and persistent side-effects although not a lot of research as I understand it so hard to know what the likelihood actually is. Also some people are fine coming off them, others (again little research on numbers) really struggle with withdrawal. And everything in between.

I think some private therapy or seeing a psychiatrist privately is a good idea, and take it from there. Word of warning, not all GPS are great with this, and some psychiatric professionals might be quite quick to push medication, as that is their specialty as opposed to therapy. So a good idea to research options carefully if you are going private, and try to find out if a particular GP in your practice has more interest or experience here.

Good luck x

My DD started on fluoxetine when she was 15 after two years of awful mental health. It has honestly turned her life around. She wouldn't have got any GCSEs without her medication.

She was self harming and suffering from awful anxiety and depression caused by PTSD.

Like you I was very reluctant for her to take anti depressants.

We saw a private child psychiatrist (after giving up waiting for CAHMs to see her ) who referred us to a therapist but after 6 months it was decided that she needed anti depressants alongside the therapy.

The difference in her is amazing. I feel like we've finally got our little girl back.

My daugher started Sertraline at 16, it has made a huge difference - I would call it life changing. Went from, not leaving her room, not talking to people, really really low .. to attending college, and working part time. (She is now looking for an apprenticeship).

My 16 year old (autistic) son has had severe mental health issues for about 5 years. In that time he has twice attempted suicide and we have had many episodes of self harm.

He was medicated using Fluoxetine in the first instance. He had this for about 18 months but it didn't seem to help him that much. He had the meds in tandem with 'talking therapy' with CAMHS which made him feel worse as his case worker was useless.

He was then switched over to Sertraline which within 2 weeks made him suicidal again. It was immediately stopped and he is now on Citalopram prescribed off license as it's not normally given to under 18s. He is having talking therapy each week with a wonderful clinical psychologist from CAMHS which he is finding helpful.

I'd say the only way to know if your child is going to improve and/or tolerate SSRI's is to take them. As PP have said, different medications act differently on everyone and it could make them better or even worse until you find the one that suits. However, I wouldn't let that put you off. You will need to be vigilant to their moods and how they are feeling in the first month or so of taking them incase they make them feel worse.

NICE guidelines state that antidepressants should be used in conjunction with a talking therapy such as CBT.

I hope your DD gets the support she needs and that it works for her.

There is a time when you start antidepressants where energy levels increase and if there is suicidal thinking it is easier to act on it. This is why people need to be closely and carefully monitored. There is no evidence I am aware of that it makes people have suicidal ideas if they did not have them before. Discussing it with people in advance is a good way to manage this early part. Once the full benefits kick in (4 - 6 weeks for SSRIs) the likelihood of acting on suicidal thoughts decreases massively. Sounds like you need to have a frank discussion with her about what you would expect to see from her in the first few months and she needs to understand that medication is not magic, it takes time to kick in and it is never enough in itself. So she also needs to have a plan for those other things too. Hopefully the psychiatrist would discuss that with her - but length of appointments varies and they may not.

PS - just because one experience of therapy was poor, does not mean they all will be. May be a mismatch with the therapist, or the modality they use, or just not the right timing.

I don’t think it’s very likely that anyone will prescribe e beta blockers to a 15 year old.

SSRIs have made a huge difference to my dd and many others.

Antidepressants really may help and especially so if she's wanting to try them. However, not sure, at 15, they'd be prescribed so only a medical professional would know that.

But I'd definitely not be looking at SSRI ones. I know they're the most commonly prescribed for people but from personal experience I would just steer clear as they're a nightmare to get off.

I was prescribed seroxat at 21 and there's a history of suicide in youngsters with that one. I ended up like an addict at the end just taking crumbs as the side effects were horrendous.

Take proper professional advice and I do hope she gets the support she needs.

Exactly the same experience as us !

I first took SSRIs at 19 and honestly wished I’d been able to have them at 14-15 when my eating disorder started.

I have not been on them for over 10 years now, but they have been a real life saver at times.

However that’s just one anecdotal experience. I wouldn’t be terrified of them though.
I’m pretty certain the risk of suicide increase is only for the first 2-4 weeks.

It sounds like your daughter has made great progress so I can understand not wanting to jeopardise anything. I think it’s so individual a choice it’s just worth discussing with relevant professionals first and considering worst case scenarios etc. good luck

So sorry to read about your son OP. What a difficult position for you to be in as a mum with your daughter.

If you had asked me a couple of years ago re Antidepressants I would have said yes do it, however I have been off them over a year now and am sure I have PSSD as a result and feel emotionally flat with virtually no libido. Many feel the same long after stopping them - years, decades later. Definitely worth a look into this because it could be something that would affect your daughter and her relationships for years to come. I wish I had never taken them.

Best of luck in your difficult situation. X

I’m really sorry to hear this. This is one of the serous and persistent symptoms I was referring to above. Would be really interested to know if there’s any good research into this, or any of the other side effects, withdrawal effects. I went back on an SSRI a few years ago and asked some questions along these lines. The consultant was very thorough and did try to research but the answer every time is some sort of variation of “there’s no research” into this.

How about trying a herbal alternative? There's a few on the market

I dont want to read and run. I know from experience that antidepressants made me very very very mentally unwell. They are not to be messed with and took years to recover from. Having said that I know many people who have taken antidepressants and they have done wonders for them. I would try anything and everything FIRST before considering antidepressants.

A CAMHS Psychiatrist prescribed my very young (junior school age) child Fluoxetine and I was very, very reluctant. GP wouldn't even take over prescription because they'd never heard of a child that young being given an SSRI. Made a huge positive difference, very glad we tried it. Reduced self injury a lot.

My DD was prescribed fluoxetine at age 16 when she couldn't return to school after the first lockdown and her mh was shot to pieces.
Was a game changer, and she became able to slowly engage with therapy and schoolwork. She has just hopefully come off after 4 years.

I shared your hesitation about antidepressants but it really benefitted my DD, who sounds very similar including the agoraphobia. She also turned out to be autistic despite never having shown symptoms prior so it's a shame your DD won't agree to being assessed. My DD went psychotic on sertraline but fluoxetine has worked really well.

If you have to take time off during possible drug-induced suicidal ideation, then that's what you need to do. Your DD will probably never forgive you for not letting her try something that might give her her life back. Also, isn't anorexia meant to be about feeling in control? I'd be afraid she might revert if she feels she has no control in this decision, especially at 15. Good luck - it's very tough.