I am really scared for difficult child

Discussion in 'General Parenting' started by Kjs, Mar 25, 2009.

  1. Kjs

    Kjs Guest

    I saw therapist yesterday per his request. I saw him two weeks ago also and he told me both times difficult child has such severe Generalized Anxiety Disorder (GAD) and ADHD that the biggest challenge is getting him to survive. I asked him specifically yesterday if he was saying difficult child is going to die. He said getting him to survive until 18 will be a challenge.

    i told him what happened at psychiatrist's office. He just shook his head and told me to bring in a list of doctors on my plan and he will review them and recommend one. In the mean time, difficult child really needs to be treated for anxiety.

    I told him psychiatrist wanted to put him on Strattera and told me that treats both anxiety and Adhd. therapist said originally Strattera was made for depression, then they realized it helped with ADHD. He said he has never heard it for anxiety.

    He also said 30mg's of Adderall is way out of line. He should of started at about 10mg's and MAYBE go up to 20. He said that may be why I see the exhaustion. To high, too fast.

    i told therapist how difficult child said since last December he feels that things aren't real and his ears are on the back of his head. difficult child said he is sick of people saying it is anxiety because it would sometimes go away then. difficult child said nothing is fun anymore.

    Well, I just checked his myspace. It says "difficult child is sick of feeling like this" his mood is "sad"

    I am really really afraid for him. therapist suggested Lexapro. But we just started adderall last week. Should I call his current psychiatrist (who I don't like) and ask for Lexapro? We tried that a few years ago and it kept him awake. Does Lexapro take a while to work? How long? therapist said maybe when we start break the 10mg pill in half and work up to 10. Help. I feel so helpless and so afraid for him. I am really scared. Please suggest what I should do. lexapro??? does it help? What about Buspar? I am so afraid and I cannot be home today or tomorrow I am in a class.

    I feel sick I am so worried..
  2. Kjs

    Kjs Guest

    difficult child is trying so hard to fight this. But it seems to be overtaking him and I am terrified. What do I do?
  3. smallworld

    smallworld Moderator

    Kjs, I'm sorry difficult child is struggling.

    My strong recommendation is to find a psychiatrist who will work with you to find the best medication mix for difficult child. In all honesty, you shouldn't be going into the psychiatrist to ask for specific medications. You should have a psychiatrist who has enough experience and skill to evaluate the situation and make medication recommendations that fit that situation. The psychiatrist should be driving the train -- after all, he/she went to medication school. That doesn't mean you shouldn't be discussing various choices with him/her and possibly coming in with your own ideas. But you shouldn't be the one to be treating your difficult child.

    Lexapro does treat anxiety and depression. It takes anywhere from 3 to 6 weeks to work. It comes in 5 mg tablets. My daughter takes 7.5 mg in addition to 225 mg Lamictal for anxiety and depression. She is very stable and has been for 2 years. It can have a side effect of wakefulness, which can be worked around by playing with when you give Lexapro (evening can interfere with sleep).

    in my humble opinion, I would ditch the Adderall until you get difficult child's anxiety and depression under control. Adderall could just be making his mood worse. Furthermore, we've found that when the mood issues are addressed, the ADHD-like inattention improves dramatically.
  4. Kjs

    Kjs Guest

    difficult child was taking lamictal it was not doing anything for him anymore. (he did take this for several years (3 years)..but quit a year ago and restarted last fall. it worked wonderful first time around. He went off of that in January. Took about two months to get him off.

    therapist is absolutely wonderful. He suggested lexapro, as did psychiatrist. But psychiatrist didn't want two at the same time. psychiatrist wanted Strattera. I asked if we could try one more stimulant without ritalin. The two bad reactions he had was with ritalin. That is when he suggested Adderall or Vyvanse. psychiatrist still had plans to add Strattera to that. Said Strattera would help with anxiety. therapist said he never heard it used for that.

    I am so scared. I just talked to him. He said he is very sad. He said he doesn't want to take medication. difficult child says it is NOT anxiety, things just don't seem real. I cannot get through to him that anxiety would do this. He has his mind made up. difficult child is on my mind every second of every day. I am so scared. And even more scared because I cannot be there.
  5. busywend

    busywend Well-Known Member Staff Member

    Are the Adderall pills 30mg each? So you can not try just giving him 10mg?

    My difficult child is 17 and a big girl and still takes only 20mg. It is the XR.

    It would not hurt him to stop taking the Adderall right away, it is quick in and quick out. I have to tell you that I took Adderall myself for a bit. My Anxiety skyrocketed and I am still feeling the effects long after stopping it. I have no idea if they are related.

  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    First of all, it sounds like a lot more than ADHD to me (maybe I said this before--I don't know). The feeling of not feeling "real" is called depersonalization. It can be caused by high anxiety or medication. I've had it caused by both, but it's a terrible feeling. I personally would not allow a high anxiety kid to be on the medications he is on, especially not a super stimulant like Adderrall (this is one of the most abused street drugs that exist because it is so potent--my ex-druggie daughter says it goes for $10/pill on the streets). Adderrall also made my son nutty. He lasted three days on it before I threw it out. He had never been so hyper or so sad. It's like he got high, then he crashed.
    I don't know too much about your child's history. Has he ever had a neuropsychologist evaluation? At any rate, this psychiatrist sounds terrible. NO psychiatrist tells a parent, "I'm worried your child will die by 18." Sorry, he'd be fired and long gone. Maybe he just has no idea what he's doing as your son isn't any better. A therapist shouldn't be recommending medication.
    If this were me, this crew would be gone and I'd find better doctors. Any doctors who are that gloomy about my child obvioiusly aren't in the right frame of mind to give him the best treatment. I prefer doctors who are confident of their abilities and not alarmists. All kids can be helped and ADHD is not high on the list of what causes suicide. Then again I doubt the main issue is actually "severe" ADHD. I do hope you try somebody else.
    Whatever happens, good luck and I'd sort of blow off what the doctor predicted. Doctors have all different levels of competence...
  7. susiestar

    susiestar Roll With It

    I am SO SORRY!!! I can completely see why you are scared!!

    Does therapist mean that he thinks difficult child will not be alive when he should be 18 or does he think difficult child will have some sort of breakdown? Is he afraid of suicide or an anxiety related or stress related physical illness hurting him (like heart problem or somesuch)? Can you call and ask him to clarify what he said? That might make a big difference in how you go about treating this.

    It is very understandable that difficult child feels no one is taking this health stuff seriously. NOT that you aren't, I know you are worried sick about him and his health and have been for YEARS. But that from the headaches to everything else the docs have discounted his reports of illness. It sort of seemed to me the docs said that since a couple of headache medications didn't fix things, or had bad side effects that difficult child shouldn't have treatment. I have been worried about how that would impact difficult child and his anxiety and other problems.

    It is SO HARD to get many docs, even those in pediatric specialties, to acknowledge that kids have real illnesses and feel real pain. Even harder to get many of them to actually TREAT the pain.

    The adderall is WAY too high if you started at 30. I know difficult child started at around 5 mg on adderall (years ago). Maybe it was 7, but it wasn't even 10 mg. I remember cutting very small pills in half.

    I would get the list of docs to the therapist ASAP. I think getting on waiting lists no later than next week would be very important. If you have to, get the therapist's fax number and send them to him that way (might save time). If you don't ahve a list, or it is online (like my insurance co - no written lists even when I beg) then maybe you can get the ins co to fax a list to either you or the therapist. If they send it straight to the therapist you should ask him for a copy of it to keep on hand, just in case.

    I know the therapist recommended Lexapro. If difficult child took it before it may not be something to revisit. While I have had tdocs who knew a bit about medications, and my mom's therapist seems to know about some basic ones, it is NOT something a therapist has been trained about. If you are going to take advice from someone who is NOT a pediatrician psychiatrist, ask the PHARMACIST. Going in to the psychiatrist and asking for a specific medication is usually NOT a good strategy. The psychiatrist may have other medications that work as well but are more appropriate for your child, or may feel the problem is something else entirely, or that the medication has more problems than you know about.

    I will say that we gave Jessie buspar for about a year when Wiz went into the psychiatric hospital. It was very helpful for her. It helped with the anxiety and PTSD, even helped reduce the number of panic attacks she had. We started her on HALF the normal dose (again by cutting a pill in half).

    One thing I have learned to do for myself and my kids is to start any medication that is not time released or an urgently needed medication like an antibiotic at HALF the recommended dose. We seem to metabolize many drugs differently, and are either far more or far less effected by medications. Starting at half the dosage for a few days or a week seems to let our bodies adjust to the medications better, and have a better chance of adjusting to them with-o as many side effects. If we hadn't done this with-Jessie's keppra she would never have tolerated it. As it was it took a YEAR to get to levels where it worked. Our neuro even saw the difference in her when we raised it the entire amt he suggested. He was shocked, but we actually raised her half as much each time and let it have an entire MONTH before increasing it again. It worked, and was worth the time it took.

    Your difficult child does not seem to have that luxury of time. But it would still be worth trying the medications at half the strength for a couple of days or a week or 2 before increasing. Esp if it meant his body could adjust and have a higher likelihood of working with the medication. It would also mean side effects would be less strong and if it needed to be stopped it wouldn't be as hard. This is JUST a SUGGESTION. Be sure to ask the doctor and pharmacist if it is OK to use a lower dose or cut the pills.

    If you can't get him in to a psychiatrist in say a month, then you may need to hospitalize him for a few days. It is worth visiting with the therapist about. You may even need the therapist to help make the appointment - sometimes you get in sooner if the therapist makes the appointment.

    I recommend working on a plan of what to do if you can't get in to a new psychiatrist in a timely fashion. What you will do for difficult child, ask his psychiatrist to do, his pediatrician to do (maybe help get an earlier appointment or rx a medication for severe anxiety until you can get in?), what to look for to know if you need to hospitalize him.

    I know this is long, and I am sorry. But it also occurred to me to start a diary where you write down what he puts on his myspace page about feeling sad or whatever. It is a good measure of how HE says he feels, and that may help the psychiatrist and therapist in treatment. Having a few weeks of this on paper for the doctor may give you a real advantage in getting the psychiatrist to understand things.

    I don't know if it is wise to tell difficult child you are recording this. Maybe NOT telling him would give a better measure of his feelings and how they change. Whether he knows or not it is a good thing to record, in my opinion.

    Sending hugs and lots of strength to you! Prayers for all of you also.
  8. susiestar

    susiestar Roll With It

    Oh - I called my local pharmacist who is excellent AND the insurance company mail order pharmacist and asked if strattera is used to treat anxiety. Neither of them had heard of it being used for anxiety, just for ADHD and depression ASSOCIATED WITH ADHD. It can actually have anxiety for a side effect I was told.

    Now, this is jsut what they told me. But the local pharmacist looked it up while I was not the phone and he is usually very accurate - and he has been my pharmacist since I was 14 (over 25 years).

    Just another piece of info to weigh.
  9. JLady

    JLady A ship lost in the night

    Lexapro works on depression. Buspar works on anxiety. Only a doctor can tell you if it is right for your child. Personally, I think Buspar is great for anxiety. I also hear that medication is often hit and miss. What works for one person doesn't for the next. If I didn't see the medications helping, I would definately be in touch with the doctor.

    In my opinion, if the medications are making things worse, I wouldn't give them to my difficult child. That is my opinion. Don't ignore warning signs. You are the mom and you know your difficult child best. Remember the squeeky wheel gets the oil. Make some noise with the doctor until you get the results.
  10. Kjs

    Kjs Guest

    The therapist difficult child sees is very, very good. He is also a forensic therapist, he has many titles. I know he doesn't do the drug thing, but he told me the same about Strattera. I asked him what he thought about buspar vs. lexapro, just for a little understanding since the psychiatrist is a jerk. He said lexapro works on seratonin and buspar works on dopamine. He thought lexapro might work. When we tried it a few years ago it was only for about two weeks. difficult child was awake for a week straight. That was 10mg's.
    therapist also told me the same as your pharmasist. Exactly the same. And this therapist clicks so well with difficult child it is amazing. HE is wonderful. He is the one who said last time he saw difficult child he was so distraught, that is why he wanted to meet with me.

    as for the adderall, it is XR. It is capsules. psychiatrist DID say take one (15mg's) for three days than take TWO. He said if two is too much we could dump some out of the capsule.

    I have to go to a class now, but will check back later. I know difficult child is trying so hard to fight this. I am just so scared.
  11. smallworld

    smallworld Moderator

    Like any SSRI antidpressant, Lexapro treats both anxiety and depression. In fact, some psychiatrists believe that SSRIs are better at treating anxiety than depression.
  12. lizanne2

    lizanne2 New Member

    Good Morning:

    My difficult child has a similiar set of diagnosis's. He started treatment young so the self reporting of symptons was less accurate and understandable. When he was in second grade the psychiatrist chose to treat the anxiety first. It was causing him the most trouble. Personal stress and crashed his self esteem. It was treated with a very small amount of SSRI it worked more quickly than expected and reduced(did not cease) his anxiety making him more 'available' for treatment. He also has severe ADHD. This is taking lots of time to treat and progress is being measured slowly. The first go around with any stimulant medicien caused increased depression and anxiety. He now tolerates and benefits from that class of medications but we had to introduce slowly.

    You are in my thoughts. Get the dr on your team, make sure he is responsive to you and difficult child. If not, draft a new team.
  13. Andy

    Andy Active Member

    Hugs! I have been there - watching my difficult child seeming to be physically falling apart and no help insight. Yours is worse since the help is not helping!

    It has taken me a long time to understand that anxiety is not just the scared feeling but everything else that comes along like feeling disconnected, feeling your body is falling apart. My difficult child sometimes struggles with that also. Right now my difficult child is certain he has brain cancer or tumor or whatever because his anxiety is focusing on his head.

    I also understand the difficult children' belief that we can be wrong because we can not feel what they are feeling - what if we are wrong?

    Sending strength your way - you are in my prayers today. Is someone with difficult child today?
  14. TerryJ2

    TerryJ2 Well-Known Member

    Oh, poor kid!

    So, you were alone with-the therapist yesterday, right?
    How often does difficult child have therapy? I would suggest it more often.
    I am wondering whether the medications are making things worse. The feeling of his ears being in back of his head sounds like what I've experienced with-medication reactions, as well as a very high temp when I had the flu (hallucinations).
  15. susiestar

    susiestar Roll With It

    Sounds like your therapist is quite good. If you have a good feeling about him and difficult child really likes him, then do NOT change. TRUST your instincts!

    your psychiatrist sounds like a stinker. It also sounds like adderall is NOT helping. As it is the XR I would NOT "dump some out of the capsule". How would you then know how much he is taking? That also might affect how the medicine lasts over the life of the extended release. VERY dangerous, in my opinion. Also NOT recommended by pharmacists or the makers of the medication.

    It really sounds like a new psychiatrist is in order.

    I am so sorry your difficult child is hurting so much.
  16. TerryJ2

    TerryJ2 Well-Known Member

    Ditto. Almost the whole point of an XR is the capsule. If you dump it out, it is no longer XR because it will be digested immediately. Yes, some of the chemicals are in the medication itself, but the capsule slows down the absorption.
  17. bran155

    bran155 Guest

    I am so sorry! You have gotten lot's of good advice. I just want to add my support and send you some (((HUGS))).
  18. Shari

    Shari IsItFridayYet?

    I'd get a list of psychiatrists to your therapist pronto and have him pick one he works well with. Hopefully he can pull some strings and get you in quickly and get difficult child on some medications to help.

    hugs to you all.
  19. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Hugs to you Kjs. I would definitely be getting a new psychiatrist asap. Adding in some prayers for your difficult child.
  20. KTMom91

    KTMom91 Well-Known Member

    I'd be looking for a new psychiatrist as well. Hugs and prayers.