Anonymous wrote:

Anonymous wrote:Anxiety often looks like irritability in children. Autism can make that irritability worse. Stimulants can make anxiety worse. You need to talk to your psychiatrist if the stimulants might be contributing (have you had a recent dose or medication change) or if a SSRI or mood stabilizer (ie, abilify) might be appropriate. Abilify saved our family and I resisted it for far too long.

Op - I have talked to our psychiatrist another it, and our gp, and both say that ssris are not a first line treatment for a child of this age and they would prefer to exhaust numerous other approaches before going down that road. These are both highly respected nyc private practitioners - this is not quackery

OP I understand your reluctance to jump straight to SSRIs - I have been on a dozen different ones as an adult before doctors figured out that like 30% of patients, I don’t tolerate them well and the side effects never resolved properly.

There is an abundance of evidence that lifestyle changes can be as effective as SSRIs at treating and managing depression and anxiety.

I would drill down hard on sleep hygiene (zero access to devices or TV during sleep hours), early morning light exposure either from outside activity (morning walk together?) or use of light box in the morning, meaningful exercise every day, meditation/breathing exercises, journaling, and cleaning up the diet - purge the added sugars and load up on whole food, cut the ultra processed stuff to the bone.

I struggled with refractory major depression, generalized anxiety and periods of suicidal ideation for years. I’m meds free and managing my mental health really well by reducing the negative aspects of modern society by giving my body the things it evolved to need and which promote optimal brain health: food that makes a healthy gut + hydration, plenty of sleep, exercise, light exposure outdoors as much as possible, quiet time away from devices.

Good luck with your boy, and hang in there.

Anonymous wrote:My 12 yo (adhd/ possibly audhd but experts have different povs on that) irritability is off the charts and i dont know what to do. EVERYTHING annoys him. I keep trying to do nice things with and for him and he's just annoyed. He has sooo much anger. He says he's tired all the time, or has headaches (have been to neurologist and all fine). He's in therapy with a great therapist, but i'm at a loss. I prefer not to put him on more medication on top of the stimulants but it's just a little heartbreaking. any advice?

Irritability is a sign of depression, especially in boys. My child with ADHD was this way (irritable) and it was depression. I didn’t realize it for years, and the depression seriously escalated. They are now on medication- stimulant for ADHD and anti-depressant. The anti-depressant is amazing and has had a major positive impact. Don’t be afraid of the medication. I know it is serious and scary. Children with disabilities are at a higher risk for depression.

https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985

Anonymous wrote:

Anonymous wrote:Anxiety often looks like irritability in children. Autism can make that irritability worse. Stimulants can make anxiety worse. You need to talk to your psychiatrist if the stimulants might be contributing (have you had a recent dose or medication change) or if a SSRI or mood stabilizer (ie, abilify) might be appropriate. Abilify saved our family and I resisted it for far too long.

Op - I have talked to our psychiatrist another it, and our gp, and both say that ssris are not a first line treatment for a child of this age and they would prefer to exhaust numerous other approaches before going down that road. These are both highly respected nyc private practitioners - this is not quackery

No one said SSRIs were first line treatment, but the OP has tried therapy alone already. Meds are indicated when therapy isn't sufficient.

Anonymous wrote:

Anonymous wrote:Anxiety often looks like irritability in children. Autism can make that irritability worse. Stimulants can make anxiety worse. You need to talk to your psychiatrist if the stimulants might be contributing (have you had a recent dose or medication change) or if a SSRI or mood stabilizer (ie, abilify) might be appropriate. Abilify saved our family and I resisted it for far too long.

Op - I have talked to our psychiatrist another it, and our gp, and both say that ssris are not a first line treatment for a child of this age and they would prefer to exhaust numerous other approaches before going down that road. These are both highly respected nyc private practitioners - this is not quackery

What other numerous approaches are there besides therapy?

I would hold him back in some nurturing private school and have no requirements for the year. Let him sleep when he wants to sleep. Learn new things. Let him see that its not just his environment that's bad but his reaction to it. That he will have to change in order to have a better experience.

Op, I, too, have spoken to numerous psychiatrists, neuropsychologists, and several neurologists and an epilologist and they ALL said Prozac is incredibly well tolerated and without long term side effects in children. My son has severe special needs and attended very expensive private schools where I met countless parents of other special needs children many many of whom started their journey on Prozac before stimulants for this reason. Go back to the drawing board and stop attacking other posters’ learned experience. If you want names and credentials you can DM me.

Agree that anxiety shows are irritability at this age.
What your kiddo might need to decompress is “quality” alone time? In other words, neither alone time with a device, NOR time doing stuff with you or friends.
This is really hard to figure out in the modern era! Because screens are everything/everywhere! For my kid, the quality alone time looks like walking the dog, going to the gym, hitting baseballs off a tee in the backyard, taking a basketball to a court alone. Walking himself to buy a snack. For an artsy kid maybe painting or drawing.
Good luck. It’s hard. ❤️

Love that only like 1 person on this thread actually asked why kid might be feeling like this. Everyone just goes straight to Prozac. Bananas

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m going to just be super blunt. You lost me at “I prefer not to put him on meds.” Families and the kids themselves deserve some relief. If my parents had towed the “I prefer not to put my depressed and irritable teenage daughter on meds” line, I’d be long dead by suicide. Your child is suffering from a real condition, just like cancer is real. He, and you, deserve relief.

op - sorry i 'lost you' but SSRIs for tweens are no joke. I have been told this by multiple psychiatrists. Every parent should start from a place of reluctance where these hardcore medications for kids this age are concerned. I encourage you to search on this board for multiple examples of why SSRIs are not a first line answer to these issues before you come with such certainty.

SSRIs are not "hardcore medications."

they are when it comes to a child. it's a ridiculous argument you're making that this is a slam dunk choice for a tween. I cant imagine that you've spoken to many medical professionals if this is your take. I'm not saying they may not be the correct route, they may well be. But a lot of things should happen before parents of a 12 year old jump to this solve.

I'm not making any arguments whatsoever. It's up to you what meds your kids take. But thinking stimulants are safer than SSRIs has no evidentiary basis. I would personally be more concerned about stimulants, but neither are "hardcore." "Hardcore medications" are antipsychotics. And those are still absolutely appropriate in certain circumstances.

Also, it sounds like parents have tried a lot of other things, so it's not as though SSRIs would be the first thing they've tried. OP mentions working with an excellent therapist but that it's not helping.

Stimulants for kids have much longer and deeper studies. Feel free to google or ask ChatGPT for further info on this

*about it

Anonymous wrote:Anxiety often looks like irritability in children. Autism can make that irritability worse. Stimulants can make anxiety worse. You need to talk to your psychiatrist if the stimulants might be contributing (have you had a recent dose or medication change) or if a SSRI or mood stabilizer (ie, abilify) might be appropriate. Abilify saved our family and I resisted it for far too long.

Op - I have talked to our psychiatrist another it, and our gp, and both say that ssris are not a first line treatment for a child of this age and they would prefer to exhaust numerous other approaches before going down that road. These are both highly respected nyc private practitioners - this is not quackery

Anonymous wrote:OP, just put your kid on SSRIs at a very low dose to start. STop being fed MAHA and take care of your kid.

Op - I am about the farthest thing from maha you can find. Still not immediately going to Prozac for a 12 yo Jfc

Anonymous wrote:

Anonymous wrote:I’m going to just be super blunt. You lost me at “I prefer not to put him on meds.” Families and the kids themselves deserve some relief. If my parents had towed the “I prefer not to put my depressed and irritable teenage daughter on meds” line, I’d be long dead by suicide. Your child is suffering from a real condition, just like cancer is real. He, and you, deserve relief.

Just to be super blunt as well, stimulant meds are known to cause irritability as a side effect, so prioritizing your kids academic success over their mental health is something to be questioned.

He’s not on tbem for academics - but your defensiveness about ssris and assumptions are both highly unhelpful additions here so please move along

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m going to just be super blunt. You lost me at “I prefer not to put him on meds.” Families and the kids themselves deserve some relief. If my parents had towed the “I prefer not to put my depressed and irritable teenage daughter on meds” line, I’d be long dead by suicide. Your child is suffering from a real condition, just like cancer is real. He, and you, deserve relief.

op - sorry i 'lost you' but SSRIs for tweens are no joke. I have been told this by multiple psychiatrists. Every parent should start from a place of reluctance where these hardcore medications for kids this age are concerned. I encourage you to search on this board for multiple examples of why SSRIs are not a first line answer to these issues before you come with such certainty.

SSRIs are not "hardcore medications."

they are when it comes to a child. it's a ridiculous argument you're making that this is a slam dunk choice for a tween. I cant imagine that you've spoken to many medical professionals if this is your take. I'm not saying they may not be the correct route, they may well be. But a lot of things should happen before parents of a 12 year old jump to this solve.

I'm not making any arguments whatsoever. It's up to you what meds your kids take. But thinking stimulants are safer than SSRIs has no evidentiary basis. I would personally be more concerned about stimulants, but neither are "hardcore." "Hardcore medications" are antipsychotics. And those are still absolutely appropriate in certain circumstances.

Also, it sounds like parents have tried a lot of other things, so it's not as though SSRIs would be the first thing they've tried. OP mentions working with an excellent therapist but that it's not helping.

I was told by several psychiatrists that mood is more important to address than ADHD symptoms. DC's irritability and anxiety symptoms were first addressed before ADHD was treated.