Reply to How did you decide to start/not start your child on SSRIs for anxiety?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]OP here -- many thanks to all of you for the helpful posts! Your experiences helped me think through options and organize approaches in my mind.

DS saw his therapist yesterday and began using a new workbook as part of his CBT. The therapist explained to him that he would need to work with her through the book, which will include homework, and we have set up a points system so he has a series of rewards when he completes the homework. He seems very excited about this approach. We are going to give this workbook a try (it is about 16 weeks long) and if at the end we do not see an improvement, we'll make the move to SSRIs.

To the PP that said the psychiatrist waited a year on the SSRI recommendation -- actually, the very first meeting we had with the doctor, he wanted to start DS on Zoloft that day. It was due to our insistence that he opted only for a med for the ADHD. So I am not exactly "sold" on this psychiatrist.[/quote]

I'm PP and perhaps I should not have pointed that out.  I sure wish my DD's psychiatrist had recommended an SSRI from the beginning. [b] if your DS was as anxious as you are making it seem[/b], this was not an unreasonable suggestion.[/quote]

OP here -- how do you define "as anxious as you are making it seem?"

On most days he is absolutely fine and has no issues.  About once every 6 to 8 weeks, he has an issue where he gets REALLY worked up and he says, "I can't do this at all!" Every two to three months, he'll have one of Those Days and he'll get even more worked up, to the point where he hits himself in the head.

So if a 9 year-old boy hits himself in the head while getting upset one time in September, one time in March and another time in May, does that warrant starting SSRIs?[/quote]

Not the PP you’re responding to but what you’ve just posted is significantly different than your original post were you say CBT isn’t helping, the ADHD medication is worsening the anxiety and your worried your DS will harm himself if he starts SSRIs.  No matter where you’re looking for assistance and advice, you need to be a better reporter of symptoms and frequency.  Your follow up post doesn’t describe anxiety that has an impact on ADL.

[/quote]

Thanks. The CDT has not helped in the past and I think (due to asynchronous development) DS wasn't ready to fully participate in the therapy. I also think that due to whatever reasons (one of them being his intellect) he knows how to "game the system" and with the moving target of med changes and additions and sleep issues and anxiety, it has made this really complicated. I also do not have full faith in the psychiatrist as DS does his "game the system" stuff, and I am sure the psychiatrist knows it.

I think having a "we'll try the CDT with the workbook" plan with a specific end date is a good plan for this portion of the journey.

And I agree -- I am a horrible reporter of symptoms and frequency. Unfortunately I am not with DS 24 hours each day (matter of fact I am only with him from 4 pm until 8 am the next morning on school days) and cannot fully account for each and every symptom and frequency.   Since you are better than I am at such reporting, would you please recommend some tools and techniques that I might use to improve on such accounting? Thanks![/quote]

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