Advice on medicating or not medicating a pre-teen?
May 23, 2018 3:32 AM Subscribe
Just curious about the experiences of others dealing with a kid who exhibits symptoms of OCD (and perhaps a related eating disorder and depression..), but it's hard to tell because the kid isn't quite cooperating.
We've been to a couple therapists so far. Last one said she would recommend medication, but before we go down that route... Maybe I'd feel more comfortable hearing about anyone else's experiences with a 12yo or as a 12yo who is now older and wiser? Any advice? Obviously, not all medication is the same, but starting as a 12yo sounds so early to us. We don't quite know how to judge the difference between "acceptable moodiness" of a pre-teen and whatever is going on right now. Last therapist also suggested some kind of "self evaluation" test to try to pin down the diagnosis, but if the kid isn't forthcoming -- we're totally unsure how that will work.
We've been to a couple therapists so far. Last one said she would recommend medication, but before we go down that route... Maybe I'd feel more comfortable hearing about anyone else's experiences with a 12yo or as a 12yo who is now older and wiser? Any advice? Obviously, not all medication is the same, but starting as a 12yo sounds so early to us. We don't quite know how to judge the difference between "acceptable moodiness" of a pre-teen and whatever is going on right now. Last therapist also suggested some kind of "self evaluation" test to try to pin down the diagnosis, but if the kid isn't forthcoming -- we're totally unsure how that will work.
I can’t speak to OCD specifically, but I can tell you as someone who started meds and therapy at 18, that I deeply regret not starting on them when my first major depressive episode popped up, right around age 11-12. Those years were so much harder for me than they had to be, and I built up so many bad coping mechanisms that I still struggle with at nearly-40. I strongly suspect that I would be a very different and probably much happier person had I had professionals helping me learn better skills from an earlier age.
This is different for everyone, but for me, meds were what I needed so that the fog of my brain weasels could lift enough for me to actually engage with therapy and learn the skills my therapist was trying to help me gain. Therapy alone was not much use until meds were added. I wish I’d had the chance to try them much sooner.
posted by Stacey at 4:42 AM on May 23, 2018 [6 favorites]
This is different for everyone, but for me, meds were what I needed so that the fog of my brain weasels could lift enough for me to actually engage with therapy and learn the skills my therapist was trying to help me gain. Therapy alone was not much use until meds were added. I wish I’d had the chance to try them much sooner.
posted by Stacey at 4:42 AM on May 23, 2018 [6 favorites]
We don't quite know how to judge the difference between "acceptable moodiness" of a pre-teen and whatever is going on right now.
A good pediatric psychiatrist will. It's great that you've checked in with a few therapists, but it seems like you're not getting a solid diagnosis, so look into working with someone who can give you better answers.
posted by yes I said yes I will Yes at 5:06 AM on May 23, 2018 [4 favorites]
A good pediatric psychiatrist will. It's great that you've checked in with a few therapists, but it seems like you're not getting a solid diagnosis, so look into working with someone who can give you better answers.
posted by yes I said yes I will Yes at 5:06 AM on May 23, 2018 [4 favorites]
As a fourteen years old who went on Prozac, I can't recommend it. The side effects were terrible (memail me) and studies have shown that in some cases antidepressants are placebo-like, that some people would have gotten better on their own, and that they are extremely hard to get off of -- all of which was my personal experience as well. Also, they have a noted tendency to increase suicidal behavior in adolescents which was the case for me. I would focus on other behavioral changes (what is their diet like? Are they sleeping? Are they exercising?) before starting my 12 year old on antidepressants. It's just a terrible crutch in some cases. I'm now 26, and have enjoyed a healthy mental health for years now without antidepressants.
posted by tooloudinhere at 5:25 AM on May 23, 2018 [6 favorites]
posted by tooloudinhere at 5:25 AM on May 23, 2018 [6 favorites]
As a fourteen years old who went on Prozac, I can't recommend it.
As a parent who had to make the difficult decision to put their child on an antidepressant which literally saved their life, I cannot overstate enough that you talk to a psychiatrist about this and not use personal anecdotes in making a decision about medication. A good psychiatric evaluation will shed light on what's happening and will include discussion of sleep, diet and other healthy habits.
One of my kids was diagnosed with OCD when he was 7 after a suicide attempt. He went on medication, had CBT boot camp and a life-changing 3-month program at the OCD Institute at McLean Hospital in Boston. OCD can be crippling and what is really tricky about it is that as parents, we see external manifestations of the disorder, but what's going on in the person's head is so much worse.
Please take what you're seeing extremely seriously and get that evaluation. Do not dismiss it as typical adolescent anything and please don't look here for advice about medication.
posted by yes I said yes I will Yes at 5:50 AM on May 23, 2018 [36 favorites]
As a parent who had to make the difficult decision to put their child on an antidepressant which literally saved their life, I cannot overstate enough that you talk to a psychiatrist about this and not use personal anecdotes in making a decision about medication. A good psychiatric evaluation will shed light on what's happening and will include discussion of sleep, diet and other healthy habits.
One of my kids was diagnosed with OCD when he was 7 after a suicide attempt. He went on medication, had CBT boot camp and a life-changing 3-month program at the OCD Institute at McLean Hospital in Boston. OCD can be crippling and what is really tricky about it is that as parents, we see external manifestations of the disorder, but what's going on in the person's head is so much worse.
Please take what you're seeing extremely seriously and get that evaluation. Do not dismiss it as typical adolescent anything and please don't look here for advice about medication.
posted by yes I said yes I will Yes at 5:50 AM on May 23, 2018 [36 favorites]
Very gently, this is not a question that you can crowdsource the answer to - this is a question for the medical professionals who treat your child. If you do not trust their answers, then you need to prioritize finding providers who you do trust. Our anechdotal responses here are, by nature, relevant to our own personal experiences, and mental health and mental healthcare is so individual that it is very unlikely that you will get any real clarity here.
I am a person who started on an SSRI when I was 12. I absolutely believe the combination of medication and therapy early on is the reason I survived my teens and have excellent coping skills and a full, happy life as an adult. But! That in no way means that this is the right path for your child - it might be, it might not be, but this isn’t a question that an internet stranger can answer.
Please, please find medical professionals you trust and take their advice.
posted by cimton at 6:02 AM on May 23, 2018 [7 favorites]
I am a person who started on an SSRI when I was 12. I absolutely believe the combination of medication and therapy early on is the reason I survived my teens and have excellent coping skills and a full, happy life as an adult. But! That in no way means that this is the right path for your child - it might be, it might not be, but this isn’t a question that an internet stranger can answer.
Please, please find medical professionals you trust and take their advice.
posted by cimton at 6:02 AM on May 23, 2018 [7 favorites]
I am sorry tooloudinhere had a negative experience with Prozac, and it is too bad that she is using that one experience to warn parents of teenagers of ALL antidepressants. Antidepressants are not mental crutches any more than insulin is a crutch for your pancreas. Please know that antidepressants do far, far more good than harm. They have literally transformed my life into something that it never could have become.
When I was 10-13 I struggled hard, mentally, with what was undiagnosed depression and anxiety. Other people scared my mother off of medication and I didn’t get the treatment I needed until I was 25. I really feel like I lost 15 years of my life to poor mental health and I so wish my mom had been my advocate and pursued medication for me.
posted by pintapicasso at 6:18 AM on May 23, 2018 [10 favorites]
When I was 10-13 I struggled hard, mentally, with what was undiagnosed depression and anxiety. Other people scared my mother off of medication and I didn’t get the treatment I needed until I was 25. I really feel like I lost 15 years of my life to poor mental health and I so wish my mom had been my advocate and pursued medication for me.
posted by pintapicasso at 6:18 AM on May 23, 2018 [10 favorites]
Oh my word. My greatest regret in life is that no one saw and recognized the GIANT red flags I was throwing up my entire childhood and got me treated for bipolar disorder before I had a major crisis at 16. Looking back, it's so obvious, and I don't understand how no one, teachers, parents, parents' friends, did anything about it. Ditto with my eating disorder -- if I had gotten help in high school, it never would have gotten as bad as it did.
You can always try these things and then decide they aren't for you/your child.
posted by fiercecupcake at 8:09 AM on May 23, 2018 [4 favorites]
You can always try these things and then decide they aren't for you/your child.
posted by fiercecupcake at 8:09 AM on May 23, 2018 [4 favorites]
I began taking an SSRI anti-depressant when I was 14 and I believe that it was very helpful to me. The only advice about that I feel comfortable giving to anyone else, however, is that starting psychiatric medication at a young age isn't inherently bad. It's not a decision to make lightly, it might or might not be the right choice for your individual child, and you might have to work together with the psychiatrist for a while to find the right medication(s). But, it's not something to dismiss out of hand.
I had to start seeking out advice and treatment on my own as a young teenager because my parents dismissed my in retrospect obvious mental illness as "just teenage mood swings". This was not a good experience. Allowing a mental illness to go untreated at any age has longterm negative implications for quality of life—please don't do this to your child. Please keep seeking professional guidance about diagnosis and treatment options and keep advocating for his/her good mental health. If your child is indeed suffering from a mental illness you'll need to find a therapist and/or psychiatrist, as appropriate, that both you and your child feel you can work with and trust.
posted by 4rtemis at 8:57 AM on May 23, 2018 [3 favorites]
I had to start seeking out advice and treatment on my own as a young teenager because my parents dismissed my in retrospect obvious mental illness as "just teenage mood swings". This was not a good experience. Allowing a mental illness to go untreated at any age has longterm negative implications for quality of life—please don't do this to your child. Please keep seeking professional guidance about diagnosis and treatment options and keep advocating for his/her good mental health. If your child is indeed suffering from a mental illness you'll need to find a therapist and/or psychiatrist, as appropriate, that both you and your child feel you can work with and trust.
posted by 4rtemis at 8:57 AM on May 23, 2018 [3 favorites]
Jumping in to add that I had the same worry about my teen, with similar symptoms plus what looked like a major depressive episode. We took said teen to a pediatric psychiatrist. Dr did a full work up and then met with us and worked out the meds they had extensive experience prescribing for exactly what we're discussing here. You need a pediatric psychiatrist--and that person will be able to best tell you what your kid needs.
Sending you parenting hugs. Hang in there.
posted by Ink-stained wretch at 9:23 AM on May 23, 2018 [2 favorites]
Sending you parenting hugs. Hang in there.
posted by Ink-stained wretch at 9:23 AM on May 23, 2018 [2 favorites]
I would also make sure that while looking out for and doing the best for your kid, throughout this process you give them as much agency and ability to speak up, to discuss their own side effects, to have opinions, as you are reasonably able to. Not every treatment is perfect for every kid, not every med is perfect for every kid, and not every kid is allowed to speak to that. The sooner you get a system of care that makes them feel listened to as a unique person, that's really important. Don't have them look back on this time and feel like they had no leeway or freedom at all, because that can calcify into trauma.
posted by colorblock sock at 9:41 AM on May 23, 2018 [6 favorites]
posted by colorblock sock at 9:41 AM on May 23, 2018 [6 favorites]
You're not medicating the moodiness, you're medicating the OCD, of which moodiness is a symptom.
OCD is fucking torture for the person who has it, which in our family was my sister. The need to control and the repetitive behaviors and the stress around testing because she knew she'd never finish on time because she went back over her work so much led to huge rages. She was fully capable of speaking to nobody in the house for 4 weeks at a time. My mother refers to her teenaged years as the Stalinist Regime. We are, all of us, still traumatized 20 years later.
The meds made a HUGE difference for her ability to cope. I wish she'd started them earlier. It would have made her teenage years so much easier on her. The family patterns that were set in those years follow all of us still, and they are not optimal.
posted by DarlingBri at 10:12 AM on May 23, 2018 [5 favorites]
OCD is fucking torture for the person who has it, which in our family was my sister. The need to control and the repetitive behaviors and the stress around testing because she knew she'd never finish on time because she went back over her work so much led to huge rages. She was fully capable of speaking to nobody in the house for 4 weeks at a time. My mother refers to her teenaged years as the Stalinist Regime. We are, all of us, still traumatized 20 years later.
The meds made a HUGE difference for her ability to cope. I wish she'd started them earlier. It would have made her teenage years so much easier on her. The family patterns that were set in those years follow all of us still, and they are not optimal.
posted by DarlingBri at 10:12 AM on May 23, 2018 [5 favorites]
If your child was exhibiting symptoms of measles or strep throat, you would not allow them to opt out of medical care. Why? Because you recognize that those conditions are possibly fatal for your child.
The same is true of many psychiatric conditions. Please seek appropriate pediatric psychiatric help for your child. Not only because it may save their life, but because it will most likely improve their life.
posted by bilabial at 11:25 AM on May 23, 2018 [3 favorites]
The same is true of many psychiatric conditions. Please seek appropriate pediatric psychiatric help for your child. Not only because it may save their life, but because it will most likely improve their life.
posted by bilabial at 11:25 AM on May 23, 2018 [3 favorites]
Adding one more voice to the choir saying to please please please work with medical professionals and your child to get them help. And be willing to talk about it with them.
Signed,
Someone who could have used intervention and medication before their 30s, but didn't due to willful parental ignorance and poor stigma.
posted by RhysPenbras at 11:51 AM on May 23, 2018 [3 favorites]
Signed,
Someone who could have used intervention and medication before their 30s, but didn't due to willful parental ignorance and poor stigma.
posted by RhysPenbras at 11:51 AM on May 23, 2018 [3 favorites]
I'm another person who didn't start antidepressants until after 18 due to parental worries about medicating a teen. As others have said, it left me with permanent damage and unhelpful coping tactics.
It also massively disrupted my life (things like dropping out of college after spending most of Spring semester in my dorm room with the curtains drawn and eventually taking 10 years to complete a BA) in ways that, like compound interest, still affect me and will do so for the rest of my life. Where would I be in terms of career and income if I hadn't been struggling with major depression and instead could have developed useful study skills, finished college in the normal time, and had both interest in a career and the energy and practical abilities to do it? I try not to think about that much because it's too depressing.
Please talk with your child and with their medical professionals and make your decision based on that, not on what anybody who doesn't actually know you says.
posted by Lexica at 12:25 PM on May 23, 2018 [1 favorite]
It also massively disrupted my life (things like dropping out of college after spending most of Spring semester in my dorm room with the curtains drawn and eventually taking 10 years to complete a BA) in ways that, like compound interest, still affect me and will do so for the rest of my life. Where would I be in terms of career and income if I hadn't been struggling with major depression and instead could have developed useful study skills, finished college in the normal time, and had both interest in a career and the energy and practical abilities to do it? I try not to think about that much because it's too depressing.
Please talk with your child and with their medical professionals and make your decision based on that, not on what anybody who doesn't actually know you says.
posted by Lexica at 12:25 PM on May 23, 2018 [1 favorite]
Get the consult(s) ASAP.
OCD, eating disorders and depression are all very serious things and you need a full consult(s) to be able to create a treatment plan to move forward.
That plan should have your input, your daughters input and the professionals input. Especially when eating disordered behavior becomes involved inaction can lead to serious and permanent health consequences including death. (OCD and depression can lead to suicide as well.)
Any good treatment plan (medication or no)will 1) Give outlines of treatment strategies and expected outcomes in a timeline 2) evaluate at regular intervals for changes in care 3)provide crisis support 4) provide education to you and your daughter why this plan is the best plan based on her current symptoms.
posted by AlexiaSky at 9:54 PM on May 23, 2018
OCD, eating disorders and depression are all very serious things and you need a full consult(s) to be able to create a treatment plan to move forward.
That plan should have your input, your daughters input and the professionals input. Especially when eating disordered behavior becomes involved inaction can lead to serious and permanent health consequences including death. (OCD and depression can lead to suicide as well.)
Any good treatment plan (medication or no)will 1) Give outlines of treatment strategies and expected outcomes in a timeline 2) evaluate at regular intervals for changes in care 3)provide crisis support 4) provide education to you and your daughter why this plan is the best plan based on her current symptoms.
posted by AlexiaSky at 9:54 PM on May 23, 2018
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If your child were a diabetic, you wouldn't feel that twelve was too early to start insulin, right? Because it's an illness, and we treat illnesses with whatever tools we can access, generally speaking. Mental health is the same way, and as someone who has mental health problems and didn't get help as a child, I really believe that early intervention is, if not life saving, at least life changing. Please don't let the unreasonable stigma around mental health treatment, and pysch meds specifically, keep you from getting your child the help that they need.
posted by mishafletch at 4:09 AM on May 23, 2018 [18 favorites]