Very worried about my 18 year old, help

[WorriedMum15]

Hi, I am new on here and i'm looking for a bit of support/advice. I have an 18 year old daughter. She is very very bright (a massive perfectionist) and suffers very badly from depression/anxiety. This all started when she started sixth form last year. She became very stressed with the work (she was taking A-Levels) around March and basically broke down. She would cry all the time, wouldn't speak, wouldn't eat, lie in bed all day. Despite being intelligent enough to do the A Levels, she was so afraid of failing that she didn't want to do them at all. She was in no state to take the AS Levels in May so dropped out of college, hoping she would be better by September to return. She is currently seeing a therapist and is on 40mg of Citalopram.

Her mood improved over the holidays (although she did have off days) and was excited to start back to college. However, now college has started, she has returned to how she felt in the beginning. She doesn't want to go to classes. She told me she is not happy at all and she feels worthless, lazy and pathetic. She feels she will never be happy. Naturally, this really upset me. She wants to do her exams so bad and wants to go to University and she's so scared she won't. I really don't know what to do. I'm afraid her thoughts will turn suicidal. Please can you give me some advice. I really want to help her and nothing seems to be working. Thanks

Hello, sorry you are dealing with this and sorry for her. Did you get the antidepressants prescribed by the GP? What about a referral to a consultant psychiatrist? Maybe get her on the waiting list for CBT, depending on how the therapy is going. How is it going? Does she talk about it? It can take a while to find the right type of therapy and the right therapist, though on the NHS one doesn't usually get the luxury of choice. If she isn't going to college, would it be worth exploring other options for her for this year - like a gap year - focusing on getting her well and broaching the exams and college once she's stronger? Just ideas. She doesn't seem to be helped by the medication from what it sounds like. Back to the GP? It can take trial and error I'm afraid to find the right one. Maybe Sertraline? Has anti anxiety component. I am not a doctor - just have been through depression more times than I care to mention. Go back to the prescriber would be number one on my list. The pills aren't helping enough, and some really can make a huge difference. On 40mg she should be better than this.

Hi JayARC, thanks for replying.

Yes, the antidepressants were prescribed by the GP. She was referred to CAHMs rather than the adult services as the GP thought she would get seen quicker. She's been seeing a nurse therapist and although I have not been in the sessions, my daughter tells me she didn't feel the nurse therapist really understood her problems and that she wasn't helping very much. She now is too old for CAHMs and how is being transferred to the adult services, however the therapist did say that the waiting list could be up too 2 years (!!!) which is no use at all. I was considering going to a private therapist (I found one who is a CBT specialist) if it did help but at £100 a session I don't think I could afford it, but if it was very very worthwhile I would consider saving. We are going to the GP tomorrow to talk about the changing the medication as it is obvious it isn't helping. I will mention Sertraline, thank you.

Hi,
I suffered from PND when i was 20 and was put on citalopram and ended up on 40mg. Does she have good days or are they all mostly bad days, because as pp says she should be feeling better on the medication. Maybe she needs to try a different type of medication

Hang in there, WorriedMum. I do understand the difficulty with waiting lists, and that it would be much easier in terms of both choice and times going private, but yes, it is very expensive. And these therapeutic relationships can be longstanding ones, thus it is a big committment, though less so with CBT as it's usually time-limited therapy.

Anyway. Glad you are going to the GP. If the medication changes and something suits her (hopefully soon - the wait while you are seeing if a new drug is going to work during the kicking in stage is agonising) then the need for the therapy may become less severe, and she might be able to feel up to making some other choices about the short to medium term re exams and college and so on. Maybe something less stressful but 'occupational' like a bit of voluntary work or something. Time on one's hands during depressing is a mixed blessing. While acute sometimes it is so crippling you actually cannot do anything much, but once she's on the road to recovery, bear in mind I would say that something to engage her, exercise or a small project - anything - could be really useful.

Come back and let us know how you get on? I cross my fingers for you both - it must be such a difficult time. Best wishes.

CBT sounds like it may be more helpful than ADs, tbh.

Have a look at e-couch ecouch.anu.edu.au/new_users/welcome01
and also live life to the full www.llttf.com/
which are both excellent and legitimate websites widely recommended by GPs, with a strong self-help CBT background.

I think they'd be excellent for an articulate intelligent young woman who has a poor self image and has got herself into a real pickle.

Could she take a year out? Do some work or some voluntary work to boost her confidence?? I had no confidence and i still suffer terribly with lack of confidence and i left school having not sat any exams at all. I went back to college when i was 24 and got into university via an access course. That isn't giving up on the course but if she is still struggling with it, why put herself through it - a year to chill might just be what she needs. Its not the same as the holidays as she will have to do something constructive with her time, but just not something too pressured. She's only 18 and just might not be ready. It would be a positvie, if the college would defer her place until next year (or if she will be 21 by the end of the course, she could do an access course, which will allow her to get into uni after studying for a year rather than two) What course does she want to do?

Also, i really don't want to worry you but im really surprised she has been put on citalopram - these are not usually recommended for youngsters as it CAN lead to suicidal thoughts. Its a rare side effect but more prominent in those under 18. Do encourage her to talk to someone/you if she starts to feel any thouhts of self harm.

Its such a worry isn't it, they are our babies forever xxxx

I sincerely doubt she'll be waiting two years for the transfer. And she WILL be seen by CAMHS until adult services take over the case. I'm currently under my local Recovery (long term support) team, and have found them absolutely brilliant, and, I must say, on the whole much better than CAMHS.

If she's not ready to be studying right now, then maybe a year out, even some home study, would be a good idea. I was sixteen when my mental health really started to affect me, and it was at least partially to do with the pressure from AS levels. How many is she trying to take?

If she's struggling still whilst on that dose of Citalopram, its worth going back to discuss the dose and the specific medication with the GP, or preferably the psychiatrist she's registered under at CAMHS. There are a variety of medications which can be brilliant for both depression and anxiety, but sometimes takes a little while to find the right one.

Thanks for the replies everyone.

rockandahardplace2012 - She'll have a few good days, but when she starts feeling really bad again, the good days to become rarer. I'm going to ask the GP tomorrow about perhaps changing the medication as the current medication doesn't seem to be effective.

JayARC - I will talk to her about doing something like voluntary work. She enjoys writing stories so I might suggest she do some writing to occupy herself. Thanks for the suggestions and I will let you know how it goes on.

timetosmile - I will show her the links, thanks for suggesting them

2girls2dogs - She wants to do Psychology at university. I think she does feel downhearted seeing everyone she knows applying for uni, but I have explained to her that everyone works at different paces and the main thing is, is for her to get better. I've told her she's not a failure if she doesn't do her exams just yet and that she is young and there is always time for it, but she really does hope she can sit her exams in January. We will see how she begins to feel if we do manage to get the medication changed. Thanks for the advice

How long has she been on he citalopram? when i was on 40m citalopram i don't think i would have been up for much studying! Bless her - you have to admire her tenacity. You sound like a great mum, she is very lucky to have you xx

I suffered with some MH problems as an older teenager although not as severe as your daughter (never on AD's). For me my life change when I quit college for a full time job, although I was bright enough for my A levels I just wasn't emotionally in the right place to be doing them. Once I got a job I began feeling far better and the things I had been doing to vent my emotions (binge/purging and some self harming) gradually stopped.