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190559 tn?1280615967

17 year old daughter on anti-depression and anti-thyroid meds

I thought I posted to the doctor forum, but it didn't show up immediately, so I don't know if it went through.

My daughter was diagnosed 1 week ago with Graves and prescribed 10 mg. of Methimozole.  The trouble is, the stupid psychiatrist with 40+ years of experience didn't bother to read the family medical history and prescribed 20 mg. of Citalopram and .5 mg. of Lorazepam (as needed) 3-4 weeks before I insisted on checking the thyroid levels (her dad, older sister, and I all have hypothyroidism).  Anyway, my daughter who normally is a solid B+/A- student and an exceptional artist is reduced to crying herself to sleep, has vague thoughts of "disappearing", doesn't want to get better, feels like her head is exploding, and can't manage reduced homework at home with a homebound teacher.  Needless to say, my husband and I have set up a schedule in which she is always with one of us and she has healthy things to do at home like reading and walking the dogs with me.

I am worried that either the order of getting psychotropic meds first and then following with Methimozole OR a side effect of suicidal thinking from the Citalopram might be going on.  Does anyone have any experience with a teenager being diagnosed with both Graves disease and depression/anxiety?  I am hoping that the psychotropic meds will only have to be temporary.  Right now we have to wait 10 days - 2 weeks for both meds to kick in. Thanks.
18 Responses
Avatar universal
Bless you and your daughter.Have you got the thyroid tested yet.Mental health is so closley tied in with thyroid health as I have discovered.Let us know when you get her thyroid tests results back.I will keep you and your family in prayer amd bi polar myself with thyroid issues and I dont know now  which came ffirst.So now I am thyroidless and bi polar.

I would also take daughter to see an endocrinologist that specializes in thyroids as well as maybe changing the anti depressent.I take celexa that work wonderful with none of the side effects that come with other anti depressents.Just a thought .
Good luck and post back here on how it goes for your daughter.
LOve Venora
190559 tn?1280615967
   Thank you so much for your reply.  I posted an abbreviated version and realized I left out some details.  My daughter WAS referred to a pediatric endocrinology clinic after her TSH blood test came back with no level on 2/14, and by 2/23 (last Friday) I had my daughter in to see them.  The very kind and informative P.A. told us that there were no nodules, thyroid does not look enlarged on physical exam, but the continued no level reading of TSH and the numbers from the thryroid (sorry, I am new to this and couldn't follow all the details, but I'm going to get a book to try to get more of a handle on it) indicated that it was a generalized disorder in the thyroid that was overproducing thyroid hormones (as opposed to a problem with her pituatary gland or a pseudo-thyroid condition).  I am told the .5 mg. of the anti-thyroid med is a low dosage to start out.  We have to wait until March 16th (2 weeks) in order to get an accurate thyroid level from her blood test.
   My daughter also WAS prescribed Celexa (and we just got a generic form of it) by the psychiatrist.  I think I may be projecting my frustration over this whole situation with my daughter at this doctor.  He probably wasn't all that bad, but I just wish he had led the way on exploring a physical cause for my daughter's anxiety and depression.
   I find that it really breaks my heart when I see my daughter crying herself to sleep, etc.  She was in National Honor Society, lots of leadership clubs and taught Bible clubs for kids, and she was just awarded her 3rd silver key (a type of 2nd place group award) Scholastic art award in 4 years for a painting of herself that looks like a photograph from a distance.  Thanks for your encouragement, and especially your prayers.  We are Christians and believe that God answers our prayers.

Take care,

- Debbie
Avatar universal
I just wanted to add to give the antidepressent time to get the full effect.celexa takes about 4 to 6 weeks to really kick in.Maybe try seeing a therapist too will help.Its hard enoough being a teen without thyroid trouble,
I wish you the best.Keep posting this is a wwonderful forum.
Love Venora
190559 tn?1280615967
Thanks for your comments and resources.  I'll have to sift through them in the coming days and weeks.

Yes, my daughter is seeing a pediatric endrocrinologist.  She has the oversight of an M.D., but we are doing most of our communicating with a P.A. who is quite responsive to call back when I leave messages.  Yes, we did start anti-thyroid med treatment the same day my daughter went to the clinic.  Blood levels will be checked 3 weeks from beginning treatment and every month thereafter for at least a couple of years.

I don't understand one thing: you said that an antidepressant and anti-thyroid med should be taken hours apart, yet you said that the anti-thyroid meds do not interfere with the anti-depressant.  I'm going to ask the psychiatrist on Tuesday.

We are doing our best to keep our daughter from stress.  Even before we knew about the thyroid problem, my husband and I sensed that we needed to keep the stress down, so we took her out of school for 2 weeks.  She continues to stay out of school and we now have a "home bound" tutor who can meed our daughter at the public library, but we are having our doubts that she can even keep up with that.  She may have to take 2-3 major classes in the summer and just be content to keep up with her art class.  For now we have her stay home and bake cookies, etc. while someone is home with her.

Thanks,

- Debbie
Avatar universal
P.S. Just in case someone reading this thread makes a comment aimed directly at me, I want to say that I do not have internet access at home, which is where I am headed now. If I had read someone else's description of depression that was similar to what I wrote this afternoon, and if the person then became completely silent, I would feel a little unnerved. ;o)
Avatar universal
One of the symptoms of antidepressants for children and teenagers is suicidal thoughts  and  your health provider should be notified if your daughter is having these thoughts, as you no doubt already aware of. Perhpas your daughter would do better on a different brand of antidepressants or a combo to two types. Unfortunitly the younger the thyroid patient the more symptoms and the harder the symptoms hit. It is not unusal for even adults with thyroid issues to become depressed and need antidepressants to help get through the rough spots of thyroid.  Thyroid meds and antidepressant should be taken hours apart from each other. Plus thyroid test are done  regurally and adjusted accordingly, the two medications should not interfer with each other. However, it is important that her thyroid treatment should not be delayed or put off. Keep her mental and physical stress at a minimum because stress can have an impact on her conditions, both thyroid and depression.

I hope you are going to an Endocrinologist for her thyroid issues, one who works with many thyroid issues/patients per year and perhaps one experienced in child/teen thyroid problems.
Also get copies of her test (TSH, FT-4 and FT-3) with Labs reference range, in which you can keep up with her thyroid progress and have more of an input to her treatment and doctor.
This is not an easy situation for adults, let alone for teens and their family. Get the right medical that fits each condition, and, be patient and understanding.  Like I said this is not an easy situation for all involved.

Below is all my resources, I hope they will be of some help to you (family) and your daughter.

Good Luck!


Children With Graves'  Disease  
http://www.emedicine.com/ped/topic899.htm
Pediatric Page on Thyroid Disorders in Children - from California ... A Brief Synopsis
http://www.cpmc.org/advanced/pediatrics/physicians/pedpage-105endocrin.html
Graves' Disease (Hyperthyroidism)
http://www.thyroid.ca/Guides/HG09.html#6
Clinical Trials Resource Center - Thyroid Disorders in Children & More
http://www.centerwatch.com/ctrc/MagicFoundation/
Children with thyroid conditions can be ostracised by their classmates -
stories from children / young people with the condition
http://www.chronicillness.org.au/invisible/thyroid_b.htm

8 year old Katies Graves' Disease and RAI Story              
http://www.lehman.cuny.edu/faculty/jfleitas/bandaides/katie.html  
14 year old young lady's Graves' Disease and surgery story
http://www.thyroid.org.au/Stories/Graves14.html
Jenny Moore - Fifteen year old who has leukemia and thyroid cancer
http://members.aol.com/romachavo/Page_2x.html
This is a site about growing up with medical problems ...any ole type. Its goal is to help people understand what it's like, from the perspective of the children and teens who are doing just that. These kids have become experts at coping with problems that most of you have never heard of. They'd like you to know how they do it, and they hope that you'll be glad you came to visit. I've divided the contents into three ponds; one for kids, one for teens, and one for adults. Figure out which you are, and jump in!
http://www.lehman.cuny.edu/faculty/jfleitas/bandaides/index.html
Thyroid Disorders in Children
http://members.tripod.com/~TDmagicmom/main.html



Just my personal opinion and/or experience. Always discuss your health issue with your doctor , always adhere to your doctors advise and, you always have the right to a second opinion. Nothing is a 100% or a 100%, 100% of the time. However, we are not all alike!

GL,
1990 - Hyper/Graves'
1997 - Dia/RAI
1997 - MVP - Mitral Valve Prolapse
1999 - TED - slight Thyroid Eye Disease
1999 - Visible Nodule (suspect Marine-Lenhart-Syndrom/hyperfunctioning nodule)
2000 - SAS  - Short Attention Span (short, spaced paragraphs, sweet and to the point helps)
2002 -  IED  - Intermittent Explosive Disorder (Graves' Range)
2007 -  A/ITP (suspect)
Avatar universal
Debby, What I meant to say, if the two medications are taken hours  apart from each other they should not effect each other or at least very little.   However, once antidepressants are taken into consideration with thyroid med. adjusted to compensate, the two  medications should be ok. The main issue is consistency.  Once the consistency is broken, regardless what it is,  then med. dose might need  readjustment to reflect or compensate for it. But you are correct in asking your doctor.
A lot of us Gravers who are either taking ATDs or T4 are taking antidepressants with thyroid meds. and levels compensating for it.

Your daughters healing is more important right now, so if she gets behind in school/work, so be it, there is always tomorrow for make-up/catching up.  Get her well first or at least on her way to wellness.  Tell her to keep baking cookies, but what I'd like to know who is eating them all ;)

God Bless you all and a speedy recovery to your daughter.

Just my personal opinion and/or experience. Always discuss your health issue with your doctor , always adhere to your doctors advise and, you always have the right to a second opinion. Nothing is a 100% or a 100%, 100% of the time. However, we are not all alike!

GL,
1990 - Hyper/Graves'
1997 - Dia/RAI
1997 - MVP - Mitral Valve Prolapse
1999 - TED - slight Thyroid Eye Disease
1999 - Visible Nodule (suspect Marine-Lenhart-Syndrom/hyperfunctioning nodule)
2000 - SAS  - Short Attention Span (short, spaced paragraphs, sweet and to the point helps)
2002 -  IED  - Intermittent Explosive Disorder (Graves' Range)
2007 -  A/ITP (suspect)
Avatar universal
Dear Debbie,

In your first set of comments, if you were projecting your frustration at the psychiatrist, who could blame you? I can only imagine the heartache you are feeling as you see your beautiful, accomplished daughter suffering to such a degree.

I am VERY glad that she is being seen at a pediatric endocrinology clinic that you are happy with, I think. At least, I had a sense from your comments that you think your daughter is getting good care at the clinic, and that matters immensely.

In case it is helpful to you, to your daughter, and/or to your husband, I am writing with a comment about thyroid problems and emotional symptoms. Before I was diagnosed with mild hypothyroidism, I knew intellectually that psychiatric symptoms could have a solely physical cause, but I had no firsthand experience.  I had spent a long spell in psychotherapy in my 20s because of my upbringing (in a definitely dysfunctional family, even though the term was not yet tossed around in those days). I certainly knew what depression was like--even severe depression--but in my life, it always had come from an emotional scar that needed to be healed, and it always had faded away as the healing was accomplished.

Fast forward more than twenty years: Long out of therapy, and after a lot of personal growth and seeking of the path that God intended for me, I was in the happiest time of my 55 years of life when my hypothyroidism was diagnosed. I still felt relatively well, both physically and emotionally, when the diagnose was made. In addition, I had never known what it was like to have my mood affected by hormones. I never had PMS, for example. I understood that many women were tearful or grumpy or otherwise affected emotionally by their reproductive cycles, but I could not imagine what it would feel like to go through it.

That was then; this is now. As symptoms of hypothyroidism began to creep in, I was amazed to learn how thoroughly a person's mind can be messed up by a body part that is not even as big as a box of teabags. When one of my thyroid medication increases caused me, after a few days, suddenly to snap back to being my usual self, I looked backward in time and jotted down all the cognitive and emotional effects that my thyroid problem had just finished (for the time being!) having on me. The sheer length to which the list grew was a little startling.

I am blessed by having the sense of perspective that comes with being 56 (a number that does not gibe with the 55 I mentioned earlier, because I have had a birthday since my hypothyroidism diagnosis). I feel deeply for your daughter, and also for you and your husband as you support her through this difficult time, because I remember so well what it was like to be an adolescent and find it difficult to imagine that I ever would feel any different from what I was feeling at that moment.

Coincidentally, I have spent this week developing the symptoms that--through five increases in my thyroid medication--I have learned to recognize as signaling a need for another increase. My endocrinologist says that although my pattern is unusual, he sees about two patients a year who have it: a pattern of increased well-being followed by a return of symptoms. For me, it takes four weeks before my thyroid gland seems to realize that although it appreciates the medicinal support I am providing for it, it is not getting enough.

All day long, I have been so depressed, I have felt as if I could barely hold my head up. I am deeply depressed because of...nothing..absolutely nothing. It is THE weirdest feeling in the world. As was true a few months ago, I definitely am in the middle of the happiest time of my life.  Needless to say, it is extraordinarily bizarre to feel that I have little reason to go on living when all I have to do is look at the objective facts of my life and know how ludicrous it is to feel even mildly sad, for I am a woman who truly has it all (with the exception of a fully functioning thyroid gland).

A large part of what gets me through these times, until the next medication increase has a chance to have an effect, is knowing that my feeling is not real, even though it feels as real as any down-and-out depression that I experienced during the most difficult times in psychotherapy. As I said, I wanted to tell you this in case it is helpful to your family. Knowing that feeling completely down and out is not "real" does not at all reduce the feeling. Your darling daughter probably will continue to cry herself to sleep until her medications have had a chance to have an effect. Maybe it will help her, though, to be reassured that her awful feelings will not last, and there is nothing she has done (or failed to do) to get herself into this situation.

I say that because at first, my common sense wanted to argue that I could not be feeling so terrible over absolutely nothing. Now I know that I certainly could, and your daughter obviously is, too. I agree with Venora. You might consider some counseling for your daughter, just as another form of support until she is through this really horrible storm and has walked into the sunshine again. Counselors are a wonderful resource for helping with life's difficult times, not just for "making repairs."

Sending you a hug and a prayer,
Jenny
Avatar universal
One more P.S. I will be back on Monday, is what I meant to say in my last comment, but I will be silent until then. By the way, Debbie, I feel SUCH empathy for your daughter's struggles with her schoolwork as well as for her heart-wrenching depression. As you can see by my having needed to write a postscript to my postscript, I currently have a thick layer of fuzz around my brain, which I think is a common experience for people with a thyroid difficulty. If a person is doing something academic (which I need to do in my line of work), it can be impossible to even begin to keep up.

As so often is true, GravesLady had a very wise comment to make. There is always tomorrow for catching up with whatever a thyroid problem has forced a person to allow to slide. All that matters now is concentrating on the journey back to wellness. It sounds as if you and your husband see that clearly, which is a true blessing for your daughter. Cookie-baking sounds like a perfect occupation for your daughter at this point. I agree with GravesLady, though; I wonder who is consuming the finished products!
Avatar universal
Once your daughter gets properly treated for Graves' disease, and at the correct thyroid levels for her to feel her best through thyroid medication, she will be so much better.  She might temporary need a little antidepressants to help her through the rough areas of Graves' or she she may not.  The treatment and thyroid meds may be all that she needs.  Believe me this is not an easy disease, and it can effect every aspect of our body and  mind. Only a Graves' person really knows what this disease is truly like.  However, it is treatable and it does get better.
There is light at the end of the tunnel for your daughter and with your help and wisdom, the help through God, prayers and positive thoughts,  she will get through it, and, with a smile too.

If you have any more question or concerns, we are here.

God Bless.

Just my personal opinion and/or experience. Always discuss your health issue with your doctor , always adhere to your doctors advise and, you always have the right to a second opinion. Nothing is a 100% or a 100%, 100% of the time. However, we are not all alike!

GL,
1990 - Hyper/Graves'
1997 - Dia/RAI
1997 - MVP - Mitral Valve Prolapse
1999 - TED - slight Thyroid Eye Disease
1999 - Visible Nodule (suspect Marine-Lenhart-Syndrom/hyperfunctioning nodule)
2000 - SAS  - Short Attention Span (short, spaced paragraphs, sweet and to the point helps)
2002 -  IED  - Intermittent Explosive Disorder (Graves' Range)
2007 -  A/ITP (suspect
168348 tn?1379360675
I know you are offline 'til Mon but wanted to share that a few yrs back I was going thru awful perimenopausal symptoms (with normal TSH, etc.) and I would be depressed for 4-5 days a month just as you describe .. would cry, take things very personally, unable to concentrate, etc., etc.  

They tried Prozac and it was not good for me .. did nothing to help and caused side effect of eyes not moving smoothly (weird, huh?) ..

I just want to say that mine was female hormonal driven (not thyroid in my case) and the the feeling was awful .. just awful .. and reading your post reminds me of just how I felt and was so so sad yet not sad about anything and no need for therapy bcz there was nothing lurking ..just down and depressed yet not true depression & would lift after my monthly cycle (like you .. afetr that homone level rose in system and in your case with increased meds)!  

That period of time has gone away and I oftentimes recall how awful I felt ... I wish you could jump start the med increase sooner vs. later so you can feel better .. it is amazing how the thyroid can do such things to our emotions!

Cheryl 47 for another few weeks :)
190559 tn?1280615967
I realize that you are offline until Monday, but I wanted to answer you back.  Thanks for all that you shared.  You might be glad to know that my daughter DOES have some good times during the day.  She followed her dad's schedule today and seemed to avoid any overt stress, so I count that as a victory.  She also markedly perks up with her 12 year old sister (even though they are nearly 5 years apart, they are extremely close and have a great time together).

In reading posts from you and other folks I realize how fortunate I am.  I did suffer from depression from the time this daughter quit nursing at 8 months until she was 6--but a very small dose of amitriptyline (25 mg.) has controlled my depression and suicidal thoughts quite well for almost 11 years.  Also, I was diagnosed with hypothyroidism about 8 years ago and have been very stable at .075 mg. with no noticeable symptoms since I started the meds (even if I switch to generic brands).  I seem to be in perimenopause right now, but it doesn't seem to affect either my depression or thyroid.

Thanks and God bless.

- Debbie
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