When your child takes anti-depressants

On August 7, 2018 By norasmum12In anti-depressants, anxiety, CAMHS, childhood depression, children's mental health, depression, mental health, mental health services, Nora's story, parenting a depressed child, suicide, Young Minds7 Comments

tablets There’s a widely accepted belief among many parents that giving anti-depressants to a child is ‘a very bad thing’. Before Nora fell ill, I was one of ‘those’ parents.

I believed that the medical profession routinely over-prescribed anti-depressants to children who ‘didn’t really need them’. I believed this on the basis of no real evidence. I believed it because other parents believed it. I believed it because I read opinion pieces in broadsheet newspapers about the damaging effects of proscribing anti-depressants to young people.

I believed it because I was incredibly ignorant about mental health problems and the devastating effects they can have on young people and their families.

The purpose of this post isn’t to debate the pros and cons of giving anti-depressants to young people. I’ve had my fair share of negative reactions from other parents who ‘don’t think it’s wise’ for my child (yep, my child not theirs) to be taking drugs that can help her get better again. Quite frankly, I’m tired of trying to explain to people that if Nora wasn’t taking anti-depressants, she would very possibly be dead.

If you’re a parent wondering whether or not anti-depressants are the right choice for you child, I can’t help you make that choice. But I can tell you this: I absolutely believe that anti-depressants saved my daughter’s life.

This post is for parents who made the same choice we did.

Based my experiences with Nora, here are the five things I wish I’d known earlier. If I had, it would have saved me a whole lot of heartache and far too many hours searching the internet for answers.

They take time to work

When Nora was first prescribed anti-depressants we had unrealistic expectations of how quickly they would work. We watched her, day after day, for any signs of improvement. For the longest time, nothing changed.

It doesn’t help that it took time to get her dosage right (see below), but the waiting really was tough.

Nora’s been taking anti-depressants for five months now. During that time, her recovery has been remarkable. She’s still not ‘better’, but she is significantly different from the mute, withdrawn, suicidal child she was a few short months ago.

I know that her recovery isn’t only down to the anti-depressants, but they’ve certainly helped.

So, if you and your child are at the start of your journey with anti-depressants, hang on in there. It takes time, but the wait really is worth it.

You may not get the dosage right first time

Because mental health is so complicated, and children’s brains are still developing, finding the right level of the right kind of anti-depressant for a child can take time.

Nora is taking an SSRI (selective serotonin reuptake inhibitor) anti-depressant called Fluoxetine (commonly known as Prozac). We had to try the drug at three different levels before we saw any effects. Because the side effects are so horrible in kids, increasing the level of medication has to be done gradually.

Again, all of this takes time. Again, it’s worth hanging in if you can.

The side effects are horrible, but they pass quickly

One of the (very valid) reasons parents are reluctant to give anti-depressants to their children is because of the side effects. They are horrific.

Nora’s depression meant she was extremely suicidal and unable to eat. She tried to kill herself several times. She was self-harming. She lost so much weight we thought she might have be fed through a tube.

Two of the most common side effects of Fluoxetine in children are increased suicidal thoughts and nausea. If your child is already suicidal, and already struggling to eat enough food to survive, you really don’t want her taking something that’s going to make this worse.

Did we see any side effects? Yes. Nora threw up for several nights after she first started taking Fluoxetine. And she was extremely suicidal (although, if I’m honest, I couldn’t say whether this was because of the drugs or part of her general illness).

However, the side effects pass. In Nora’s case, they passed relatively quickly (I would say they had disappeared completely after three weeks).

They won’t ‘cure’ your child but they will help

I really wish I’d known this earlier. Somehow, I believed anti-depressants would miraculously ‘cure’ my daughter. I read other people’s experiences of taking anti-depressants. They spoke about waking one morning and feeling as if a cloud had lifted from them. I thought this was how it would be for Nora, but this wasn’t our experience.

Nora’s recovery was gradual. Day by day, we started to notice small improvements. Taken together, those improvements are dramatic. But they are still only part of her recovery.

The really key part from now on will be the work she does with her CAMHS counsellor, helping her to manage her feelings and build the resilience she needs to navigate her way through her teenage years.

When they start to work, it’s the best thing ever

This is why you have to hang in there when your child starts taking anti-depressants. For all the reasons listed above, it’s not easy. But it’s worth it.

My child was so very ill. She had stopped talking. She wanted to die. She had developed psycho-motor retardation, a condition that slows down your thought processes and body movements.

Today, she is engaged with the world again. She can fall asleep without needing me to be with her. She speaks and laughs and cracks jokes with her brother. She sees her friends. We go swimming in the sea. She is alive and embracing life.

All of this means more than anything. My girl is coming back to me.

We chose to give Nora anti-depressants, exactly as we would choose to give her life saving medication if she had cancer or any other illness. I am very glad we did.

Tips for parenting a depressed child

On July 21, 2018July 21, 2018 By norasmum12In CAMHS, childhood depression, children's mental health, depression, mental health, Nora's story, parenting a depressed child, suicide3 Comments

background conceptual contemporary creativity — Photo by Public Domain Pictures on Pexels.com

I have never suffered from depression, or lived with someone who has. So, when Nora first fell ill, I wasn’t equipped to help her. I did my best, but I made a lot of mistakes along the way.

Over the last six months, I’ve learned a huge amount about mental illness in general, and depression in particular. Through trial and error, I have gained some understanding of the practical ways a parent can support a child who is suffering from depression.

Here are my top five tips for parenting a depressed child. I hope they help.

Stay calm

Supporting your depressed child is exhausting, time consuming and deeply distressing. When Nora first fell ill, I stupidly thought it might help if she knew how upset I was. As if this might, somehow, reverse the course of her illness and bring back the happy, confident girl she used to be.

I realise now how ridiculous this was. Depression isn’t something its sufferers can ‘control.’ It’s a real illness, that leaves you feeling empty, terrified and utterly helpless.

More than anything, a depressed child needs to feel safe and loved. They will not feel safe if you’re crying and falling apart. This will make them even more scared than they already are. They will not feel loved if that love comes with ‘conditions’ (ie, that your love is somehow connected to them ‘not being sick’).

Don’t be afraid to talk about suicide

I’ve already blogged about this. Talking openly about with your child about suicide is a terrifying prospect. Like many parents, I worried that doing so might ‘put thoughts’ into my child’s head.

This is a fallacy.

If your child is depressed and self-harming, then there is a very strong likelihood your child has – at one stage or another – also had suicidal thoughts. These thoughts will be extremely frightening for your child. They may feel they cannot speak to you about them for fear of upsetting you.

It will be a huge relief if they know they can talk openly with you about suicidal thoughts. So, don’t be afraid to ask your child this very simple question: ‘Have you had any suicidal thoughts?’

If they say no, leave if for now but keep a close eye on them. If they remain depressed and are still self-harming, ask them the same question again in a few days’ time.

You can tell them it’s very common for depressed people to have suicidal thoughts. You can tell them it might help them to talk about this. Let them know it’s okay for them to talk to you about what they are thinking. Let them know you want to understand how they’re feeling and what you can do to help.

Most importantly of all, remember this: In the UK, suicide accounts for 14% of deaths in 10 – 19 year olds. Young people can – and do – kill themselves.

The more you understand about what your child is thinking, the better able you are to keep them safe.

Don’t try to do this alone

As parents, we want to do everything we can to keep our children safe. We believe no one in the world is better placed than us to do this. Most of the time, we’re right to think this. But not when our child has a serious illness.

If your child has mental health issues, you need help. You need professional help from your doctor and mental health experts. And you need all the support you can get from friends and family.

There is no shame in admitting you cannot do this by yourself. You can’t, and the sooner you accept that, the sooner you’ll be able to give your child the support they need.

The first thing you need to do is make an appointment with your family doctor. Tell your doctor your child is ill and needs help. Insist on a CAMHS referral.

Due to woefully inadequate funding of children and adolescent mental health services, you may or may not get seen by CAMHS. If CAMHS are unable to see you, don’t give up hope.

Take your child directly to the emergency unit of your local hospital. Tell the people there that you are worried about your child’s safety. Tell them you do not want to take your child home without a psychiatric assessment. Be as pushy as you have to be to get the help your child needs.

At the same time as you are pushing for medical help, don’t be afraid to reach out to friends and family. Taking care of a child with a mental illness is a very lonely experience. Most of your friends and family will have very little knowledge of mental health issues. But if your friends and family are anything like mine, that doesn’t matter.

They may not understand what you’re going through – and that’s really okay because how could they? – but they will be there for you. Tell them what’s happening. Explain your child’s illness to them. Ask for help. Keep asking for help. Your friends and family will want to help. So let them.

Trust the mental health experts

In an earlier blog, I spoke about the doctor we met who ‘didn’t believe’ in mental illness. I’ve also blogged about our negative experience with one CBT counsellor. These bad experiences are the exception. Almost every other medical professional we’ve met has been amazing.

Your child’s psychiatrist, mental health nurse and counsellor have all spent years studying young people’s mental health. While you are the person with expert knowledge about your child, they are the people with expert knowledge about your child’s illness.

It’s important you listen to their advice, particularly when it comes to choosing the right course of treatment for your child.

Remain hopeful

During the worst of my daughter’s illness, I never let go of the belief that she would get better. It was the single thing that kept me going. I was right to be hopeful.

Slowly, after six of the most harrowing months of my entire life, Nora is showing signs of recovery. She has started speaking again, she can eat enough food to stop her losing any more weight. Most importantly of all, she has started to engage with life again. She still isn’t ‘better’ but she is definitely ‘getting better’.

Your child will get better too. Never let yourself stop believing this.

There will be days – many days – when you feel as if you cannot bear what is happening to your child. You can bear it. You must bear it. Now, more than any other time in your child’s life, they need you to be strong.

One of the things that helped me enormously was reading Matt Haig’s blog Reasons to stay alive.

For months I read this every day. I read it to myself, and I read it to Nora.

If you are feeling hopeless right now, I urge you to read it too.

hope

Ignorance is no excuse

On July 10, 2018 By norasmum12In anxiety, CAMHS, childhood depression, children's mental health, depression, mental health, mental health services, Nora's story, parenting a depressed child, suicide8 Comments

If you’re the parent of a child with severe depression, you quickly learn that you will spend time in and out of hospital. There will be occasions when either you or your child know that hospital is the only safe place to be right now.

Nights spent in hospital with your sick child are no fun. If you’re lucky, you’ll get a bed to sleep in. Otherwise it’s a chair beside your child’s bed. If your child is a suicide risk, you have to spend the night sleeping by the nurse’s station. Sorry, did I say sleeping? I meant ‘trying to get some sleep, despite the bright lights and the constant noise’.

After one of these nights, Nora and I were waiting to be seen by CAMHS (Child and Adolescent Mental Health Services). We were exhausted. By now, Nora was very sick indeed. She was extremely suicidal, withdrawn and desperately in need of help.

Midway through the morning, a woman approached Nora’s bed and introduced herself as the ‘community paediatrician’. I had never met this woman before. Neither had Nora.

Here’s what happened next

Community Paediatrician (CP) shouts at Nora: ‘Hello, how are you this morning?’

When Nora doesn’t respond, CP looks at me: ‘Have you considered…?’ Her voice trails off as she whispers the final part of her question.

Assuming she’s going to suggest something helpful, I ask her to repeat her question.

She raises her voice, shouting again to make sure I hear this time: ‘Autism,’ she roars. ‘Have you considered your daughter might be autistic?’

Me: ‘Um… no actually. She’s under the care of a psychiatrist and her diagnosis is anxiety and depression.’

CP, holding her hand up to prevent me saying anything else: ‘It’s autism. I see this in young girls all the time. They do okay in primary school by pretending. But then they start secondary school and their strategies don’t work. Their autism becomes apparent. You need to get her screened for autism. I will speak to CAMHS about this.’

Me: ‘She’s been seeing a psychiatrist for two months. Wouldn’t her psychiatrist have mentioned it if she thought Nora was autistic?’

CP: ‘They always miss it. Me? I see this all the time. You need to get her screened for autism.’

I glance at Nora, and see she’s listening intently to this conversation. I want to say something. I want to tell her not to worry, I’m sure she isn’t autistic. But I can’t because, in my befuddled state, I think this person – who is a doctor, after all – must know what she’s talking about.

doctor When I look up, the doctor has already left. Nora and I are alone. Only we’re not. Because the nurses in this children’s ward are incredible. Without me realising it, one of the nurses – Sandy – has appeared. She takes one look at my face and calls for another nurse – Joyce – to come in.

Sandy: ‘Nora’s mum, you come with me. Joyce will stay here with Nora.’

Sandy takes me outside. We walk around the hospital grounds.

I am not making much sense. I keep saying things like: ‘I don’t understand. Can someone suddenly become autistic? That’s not how it works, is it? If she was autistic, wouldn’t I have realised it before now?’

All the while I’m muttering like this, my mind is going back over the last eleven years of Nora’s life, looking for signs my daughter is on the spectrum. I can’t find anything specific, but then I think maybe – to a greater or lesser degree – we’re all somewhere on the spectrum.

When I say this to Sandy, she smiles and says: ‘You’re absolutely right.’

‘But she has lots of friends,’ I say. ‘And she’s really socially aware. Too socially aware. That’s what got her into this mess in the first place. I mean, surely I would have guessed something was wrong?’

Sandy gives me a sympathetic hug and asks: ‘When was she first diagnosed with autism?’

Me: ‘Oh just now. Well, not diagnosed but the doctor thinks that’s what’s wrong with her.’

As I say this, for the first time I start to wonder how someone who has never met my daughter before could reach such a conclusion so quickly.

Meanwhile, Sandy takes one of my hands in hers, squeezes it and says: ‘Ah. I probably shouldn’t say this, but I’d take what that doctor tells you with a pinch of salt. You see, she doesn’t believe in mental illness.’

She doesn’t believe in mental illness

I replay these words inside my head, looking for the joke. Then I realise, Sandy isn’t joking. The paediatrician – a medically trained doctor whose job it is to take care of sick children like my daughter – doesn’t believe in mental illness.

That doctor wasn’t speaking to me as a medical expert. Instead, she was choosing to share her uninformed, and unforgivably ignorant opinion on why some adolescent girls ‘appear’ to have mental health problems.

Now, you might be reading this and wondering why I’m sharing this story with you? Well, I’m NOT sharing it with you because I think a diagnosis of autism is ‘worse’ than one of severe depression. I don’t know what it’s like to have an autistic child, so I cannot make that comparison.

Nor do I think the doctor was wrong for wanting to explore autism as a possible cause of my daughter’s symptoms.

However…

This doctor had never met me or my daughter before. She had no right – none, whatsoever – to assume it was okay to discuss Nora’s health in front of her the way she did. One of the key things you learn when your child is depressed is the importance of creating a safe environment which reduces your child’s anxiety levels.

Telling a depressed child she quite likely has other health problems is not a very clever way of reducing her anxiety.

Whether they like it or not, doctors are part of a profession which treats all aspects of people’s health – mental, as well as physical. It is simply unforgivable to ‘choose’ not to believe in some illnesses.

Would we trust a doctor who ‘didn’t believe in cancer’? I don’t think so.

When your child wants to die

Tag: mental health awareness