Depression concern in DS age 16

[Anonymous]

DS age 16 seems to have depression that started this year. Says he does not like school, does not talk a lot when at home, uses his phone too much, every few months he sits in a room and cries and says he doesn’t know why he is sad. Then the next day he says he is ok and he grinds through. When we ask him why he feels sad he says it isn’t school, friends, his sport, or relationship issues. He is in a high workload mcps school and does a sport year round that takes 3 hrs a day after school. He says the sport is the only thing that gives him a break, makes him happy and he enjoys the camaraderie of the team. In MS he was happy, got all As, had lots of friends and did not do this. Now he is in 10th, still getting all As but grades going down a bit from 90’s to high 80’s. Does not seem to be doing drugs because he would be worried about his sports performance. Husband’s siblings and their kids (his nieces and nephews) all have a host of mental health issues - ADHD, anxiety, drug and alcohol addiction/abuse, depression and one of his nieces attempted suicide in college. Spouse did not reveal any of this to me until several years into our marriage (unfortunately for me). Clearly DS needs to be evaluated - what are the first steps we should take ? Neuropsych evaluation? Any recommendations for psychiatrists in MoCo that you could recommend ? Will they start him on medication? Not sure where to start or how urgent this is. Any advice welcome - thank you !

[Anonymous]

Not sure what your husband's siblings have to do with this but, anyway, have you brought up the topic of therapy with your son? If he is willing, I'd definitely pursue that.

I don't see anything in what you wrote to suggest he needs a neuropsych evaluation.

He needs to be screened for depression and then possibly treated for it with therapy and maybe meds.

[Anonymous]

Does depression or anxiety have a genetic component? Maybe that is why OP brought up family history?

[Anonymous]

I think therapy is where you start. Also, emphasize nutrition, good sleep, multivitamin, time with friends and hobbies: self-care stuff. Try therapy and see how that goes. He may not need medication.

[Anonymous]

Anonymous wrote:Does depression or anxiety have a genetic component? Maybe that is why OP brought up family history?

It's pretty irrelevant. Depression can have a genetic component but also he's 16.

[Anonymous]

It feels like you are blaming your husband for having bad genes? Not sure that is helpful.

[Anonymous]

I can’t figure out why you’d think that a neuropsych would be warranted. You didn’t mention any concerns about him having learning disabilities.

As to what to do, so long as he’s not a danger to himself or others, find a psychiatrist or psychiatric nurse practitioner. If you need to use insurance and you have only in network benefits then go to your insurance website and get a list and start calling. If you don’t need in network then you can just find lists online.

Yes a psychiatrist or PNP will likely prescribe meds. If that’s not what you want, find a therapist. Same process - use your insurance list if you’re using in network benefits. Otherwise google.

If he’s a danger to self or others, you need an ER.

[Anonymous]

Honestly, unless you think he will be super open to therapy, I would start with meds if a psychiatrist thinks it is warranted. Often times kids need the meds to help them be able to really do the work of therapy. And I feel like a 16 year old boy who doesn’t want to talk much isn’t a great therapy candidate in his current state.

[Anonymous]

id have an adult only appt w the pediatrician to determine next steps. either therapy first, psychiatrist first, or an integrated practice.

[Anonymous]

It could be a phase because of his age and hope he can ride it out in the process of maturing.
I would ask his peds first and you can go from there.
Meanwhile you just need to be there and to be more present, show support but also leave him room for himself.
I would not jump to meds as it not always helpful and in some case make thing worse.

[Anonymous]

Anonymous wrote:I think therapy is where you start. Also, emphasize nutrition, good sleep, multivitamin, time with friends and hobbies: self-care stuff. Try therapy and see how that goes. He may not need medication.

all of that, plus less time on the phone/internet.

[Anonymous]

Genuinely curious. Would you not have married or had kids with DH if I had told you his family history of mental health issues before you married?