Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS's anxiety was the direct result of ADHD. He's off the SSRI. He's 20 now and recently told me that therapy was more of a help for him than the SSRI.

Good luck to you and your DC.

Therapy is more of a help than SSRIs for most people. The reason it takes a back seat to medication is only because it is expensive and time consuming and requires commitment. SSRIs are definitely easier and cheaper (but ugh, the side effects).

I don’t think you can claim most people just because of your experience. For many kids with anxiety, they are not able to open up in therapy and make effective progress until some of the “edge” is taken off by a low-dose SSRI or other similar drug. I have worked with kids on mindfulness and unfortunately this has been the case for many, although not all. For some children with anxiety just talking about the anxiety, makes it worse for them.

I’m an adult that took an SSRI for GAD. The SSRI doesn’t make you more open to therapy - it can be effective at tamping down anxiety but then you don’t really have any anxiety to work on in therapy. Mindfulness didn’t work because … mindfulness is not actually and evidence based therapy for anxiety. If my kid was having acute anxiety or especially OCD I might consider an SSRI. But my impression is that most families don’t actually access good pediatric anxiety therapy and are anxious themselves about their child’s anxiety. So it becomes easiest to medicate.

In my experience, the point about meds not making you more open to therapy is false. I think it depends on the person and their needs. For me, it was eye-opening to see a different way of life. I didn't realize people could really feel that calm until I did, and it enabled me to be more open to therapy and processing things so that I could look at things more clearly after I stopped meds. I'm still anxious without meds but have some tools to help now and can recognize the feelings and when I'm not in a good place.

It can also help set up new norms if you need to break certain negative cycles. Sometimes even the idea of a new start on meds can be useful.

But it depends on the person and the needs. There's no reason not to consider stopping the SSRI and seeing how things go, but remember that it takes a while for those meds to build up in your system (unlike ADHD meds), so it will be a slow weaning process, and if you need to start up again, it will be a slow start-up process. With a teen, this can be hard. Just something to consider.

Also note that ADHD meds can make anxiety worse for some people. I would talk through it with your DD and the psych to decide what is the best approach.

Yes try and start tapering slowly. SRRI's shouldn't be long term anyway

OP my son received a diagnosis of GAD and ADHD as well. Both were severe but, for him, the GAD affected him even more at that time. He had already been in therapy for at least 1.5 years at that point and while it had helped, we were heading toward crisis in anticipation of a big life change. The SSRI was truly life-changing for my child. We are lucky that it never had any side-effects either but it was fast, progressively better, and all extremely positive. He went from being unable to leave the house and having horrible panic attacks to being a regular kid with manageable ups and downs.

I am giving you all these details to make it clear that, not only was the SSRI absolutely logical but extremely effective and I couldn't be more grateful. And STILL, after about two years, we worked with the psychiatrist to wean him off of it. We had always considered the SSRI as a reset. My son had continued going to therapy and, for him, it was increasingly effective because I think he WAS more open to it and also older and more able to rationalize thoughts. Deep down, I was hoping he might be okay without the SSRI, but we framed the weaning as a check to see what his new baseline was.

He is now in college and has never had to go back on an SSRI again. For him, ADHD meds have actually been much trickier. Initially, even on the SSRI, he could not handle them at all. Even at a quarter of a therapeutic dose, they increased his anxiety to the point of panic and would disturb his (already troubled) sleep. When he was much older , he tried again and settled on an as-needed kind of pattern. I think he refills twice a year and uses them for test days basically.

My post is already too long to explain all the other ways we tried to address hyperactivity and anxiety but of course we did HUGE amounts of exercise and outdoor time, moved him to a better school fit, weekly therapy, and got all the good parent-training and so on and so on. Takeaway: even a kid who absolutely had anxiety AND ADHD, went off and stayed off the SSRI. I would encourage him to go on one again if he ever needs it. I feel fortunate that we had so many tools available to us and that they were all so helpful.

Yes OP. My DD was on Lexapro for a year that kinda just numbed her a bit before getting an ADHD diagnosis. They are now on Methylphenidate and did very well. So after a month went from 10 to 5mg of Lexapro over 2 weeks and then 2.5mg for another two weeks and then started .1mg of Clonidine in AM, Magnesium Gluconinate after dinner, and .2mg of Clonidine at bedtime.

That along with a multi vitamin, vitamin D, and fish oil daily and she is a new person. Sleeps well, isn’t “numb” but is calmer, more focused, and so much less impulses, blurting out, or shifting/fidgeting. Clonidine will make them tired the first week or so, so it’s better to start in summer, a school break or at least like a Wednesday of a 4 day weekend. Dong give up on it right away if you try it!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes. Switched from SSRI to ADHD meds. Ended up being so much better. I think the ADHD symptoms were leading to anxiety and depression.

Alternatively and I know you don’t want to hear this - but stimulant drugs produce a feeling of euphoria some times. That’s why people take them recreationally. Now I have zero bones with taking a psych med that you feel has a better profile for you, but these just-so stories about meds are really questionable. Treating your ADHD didn’t fix your anxiety. You took a drug that made you feel more focused and made you feel slightly euphoric due to the effects on dopamine.

Nope. I am not the PP you are talking to but many times ADHD symptoms mirror anxiety symptoms or kids/teens just feel anxious or depressed about not acting or feeling normal compared to their peers, especially in school. ADHD meds aren't euphoric that they don't care. For kids that truly need them, they are life changing. Being able to concentrate, not fidget, wait to talk in a conversation, finish a task, not have their mind racing with 100 thoughts.

And many docs put kids on SSRI's that just need to be on better ADHD meds. Not all, but enough

Anxiety always has triggers. Just because you theorize that it’s triggered by inability to focus doesn’t mean its different from other kinds of anxiety. If stimulants work for you great - but this narrative about ADHD being the root of everything is nonsensical. OTOH there are a lot of terrible diagnosticians out there who might claim (for a child) that any disruptive behavior was due to anxiety, when ADHD is a more likely diagnosis.

Anonymous wrote:

Anonymous wrote:My DS's anxiety was the direct result of ADHD. He's off the SSRI. He's 20 now and recently told me that therapy was more of a help for him than the SSRI.

Good luck to you and your DC.

Therapy is more of a help than SSRIs for most people. The reason it takes a back seat to medication is only because it is expensive and time consuming and requires commitment. SSRIs are definitely easier and cheaper (but ugh, the side effects).

The side effects, especially long term and especially on growing kids. They really need to be temporary. Taking it for years unless needed, is insane

Anonymous wrote:

Anonymous wrote:Yes. Switched from SSRI to ADHD meds. Ended up being so much better. I think the ADHD symptoms were leading to anxiety and depression.

Alternatively and I know you don’t want to hear this - but stimulant drugs produce a feeling of euphoria some times. That’s why people take them recreationally. Now I have zero bones with taking a psych med that you feel has a better profile for you, but these just-so stories about meds are really questionable. Treating your ADHD didn’t fix your anxiety. You took a drug that made you feel more focused and made you feel slightly euphoric due to the effects on dopamine.

Nope. I am not the PP you are talking to but many times ADHD symptoms mirror anxiety symptoms or kids/teens just feel anxious or depressed about not acting or feeling normal compared to their peers, especially in school. ADHD meds aren't euphoric that they don't care. For kids that truly need them, they are life changing. Being able to concentrate, not fidget, wait to talk in a conversation, finish a task, not have their mind racing with 100 thoughts.

And many docs put kids on SSRI's that just need to be on better ADHD meds. Not all, but enough

Anonymous wrote:Yes. Switched from SSRI to ADHD meds. Ended up being so much better. I think the ADHD symptoms were leading to anxiety and depression.

Alternatively and I know you don’t want to hear this - but stimulant drugs produce a feeling of euphoria some times. That’s why people take them recreationally. Now I have zero bones with taking a psych med that you feel has a better profile for you, but these just-so stories about meds are really questionable. Treating your ADHD didn’t fix your anxiety. You took a drug that made you feel more focused and made you feel slightly euphoric due to the effects on dopamine.

Yes. Switched from SSRI to ADHD meds. Ended up being so much better. I think the ADHD symptoms were leading to anxiety and depression.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS's anxiety was the direct result of ADHD. He's off the SSRI. He's 20 now and recently told me that therapy was more of a help for him than the SSRI.

Good luck to you and your DC.

Therapy is more of a help than SSRIs for most people. The reason it takes a back seat to medication is only because it is expensive and time consuming and requires commitment. SSRIs are definitely easier and cheaper (but ugh, the side effects).

I don’t think you can claim most people just because of your experience. For many kids with anxiety, they are not able to open up in therapy and make effective progress until some of the “edge” is taken off by a low-dose SSRI or other similar drug. I have worked with kids on mindfulness and unfortunately this has been the case for many, although not all. For some children with anxiety just talking about the anxiety, makes it worse for them.

I’m an adult that took an SSRI for GAD. The SSRI doesn’t make you more open to therapy - it can be effective at tamping down anxiety but then you don’t really have any anxiety to work on in therapy. Mindfulness didn’t work because … mindfulness is not actually and evidence based therapy for anxiety. If my kid was having acute anxiety or especially OCD I might consider an SSRI. But my impression is that most families don’t actually access good pediatric anxiety therapy and are anxious themselves about their child’s anxiety. So it becomes easiest to medicate.

Anonymous wrote:Diagnoses are for insurance companies. There will be significant overlap in symptoms between those two diagnoses and you will want the help of a psychiatrist who can address those symptoms as well as possible. I'm a big fan of weaning off of SSRIs, but everything comes at a cost -- be aware that sometimes people come off of them, realize they are better off on them, and then go back and it doesn't work as well. But you are saying you don't think it did much anyway, so I'd go ahead and try to get DC off of it.

Psych prescribing is art as well as science and very complicated. Good luck.

Yes and no. Some diagnoses are clear-cut and the particular medications well studied (bipolar and OCD especially). But otherwise around here seem to be very trigger-happy about medicating kids, with a lot of incorrect beliefs about what medication can and cannot do.

Anonymous wrote:My DS's anxiety was the direct result of ADHD. He's off the SSRI. He's 20 now and recently told me that therapy was more of a help for him than the SSRI.

Good luck to you and your DC.

Curious, about what type of therapy was effective for him – CBT, executive functioning, etc.?

Anonymous wrote:

Anonymous wrote:My DS's anxiety was the direct result of ADHD. He's off the SSRI. He's 20 now and recently told me that therapy was more of a help for him than the SSRI.

Good luck to you and your DC.

Therapy is more of a help than SSRIs for most people. The reason it takes a back seat to medication is only because it is expensive and time consuming and requires commitment. SSRIs are definitely easier and cheaper (but ugh, the side effects).

I don’t think you can claim most people just because of your experience. For many kids with anxiety, they are not able to open up in therapy and make effective progress until some of the “edge” is taken off by a low-dose SSRI or other similar drug. I have worked with kids on mindfulness and unfortunately this has been the case for many, although not all. For some children with anxiety just talking about the anxiety, makes it worse for them.

The "defiant attacks" were likely anxiety. But I think it's always worth trying to wean off a med that you don't think it helping.

Anonymous wrote:My DS's anxiety was the direct result of ADHD. He's off the SSRI. He's 20 now and recently told me that therapy was more of a help for him than the SSRI.

Good luck to you and your DC.

Therapy is more of a help than SSRIs for most people. The reason it takes a back seat to medication is only because it is expensive and time consuming and requires commitment. SSRIs are definitely easier and cheaper (but ugh, the side effects).