Fluoxetine for teen day 20 and still anxiuoss

[Sonoio]

Helllllppp! Positive stories. I hoped by now I would see a difference.🤪

Yes, I agree. I think what I meant it's not difficult to pass Gcses for a bright enough neurotypical child who goes to a good school? I don't know. The way things are ,if DD passes a few GCSEs, eventually anyway, i would be happy. 🙂

@Teendivided Cahms are thinking of upping dd' Fluoxetine from 20 to 30 /40, she has been 3 months on 20, still a lot if anxiety,but it s true that at least now she can engage with therapy. Did you notice a big difference with your dd with an increase? I thought 20mg was the maximum.

Yes we noticed a big improvement going from 20 to 40.

Fab ,thankyou. 😊

Did this happens after 12 weeks?

We had 10 weeks originally (starting at 5, working to 20 and staying there). helped with getting up and interest in things but not enough.

Then stopped meds for 6 weeks because of possible side effect that wasn't related in the end.

Then 6 weeks restarting straight at 20 and working up to 40, saw a clear positive impact when up at 40 (but distorted as she simultaneously sat GCSE assessments which exhausted her)

Stayed on 40 for around a year (first year at college, 75% attendance), then dropped back to 20 but too far so ended on 30.

Having various therapy in parallel with all of this. I think the 2 have gone hand in hand to help her recovery so far.

Sounds like quite a journey. I am beginning to see a light at the end of the tunnel. Thankyou.

We are 2.5 years in. DD is so much better than she was.
But also so much not where an 18yo would normally be.

You could ask the school or CAMHS if they could refer you to Early Help in Children’s Services to get you some additional support (completely voluntary)

Thankyou,that's all v helpful. 🙂

Advice please. Dd has been on 3 months of 20mg of Fluoxetine. She is so much better in so many ways More interested in things, agoraphobia almost gone, better mood, able to see friends,etc. Still v anxious about school. Home tuition starting next week. But since learning about home tuition her anxiety has increased, today she hasn't left her bedroom which is unheard of. I am going to ask cahms to review her meds, up the Fluoxetine to 30. What do you suggest?

That's fantastic that it's helping.

How much Home Tuition is planned? When DD restarted she was able to manage 30mins max per day. You'll need to be careful not to overload her.

My suggestion. Lots of reassurance that if the HT is too much you'll stop or scale back. If you have 3 hrs per day or something planned then change the plan to make it seem more manageable. (Maybe 30 mins Mon, Wed & Fri?)

It probably wouldn't hurt going up to 30mg. DD started on 20 which had some effect but not enough, then to 40, and we cut back this summer to 30. Not planning to try reducing again until next summer.

DD has ups and downs, but the main trajectory is improving. When she has a low few days I'm no longer terrified it is the start of a total collapse again. You'll get there.

If you aren't already, keep a short diary of what your DD manages each day, it will help you see the trajectory and keep the faith.

Is DD receiving therapy alongside medication?

Reassure DD the home tutoring doesn’t need to be formal academic tuition, it can be more relaxed, informal provision if that’s what she needs.

She has had 4 sessions of therapy so far. She refused to talk during the last session though, not sure if that bodes badly. Cahms have been fab. Her tutution ion will be 45minutes 3 days a week, this is what she said she wanted. 😩

Dd told me that when she has a few low days, I catastrophise 😲

I don't blame you. It took me a long time to get confident that low days would pass. I've had counselling myself for 2 years, only just stopped.

I'd just reassure her that if it is too much you'll pull it back.
We just pulled DD out of her Engl resit as she was hiding behind a chair rolled into a ball saying it was too overwhelming.

my DD needs to be given space to try when she feels strong, but reassurance she can stop if it's too much. (We also don't give her too much warning of stressful things if possible)

4 sessions is still very early days. It’s probably not a refusal to talk, but a can’t talk. If therapy that involves talking isn’t suitable there are other therapies that don’t rely on verbal communication so much.

Great suggestions,thankyou! I just read a thread about pathological avoidance disorder and I am worried that's what she has.😔

I’m so sorry to read your posts OP.
It may be a while before your DD opens up to the idea of therapy and the therapist, especially if, as you say, she displays traits of ASC.
My DS (15) is under CAMHS and sees a psychiatrist and nurse practitioner. He was prescribed sertraline as apparently this SSRI is slightly better for anxiety. Although his appetite is through the roof. It has worked wonders for him. He’s been on the medication since February, and has worked up to a doseage of 125mg slowly. It may be worth talking to the psychiatrist about options of changing medication. I read that Fluoxetine was the only SSRI licensed for under 18s but actually others can be prescribed in different circumstances. (My DS is autistic)
NICE guidelines do stipulate that any antidepressant medication should be used in conjunction with therapy. Although CBT is too heavy for her at the moment, talking therapy would maybe be better until there is an improvement and also, she feels more confident with her practitioner.
Remember to take care of yourself too OP. 💐

More likely overwhelmed and scared of failing?
DD's therapist talks of Fight, Flight, Freeze or Appease.

Have you considered that your daughter isn’t depressed per say but it struggling to regulate her emotions/worried about education as she has ADHD.

I noticed you mentioned up thread you think she’s autistic. Many autistic individuals have ADHD. I’m autistic and spent 20 years on various depression tablets and they rarely made any difference. On the other hand, taking a stimulant has made a huge difference to my ability to regulate my emotions and calm the racing thoughts I had.

If you think PDA is a possibility have you looked at the PDA society’s website and tried any PDA strategies? Often more general autism strategies aren’t as useful with PDA.

Teen anxiety, being overwhelmed and scared of failing could due to PDA.

I guess I thought PDA would have showed up before? Whereas if she has been masking due to autism it's not surprising now she is out of the stressful situations she's scared to go back? I don't have first hand experience of Autism (though have a good friend who does), and know next to nothing abut PDA.

PDA is a profile of autism and can be masked just like any other autistic profile. It isn’t uncommon for it to first become obvious in teenage years, especially in girls, as the demands and expectations increase. There is probably school related trauma but it may well be driven by some form of neurodiversity.