![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Nella on October 6, 2008, at 3:40:52
My daughter was the happiest kid on earth until puberty. Since then, the road's been bumpier, but that's supposedly normal. From time to time, I've been concerned about episodes of gloom, but it's always turned out to be PMS (albeit PMS on the lengthy side).
She's a serious athlete and stellar student with no prior social or behavioral problems. About six weeks ago, on the first day of her junior year she did not make an extremely competitive Varsity team, and that clearly seems to have triggered the black dog of depression. Since then, she's been an entirely different kid and I am very concerned.
Okay, I'm aware no advice given here is a substitute for a good shrink. On the other hand, so many posters know so much about drugs (and I am so lost) that I'd love some opinions/ideas.
Kid started seeing a psychologist. Drugs have been mentioned. I don't know how long to wait, and I can't seem to parse the conflicting info on teens and ADs.
My guess is a p-doc would start her on an SSRI. And maybe the only approach is trial and error. I haven't had much luck with SSRIs. I manage my own depression (which started young and at times has been severe) with micro-doses of Prozac as needed. I can't take it for months at a time: makes me too lethargic. And I definitely can't tolerate the "standard" dose. Makes me anxious and aggressive. So yeah, based on my experience I have reservations about SSRIs.
Kid has always had trouble falling asleep, but no matter what she got up early and went to school enthusiastically. Now that she is indisputably depressed, she simply cannot sleep at night and cannot get up in the morning. I have to wonder if fixing the sleep problem would take care of many issues. The psychologist feels anxiety is a key problem...
So my questions:
1) Anyone know the latest and greatest thinking on teens and SSRIs?2) Any response to my sleep theory? I've read conflicting reports on melatonin for teens. I imagine there are reasons to avoid Ambien, but maybe not. If it were up to me, she'd take xanax (a true life-saver for me), but I well know many docs won't even consider benzos.
3) What about the hormone approach? Another theory (or denial strategy) is that the combo of a real life disappointment and raging hormones could be at the root of this. Maybe birth control pills would attenuate the emotional roller coaster.
4) Any other suggestions?
Gotta say, this is HELL. Poorly timed hell, as well, in terms of a great student's college potential. Six weeks ago I had a well-adjusted kid who was looking forward to "the best year yet." I now have a heart-breakingly miserable child who's missing at least one of day of school a week, struggling academically for the first time, and feeling extremely unsupported by her friends (which may or may not be true). Some days she's stone-faced, some times she cries all day. It happened so fast... and she's sunk SO frighteningly low. Any and all advice deeply appreciated.
Posted by manic666 on October 6, 2008, at 4:46:04
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
is there any other reason, like is she being bullied at school, or boyfriend trouble ,or drugs sorry but you have to rule all these thing out first. i dont like to see a kid on meds if they dont really have to , you no yourself no the side effects themselfs are worse than the illness at times an can make matters worse, 16 is a mad age an if they feel they are not fitting in, they can go on a downer.rule out growing up first before the meds.because its a long road to once you start. hope that helps manic666
Posted by Phillipa on October 6, 2008, at 12:17:32
In reply to Re: Depressed 16-yr-old. Help?, posted by manic666 on October 6, 2008, at 4:46:04
Seems like there is a pattern as you say almost the same things about yourself have you told the psychologist that? I too think sleep is very important. Has bipolar ever been suggested? Just trying to help you rule things out. Phillipa
Posted by sam K on October 6, 2008, at 12:19:51
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
i'm 17 years old and anti depressants tend to make me think of suicide. (I dont know why) They work pretty well though. When I took Prozac, I swear, it cured depression. It was like a dream come true, but my anxiety was exaberate to an extreme level where I had pretty bad agorophobia, social anxiety, etc. Any anxietes or phobias I had got worse. So it was pretty imbalanced. But I may soon try it again in a combo with Lithium (sounds scary) and Lamictal. I do real well on Lamictal!! My depression is much better! There are side effects like cognitive stuff, but it doesn't bother me that much. Mostly short term memory! My parents always blamed it on hormones, but I think that it has little to do with it. Maybe some. But I have no idea for a girl.
haha, My mom gets reaaaaaal bad if she doesnt do her hormone thing!
SSris are pretty overwhelming for teenagers Id think. My advice may be sorta crappy today because Im a little down! but hey I do my best. I hate anti pshycotics! I wouldnt put her on one of those. But alot of people respond good to them dont get me wrong. I wouldnt go into natural things either.. Some people say sam-e is good though. I hope she gets better it sucks being my age and being depressed........
Posted by Nella on October 6, 2008, at 13:25:42
In reply to Re: Depressed 16-yr-old. Help?, posted by manic666 on October 6, 2008, at 4:46:04
Prior to the Varsity rejection, there were no issues like the ones you mention. She's a sports maniac: in her universe, it was a very public and painful rejection.
I could write a book about the insanity of "elite" sports. It kills me that team sports are often recommended as a way to help teens because from where I sit highly competitive high school sports are a hot house of cut-throat allegiances and pettiness and ego games, which coaches reinforce.
It's hard to say where she is now. I contacted her friend's parents: they said their daughters report that she is depressed and has pulled away from them. The kids further reported that she has done this before, which was news to me.
I know she feels alienated. I also know it's complicated because her close friends are involved in sports; and I have seen that various sports up and downs (A team vs. B team / Varsity vs. Junior Varsity) do, in fact, hurt their friendships. It's just an over-competitive scene, and I regret letting her participate in it.
Yes, I agree SSRI side effects are often as bad as the disease, so it seems like opening a can of worms. (And that is why I would prefer benzos, but doubt I could persuade a doc to prescribe them.) Meanwhile, the downward spiral continues.
This started out situational and has taken on a life of its own -- so quickly, so dramatically. It is a mad age: it now seems crazy to make a group of teen girls run the gauntlet, then publicly reject a few of them. Many kids handle it gracefully, though I also think if the coach had been a bit less brutal, my daughter would have been disappointed, rather than devastated.
Bottom line: she was not awarded the privilege of fitting in where she'd hoped to fit in. And since it is a highly competitive team and she is a good player, her rejection is the source of much gossip.
Long road: it was for me and for many of us on this board. I'd hoped my kid had escaped the family disease. Still wish there was "something" that could help her get back on her feet. She's now behind in three AP courses, has failed tests for the first time, and doesn't want to go to school. Every day brings further proof that, as she frames it, "she sucks at everything."
Growing up is the answer. Theoretically, this is a "character-building" experience. But it sure looks like depression, and we all know how character-building that is.
Posted by Nella on October 6, 2008, at 13:29:17
In reply to Re: Depressed 16-yr-old. Help?, posted by Phillipa on October 6, 2008, at 12:17:32
> Seems like there is a pattern as you say almost the same things about yourself have you told the psychologist that? I too think sleep is very important. Has bipolar ever been suggested? Just trying to help you rule things out. Phillipa
Oops, I'm never sure how to use the board. I guess one includes the prior post so one knows whom one is addressing.
May I ask why you bring up bipolar? Are sleep problems an indicator? Right now, she is overwhelmed with emotions, but she's always had trouble getting to sleep.
Posted by Nella on October 6, 2008, at 13:36:30
In reply to Re: Depressed 16-yr-old. Help?, posted by sam K on October 6, 2008, at 12:19:51
> i'm 17 years old and anti depressants tend to make me think of suicide. (I dont know why) They work pretty well though. When I took Prozac, I swear, it cured depression. It was like a dream come true, but my anxiety was exaberate to an extreme level where I had pretty bad agorophobia, social anxiety, etc. Any anxietes or phobias I had got worse. So it was pretty imbalanced. But I may soon try it again in a combo with Lithium (sounds scary) and Lamictal. I do real well on Lamictal!! My depression is much better! There are side effects like cognitive stuff, but it doesn't bother me that much. Mostly short term memory! My parents always blamed it on hormones, but I think that it has little to do with it. Maybe some. But I have no idea for a girl.
> haha, My mom gets reaaaaaal bad if she doesnt do her hormone thing!
> SSris are pretty overwhelming for teenagers Id think. My advice may be sorta crappy today because Im a little down! but hey I do my best. I hate anti pshycotics! I wouldnt put her on one of those. But alot of people respond good to them dont get me wrong. I wouldnt go into natural things either.. Some people say sam-e is good though. I hope she gets better it sucks being my age and being depressed........--------------------------
Yes, it sucks and I'm sincerely sorry you're going through it too. Substantial research links suicidal thoughts to teen SSRI use, so yeah it's a scary option.I'm glad your depression is better, and I hope today starts looking up. For what it's worth, I was horribly depressed as a teen and it HAS gotten better. I was thinking about SAM-E and also Deplin, which I read about here. I dunno: guess it's always a crap shoot. But I am glad you're finding meds that help you.
Posted by desolationrower on October 6, 2008, at 13:37:25
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
sorry, must be tough if you can't help. I think you are right though, a drug to help improve sleep would be a good thing to start on. Trazodone is an antidepressant that can help with sleep at lower doses. Mirtazapine too, however it can cause weight gain, which might be very distressing for a teen girl even if she is a healthy weight. The 'z-drugs' could also be a good choice especially since the insomnia isn't a chronic problem. I think starting an ssri would be something to put off for a while yet. Making sure she has good food to eat and is getting nutrition and being active and getting out to do things she enjoys might be things you could make sure are available for her (it can be hard to get organized for and signed up for personal things when struggling with school obligations and low energy). I don't know enough to speak to the hormones.
One thing i'll mention that i've seen in my own family is that when my sister was depressed, my mother felt like it was a personal failure, which made my sister feel guilty. Being concerned and there for her is important but let her have her emotions and let her know she isn't letting you down.
-d/r
Posted by Phillipa on October 6, 2008, at 20:00:58
In reply to Re: Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 13:29:17
If sleep has always been a problem then I agree that straitening that out might help what about lunesta? A psueudobenzo? Phillipa
Posted by greywolf on October 6, 2008, at 20:05:19
In reply to Re: Depressed 16-yr-old. Help?, posted by desolationrower on October 6, 2008, at 13:37:25
IMHO, you want to stay away from all meds with a 16-year old unless they become absolutely necessary. In my view, what you need is a good therapist, particularly one who has experience dealing with athletes.
I have 2 kids who are considered by others to be "elite" athletes in lacrosse and football. The only advice I EVER give them is to grab them by their face masks and demand that they go out there and, come hell or high water, HAVE FUN. We keep the elitism in its place--other people's houses.
As I'm sure you also do, I work hard to instill the understanding that their performance on the field has nothing to do with their value as people. Unfortunately, societal pressures too often overwhelm that message. A good therapist with a background in working with sports figures should help as much or more than meds in that area.
Greywolf
Posted by azalea on October 6, 2008, at 20:06:40
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
With onset of depression at a young age, bipolar II is something to consider. For this reason in combination with family history of SSRI sensitivity, I would NOT recommend an SSRI.
You can read more about bipolar II at www.psycheducation.org.
You may find this screening tool useful:
http://www.psycheducation.org/PCP/launch/downloadMoodCheck.htmYour daughter is lucky to have your support.
> My daughter was the happiest kid on earth until puberty. Since then, the road's been bumpier, but that's supposedly normal. From time to time, I've been concerned about episodes of gloom, but it's always turned out to be PMS (albeit PMS on the lengthy side).
>
> She's a serious athlete and stellar student with no prior social or behavioral problems. About six weeks ago, on the first day of her junior year she did not make an extremely competitive Varsity team, and that clearly seems to have triggered the black dog of depression. Since then, she's been an entirely different kid and I am very concerned.
>
> Okay, I'm aware no advice given here is a substitute for a good shrink. On the other hand, so many posters know so much about drugs (and I am so lost) that I'd love some opinions/ideas.
>
> Kid started seeing a psychologist. Drugs have been mentioned. I don't know how long to wait, and I can't seem to parse the conflicting info on teens and ADs.
>
> My guess is a p-doc would start her on an SSRI. And maybe the only approach is trial and error. I haven't had much luck with SSRIs. I manage my own depression (which started young and at times has been severe) with micro-doses of Prozac as needed. I can't take it for months at a time: makes me too lethargic. And I definitely can't tolerate the "standard" dose. Makes me anxious and aggressive. So yeah, based on my experience I have reservations about SSRIs.
>
> Kid has always had trouble falling asleep, but no matter what she got up early and went to school enthusiastically. Now that she is indisputably depressed, she simply cannot sleep at night and cannot get up in the morning. I have to wonder if fixing the sleep problem would take care of many issues. The psychologist feels anxiety is a key problem...
>
> So my questions:
> 1) Anyone know the latest and greatest thinking on teens and SSRIs?
>
> 2) Any response to my sleep theory? I've read conflicting reports on melatonin for teens. I imagine there are reasons to avoid Ambien, but maybe not. If it were up to me, she'd take xanax (a true life-saver for me), but I well know many docs won't even consider benzos.
>
> 3) What about the hormone approach? Another theory (or denial strategy) is that the combo of a real life disappointment and raging hormones could be at the root of this. Maybe birth control pills would attenuate the emotional roller coaster.
>
> 4) Any other suggestions?
>
> Gotta say, this is HELL. Poorly timed hell, as well, in terms of a great student's college potential. Six weeks ago I had a well-adjusted kid who was looking forward to "the best year yet." I now have a heart-breakingly miserable child who's missing at least one of day of school a week, struggling academically for the first time, and feeling extremely unsupported by her friends (which may or may not be true). Some days she's stone-faced, some times she cries all day. It happened so fast... and she's sunk SO frighteningly low. Any and all advice deeply appreciated.
>
Posted by Gee on October 6, 2008, at 20:23:36
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
Have you tried asking her if she wants to try medication? Maybe she feels it's bad enough to want to try something to make her feel better or maybe she doesn't feel it's bad enough. Talk it over with her. Ultimately it's her body, and she's the one who has to be in charge of taking the meds other wise it'll be a constant battle. Also, if meds is the way you guys decide to go, ask your t for a referral to a pdoc that specializes in kids and teens.
Just some thoughts. She's lucky to have a mom who supports her
Posted by Nella on October 7, 2008, at 0:20:19
In reply to Re: Depressed 16-yr-old. Help?, posted by greywolf on October 6, 2008, at 20:05:19
> IMHO, you want to stay away from all meds with a 16-year old unless they become absolutely necessary. In my view, what you need is a good therapist, particularly one who has experience dealing with athletes.
>
> I have 2 kids who are considered by others to be "elite" athletes in lacrosse and football. The only advice I EVER give them is to grab them by their face masks and demand that they go out there and, come hell or high water, HAVE FUN. We keep the elitism in its place--other people's houses.
>
> As I'm sure you also do, I work hard to instill the understanding that their performance on the field has nothing to do with their value as people. Unfortunately, societal pressures too often overwhelm that message. A good therapist with a background in working with sports figures should help as much or more than meds in that area.
>
> Greywolf----------------------------------
A sports therapist would be great. I had no luck finding one through my insurance company. And I'm sure I sounded strange to the shrinks I phone interviewed by asking how much they knew about sports.Fortunately, the school counselor recommended someone who understands the school's "hothouse" sports mania. My daughter likes him and is going twice a week. He's been talking drugs from the get-go cause she looks so depressed.
All I can say is she was not like this six weeks ago. The change in her confidence and demeanor is frightening.
So I'll vent. I DO think the school brainwashed my kid into thinking performance is a measure of her value. I AM angry at them and angry at myself for not seeing the risk of kid going "all out." They send packets home about the qualities they look for in Varsity players: scholarship, integrity, character, a good attitude... and somewhere around quality number forty they mention height and playing ability. I can't tell you how many times she's reminded me that "Tryouts aren't once a year. They're every day."
They claim to be looking at the "whole" person. (They aren't, BTW.) Problem with buying into that is then the "whole" person is rejected. I'm not a sports person, and after seeing the wreckage, I think these hyper-competitive programs are crazy. Adolescents have enough stress: public rejection the first day of Junior year serves no academic purpose whatsoever.
She got two recruitment letters from top 20 D-1 colleges on September 1 -- the first day college recruiters are allowed to contact players. She can play in college. Meanwhile, she's viewing high school as a two year death march through AP courses she's no longer interested in.
It's her problem -- or our problem: she's not the first kid to not make Varsity. But it sure zapped her spirit, with no easy solution in sight. I'm glad you can keep elitism in its place: IMO coaches work to make sports a "do or die" endeavor.
So confusing. On the one hand, it's just a dumb game. Then I see the agony in my kid's face and realize it was so much more to her. It's like we need a complete values overhaul, and I don't even know how we got here. I never passed a ball in a life; didn't even know what Varsity was. But I have valued her hard work and conscientiousness: bugs me that got slapped down.
Thanks for listening. I'm trying to keep a lid on my reactions at home. I had to learn how to manage depression; never realized managing a sweet, sensitive kid's depression would be harder.
Posted by azalea on October 7, 2008, at 18:53:52
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
Nella,
I wanted to alert you to a particular part of this website:
http://www.psycheducation.org/depression/02_diagnosis.html#softHere's the list of items which are found with bipolar disorder more often than you would expect by chance alone.
The first episode of major depression occurred before age 25 (some experts say before age 20, a few before age 18; most likely, the younger you were at the first episode, the more it is that bipolar disorder, not "unipolar", was the basis for that episode).
Posted by Nella on October 8, 2008, at 1:18:20
In reply to depression in teens » Nella, posted by azalea on October 7, 2008, at 18:53:52
You two are making me broaden my perspective.
Because I had early depression, I've devoted a fair amount of time to reading psych books in an effort to determine just how crazy I am/was. So I have a reasonable understanding of psych diagnoses. I've also had biases regarding bipolar distinctions and only paid attention to full-blown bipolar I -- which I'm certain I do not have, doubt my daughter has, and which a cousin undoubtedly has.
So due to your comments, I've been reading about bipolar II. Had an initial knee-jerk reaction along the lines of "who doesn't have it?" -- but am starting to connect the dots.
I now have no doubt both my daughter and I could easily be dxed with it -- especially me. I wasn't exactly looking for twin diagnoses, but certain pesky similarities are emerging.
At this point, I'm most interested in determining whether such a dx would be helpful. I've been willfully blind to bipolar meds, so I have to get educated. Every respondent has agreed that psych meds can be worse than the disease -- and I agree. But if they help, that's a different story.
I am also trying to sort objective from subjective criteria. Neither of us have ever had anything resembling a Kay-Jamison-type manic. But my daughter's spells of irritability that I've chalked up to PMS could easily be reframed. One of her Sophomore teachers mentioned concern about an episode of irritability, while acknowledging she is far more often regarded as an "easy" kid.
My reaction to SSRIs is indisputable. The standard dose (or even half) guarantees instant trouble. I'm now looking for info about how robust a measure of bipolar that is. A while back I saw some fascinating info here about SSRI sensitivity and one's ability to metabolize a certain enzyme. (Anyone know what I'm talking about? Can't recall the name of the enzyme.) At the time, I concluded I was a non-metabolizer, but bipolar I could explain SSRI sensitivity as well.
Sleep problems abound. I'm aware they're linked to all mood disorders. Long ago, I posited the theory that my internal clock runs on a longer-than-24-hour daily cycle: I can easily both stay awake and sleep longer than most people. Later, I read that is a bipolar trait. Kid has never been a sleeper. Most people would drop dead on her schedule. On the other hand, until recently, she's been uniformly far more stable and higher functioning than I was at her age -- far higher functioning than most kids.
So thanks, I'll keep reading. The big question is whether bipolar I meds are a help or a hindrance: and I guess trial and error is still the only way to know. We are still in a mess, and I thank you all for your support.
Posted by desolationrower on October 8, 2008, at 13:04:46
In reply to Bipolar II --) to azalea and phillipa, posted by Nella on October 8, 2008, at 1:18:20
You may be referring to the Cytochrome P450 enezymes in the liver, which includes specific enzymes with names like CYP1A2 and CYP2C9.
The fact that you say she is 'higher functioning' is perhaps indicative of bipolar too: there is speculation that a having a hyperthymic personality might make one more susceptible to depression. Sort of like if you are running an engine too hot, it can burn out. Of course, it can also just be too much stress causing depression.
Also, when i think of "bipolar I" meds i mostly think of lithium. Which might be helpful, for the depressive phase, but lamotrigine is really the gold standard for the mostly-depressive, cycling type of soft bipolar. And of the frequently prescribed antidepressants, bupropion is probably the least likely to worsen it.
Nella, have you tried melatonin personally? Regularizing sleep cycle could help keep your mood steady.
-d/r
Posted by azalea on October 8, 2008, at 15:01:31
In reply to Bipolar II --) to azalea and phillipa, posted by Nella on October 8, 2008, at 1:18:20
You raise an excellent question about whether such a diagnosis would be helpful. If you (and your daughter) experience symptoms consistent with bipolar spectrum, it's likely you will respond well to a mood stabilizer. The traditional bipolar meds do have side effects, which is likely why you've been "willfully blind." You might consider a trial of Lamictal (lamotrigine). Originally developed for epilepsy, it is now used frequently for bipolar maintenence. Research studies show it has powerful antidepressant properties, but is less effective for mania. This makes it a good choice in my mind, as neither you or your daughter have experienced full-blown mania. I'll also mention that a trial of Lamictal takes a while because you have to start at a very low dose (12.5mg or 25mg) to minimize the risk of a serious side effect called Stevens-Johnson Syndrome. SJS is a life-threatening rash that Lamictal has caused in some people. The risk is quite low, but not something to ignore. 200mg of Lamictal is considered the goal therapeutic dose and it can take 6-8 weeks to get there, depending on the titration schedule your doctor recommends.
Another positive for Lamictal is that it has been studied and approved to treat children with seizures. Although not FDA-approved to treat depression or bipolar disorder in anyone under 18 years, there is evidence it is a safe compound to use in kids.
Any questions, just post.
Best wishes to you and your daughter.
Also, perhaps the enzyme you're thinking of is cytochrome P450 2D6?
> You two are making me broaden my perspective.
>
> Because I had early depression, I've devoted a fair amount of time to reading psych books in an effort to determine just how crazy I am/was. So I have a reasonable understanding of psych diagnoses. I've also had biases regarding bipolar distinctions and only paid attention to full-blown bipolar I -- which I'm certain I do not have, doubt my daughter has, and which a cousin undoubtedly has.
>
> So due to your comments, I've been reading about bipolar II. Had an initial knee-jerk reaction along the lines of "who doesn't have it?" -- but am starting to connect the dots.
>
> I now have no doubt both my daughter and I could easily be dxed with it -- especially me. I wasn't exactly looking for twin diagnoses, but certain pesky similarities are emerging.
>
> At this point, I'm most interested in determining whether such a dx would be helpful. I've been willfully blind to bipolar meds, so I have to get educated. Every respondent has agreed that psych meds can be worse than the disease -- and I agree. But if they help, that's a different story.
>
> I am also trying to sort objective from subjective criteria. Neither of us have ever had anything resembling a Kay-Jamison-type manic. But my daughter's spells of irritability that I've chalked up to PMS could easily be reframed. One of her Sophomore teachers mentioned concern about an episode of irritability, while acknowledging she is far more often regarded as an "easy" kid.
>
> My reaction to SSRIs is indisputable. The standard dose (or even half) guarantees instant trouble. I'm now looking for info about how robust a measure of bipolar that is. A while back I saw some fascinating info here about SSRI sensitivity and one's ability to metabolize a certain enzyme. (Anyone know what I'm talking about? Can't recall the name of the enzyme.) At the time, I concluded I was a non-metabolizer, but bipolar I could explain SSRI sensitivity as well.
>
> Sleep problems abound. I'm aware they're linked to all mood disorders. Long ago, I posited the theory that my internal clock runs on a longer-than-24-hour daily cycle: I can easily both stay awake and sleep longer than most people. Later, I read that is a bipolar trait. Kid has never been a sleeper. Most people would drop dead on her schedule. On the other hand, until recently, she's been uniformly far more stable and higher functioning than I was at her age -- far higher functioning than most kids.
>
> So thanks, I'll keep reading. The big question is whether bipolar I meds are a help or a hindrance: and I guess trial and error is still the only way to know. We are still in a mess, and I thank you all for your support.
Posted by tepi on October 11, 2008, at 19:12:37
In reply to Depressed 16-yr-old. Help?, posted by Nella on October 6, 2008, at 3:40:52
> My daughter was the happiest kid on earth until puberty. Since then, the road's been bumpier, but that's supposedly normal. From time to time, I've been concerned about episodes of gloom, but it's always turned out to be PMS (albeit PMS on the lengthy side).
>
> She's a serious athlete and stellar student with no prior social or behavioral problems. About six weeks ago, on the first day of her junior year she did not make an extremely competitive Varsity team, and that clearly seems to have triggered the black dog of depression. Since then, she's been an entirely different kid and I am very concerned.
>
> Okay, I'm aware no advice given here is a substitute for a good shrink. On the other hand, so many posters know so much about drugs (and I am so lost) that I'd love some opinions/ideas.
>
> Kid started seeing a psychologist. Drugs have been mentioned. I don't know how long to wait, and I can't seem to parse the conflicting info on teens and ADs.
>
> My guess is a p-doc would start her on an SSRI. And maybe the only approach is trial and error. I haven't had much luck with SSRIs. I manage my own depression (which started young and at times has been severe) with micro-doses of Prozac as needed. I can't take it for months at a time: makes me too lethargic. And I definitely can't tolerate the "standard" dose. Makes me anxious and aggressive. So yeah, based on my experience I have reservations about SSRIs.
>
> Kid has always had trouble falling asleep, but no matter what she got up early and went to school enthusiastically. Now that she is indisputably depressed, she simply cannot sleep at night and cannot get up in the morning. I have to wonder if fixing the sleep problem would take care of many issues. The psychologist feels anxiety is a key problem...
>
> So my questions:
> 1) Anyone know the latest and greatest thinking on teens and SSRIs?
>
> 2) Any response to my sleep theory? I've read conflicting reports on melatonin for teens. I imagine there are reasons to avoid Ambien, but maybe not. If it were up to me, she'd take xanax (a true life-saver for me), but I well know many docs won't even consider benzos.
>
> 3) What about the hormone approach? Another theory (or denial strategy) is that the combo of a real life disappointment and raging hormones could be at the root of this. Maybe birth control pills would attenuate the emotional roller coaster.
>
> 4) Any other suggestions?
>
> Gotta say, this is HELL. Poorly timed hell, as well, in terms of a great student's college potential. Six weeks ago I had a well-adjusted kid who was looking forward to "the best year yet." I now have a heart-breakingly miserable child who's missing at least one of day of school a week, struggling academically for the first time, and feeling extremely unsupported by her friends (which may or may not be true). Some days she's stone-faced, some times she cries all day. It happened so fast... and she's sunk SO frighteningly low. Any and all advice deeply appreciated.
>
Hi Nella , I thought in my parents when I read your post. My problem started at that age too and they were very worried because of me. In some way I understand how you feel , just a little , I have seen how my parents have going through this with me and I have not enjoyed it too much
Im not a shrink and I havent read other babblers suggestions . I just can say that meds should not be first option ( It depends on each case of course ). Dr must decide but , sometimes docs only think in meds as unique solution in the beggining.
Its great you are following very close your daugther behavior . That will help to have more htings to say to Doc. My parent did not do this because they never thought the situation was that bad and also I alwayed tended to stay away from them, wich complicated my treatment and led me to some stupid things.
Stay close to her pls , even if she dont wanna talk or wants to be alone you can be near to her in other ways .
She is gonna be fine , she is so lucky you are with her
wishing you the best
tepi
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