Is this depression? Updated

[Josie]

easy child/difficult child has been complaining for months about her head hurting. She does have migraines and was off her migraine medications for a while to try some medications for Obsessive Compulsive Disorder (OCD). She's been back on her migraine medication, Elavil, for close to 6 weeks, and she's still complaining about her head hurting.

She has a low grade fever of about 99.6. She's had this the whole time also. This isn't normal for her.

She has extreme anxiety. Today, for example, we were supposed to go out of town for a doctor and she was going to miss 2 days of school. The appointment got cancelled and she was so distraught that she was going to have to go to school that it caused a 30 min. mini rage. Then every time she thought about it, she started going down that path again. She ended up not going to school.

She has only been going to school for 1/2 day, saying she can't go any longer because her head hurts too much. When she gets home, she lays in bed, watching TV. She will sometimes get up to play the computer but not for long.

She doesn't want to play with friends. One time, she did go to her best friend's house all day for a birthday celebration. She came home and cried because it was too much.

The doctors think it is depression. She says she is sick and doesn't feel well. Since she does have the low grade fever, I am not convinced it's just all depression. Does it sound like depression to you?

If it is depression, she's already done all of the SSRI's with intolerable side effects. Her psychiatrist is talking about possibly Trileptal. Would this help?

Thanks for any insight.

 

[ShakinThingzUp]

I'm no doctor........ but, I've had migraines --- and migraines cause depression.

I would think that yes, it is depression, but her depression may be CAUSED by those migraines....... and when migraines/tension headaches interfere with your life --- school, birthday parties, not wanting to go outside to play ---- all those are signs that the pain is out of control.

I would have her seen by a doctor who specializes in headaches/migraines.

I saw a neurologist who specializes in headaches for a period of about two years. If you get a good one, he will focus on what is causing the migraines AND managing the pain. She should not have to live in that much pain.

Think about it........ if your head was hurting 24/7, you wouldn't want to do anything either... it takes too much energy to battle the pain long enough to enjoy life, so you don't. When you don't enjoy life AT ALL, you become depressed.

God Bless!
Amy

 

[smallworld]

Hi, given that she has a low-grade fever, you need to rule out all physical causes before accepting that it's emotional. Has she had recent blood work (including CBC, mono, Lyme disease, thyroid, liver, the works)? Has she had a recent strep test? How about an MRI?

If all checks out normally, it does sound like depression. It's exactly how my daughter presented at age 10 -- with migraines and persistent nausea (without a fever, however) -- and major school avoidance. We did the full physical workup and nothing turned up. She then was put on Paxil and completely flipped out. That's how she ended up on a mood stabilizer.

If you're considering a mood stabilizer and your daughter has depression, I'd strongly recommend Lamictal instead of Trileptal. It's used for both bipolar depression and treatment-resistant unipolar depression. It's done a great job for my SSRI-reacting kids whose primary symptom is depression.

Hugs to you and your daughter. I hope you get to the bottom of what's going on soon.

 

[gcvmom]

Ditto on getting the fever issue sorted out. That's always a sign that there is something going on in the body and you need to find out if it's connected to her headaches.

Does she have any other symptoms? Runny nose or sinus congestion? Cough? Swollen glands? Sore throat? Pain anywhere else?

 

[Josie]

I'm taking her to an Environmental Physician/psychiatrist who did extensive blood work. We are still waiting on the PANDAS test. I should get a copy of it all in a few days to look over myself, but so far, what I've heard, is that it is normal. She has been tested for strep and mono.

I don't think he checked for Lyme. I was just researching this myself because I am wondering about it. A lot of her symptoms match up to Lyme and I even remember something about a suspicious rash on her that made me ask the pediatrician about it. The pedi dismissed this but I've read that is typical even when there is Lyme. I will ask the env. doctor about it.

We are waiting on this Environmental psychiatrist's testing to decide what the next step will be. It is just so frustrating that it is taking so long. That's where we were supposed to go today but it got cancelled. I wanted to have a meltdown myself when I heard.

If we decide to do a mood stabilizer, I will ask the psychiatrist about Lamictal. She can rage to the point we are afraid she will hurt herself. Does it help with that?

 

[Josie]

She doesn't have much congestion or a runny nose. She told me today that her throat hurts. Since she was just tested for strep, I'm thinking it's from all the loud crying she did yesterday.

She says her leg muscles hurt.

I just took her to the pediatrician 2 weeks ago and she couldn't find anything obvious.

 

[smallworld]

The reason I mentioned Lyme is because when my daughter suffered from daily headaches, her neuro insisted that Lyme be ruled out because he said it can cause constant headaches. The muscle aches and fever would also make me suspicious.

 

[Josie]

How did he rule it out?

 

[BusynMember]

I'm thinking "walking mono." That knocks you out, makes you depressed, and zaps you of all energy. Also gives you headaches.

 

[Josie]

I think the blood tests looked for an autoimmune condition. I am interested to see them myself to see what exactly it showed.

I am all for an additive free diet. She is already gluten, casein, and soy free so I have to make most of her food anyway. I haven't gotten up the strength yet to tell her she will have to give up food dyes and preservatives. The only "normal" things she can eat are full of those. She does get much less of that than a typical kid just because of her special diet.

I really thought she might have mono, too, but the quick test at the doctor was negative. I wonder how accurate it is, especially if it is "walking" mono.

 

[smallworld]

Lyme Disease is detected with a blood test.

Can you get a copy of all the blood work done thus far and post the tests the doctor has administered?

 

[Josie]

Yes, I will. It will be a few days before I get them.

 

[Josie]

I spoke to the doctor today. He is a Board Certified Child/Adolescent Psychiatrist and an Environmental Physician. He ran a lot of tests to see if there was any known medical condition causing her mental problems.

He said she is "very sick" and probably doesn't feel well. He didn't give me any ideas about what exactly was making her sick, yet. He is basing this on a low White Blood Count. Hers is 3600 and normal is 4000 - 13,500. He likes to see it at 9,000. The low grade fever is also an indication something is going on, according to him. I asked him about Lyme Disease and he thought we should get it checked out right away. She does have a lot of the symptoms and my mom was diagnosis'ed with Lyme after visiting us from a bite she got here. easy child/difficult child had a rash at the time also but it was dismissed by the doctor. Then my mom went to her regular doctor and he dismissed my mom's diagnosis also.

She also had high bilirubin and high gluten antibodies indicating gluten intolerance, which we already knew. I thought it was interesting that he checked for that, though. It makes me wonder if some how she is getting some gluten which would definitely, in her case, contribute to her mental state.

The other tests that he ran were thyroid, ANA and Anti-DNase for PANDAS(?), lead, Rheumatoid Arthritis Factor, Antistreptolysin, Homocysteine, Sedimentation rate, CBC with differential/platelet, Comp. Metabolic Panel, and a urinalysis. All were normal except they did see some crystals in the urine.

We don't have the answers yet, but I do feel like this doctor will keep looking. At least he believes there is a problem more than just a mental issue. I'm pretty sure her pediatrician thinks it is all mental.

 

[nvts]

Ok, can we clone this guy?

Amazing - a doctor that listens!

Hope they can track down the problem quickly! That poor kid has to be feeling lousy! Saying extra prayers for her (and you!)!

Beth

 

[smallworld]

Glad you are making some progress.

Clearly, I'm not a doctor, but just throwing out some thoughts here for you to consider:

If her bilirubin is elevated, liver function tests should be run. It's a blood test so it can be done at the same time the Lyme Disease test is administered. High bilirubin can be an indication of a liver disease like hepatitis so it needs to be checked into further.

My kids have had perfectly normal WBC at 4000 so 3600 is only slightly low. Where you really worry (as in leukemia) is when WBC is lower than 2500. But it should definitely be further investigated. Autoimmune disorders like lupus can cause low WBC.

Has she been on any antibiotics recently? Antibiotics can produce low WBC.

Hope you figure out what's going on soon.

 

[ShakinThingzUp]

Unbelieveable that her pediatrician dismissed the low grade fever without even checking her white blood cell count....

Glad you found a good doctor to help!!

God Bless!
Amy

 

[Josie]

Yes, I like this doctor but I wish he had given me more to go on than "she's a very sick girl". "Let's talk in 2 weeks."

He did mention hepatitis and say we would re-run the test. I will ask about the full liver function test.

I am concerned about autoimmune disorders as a possiblity because celiac disease is an autoimmune disease and linked to a higher incidence of other ones. Autoimmune disease turned up on a website about low grade fever, too.

Lyme disease is another one, from what I'm reading now, that is hard to diagnosis and missed by a lot of doctors. It does explain a lot of her symptoms, including it can cause psychiatric disturbances.

Glad you are making some progress.

Clearly, I'm not a doctor, but just throwing out some thoughts here for you to consider:

This is the part that scares me. That we moms have to research and come up with ideas for the doctors. At least this doctor is like-minded and willing to do the tests.

 

[Josie]

I told the pediatrician that we just had a full blood workup and were waiting on results so it isn't as bad as it seems. Hopefully, she would have done one.

 

[TerryJ2]

Gosh, I'm late to this, but Lyme Disease popped into my head, too. Anti-inflammatories work well for that, in addition to the antibiotics.
I hope you get it straightened out quickly. Let's hope the depression is just an effect of long-term illness.