Need advice re college freshman daughter and depression

<p>This is really not my first post on CC (far from it) but I am using a different name to protect my daughter's privacy. She is a college freshman and has been struggling moderately although not dramatically all year, both in terms of her academics and her social life. Now she has asked to see a psychologist because she thinks she might be depressed. She is adamant that she does not want to see anyone at her school's counseling center; the center has recommended two private therapists--one is a male, probably mid-50s in age, and a clinical psychologist, while the other is a female, probably 35ish in age, and a licensed clinical social worker. </p>

<p>I will contact both of them on Monday and will probably schedule an appointment with whichever can see her first, but I am wondering whether anyone with experience with a depressed teenage daughter who has sought treatment has any thoughts about which dynamic might be preferable--the older male psychologist or the younger female social worker?</p>

<p>Does your daughter have a preference? Without knowing her, I’d say start with the LCSW. Women are often more comfortable with female health care providers in general. As a freshman she’s probably 19yo. She may need to discuss pretty intimate things at some point and find a younger woman more approachable. She could also have an initial interview with both and see how she feels.</p>

<p>Good luck. The fact that she has approached you and asked to talk with someone is a very positive step.</p>

<p>Impossible to tell without your D meeting them both. My D needed to see a counsellor in HS and the first one we went to was a middle-aged man who I thought was wonderful. But D got a vibe that he wasn’t taking her seriously, so she didn’t go back. Then she saw a young man, newly minted MSW, and they worked really well together; I think she felt he “got” her because they were closer in age. OTOH, the best therapist I ever had was a woman about 20 years older than me with a lovely maternal air. So it’s very individual, but you’re right, the “click” is important.</p>

<p>I’d probably have your D start with the woman, but make it very clear that if it doesn’t feel like a match, she should make an appointment with the man.</p>

<p>Agree with blueiguana that it’s great that she is taking the initiative; that’s a predictor for a successful outcome.</p>

<p>Couldn’t agree more - it’s all about fit but I would start with the younger female. All things being equal, my girls have always preferred female docs - just felt more comfortable with them. And the most important thing IS that she recognizes that she needs help and has asked for it. First year of college is just plain hard - so many adjustments to make and you’re doing it in an environment that is unfamiliar, normally without the comfort of old friends to lean on… frankly, I’ve had the thought that a little bit of counseling should be mandatory for all college freshmen.</p>

<p>I have a daughter who is a freshman and has been struggling with depression for almost two years now. She has a great therapist that she has “clicked” with who happens to be a younger woman. She was our third try, the others being women as well. So the connection is very important. Best of luck to you.</p>

<p>Don’t forget to get your daughter a complete physical including an appt and blood work by an endocrinologist (hormone work up). Many young women have problems that present as depression but are really physically based.</p>

<p>Spoken with experience.</p>

<p>I agree with SAX wholeheartedly. My freshman year in college I struggled with depression. I even wound up transferring schools thinking a different environment would help. My weight kept dropping and dropping until it hit 90 lbs and my parents became extremely concerned. I was always “hyped” up and I’m sure they suspected drug use. It turned out I had Graves disease. One of the symptoms is depression. Once treated, I felt SO much better. My D, who is a current freshman, was diagnosed this Christmas with an autoimmune/endocrine disorder as well, so it’s quite common. As far as the counselor goes, I would also start with the female CSW, and if it’s not a match, move on until you find someone she likes. I’m so sorry she’s experiencing this, but I agree…admitting to needing help is a very positive step.</p>

<p>My D is a HS senior and she also has depression-she goes to a woman and it has worked for her-so many kids these days have some sort of depression. Good luck to your D.</p>

<p>jc40, what are the symptoms of Graves? My daughter recently had a physical with a battery of tests when she had a recent relapse. One of the things she was reporting was weight loss. Her doctor ended up changing her meds which has helped but I couldn’t help but feel that something else was going on. Her thyroid was tested and came back fine. It is frightening how many things can coexist with depression or mask themselves as depression. It’s very hard to get to the bottom of things with so many variables. OP, good luck in your efforts to help your daughter.</p>

<p>Just making sure: your daughter is not at all limited to these two suggested therapists, is that right? Often insurance companies have a list of approved therapists, which can be overwhelming. So having the college center recommend people is very helpful. But if these two don’t work, perhaps they could suggest some others. Researching therapists online can often produce results, as can phone calls to other providers you trust, for names.</p>

<p>Thyroid problems can cause depression, as someone said. Also hormonal imbalances, and for some, birth control pills. Getting regular sleep and eating well, and taking breaks from stress, help a lot too, but can be hard to achieve in college (sorry for stating the obvious!). I think studies have also shown that exercise helps depression, even as much as antidepressants. (Is she considering meds as well as therapy?)</p>

<p>Good for your daughter by the way. Many kids who are depressed don’t show that kind of initiative to help themselves. Sounds like she will be constructive in pursuing health, and is taking responsiblity for it in a very mature way.</p>

<p>In general, I prefer female health care providers, but I have clicked with male doctors and therapists, so it really does depend on the individuals involved.<br>
Kudoes to your daughter for being open to therapy and motivated enough to suggest it.</p>

<p>Best to your family at this difficult time. I would be encouraged by your daughter’s willingness to seek help. Agree with others that gender can be a variable. Some clinicians can not prescribe medications, which many find helpful with some forms of depression. That said, a good therapist can accurately assess whether a psychopharmacological consultation is in order and many work collaboratively with psychiatrists. I think this is a common age to find it good to have someone to speak with about your concerns, but I also wouldn’t want anyone to have additional struggles due to a failure to assess the medical aspects of the situation adequately. The Drs. should have expertise in treating people this age and with medications. I would want to know going in what connections the clinicians (psychologist and social worker) had for other forms of treatment.</p>

<p>It is rare for a Clinical Psychologist to prescribe meds (this is based on the state, and sometimes their degree). The LCSW will not. It is a very good point to ask in the initial interview if they feel medication or labs in conjunction with therapy is worth exploring, do they assist in coordinating through a provider they commonly work with, perhaps even the university health care system? The more streamlined her care is, the more compliant she will be in following up with med checks and labs if this becomes part of her care. What she doesn’t want is for her care to become cumbersome and stressful in it’s own right. I would agree that a full physical with metobolic blood work is a very good idea.</p>

<p>OP, upon reflection, I wanted to add to my first post, #3.</p>

<p>Please don’t feel like you’re facing a make-or-break decision about your D’s future. The decision probably isn’t quite as critical as you might think. Both of these people are trained professionals. Both know how to establish a good working relationship with a client; it’s part of their skillset. Both know how to make an assessment, develop a treatment plan, refer to other professionals as needed, and carry out treatment. Your D is a rational, intelligent young woman; she’s not going to decide she can’t work with someone because she doesn’t like the color of their shoes. So it’s very likely that whoever she sees first is who she’ll stay with, or to paraphrase what I read alot on CC this time of year, “There probably isn’t a bad choice.” But it is very nice to have a backup, on the off-chance that she just doesn’t hit it off with the first choice.</p>

<p>So sorry your DD is struggling with this issue. It is especially hard for parents, I believe, when a child is depressed and away from home. As a NP, ditto the suggestions to couple finding a good counselor with a complete history and physical. Remember that in our current managed care environment, some physicians and other providers will not typically order labs that include a FULL thyroid profile. So be sure, either you or your DD request this. Also, a number of oral contraceptives can cause or exacerbate depression. Our DD had a major problem with this while on OC’s for endometriosis. </p>

<p>Your insurance company should have a search feature that allows you to look for the specific type of mental health provider you are seeking, e.g. age, sex, expertise. number of patients seen under your plan, etc. There are a number of LCSWs who work in practices with psychiatrists-which would be helpful if your daughter will need medication. Agree with many posters, that your DD is very insightful and courageous to know she needs/wants help and kudos to you for having the relationship with her that makes her comfortable letting you know she needs help.</p>

<p>Thanks for the advice and support. It makes sense that she might be more likely to connect with the younger woman, and it especially makes sense to think about finding a therapist as a process–I knew this in the back of my mind but it is good to be reminded of it (and to remind D of it, that she shouldn’t necessarily expect to click with the first person).</p>

<p>I also will look into finding an endocrinologist. And possibly a nutritionist–I know that she eats too much junk food and I do think that could be influencing her mood. Not that it is everything, by any means–she has always had a hard time adjusting to new situations, so college was just bound to be hard for her. And she made it harder on herself by choosing to go away to college, but it had to be her decision (she would have hated going to one of the local schools if we had tried to make her, and we could not persuade her, though we did try).</p>

<p>antiquefreak…Graves disease is basically intense hyper-thyroidism; hence, if your daughter had a full thyroid panel run (not merely T-3 and T-4 but TSH, etc.) it would have been discovered. I hope the doctors are able to properly diagnose your D. Best of luck!</p>

<p>I’m not sure if she had a full panel to be honest with you. She was checked for other things like mono and lyme because she was sleeping a lot/very tired and was losing weight. As I said we weren’t sure if it was something else or a relapse of her depressive symptoms. She also had just recently switched her bc brand so that could also have been a contributing factor. Sorry to hijack the thread, it just shows that many illnesses/issues can have similar symptoms. OP sounds like you are headed in a positive direction with your daughter. And I agree also with the other posters that her recognition that she is “off” is huge and very encouraging.</p>

<p>I think that either male or female can be OK, as long as your daughter is comfortable with the person. Good luck; we’ve had to hoe this row in our family and it’s very challenging. But as others have said, the fact that your daughter has asked for help is a huge plus!</p>

<p>In her first semester, my D was also depressed and homesick. She went to the school counseling center and found someone there who worked with her short term. When she came home, I took her for a full physical since thyroid runs in the family (my mom had cancer in her early 30’s but lived 50 years after that). She was ok physically, although very deficient in Vitamin D and iron, both of which can make you tired.</p>

<p>It’s a good thing that your daughter is seeking help. I would also suggest starting with the female because she may get certain things a man may not. For instance, the person my daughter saw picked up on a pattern to her feelings that correlated to her period. Now, my D charts her cycle (a little tricky because she’s a virgin and not on bc) and adjusts her diet a week before. Many of her symptoms have subsided and the others have become more manageable.</p>

<p>I agree with getting a nutritional assessment as well. My D’s RM first year was a nutrition major and she helped D get an appointment with one of the professors, who reviewed her eating habits and gave her some suggestions. My D did not have a weight issue or an eating disorder but tweakng her eating times and adding and subtracting some foods helped with her moods. If your D’s school has a nutrition or dietician program, it may offer a service of free evaluations for students, like my D’s school does, and you should urge her to take advantage of it.</p>

<p>Good luck with exploring all of your options and hopefully your D will have time to relax and recharge over the summer.</p>