Medication for difficult child and case of motherly pride

Discussion in 'Parent Emeritus' started by SuZir, Oct 24, 2012.

  1. SuZir

    SuZir Well-Known Member

    I’m sure there is a whole chapter in ’Successful Parenting for Dummies’ about how you are not supposed to be almost giddy from relief and pride when your nineteen year old, living on his own, supporting himself, intellectually gifted son is able to handle a doctor appointment appropriately all by himself. However difficult child didn’t come with that book and I’m still little clueless on those things. ;)

    Anyway, difficult child had an appointment with both his team’s doctor and his psychiatrist (there are some benefits on being a pro athlete; you don’t have to wait for appointments like rest of us…) to discuss the need to medicate his anxiety. difficult child has serious doubts about psychiatric medications and especially didn’t want SSRIs and was very worried he would be bullied to have them. difficult child is afraid of side effects of SSRIs and I’m worried about possibility of drug induced mania and that leading to onset of bipolar.

    difficult child has had high anxiety after summer and a week ago even had a bad and long lasting panic attack that only stopped after he was given diazepam. His team’s doctor thought it was high time to try medications because difficult child is having very difficult time dealing with his anxiety and it influences to both his sport performance and his peer relationships. He has a lot on his plate, he feels lots of pressure in many areas on life and that has likely been a cause for heighten anxiety though he has always been prone to it. His psychiatrist also said that starting therapy can be a cause. Trauma therapy tends to be very hard.

    But anyway, I’m being giddy because difficult child was able to share his worries and apprehensions for psychiatric medications, felt doctors did listen to him and gave him answers he could understand. And most importantly gave him impression that he is on driver’s seat on this.

    psychiatrist thinks SSRI may be needed in later time, but difficult child doesn’t need to try them now, if he doesn’t want to. Her choices for difficult child would be either Lexapro or Celexa. She wasn’t too worried about mania, because according to her, drug induced mania with antidepressants happens most often with patients, who are already experiencing deep, often rather sudden, bipolar type depression to begin with. She also didn’t think difficult child has too big genetic risk, because neither of his parents have bipolar even though there are bipolar people in my family tree. Also difficult child not suffering depression points to low risk.

    But because of difficult child not wanting SSRIs at least now, she recommended him trying BuSpar first. Apparently it should have low side effect profile, it shouldn’t be addictive and if it works, it is a really good drug. Con is that for many it doesn’t work too well on it’s own but then again works well with SSRI. difficult child has a phone appointment with her next week to discuss it more after he has few days time to think if he is willing to try it.

    difficult child was also prescribed Atarax to be taken as needed and he promised to try one Saturday night. Apparently it helps with sleep and can reduce anxiety, but many feel drowsy and lazy even next day and sleep longer after taking it. But then again it depends on person and some don’t feel drowsy at all even though for most it makes them sleepy half an hour after taking it. It is antihistamine and shouldn’t be too habit forming though some people feel they can not get sleep without it after taking it long time. If used every day it also may stop working for anxiety and sleep and only continues to work as antihistamine. But difficult child is not told to use it every day anyway. Depending how it affects him he is supposed to take it after a bad day to prevent it continuing with bad night and even worse next day. If it makes him drowsy next day he should only take it before day off or at least day without a game. I think difficult child has had Atarax before, many moons ago when he was little and had a terrible case of chicken box, all itchy and unable to sleep. If I remember correctly, it didn’t make him too drowsy after good night sleep then.

    The benzo team doctor has added to team’s medicine cabinet (difficult child hated diazepam) is Xanax. For me that is scary, but doctors don’t think it is a risk at all. They are not prescribed for difficult child but if he has a new panic attack, team’s medical staff will give him one. And if he wants to, he can get one pill at the time with him if he needs one at home. And if he ends up needing them more than couple a month they will change it to something less addictive. But they feel that Xanax is best for rare panic attacks and addiction is not a threat when not used too often.
  2. Calamity Jane

    Calamity Jane Well-Known Member

    That's encouraging news, Suz. When you consider that he's only 19, I would say his progress is very impressive. You should be proud!
  3. stalln4x

    stalln4x Member

    I hope it's not out of my place to chime in but I saw your post in the watercooler and I have specifically read and heard about Buspar being better if someone's an athlete than benzos to avoid excessive sedation and the ataxia/clumsiness that benzos can bring. But, Buspar is supposed to take a while to start working and wouldn't help for acute episodes of panic (though it would/may prevent them).

    I used to be a pretty avid runner and I took a xanax once and was wobbly and tired well into the next day (but I think the dose was too high).

    May I ask what he didn't like about Valium? My doctor's pushing for this as maybe a once-in-a-while sleep aid or anxiety medication because he thinks the longer, less sudden/potent effect would be less addictive but eh.

    It sounds like his doctors are very competent and that involuntary tranquilizer addiction (as the people who accidentally got hooked on benzos in Europe call it) shouldn't be an issue. On the other hand, I'm an addict of sorts myself and I honestly thought Xanax was a street drug until I started reading up on pharmacology.

    That's cool your son's living independently and at such a young age. I'm jealous and you must be super proud. :)
  4. stalln4x

    stalln4x Member

    Oh, I should also add... have they thought about Ativan? When I was in a psychiatric hospital once, I would get pretty bad panic attacks and Ativan stopped them pretty well every time except once without making me feel sedated like Xanax did. It's not as much of a drug of abuse either, to my knowledge, although I don't think they have the super small doses of it like they do with Xanax sometimes (like 0.125mg).
  5. Andy

    Andy Active Member

    Congratulations! You have every right to be proud!
  6. DammitJanet

    DammitJanet Well-Known Member Staff Member

    sounds very good. Lots of doctors try atarax now. I think its useless because its basically a stronger benedryl but thats just me. And yes, they gave it to one of my boys when they were about 5 for a bad case of poison ivy.
  7. SuZir

    SuZir Well-Known Member

    I do like that they try 'milder' ones first. If they work, that is awesome, if not, they can try something else. I do think that this way difficult child is also more willing to try. As we all know, psychiatric medications tend to be quite trial and error anyway, so mostly I'm just happy, that difficult child was able to voice his opinions and felt he was heard. That is huge for him and I hope that this experience helped his self esteem in these things. That in future he dares to advocate himself more in appropriate matter and is more willing to deal with these kind of things. Until now difficult child has usually decided beforehand that he would not be heard anyway and simply sulked or behaved in obnoxious manner in this kind of situations. And then felt bad and violated afterwards. I'm sure that his success now was mostly because of doctors knowing him and being able to handle him and encourage him and he wouldn't had done as well, if doctors wouldn't had known what they were dealing with, but still this kind of success is a great learning experience for difficult child.

    And of course these kind of medications work so differently for different people. I'm sure many people would not feel so strongly about dizepam as difficult child. After all many people use them during the day and are perfectly able to function. difficult child got the panic attack after away game and the home team doctor was the one to give him diazepam. difficult child got first quite sleepy but was able to pack his things etc. but fell quickly asleep at bus and when they got home few hours later in early morning hours they had tough time waking him up. And even after they got him awake, he was less than coherent. He was able to walk and talk and do what he was told to do (even brush his teeth), but apparently his conversation topics were quite interesting and he behaved like he was drunk. Two of his team mates escorted him home with orders to make sure he was in his bed and sleeping before leaving him. Next day difficult child felt slow, clumsy and out of sync in practise and that is his main problem with diazepam. He also didn't really remember much about things between falling asleep in the bus and waking up from his own bed at morning and didn't like much about that either. Especially when he apparently got teased about what he had talked about during the night.
  8. SuZir

    SuZir Well-Known Member

    difficult child had tried Atarax at Saturday night but is not yet sure how it will work for him. He did get sleep easily and slept well, so that is good and didn't have any big adverse reactions. He did say he felt lazy at Sunday, but then again, he always feels lazy at Sundays so he is not sure if it was a drug or not. He also did some reaction and reflex training to see if there was influence on that, but is not sure. Again he is not sure if it helped for anxiety other than helping with sleep. But still a good experience and he plans to continue trials with that medication.

    I think he is also planning trying BuSpar but they are debating about when to start. He should absolutely need to be on the top of his game a week from now and they are worried that if he will have some adverse reactions or side effects, that could be screwed.

    But again, I have to say I'm very proud how much more proactive and accepting he has became over last half of the year-year when it comes to his problems and working with them. He still needs his own time to think things through, but if he is given that, there is so much less passive-aggressive rubbish and simply letting go than before.
  9. SuZir

    SuZir Well-Known Member

    difficult child has now been four weeks on BuSpar and the side effects he did have (some nausea and headache) have gone away. He isn't noticing that much difference himself (but having so tough time with sport kind of explains all that) except maybe for sleep. However his sleep diary shows that sleep is drastically better (he is able to fall asleep just fine mostly, has used fewer Ambien-tablets than before and has had much fewer nightmares or waking ups middle of the night.) Also his heart rate (resting and changes during and after exercises) is much more to his trainers' liking. They also feel that considering the situation difficult child has been less irritable and difficult than could be expected and think that could also be because of the medication and lowered background anxiety. He will have a phone appointment with his psychiatrist later this week about continuing/discontinuing BuSpar, but at least his team doctor is pushing him to continue.

    Atarax difficult child does like and has used it once or twice a week and feels it helps to cut the anxiety cycle. But it does carry over a bit for next day so he is not willing to use it more often. He has not yet had another full blown panic attack he wouldn't had been able to handle with breathing exercises and other non-drug methods so he doesn't know if Xanax will work for him or not.

    His stress over sport complicates things badly just now and I hope he gets to more stable phase with that so it would be easier to see what is just situational and what is real mental health problem. Could be that we will need to wait till thee end of the season before his life gets low-stress enough to really tell.
  10. DaisyFace

    DaisyFace Love me...Love me not

    LOL! Ain't that the truth?

    I've had days when I've been thrilled beyond words to find there were no new holes in the walls. Yay!!!

    Yes - this is progress...and you should feel proud!
  11. SuZir- That is promising! Especially about the sleep patterns. Every one of our doctors and difficult child's therapist have told him how important getting enough sleep is and how quickly you can get messed up with one bad night.

    Proud of your difficult child and what he is accomplishing and working through for himself. :)
  12. SuZir

    SuZir Well-Known Member

    Yes, I too am happy with sleep getting better. For him it's not even just anxiety thing. His profession really plays havoc with sleep. They (of course) have most of their games at evenings. After a game they are usually done their post-game things, media, showered, eaten and packing in little over an hour. After that it is often bus trip (or bus-plane-bus) home, anything from few hours to seven, eight hours. Napping at bus, being home most often at early morning hours, unpacking, going home, trying to get back to sleep etc. And at morning back for practise (after eating etc.) And even though they are of course home early after home games, adrenalin is not that quickly out of your system so getting sleep is difficult. And they usually have a couple games a week, at times even four.

    In fact sleep is one of the newest main interests of sport medicine around here. Athletes eat well already, they train well and very scientifically, sleep has been somewhat less thought of till now. And new studies have made it clear how important sleep is to well-being and also performance levels. And there are many sports that tend to have very challenging timetables. My difficult child's sport is one of those. His league luckily is not one of the worst because distances are not that big.

    But when you combine sleep difficulties based on occupation and sleep problems based on anxiety you of course get a difficult cocktail. Help with sleep is a huge thing in my books when it comes to difficult child.
    Last edited: Nov 29, 2012
  13. SuZir

    SuZir Well-Known Member

    difficult child had a psychiatrist appointment again this week. It seems his anxiety trend is getting down and sleep has continued to improve. There was one very bad week amongst it, but other than that especially their 'How much you want to strangle difficult child today?'-index has shown improvement. So I guess I should be relieved that the most imminent threat of difficult child getting himself man-slaughtered has diminished :rolleyes: They also think he shows some progress with peer relationships with the team mates closer to his age and take that as a sign of lessen anxiety (things go smoother when he is less irritable.) Physical results have also got better (heart rate etc.) However difficult child himself is still not able to say if there is much change, but also his self kept daily anxiety rates show some decrease. I wonder how much in this is, that he has difficult time telling how he feels and analysing that. Also his coaches and medical staff reported that they feel difficult child has been more introverted than before and his trust issues are getting worse. psychiatrist would had hope more rapid improvement and had again talked about adding SSRI, but that was dropped because difficult child just doesn't want to try. So they continue with this medication, just up BuSpar a little. There doesn't seem to be any side effects so that is good.

    So sleep patterns and physical signs are definitely getting better but other than that, I'm wondering if he is just internalizing his anxiety more. His mood is bit up but that could be just because his sport performance has started to look little brighter after Xmas. We will see how it all develops.
  14. InsaneCdn

    InsaneCdn Well-Known Member

    sleep patterns are a "critcal index".
    Anxiety really affects sleep... and lack of sleep really affects anxiety.
  15. SuZir

    SuZir Well-Known Member

    Yes, sleep is a priority. That alone makes it worthwhile to continue with this medication even if difficult child himself isn't feeling much of the change otherwise. And luckily better sleep and pressure from team's medical staff is enough for difficult child to want to continue. He still isn't thrilled of the idea of taking psychiatric medications but he is willing to continue because of very few and mild (and almost gone) side effects and because of the sleep and his team's doctor saying he should.
  16. busywend

    busywend Well-Known Member Staff Member

    Sounds like real progress! It is so nice he is a part of his medical care. He is a good kid!