Depression and/or Anxiety

[pattig]

My daughter has been having a lot of physical symptoms that the docs can find no reason for.  We are about to start seeing a psychiatrist.  Will the psychiatrist be able to determine if her "somatic disorder" is caused from depression or anxiety.... because she doesn't seem to have either.  Is there different medications for depression and anxiety?  And will there also be psychotherapy involved.  I really don't want my daughter depending on drugs, but I think it may be the only way to help her.  How long does treatment usually take?  Again, I don't think she is severely depressed or anxious, but every single day, she has head pressure, dizziness and sometimes nausea.  She is very hyperfocused on physical symptoms and even after many many tests and bloodwork, she still thinks there may be something seriously wrong with her.

She is a senior in high school, is very very smart, has excellent grades, got accepted to every college she applied to and I am so afraid she may not be able to start college in September due to these problems.  They have been going on for about 7 months now.

Thank you.

[misssleepy]

and by tha way
i took paxil for a year and it did help me alot. And i still dont find in your comments what your daughter thinks about that.

maybe just having some pills ex clonasepane can help, they are just to take in case of anxiety, if she take it and feel better, its a good sign that physicaly is reliate to mentaly.

when you start an antidepresser you start at a really small dose. and gradualy get higher only if it makes you feel a little bit better after couples of weeks. If not you just stop it.

i know some people had trouble quitting paxil but for me i had no probleme and i took it for the first time one year 10 mg when i was 14 years old.

[misssleepy]

just pass by to say, i had and still have those symptomes. Since 3 years, my mother and I are looking for answers but its hard to find. I feel better now, i did return to school but gradualy.

I didint stop school at the good time even if a psychiatrist told me to stop and go in consult day groups. I was so afraid of quitting school cause it s my life and i didnt want to disapoint my family. After a realy hard year, crying because how i feel physicaly and feeling stuck in my head. I think that i am more close to my mother now than i had ever had. first she didnt want me to quite school because she was worried for me. than she did and i did understand that what is realy important is getting better for good. Wish sometimes require some other issues than our first tought.

My family doctor and therapys agreed for me to pass a scan. I felt way better after being sure that nothing was wrong.

We are still looking for the reasons of my physical states but i am way better now 3 years after. My consuling with therapist had help me alot to realise that even if i dondt tought i was, i was suffering from general anxiety.

best luck, just be there for her and show her how you love her for who she is what ever  what she do ,)

[Hensley258]

Sounds like a good plan. If she does end up trying medication, then make sure she starts slow. Some P-docs have a bad habbit of starting with too high a dosage which can cause some uncomfortable side effects for the first few weeks.

Start low for the first few weeks. The dosage can always be raised if results are not being produced. This approach gives the patient some head room and allows the body time to adjust.

I only take the smallest dosage nessasary to produce results. For example when I changed to Lexapro my P-doc wanted to get me up to 30Mgs in only 10 days. I went slow and found that 20Mgs does the same job with much less side effect. More is not always more effective with this stuff.

[pattig]

Hi Hensley, yes I do already have the psychiatrist visit scheduled, tomorrow.  I am going to take her anyway.  I'll let you know how it goes.  If she prescribes meds and I am not comfortable with that I can always get a second opinion with a psychologist.  As I said before the facility is a large mental health group, so there would be other resources if this route doesn't seem the best.

[Hensley258]

Ahh, now I understand what you ment. You are much more informed that what I thought.
You are wise to seek the opinion of a good Psychologist first. No doubt about it.

You are correct in that, if you first take her to a Psychiatrist then the first corse of action may be medication.

It is always wise to first try to correct the condition without the use of meds. If meds are nessasary then so be it, but therapy alone should always be tried first.

I had thought that you already had your daugher scheduled to see a Psychiatrist.

Keep meds and the help of a Psychiatrist on the table, but try the no medication approach first. With this approach you have nothing to lose.

If it comes down to Medication as the last resort, then please do not hesitate to have her try them. I know you hear a lot of horrer stories about medication, but if prescribed by a good Psychiatrist that knows his stuff, then it's the best last resort.

[xanweaner]

It's my opinion that I would bring my child/teenager to a clinical psychologist (ph.d.) for an evaluation first.  A well-trained psychologist can determine if medication is warranted, as they work as part of a medical team.

I believe that your trepidation is warranted. It's well documented that psychiatry has become a medical practice that utilizes drug management in large proportions. If the psychologist feels that your daughter requires drug intervention, he/she will refer her to the psychiatrist for an evaluation. I know you want to ensure that your daughter receives the proper medical treatment and care.

If I'm not clear, I would start FIRST with a psychologist, preferably one with a ph.d. and experienced with dealing with children and adolescents.

Good luck,
xan

[pattig]

Maybe my last post was confusing.  I am questioning my decision to start with a psychiatrist vs. a psychologist.  If my daughter doesn't need medication, will the psychiatrist refer me to a psychologist?  I don't want to start with the most aggressive path it maybe she doesn't need medication.  I am not against medication, just don't want her to receive it unnecessarily.  Should I rely on the psychiatrist to determine this?  Or is that all they do, prescribe meds?  Will they automatically think meds, and not so much therapy?

So I guess the bottom line of my question is, is it better to start with a psychiatrist or a psychologist to evaluate all the symptoms physically and mentally and tell us whether or not medication is needed or not and which doctor we should continue to see.

Thank you all again.

[Hensley258]

I have to agree with Xanweaner. She may not even need medication, but this must be looked at as an option if nothing else works.

I can truly understand that you don't want your daughter taking any medications for her illness, but I must ask.... If your daughter was suffering from cronic high blood pressure, would you allow her to take medication for it? Mental illness is no different in the sence that it often requires medication.

Much of this is speculation anyway, considering that your daughter has not yet been diagnosed with depression, OCD, anxiety, ect...

This could turn out to be something other than a mental illness.

I'm just saying that if it is related to a mental illness, and therapy alone produces no result then it wouldn't be fair to let her suffer. Not to mention that any type of un-treated mental illness can eventually have disasterous results if left to fester.

When considering treating this illness with medication you must first determine if the benifit of taking medication, outweighs it's dis-advantages. If it does then the choice is clear.

Just because someone has to take Psycotropic medication for their dissorder does not mean they will be strung out on drugs. Medications for OCD and depression just don't work like that. If they did then I know I wouldn't take them for my condition.

Sometimes these medications are just used temporaraly, to help the patient get more out of their therapy. To get over the hump so to speak.

Either way, all options must be considered. To suffer needlessly is not an option.

Please let us know what the P-doc says after her evaluation.

Hope she feels better soon.

[xanweaner]

It's my opinion that I would bring my child/teenager to a clinical psychologist (ph.d.) for an evaluation first.  A well-trained psychologist can determine if medication is warranted, as they work as part of a medical team.

I believe that your trepidation is warranted. It's well documented that psychiatry has become a medical practice that utilizes drug management in large proportions. If the psychologist feels that your daughter requires drug intervention, he/she will refer her to the psychiatrist for an evaluation. I know you want to ensure that your daughter receives the proper medical treatment and care.

I tend to prefer a more conservative route as that tends to be my nature. However, I personally take (and have taken in the past) an AD and drugs for anxiety. These were a critical part of my medical treatment as my depression and anxiety were severe and debilitating. There was no question that I needed drug intervention. From the description of your daughter's symptoms, I would tend to first get the psychologist's opinion first and take the proper course of action after their evaluation.

I know how difficult this must be for you. If my son was suffering, I know this would be the route that I would take if all the medical and diagnostic evaluations could not show a cause of his symptoms.

I wish you the very best in your daughter's recovery....

[pattig]

So I have been reading more and more regarding depression and I am now very nervous whether or not I should be bringing my daughter to a psychiatrist.  Is medication their only course of action?  I thought they would also engage in therapy.  Should I be taking her to a psyhologist first to see if medication is necessary?  If we go to a psychiatrist first will medication be the first choice.

I am very uncertain what to do .  Meanwhile every day my daughter is in severe pain.  I know I need to be her advocate as she is only 17.  

[pattig]

Thank you everyone for your replies.  As you can see though I am getting some conflicting advice here.  I know you all have your own experiences to share and I will take all the comments and try to figure out what we think is best for my daughter.

My husband and I met with a psychiatrist last week and daughter has a first meeting with her next week.  The psychiatrist is part of a behavior health center that also has psychologists, social workers and psychotherapists.  So perhaps after the first meeting next week I will discuss the treatment options, medications vs. no medications, etc.  As I mentioned before, I really don't want her to be dependent on drugs if not necessary.  

Again, I appreciate your time and words of advice.

[hope_for_more]

As a parent I know how hard it can be to know what to do.  My daughter has been dealing with anxiety and depression triggered by a physical illness well over a year ago. I came to this board because of my own daughter.  

If I'd known six months ago what I know now I'd have started her in therapy with a psychologist before she started on antidepressants.  We did pursue the possiblity of an underlying medical cause for her anxiety and depression (which was triggered by a physical illness) and believe she had lymes which has now been treated. She is weaning off an antidepressant that I don't think she probably needed and is seeing a therapist to work through all the problems that have come up because of her situation (loss of special relationship because of all this, inability to succeed in school where she's always done well and more).  Dealing with the doctors has been frustrating at times.

So I say be an advocate for your daughter and follow through on everything you can think of.  

[robkfromphilly]

I was there myself once. It doesn't sound so much like depression as it does anxiety complient on an OCD complex. The constant wondering about the future, the strive to push foward, and the 'thinking of the worst.' Maybe a few weeks in Cognative Therapy would best suit, rather then medication. And if medication is necessary, I think perhaps a small dose wouldn't be bad at all. Again, a lot of kids this age and time of life experience this, its totally natural. I think maybe keep her, and yourself off of google (looking up symptoms), and work with her and a therapist, for however long it takes, maybe sooner, maybe later, but I think this is a part of life, many go through. Just my two cents.

[Hensley258]

Sometimes symptoms of clinical depression can start with the effected person complaining of head pressure, dizziness and sometimes nausea.

I'm not saying for sure that that is the case with your daughter, but it is a possibility.
I was also very young like your daugher when my first symptoms of Severe Uni-polar Depression and Anxiety manifested, and head pressure (deep inside my head) dizziness and nausia were some of my most profound initial symptoms.

I had also been convinced that I was sick or that I was suffering some undiagnosed physical condition. Unfortunatly after months of just about every test known to man, I was found to be physically healthy.

Months later my symptoms developed into a deep depression and elevated anxiety. I then became uninterested in taking part in life simply because I felt so horrible all the time. I think you are very wise to have her evaluated by a Psychiatrist.

This may not be depression in her case, but there is a good chance it could be and a good psychiatrist should be able to determine this.

As for the treatment of clinical depressive and anxiety dissorder..... there is no cure, BUT it can be treated and managed. In most cases this condition is a lifelong affliction, but with proper treatment it can be put back in a remissive state. That doesn't mean that it is gone forever though.

Oh, you mentioned how smart and intelligent your daughter is. Try to understand that clinical depression can effect anyone. Some of the most brilliant people in the world suffer from depressive dissorder. For example, I am a sufferer myself and I have a tested and confirmed IQ of 132 which is well above average. Of corse when my condition was at it's worst, I had alsot of difficulty with my focus and concentration. In the later stages clinical depression makes it very difficult to concentrate and you don't feel sharp because your mind is pre-occupied with anxiety and irrational worry.

I just didn't want you to think that if your daughter is diagnosed with depression that she is somehow mentally defectve. Depression is just a disease, it is not the sum of our being.

If it does turn out to be depression, then educate yourself about this condition. This is the best way for you to help her. This condition is often frustrating for sufferers to describe because often it's symptoms can be kind of bizzar and hard to describe.
Trust me when I say it is painful beyond words for the person that is suffering it.
I know it's doesn't sound logical because for a non-sufferer it's easy to think, "whats the problem? her life is fine and she has no reason to be depressed."

It's a lot different than normal sadness. It's a dispair so deep and so powerful that it actually physically feels like your brain is bursting. Mine was so bad that I had actually convinced myself that I was going insane, even though that was not the case.

Just be supportive and don't expect to understand exactly how it feels. The symptoms of this condition are absolutly impossibe to understand if you are not also a sufferer.

Not only that, but they are hard to describe in a way that a non-sufferer can actually understand. It's kind of like explaining color to a lifelong blind person. It just cant be put into words.

Just try to understand that her pain is very real and not just something she can will to make stop.

I hope that helps you a bit in understanding the complexity of this most bizzar condition.

Don't worry! if it is severe depression then she can and will feel better. Just make sure she gets the help she needs.  

Keep us updated.

[xanweaner]

First off, I am so sorry about your daughter and how she is feeling. What a difficult time she must be having - suffering throughout her senior year and wondering if she has the ability to start college in September. She's a high achiever, and I'm sure she's putting pressure on her inability to "perform" right now.

I understand why you're considering a psychiatrist, but I'm concerned that psychotherapy might not be as intensive as she might need and benefit from. These days, psychiatry is heavily involved in drug prescribing and management. It seems that the good ole days of psychoanalysis have taken the back seat to the prescription pad and sampling of the latest drugs.

I would look for a psychologist (ph.d.) who specializes in adolescents right away, possibly before I'd consult a psychiatrist. I'm assuming that she's still attending high school?
Her problem may be handled most effectively this way, and the psychologist can better evaluate if drug management is required.

Another factor - would she be going away to school? Who would be treating her at her new location? There are a lot of factors to consider, and I wish the very best to you in helping her find the root cause of these physical symptoms.