Struggling with the idea of medicating for anxiety

[Anonymous]

I'm one of the posters from the recent thread on anxiety http://www.dcurbanmom.com/jforum/posts/list/178234.page#1677089 (I'm 7:38/19:03). My eight year old DS has ADHD (inattentive/impulsive) and generalized anxiety which waxes and wanes. We're enrolled in the NIH study and we get to chose if we want to start out with CBT or fluoxetine (generic for Prozac). Whichever one we start with, we can switch tracks at any time but if we switch from CBT to fluoxetine, we have to stop CBT for about 4 weeks to wait for the medication to kick in. Once the medication kicks in he will start CBT. I know DS's anxiety is going to get worse as the start date for school approaches and will continue for about a month until he settles into a routine. Last year, it was awful and really negatively impacted our entire family and influences the choices DS makes. I've talked to his pediatrician and his dev ped and they both think anxiety medication might be beneficial and that CBT might also be beneficial. The dev ped knows the researchers in the study and thinks highly of them. So, why am I struggling with the idea of giving DS the Prozac? It's not like we haven't had this initial struggle. We did a lot of handwringing when we considered medication for DS's ADHD. Initially, it was hard but we knew it was the right thing to do and we did it. I strongly suspect that if we start with CBT, we're going to want to switch tracks as we get closer to the start of school because DS's anxiety will be awful for everyone. It's best to start the medication now because it can take about 4 weeks to really kick in. If we delay it, he won't have full benefit of it when school starts. Why do I continue to struggle? Can anyone encourage or reassure me? TIA

[Anonymous]

I don't have any advice to offer, but will only share that we are going through a similar situation with our DD who doesn't have ADHD but has autism. She too deals with anxiety that comes and goes, but when it comes it's very strong. And we know it's coming on for her transition to kindergarten with a new school and new teacher. I wonder if our hesitation is because it's scary to give medicine to a child that you just can't start or stop if it's working or not working? I have a DS with ADHD, and we hardly hesitated with his medication, and I wonder if that's because we knew going into it that we could always stop it immediately if there were negative side effects. We haven't yet started medicating our DD for her anxiety, but I think we're just going to have to jump into that, too. Sadly for us it won't be in time for school. I wish you luck OP! You'll make the right decision.

[Anonymous]

Last summer my oldest went through a prior of extreme anxiety that practically ruined his summer and made things difficult for all of us. At the time we didn't realize what was going on so we didn't put him on meds. Later when the light went on and we realized he needed help and we got it for him, his quality of life was a thousand times better. He actually enjoys life now and we are all enjoying each other. Unless there is some negative you haven't mentioned, I'm not sure why you would delay.

[Anonymous]

One of my kids is on Prozac for anxiety. Of our five, she is the most loving, stable, cheerful and helpful. She is now a senior in high school with a 4.45 GPA. She will start college as a sophomore because she has been taking college classes since the eight grade. I say all this not to brag, but simply to explain that in my daughter's case, her relatively severe anxiety was treated successful with medication.

She was a mess before medication. She was stressed all the time. She didn't want to go out. She was ruining her teeth by grinding at night. She suffered stomach aches and diarrhea. The thing that finally pushed us to try medication was when she said she wished she wasn't alive. She said she would never kill herself because she knew it would hurt us. But she didn't see the point of living. I thought she was depressed. But it wasn't depression. It was anxiety.

I wish we hadn't waited as long as we did. At one appointment, the doctor said "Would you hesitate in giving her insulin if she had diabetes?". Of course not. It's no different. Anxiety disorders are no different.

My daughter was a different child within about eight weeks. She still occasionally gets anxious. She puts a ton of pressure on herself to succeed. But it's not the crippling anxiety that it once was.

[Anonymous]

OP, I am 8:47 from that thread. Have you done CBT at all yet? We started CBT with her at 8.5 and it really, truly did help tremendously. While we knew that an SSRI was a possibility, we did not personally feel comfortable starting an SSRI until we had given CBT a chance. And CBT absolutely did help and we continue to use and need those techniques even with the SSRI.

Also, we started with Zoloft and it was awful. I mean really awful. She became a monster and totally out of control until we weaned off and began Prozac (generic actually, in both cases). Prozac has been a godsend, but our psychiatrist said that sometimes the SSRI has the opposite effect and makes them more anxious or disinhibited. But seriously, she was almost suspended from school before we could get her off the Zoloft. Prozac has been amazing for her, but you do have to be prepared for side effects. These are serious medications and you cannot stop them cold turkey.

[Anonymous]

We worried about this a lot, but then I thought about how my mother has never been able to engage the world because she is so afraid of it. I would never wish that on my daughter two years in, CBT and Zoloft have made a huge difference. She is willing to try new things, engage people does not not exhibit fears of random things like elevators and trains. Anxiety is a malfunctioning of the brain circuitry and chemicals. If blood cells malfunction we do chemo, a temperature rises we use ibuprofen. It does not feel so awful when you see it in that context. If you are still struggling read Judith Warner's book We've got issues. She has a very helpful discussion about unpacking how our society has portrayed psychiatry.

[Anonymous]

OP, my husband sufferes from severe anxiety and it got so bad at one point that he was suicidal. Not because he was depressed, but because he couldn't bear the anxiety.

As a result I learned a lot about anxiety, and I learned about a concept called "kindling". I do not know if it is scientifically accepted as fact or is just a theory and I am sure my explanation of it won't be correct, but my understanding of it is that every time you have an anxiety attack, you make it easier for the next attack to take place. If anxiety goes untreated, eventually people can get anxious by nothing at all.

That has helped us to manage my husband's anxiety by having the rule of thumb that No anxiety is to be tolerated. he used to try to struggle through the little things that worried him because he felt it was better to manage without medication, but that has changed.

After several years of keeping his anxiety under check with meds he has been able to live on a more even keel and control anxiety more with lifestyle changes alone, exercise, CBT and so on, and has reduced his need for meds. it's like his system has calmed down.

But I would encourage anyone with a child who experiences anxiety to do everything possible to prevent even a single anxiety attck, if possible. CBT sure, but if that isn't immediately effective also medication or removal from the situation causing the anxiety. Do NOT allow a child to experience a single bout of anxiety. it's that important.

[Anonymous]

If you're struggling, don't do it. There are other options. Find a DAN Doctor...they aren't just for treating autism. There are thousands of more natural supplements to choose from if you head to an alternative doctor.

Honestly, it's all about detoxing, anyway.

[Anonymous]

Anonymous wrote:One of my kids is on Prozac for anxiety. Of our five, she is the most loving, stable, cheerful and helpful. She is now a senior in high school with a 4.45 GPA. She will start college as a sophomore because she has been taking college classes since the eight grade. I say all this not to brag, but simply to explain that in my daughter's case, her relatively severe anxiety was treated successful with medication.

She was a mess before medication. She was stressed all the time. She didn't want to go out. She was ruining her teeth by grinding at night. She suffered stomach aches and diarrhea. The thing that finally pushed us to try medication was when she said she wished she wasn't alive. She said she would never kill herself because she knew it would hurt us. But she didn't see the point of living. I thought she was depressed. But it wasn't depression. It was anxiety.

I wish we hadn't waited as long as we did. At one appointment, the doctor said "Would you hesitate in giving her insulin if she had diabetes?". Of course not. It's no different. Anxiety disorders are no different.

My daughter was a different child within about eight weeks. She still occasionally gets anxious. She puts a ton of pressure on herself to succeed. But it's not the crippling anxiety that it once was.

You know, I was similar to this when I was a child (not quite so bad, no judgement here). It starts as this type of anxiety but then manifests in depression in later years because the thought process is more developed . Can lead to crippling insomnia. I WISH THERE THESE TYPES OF DRUGS WHEN I WAS A KID. IT HAS TAKEN A LIFETIME TO WORKOUT THE ISSUES CAUSED BY THIS. PUT YOUR KID ON MEDICATION PLEASE!!!!!!!!!!!!! It is no different than diabetes, high blood pressure......like asthma almost. Would you hold back the inhaler if your child could not breathe? Think about it.

[Anonymous]

10:34 here again. I just read some of the "natural" type remedy posts-forget that. I do think that CBT along with the medication is good. Get out of the study and do both at the same time. Your kid is not a science experiment for the benefit of some Phd disseration at NIH. Take it from someone with lots of experience (with my kids anxiety/depression too!!!) They are related/entertwined.

[Anonymous]

OP, I grew up with terrible, debilitating anxiety. I kept it inside and didn't tell others about it at all. I didn't know to name it as anxiety - we didn't have that term for the disorder then - I just knew I had what I called in my head "the fear." It would come and go, but when it was there, it was unbearable. I had a very serious eating disorder, had all sorts of superstitions, had so many "rules" about how to manage my unnamed anxiety that it's a wonder I had friends and was able to get good grades at all. I look back on my younger self and feel sad that I went through what I did. I was popular, smart, pretty, good athlete, great family - how and why did I suffer the way I did? The good news is that as an adult, I got help and now know how to manage and tame my anxiety.

DS, 7, was recently diagnosed with anxiety, and I did not blink when the psychiatrist prescribed prozac. I was simply happy for him that there is a drug like this available for him, to save him hopefully from experiencing what I went through as a child. We are only three weeks into it - through one step up to .4ml now - and not seeing any effects yet, but I look forward to the drug taking effect and to knowing that I am doing RIGHT by him, by saving him from the hell of growing up with anxiety.

We all need to make the decisions that seem right for our children, and I think it's good to take your time and think about it and ask for input. And then to do what you think is best.

Good luck with your decision.

[Anonymous]

Anonymous wrote:10:34 here again. I just read some of the "natural" type remedy posts-forget that. I do think that CBT along with the medication is good. Get out of the study and do both at the same time. Your kid is not a science experiment for the benefit of some Phd disseration at NIH. Take it from someone with lots of experience (with my kids anxiety/depression too!!!) They are related/entertwined.

HUH? I've been working with alternative medicine for 4 years now and I still have barely tipped the iceburg. You did it all in about 5 minutes? Wow, you're good!!! I bet you're real thorough too. Medication is the easy road because it is suppressive medicine....just a bandaid for the symptoms of a bigger picture of disease that western medicine has no idea how to comprehend. When you use alternative medicine, you work with your body to eliminate the issues. In time, your body actually heals itself. If you use suppressive medicine, you'll wake up one day in about 10 years and realize that your child has not healed one ounce from meds.

I wish you the best of luck, OP. If you're taking advice from the pharma-happy people on this board, it's more than likely you'll head down the same road. Dare to be different and find the root cause of your child's anxiety. You wont find those answers HERE on DCUM though.

[Anonymous]

OP here. Thanks for all your kind and helpful thoughts, it really has helped. DS has not yet started the CBT or the medication. I wouldn't start both of them at the same time because, at this point, his anxiety isn't at a crisis level and I've learned that when you introduce two interventions at the same time, it's difficult to determine how effective, if at all, each one is. My DS has had a lot of OT and we've been working for a very long time on him learning to be aware of what he's feeling and how to change it. He's actually pretty good at it and while I'm hopeful, I don't think he has sufficient skill to manage his anxiety as we approach the start of school. That's why I think we should really start with the medication. I totally relate to the 'kindling' theory - our counselor has talked about something similar with depression. The longer it goes untreated, the more frequent and severe the cycles. I'm also reading Judith Warner's "We've Got Issues" right now and feel like giving her a big hug. It is really a great history on why there's a perception of overdiagnosis/overmedication and is helping me through this. I highly recommend it. DH and I have talked to DS and we're going to start with the medication. I know it's the right route for us. Thanks, again, to everyone.