OP here. I truly appreciate the wonderful help provided by everyone!

To the PP, I'm relieved your DD is stable. I've accepted that my DD might not be able to attend college for a while, and I'm okay with it. DD, on the other hand, is upset about the possibility that her life will look entirely different than the one she'd planned.

It's gratifying to read and learn about people who've struggled and yet managed to lead productive, happy lives.

My DD13 is on Lamictal and has been for over 6 months: the doctor warned us about Stevens-Johnson and fortunately, it didn't develop. She was also on Latuda (Bipolar DX although at this age of course it's hard to tell) but the doc took her off of it after a couple of months because there was no real therapeutic impact: DD's psychiatrist is one of the leading child psychs and was heavily involved in clinical trials for adolescents and Latuda, and I really trusted her to monitor it carefully.

DD also has DX of severe anxiety disorder as well as ADHD, and she takes Intuniv and Sertatraline. She still struggles with insomnia and so has to take Benadryl or Melatonin occasionally, but she at least CAN sleep now and wakes up refreshed.

Under a previous pscyhiatrist, she was on Abilify (a COMPLETE disaster: DD was begging to come off of it after two days), Straterra (almost as bad) and Zoloft (which she took for a period of time but which caused such weight gain/appetite increase and which had little therapeutic benefit).

The current combination, along with therpay 1-2 times a week and consults with the psychiatrist twice a month (30-45 minutes, so some therpay there as well), seems to be stable for her. Her ideation is calmed down considerably and thoughts of self-harm and acting on it are basically dissipated.

OP, I know this is SO hard, but as someone who has acute mental illness in her families -- including both grandparents with bipolar -- as well as alcoholism (my husband/DD's dad and my mom along with grandparent who had bipolar along with my own battle with anorexia and severe depression) we have long ago come to terms with needing to treat DD's illness very aggressively, despite trying every more gentle approach in the book. It sucks: it really, really sucks. I feel so badly for DD and would give ANYTHING if she didn't have to take the meds and live with the pain. Having said that, I am so grateful that we seem to have found a combination that's livable.

And in terms of college and your DD: I had to take a gap year before ANYONE was diong that (1983-4) because of the anorexia and depression. At the time, I thought the world would end -- in fact it occasioned one of my hospitalizations as I had such a hard time with it). However, once I did go to college a year later, I really struggled, had to take off a term, and can't imagine what would have happened had I gone straight from high school. But it worked out, it really did, and after earning a PhD and having an amazing career, I am so grateful for super docs and the realization that I needed the year. It also helped me profoundly when we saw the signs of DD's challenges -- I guess I'm saying hang in there, and if she does need the year before going to college, please know that it really can be okay. It won't be easy, but it will work out. I promise.

Good luck to you and your DD.

Anonymous wrote:OP here. Thank you all for your help. My heart goes out to all of you struggling with these worries. Yes, I need to remember that my DD has a way forward. She's had suicidal ideation and come close, but she's never made an attempt.

She is on Wellbutrin now (helps a bit with the anxiety), and she hasn't been taking her ADD meds. Do you think ADD meds would help the depression? She's loath to take them because she always wants to power through.

She's worried about mood stabilizers and would prefer not to take them, but of course she wants to feel better. Her regular psych has a wonderful bond with her, so getting a second opinion might seem threatening to DD, but I agree it's a good next step. I'll look into Dr. Hemanth.

OK, your first step is right there. She HAS to take her ADHD meds. Having to fight distraction and corralling scattered thoughts all day takes so much energy out of you, especially in a school setting where students need to write all day - writing is the single most exhausting and difficult academic task for people with ADHD, because it necessitates so much multitasking - no wonder she's moody and depressed, poor thing.
I'm amazed her psychiatrist hasbn't said something already - she or he mustn't be that good.

You need to insist on this, OP.

OP here. To 14:20, no, those are her words. I have depression myself and am a big fan of the meds that saved my life! I have always reminded her that meds are as important to heal mental health concerns as physical ones. However, an aversion to meds is part of her condition, as it was for me before I was mentally healthy.

To 17:02, my DD's struggles started around age 12, so during middle school. Looking back, she was always sensitive and emotional, but nothing out of the ordinary (I have other kids).

Thank you for the additional Lamictal info.

Anonymous wrote:

they recommended Lamictal. The rash is a real danger, but it shows up in the first two weeks or so. You have to be very alert and get immediate medical attention if it does.

The literature says that about 10% of people get the rash and it usually shows up within the first 8 weeks but can happen after that. This is what my so s psychiatrist also said. We’d have to do the rash checks for the entire time he’s on the medication. It would not have been an issue if it was only two weeks because he would have been in the hospital the entire time.

That being said, I have heard really good things and I would like to hear other’s stories because who knows what’s next for my son. The only other thing that my son’s psychiatrist said was that it takes la very long time (compared to others) to get to therapeutic level. She does like it though, except for those two things. I think the issue for my son was compliance with body checks and the concern about whether he could handle the long period to get to therapeutic level.

Ten per cent of people get A rash. It's usually a mild, transient rash. About 0.3 per cent of people get a serious rash. In rare cases, the serious rash can turn into a very dangerous rash called Stevens-Johnson Syndrome. So if you go on Lamictal, you must be on the lookout for rashes and go to the doctor immediately if you get one. But other than that it is very safe. I've been on Lamictal for years with no side effects. I did get a rash at the beginning that turned out to be shingles.

Other mood stabilizers also have some serious side effects, some of which can be permanent. I think overall, Lamictal is safer.

There is also a danger in living with untreated depression, so going without treatment is not a good idea either.

they recommended Lamictal. The rash is a real danger, but it shows up in the first two weeks or so. You have to be very alert and get immediate medical attention if it does.

The literature says that about 10% of people get the rash and it usually shows up within the first 8 weeks but can happen after that. This is what my so s psychiatrist also said. We’d have to do the rash checks for the entire time he’s on the medication. It would not have been an issue if it was only two weeks because he would have been in the hospital the entire time.

That being said, I have heard really good things and I would like to hear other’s stories because who knows what’s next for my son. The only other thing that my son’s psychiatrist said was that it takes la very long time (compared to others) to get to therapeutic level. She does like it though, except for those two things. I think the issue for my son was compliance with body checks and the concern about whether he could handle the long period to get to therapeutic level.

I took Lamictal from 19 to 24 and the only side effect was trouble concentrating which was addressed with Adderall.

Another view of Lamictal.

My DD has epilepsy and was on Keppra. This gave her movement side effects and at 16 she announced she would no longer take it. I was able to talk her into at least tapering it off rather than stopping abruptly. (Note: She had no driver's license and was disqualified for one because of unmedicated epilepsy.)

She went without seizures for a couple of years, then she had a couple within a few weeks, the last of which landed her in the ER because of a concussion. After discussing her previous medication experience with her, they recommended Lamictal. The rash is a real danger, but it shows up in the first two weeks or so. You have to be very alert and get immediate medical attention if it does.

My DD didn't get the rash and we have been home free with zero side effects. It has been a miracle drug for her.

Anonymous wrote:OP here. We'll research Lamictal more, thanks!

PP here whose son is on his second mood stabilizer. Lamictal is my son's psychiatrist's last choice for him. There is a small chance of a deadly side effect. It starts with a rash. The benefit is that there isn't as much of a likelihood of weight gain. If my son had not agreed to a different medication and we had to go to Lamictal, I would have had to a full body check on him daily for as long as he is on the medication. My son opted for a different medication, which I was glad for because I didn't think he would cooperate with the body check.

At what ages was the onset of mental illness, PPs? Did your kids’ struggles begin in elementary school?

Anonymous wrote:
She is on Wellbutrin now (helps a bit with the anxiety), and she hasn't been taking her ADD meds. Do you think ADD meds would help the depression? She's loath to take them because she always wants to power through.

I deal with depression, and ADD meds do help it. Not because it directly resolves the depression, but because they give me focus and energy to accomplish whatever goals I set out for the day. It creates a positive cycle of feeling good about myself, being productive, sleeping well, having routine, etc. -- and those improve my self esteem, which helps my depression, helps me stay on top of taking my other meds, doing self-care, etc.

One thing I want to gently point out, although I suspect you already see this... you said she "wants to power through." You're expressing concern about her taking other medications (understandably). It sounds to me like she has picked up on that, and there's some family belief that medication should be avoided, it's better if you can "power through" or fix yourself without meds, etc. -- I'm sure you've never directly told her that, but kids pick up on this stuff.

That's a really dangerous mindset for someone with depression and anxiety. It often leads to an increased cycling on and off meds... things get bad, they start taking meds, things start to feel better and then they think "Oh man, I'm doing well, I should try to power through this myself now and see if I can do it without meds." Adherence to med schedules is hard even without any sort of underlying belief about meds being bad/good, but I'd almost encourage you to swing to the other side for awhile, just to help head that off. "If you had an infection, you'd take antibiotics. If you were diabetic, you'd take insulin. This is no different - it's chronic, and you need the meds, and we are so grateful they're available."

I agree with PP on the ADHD meds reducing anxiety because their level of struggle with daily tasks and school is much lower. (Depends on the kid for sure, but I found that to be true with my teen DD.) It's also fairly common to use wellbutrin in addition to an SSRI. My DD takes wellbutrin and prozac and the combination works better than either by itself.

OP here. We'll research Lamictal more, thanks!

Anonymous wrote:OP here. Thank you all for your help. My heart goes out to all of you struggling with these worries. Yes, I need to remember that my DD has a way forward. She's had suicidal ideation and come close, but she's never made an attempt.

She is on Wellbutrin now (helps a bit with the anxiety), and she hasn't been taking her ADD meds. Do you think ADD meds would help the depression? She's loath to take them because she always wants to power through.

She's worried about mood stabilizers and would prefer not to take them, but of course she wants to feel better. Her regular psych has a wonderful bond with her, so getting a second opinion might seem threatening to DD, but I agree it's a good next step. I'll look into Dr. Hemanth.

ADD medications don't help depression directly. But if she is having trouble focusing and can't "power through" they could help her overall mood just by making daily life easier.

There are different types of mood stabilizers. Lamictal is commonly used and pretty safe. Is she worried about that one?