DD in crisis - think anti depressants might help but no experience of these?

[Houseplantmad]

Long story short, we’ve brought DD, 20, home from uni as she is having what I would call a mental health crisis. She had a terrible time last year with stress/anxiety and we got her regular therapy, uni was brilliant and she got through the year and passed her retakes in the summer. She felt back on an even keel over the summer holidays.

Now she is in an awful place where she describes herself as either being rational or totally irrational - nothing in between. Although she’s keeping up with uni work, and seems to be doing well, she’s so stressed about negative possibilities and says she is getting no enjoyment from anything, and feels so guilty as these are what’s she believes are supposed to be the best years of her life.

She is not sleeping, feels sick and anxious and can’t eat properly, which obviously isn’t helping. More worryingly, this morning she has said she has recently had thoughts that it would be easier if she wasn’t here, although she’s said that’s not a possibility because of what it would do to others.

We plan to get her in front of a GP tomorrow as this is beyond our capabilities and is more than therapy can help with. I think it sounds like (and from what I’ve read) she has a seratonin/dopamine imbalance and anti depressants could help with this.

I have no experience of anti depressants so would welcome what questions we should ask GP, or what is useful to know at this stage.

Thank you if you’re able to share.

Slealing as the parent of a ND 17 year old Dd, who suffers constant anxiety and stress, I’d at least give this a thought.

She may not be, she may just be stressed. Buy it’s worth considering.

The chemical imbalance theory was debunked many years ago however many people do feel a benefit from taking antidepressants (either from the effect of the drugs themselves or the placebo effect) so they shouldn't be discounted.

How were her school years? Did she enjoy them? Was there any (internal) lack of confidence in her abilities?

She's 20. Will she be OK with you going in with her?
If she is, then I would just say to her to tell the doctor what she said to you.
She needs to advocate for herself and be able to tell the doctor how she's feeling.
If she truly can't, then it's an indication of how unwell she is also.
Sounds like she would definitely benefit from some anti depressant or anti anxiety meds.
They can make a huge difference.

Thanks all @Doteycat yes, she’s ok with the thought of advocating for herself although is terrified she’ll feel ok when with the GP and won’t be able to articulate how bad things are when she’s not feeling ok.
I am getting her to write some notes so she can use these as a prompt or share them with the Dr. She also will have the option of one of us being there if she feels she needs that support at the time of the appointment. She very much wants to deal with things herself but today has said she is very scared, which is why we want her to see the GP.
@Eyesopenwideawake that’s interesting, thank you - could you point me to where I can read more about this please as I want to learn more?

Even saying to the doc 'I can't explain how bad I feel' is an expression of how bad she feels.
It can and will get better.
You are doing the right thing. She spoke up.
That's huge. That's the first step to being ok again.
At 20, she's had a v tough few years. They missed out a lot of growing and learning how to be out in the world due to the pandemic I think. They went from being kids to adults with none of the usual rites of passage into it. I see it with my dd.
She had a 'wtf do u mean I have to be an adult now' period once the pandemic ended and suddenly she was an adult out in the world. She was a teenager in school when we first locked down.
It's a lot to handle.

The chemical imbalance thing is a myth isn't it? I'd consider options carefully, SSRIs made my anxiety much worse and venlafaxine was the worst experience of my life. They work for some but not others and you don't know which way it will go.

There's a couple of videos that might help you/her understand the roots of anxiety and depression and how to combat them;

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And a useful one on Core Beliefs (the way we think about ourselves, other people and the world at large)

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Thanks @Doteycat you’re right - it seems from what she’s shared that this all stems from year 12, when the lockdowns started and her school were abysmal in their pastoral care and academic provision. And yes, by sharing what’s going on inside her head, it is a huge step.
@Eyesopenwideawake thanks for these - really useful.

It is awful watching your child suffer, especially when we feel so ill-equipped to offer help, so your contributions And experience are much appreciated.

@Houseplantmad
I can imagine how worried you must be !
Fellow mum to depressed DD16 so I know what you are going through especially as there is no quick answer to mental health issues.
You did the right thing in bringing her home.
Tell your DD it's great she wants help.
I hope your GP is helpful with good solutions.
Did she continue therapy at uni?
Would ongoing therapy help her?

If the main symptom is anxiety, she should be fairly safe to take Sertraline which is a much gentler drug than most SSRIs and would be unlikely, if she's aged 20, to have an adverse affect on her mood (it may for a couple of weeks or so, so she should be made aware of this and cared for at home 24/7 until it stabilises, but it could give her her life back.

I do agree with PPs that non chemical therapies would be ideal rather than long term medication but you need to have the head space to begin processing them and it sounds like she is in crisis right now.

Ds21 has taken 2 years out of uni, unable to work or study due to v poor mental health. His place was held open for him, SFE were fine about interrupting etc, and he was able to get UC. (Gone back to uni this year).

Maybe she would benefit from
time out?
switching to a uni nearer home? (if an option?)
And definitely consider medication. IME it can really take the edge of the worst feelings and enable you to function, even if you're not "happy".

But definitely, as her parent, support her to take time out of uni to recover, heal, strengthen- to resource herself emotionally and physically. She can come home and maybe at some point volunteer or get a p/t job-- but if she is forced to push through, it may break her.

So what if she graduates aged 23 instead of 22??? They've got DECADES of work ahead of them!

@Eyesopenwideawake thanks for those links. OP - I hope your Dd is able to speak to the GP & slowly recovers.

@AvengedQuince, that's your experience, but it might not be like that for other people.
OP, my DC2 went through a horrendous mental health crisis. The whole thing took place over a period of two and a half years - GPs unhelpful, local mental health services downgrading their referral (multiple times), refusing to consider medication. They eventually agreed to try medication, and got a prescription for fluoxetine. It was the key factor in turning their life around, to the point they started to study an A level (having had to drop out of sixth form), and then moving on to an apprenticeship in the same subject. They now work in the field and are living away from home.
It will be a tough time, but work with whatever your DD feels able to do (you might have to get a bit tough if she wants to continue uni but is on a downward curve). It would be helpful if you contact the mental health service at the uni. I'm pretty sure that they well might recommend deferring for a year and then carrying on. It will give your DD the space to work on her mental health, with your health, and hopefully the help of others too.
Just make sure you take care of yourself too - I know what a toll it can take on your own mental health.

@vipersnest1
Why quote me simply to say essentially what I already said in my last sentence, they work for some but not others? I never said everyone would have my experience, just to be careful.

It's worrying that she is hinting at suicide. It's great that you're going to see a GP, I hope they can help.

It might also be worth giving Samaritans a call on 116 123 and they can give you advice. I hope she feels better soon, sounds like she is really struggling.

@Houseplantmad
Hope you managed to get DD some assistance from the GP and you are all coping.
Xx

Thank you @DarkChocHolic . It’s been a fairly rough ride.
She saw a lovely GP who spent ages with her and is now on anti anxiety medication as well as sertraline. The GP arranged a follow up, which has happened.
Towards the end of last week she was much much better, although I think having distance from uni really helped and she managed to do some uni work and submit an essay.
She has always insisted she had to go back, although we weren’t in agreement, and we took her back yesterday. It was so hard leaving her as she was low again and today has been a real struggle. However we have had phone and message chats and she has got through the day and is now on the way to play sport.
It’s just one assignment that has sparked all this so she has emailed the lecturer and is meeting with her this week to get clarification on the areas of concern.

She has also registered with the disability support to receive extra consideration for the remainder of the term, if not year.
Whether she gets there or needs to stop, remains to be seen. I worked out she only has something like 14 teaching weeks plus exams to go but if she needs to stop, she needs to stop.

Aww I feel for you @Houseplantmad
It's hard enough to watch them struggle when they are with us but to have to leave her at uni when she is low must be really a worrying time for you.
I really hope she gets the help she needs. I keep hearing uni are quite good at offering student support if the student reaches out.
If not, she has a supportive mum in you to give her all that she needs when she is home.
Do look after yourself if that is at all possible.
My favourite quote from the book " The Boy,the Mole, the Fox and the Horse"

"What is the bravest thing you have ever said said? Asked the boy. 'Help', said the horse.

I hope your DD feels much better after asking for help and she gets all the help she needs and more.
Xx

Meds can really help. I rely on mine in bad patches. BUT everyone is different. Some people don't get in with Sertraline for example but do get on with fluoxetine. Be prepared to try things and to change if necessary - don't give up straight away. For me, the right meds have been life changing.

Fluoxetine was a game changer for my then-16yo.
It made her better enough that she could access therapy and eventually education.

I agree re the serotonin hypothesis having been totally debunked but also ADs can help. You’ll need to keep a close watch on her if she chooses to go on them though because ADs don’t always help the first time and can cause things like suicidal ideation or other stuff that makes the situation worse.

@TeenDivided
DD16 is on Day 4 of Fluxotein for depression after a recent OD.
I am keeping everything crossed it helps her.
We have been warned of the side effects for the first few weeks especially as had an OD episode before. So I am watching her like a hawk and keeping note of her sleep, mood, headaches etc

Not able to discuss this in RL as its a very controversial topic so having a forum to vent is keeping me sane.

@DarkChocHolic There is also a Children's MH board which you may find helpful if you haven't seen it already.

DD was lucky and didn't really have bad side effects starting up, but you are very right to keep a close eye on her. She's been on it for nearly 3 years now. After 18mnths we reduced from 40 to 30mg, and have just reduced to 20mg. Planning to try to reduce to 10mg in Dec/Jan with an aim to stopping entirely if possible.

What dose are they giving? (DD started on 5mg then stepped in 5s to 20mg. Then came off for 2 months as had a symptom they thought might be a side effect and wasn't. Then went back to 20 stepping up to 40mg as 20mg had had some beneficial effect but insufficient.)

@TeenDivided
She is on 10mg for 2 weeks and then 20mg for a month.
There will be a review after that I think.
She complains of interrupted sleep in the night but does seem to want to crash after school so sleeps then.
Is also complaining of nausea...
I think she will swiftly return from school in an hour today and fall asleep...

Thank you for letting me know about the child mental health board. I will wander over and have a look.
I am on a support thread for teens in the adult mental health board which helps.

DD is also on melatonin to help sleep and was on something called promethazine hydrochloride (?) which really knocked her out when very anxious.