Fluoxetine for teen day 20 and still anxiuoss

[Sonoio]

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

DD (17) has been struggling for several years. Self harm, deep depression, enormous mood swings, risky behaviour, destructive and devastated, aggression, sabotaging friendships, school refusing - the lot.

We wondered about bi-polar but she is almost certainly suffering with borderline personality disorder.

We tried counselling but it was poor. Even with DH's private health care, we couldn't find anyone doing face to face. This is London, when everyone else is back in the office, and she said that online wouldn't work for her - no connection, no privacy .

So as a last resort the GP started her on 10mg of Fluoxetine five weeks ago. Two weeks ago, she was thinking she couldn't notice a difference and she'd have to go up to 20mg and then suddenly - a couple of days later - she said she felt different. We can all see it. It isn't a magic fix, but she is just able to manage situations that would tip her over the edge and cause her to spiral. She said she feels calmer.

that's just our experience though, and we are only two weeks in from feeling the benefit. Happy to keep talking.

Thank you @Thatsnotmycar very informative.

We wondered about bi-polar but she is almost certainly suffering with borderline personality disorder.

Have you considered DD is ND? It’s not uncommon for teen girls and women to be misdiagnosed with BPD &/or bipolar when they are actually autistic &/or have ADHD

Teen it’s also worth pointing out PDA isn’t diagnosed as a stand alone diagnosis in many areas, instead it is all encompassed under ASD. And even where it is recognised it’s possible to have demand avoidance traits without having PDA.

Thankyou,this is helpful. My 14 year old dd seemed pretty neurotypical till the age of 12, pretty helpful,amenable, ok with doing whatever she needed to do to function. I noticed a little bit of anxiety, here and there, but nothing extreme. I am pretty sure she is autistic though, both psychiatrist and her therapist are really good and I trust their opinion. No mention of PDA, but true this is a profile of autism.dd is meant to sit the autism test in 3 weeks, she volunteered to do it because she wants to know whether she has it. I don't know if Sertraline would work better fir her. She was binge eating before the Fluoxetine,so may be meds that increase her appetite not ideal.😩

Thank you for thinking about her @Thatsnotmycar . To be honest, she doesn't fit an ADHT or Autistic diagnosis at all. She is pretty focussed when she wants to be - social, engaged, chatty, communicative, emotive, affectionate, tactile etc.

But this is all tempered by huge swings and deep, deep depression that can last for weeks and weeks. The self harm has been on and off since she was 13 and pretty much everything fits with BPD. I am trying to find an affordable Dialectical behavior therapist as I think this, along with the fluoxetine, might hold the key.

My dd is autistic also has a diagnosis of pda, borderline personality disorder, generalised anxiety plus several more 3 letter acronyms which she's collected and I'm not sure what they mean! She's older now in her mid 20's.

Fluroxotine seemed to help, she was on 50mg as a younger/mid teen. We dealt with the school issue differently, I dropped her daily and walked her in, some days I was called by 10am to fetch her (thanks saintly boss) but she didn't get to go home, she came to work with me. She had a place to work at school at the back of the school office eventually which really helped

Sertraline was a disaster here btw, she's now on a completely different med (don't know name) but that's not licenced for under 18's

She is pretty focussed when she wants to be - social, engaged, chatty, communicative, emotive, affectionate, tactile etc.
huge swings and deep, deep depression that can last for weeks and weeks. self harm has been on and off since she was 13

None of this rules out ASD or ADHD. It really is worth considering as many girls and women are misdiagnosed.

Fluoxetine is the only antidepressant licensed for use in children and young people for depression, but others are used off license. DS1 tried fluoxetine, sertraline (which is licensed for children and young people with OCD) and citalopram before settling on mirtazapine.

I can tell you I was on medication as a teen. yes it did take a bit too kick in, but it was best decision, changed my life.
I was on this and sertraline just after 16. ( put on propananol at first till they realised it was def mental health and not just normal teen anxiety/down in the dumps).
im so glad I had a good supportive gp who didn’t just think as I were young not to medicate.

The main 'issue' my DD has with fluoxetine is she says she can't cry so doesn't get that release. And she doesn't feel great joy either. But I guess that's the whole point, it flattens out the emotions.

@BobDear Your description of your daughter is how most females with ADHD would be described. The description fits many of the women in my family, all have ADHD.

Yes, I can see that, that's v useful to know.

@gogohmm I am glad your dd could cope with school and school work and so lucky you had an helpful boss. How is she doing now?

Thanks all who have pulled me back to considering an ADHD diagnosis. Never occurred to us.

I had no idea it could present like that in teenage girls. We will look into it. Regardless fluoxetine is helping.

Sorry for the slight hijack

My dd is similar to yours, when she wants/ is able to be like that. We also thought she was bipolar. Definitely, look into neurodivergency, the key is to have an experienced psychiatrist, I have friends whose kids were misdiagnosed.Good luck.

Quick update: dd14 started home tuition. Week 1 she did 1 hour on Tue and Wed,Thursday she had a hospital appointement. Week 2 she did 1 hour on Tuesday and Wednesday, on Thursday she eventually got out of bed on condition it would only be 20 minutes. Week 3 she did 1 hour on Tuesday and Wednesday, but she stayed in bed on Thursday saying she felt too awful. 😩 It s draining. Still wondering whether more Fluixetine would give her some more energy. 🤕 Part of me thinks she is doing well to have done any tuition at all. 2 months ago she wouldn't have managed.

Glad you're getting some tuition in. Maybe 3 days in a row is too much right now? Would alternate days work better or does that give you no time in the week for other appointments? It takes time.

As a comparison for you:
DD y11 (20-21) - No school at all. English tuition weekly, but cancelled quite a lot of them, fluoxetine added and at full dose April 21. Managed assessments for 4 subjects spread out over 8 weeks, 1hr assessment plus max 20 mins revision each day.

y12 (21-22) - Attended college supposedly 4 days per week but actually averaged 75%. No homework. June sat Eng Lang GCSE staying in exams for ~90mins.

y13 (22-23) - Meant to be in 4 days a week, was at 90% atendance 3 weeks ago, has now dropped to 85%. Managing small bits of work outside college.

DD was at 40mg, but over the summer has dropped to 30mg. DH thinks maybe we shouldn't have dropped, but I've pointed out she is doing more now than in May despite the reduced dose.

Are you keeping a diary / table of progress? It really helps me to see we are moving forwards, even when we have weeks like the last couple. It is only this term I have got to the point where I have faith she won't slip back completely when she has a bad few days. You won't be anywhere near there yet, so a diary showing what she is managing, and tracking med levels and other indicators will help you.

My daughter started Sertraline for anxiety and it took 6 months to work so I guess be patient. She had to increase doses though.

This is something that you probably won’t want to hear, but medicine for depression or anxiety aren’t magic pills. This needs to be combined with therapy and self-determination to change. In my late teens, I took Flux for depression. I combined this with a year of therapy (which I was very reluctant to go to at first). I also made little changes in my life eg going out on my own, finding projects to do etc. I gradually realised I wanted and could get better.

Your dc won’t get better if she isn’t eating well, not leaving the house, not going to therapy to address her issues etc.

Also, I noticed you mentioned she’s glued to the screen. There might be apps/forums that are contributing to her anxiety. Might be best to limit it. I remember deleting all social media when I was 18 (and severely depressed). She desperately needs therapy if she’s not going to school and not going out in general. You all need to figure out what is happening to her and she needs to make steps to recover under the care of professionals.

This thread resonates with me.
My teen offspring didn't get any better on Prozac.
I was very surprised. I fully understood it's not for everyone, but it's been a godsend for me so I assumed she'd do well on it.
Took over a year to even get some, was 16. Not in school properly for 2 yrs.
You get the gist.

Tried sertraline and this made a difference.

Just saying, it could be worth a go.
I've simplified our long story and all the symptoms but that change DID make a difference.

Sending you strength. X

@Sushi7 I agree that meds need to go hand in hand with therapy. In my DD's case she couldn't really access meaningful therapy until she was on the meds as she was too overwhelmed So the meds opened the door to the therapy.

Also re screens. That is I agree a difficult one. Again we found that DD 'needed' the screens to distract her from her feelings of overwhelmedness, and it was only as she started to improve a bit we could replace them with other things. What is being watched does need to be monitored though. We have a strict rule of nothing exciting after 6pm, and these days she falls asleep to QI on Dave (interesting enough to distract her, but boring enough to fall asleep to.)