Treatment for teen with Anxiety?

<p>I have read through several threads here about dealing with anxiety and very much appreciate everyone’s willingness to share their experiences. It really helps to know we aren’t alone.</p>

<p>My D (16) has been struggling with anxiety.</p>

<p>It seemed to start suddenly with a big panic attack, and then continued with physical symptoms which led to more anxiety…I am sure many of you know that cycle. It’s been up and down now for a little over a year. </p>

<p>Early on we tried some self help books/tapes that did seem to help in the short term, and then she tried counseling, tried a couple counselors. She did find one she seems to like, but going just makes her feel worse while she is there, focusing on the issue, so she did get some strategies, but then stopped going. The counselor was on board with her decision.</p>

<p>She has made progress and has ok days…her perspective on how ‘good’ her good days feel changes based on how she is currently feeling.
I think the period of time that she has these good/ok days has gotten longer over time, but it is also getting more frustrating to her when she has setbacks. That is where we are now.</p>

<p>She had a setback a couple weeks ago, when she had to be in a situation similar to when she had her first panic attack, and since then has really had a hard time again. </p>

<p>It is so hard to see her struggle, and she is just worn out and so tired of dealing with it. I think this time is extra hard because she was feeling the best she had in a long time right before this setback…although the anxiety had never truly gone away.</p>

<p>Since there have seemed to be times when it wasn’t so bad, I haven’t focused much on diet, vitamins, etc and have now renewed that research, but we are also talking about meds, and are trying to get an appt with a doctor who can prescribe them, but I am still very hesitant to have her go down that path.</p>

<p>If it she can do meds for a fairly short term (even if that means a couple years) and that makes her more comfortable with sitting in counseling, and then is able to get off the meds…that, of course, is what we’d hope for, but if it means a long term odyssey of meds and side effects, and withdrawals, then that is more troubling. But, if she is going to end up with meds, I would rather she get that figured out now, than wait until she is trying to deal with college.</p>

<p>If you are willing to share more about your journeys and what treatments you found to be effective, or any words of wisdom, it would be appreciated.</p>

<p>My daughter is the same age and has crippling anxiety. She’s very bright, but now I am concerned she won’t even be able to finish high school because of it, or live a normal life. It’s awful. I wish I had some great advice, but we’re in the midst of it ourselves. Unlike you, I don’t fear the medication. She’s just on Prozac, and it’s fine, and helpful, without side effects, and probably helps her not be as depressed about the situation, but it’s not a cure for the anxiety. I guess I’m just chiming in now, in empathy.</p>

<p>Just making sure she’s had a complete physical with her primary care physician, including blood work. Thyroid issues can manifest themselves in anxiety, as well as many other conditions. Any good counselor should have suggested your D get a thorough physical.</p>

<p>Before trying a daily medicine, you might ask for her to try Xanax, which can just be used when she is feeling anxiety or a panic attack. Sometimes, just having the Xanax available IF needed can help relieve some worry about the possibility of having an attack.</p>

<p>Just a head’s up, because I’ve been around these boards for so long. As this thread unfolds, you’re going to get a wide range of recommendations on both ends of the continuum… meds, no meds (and kinds of meds); therapy, no therapy, etc. You need to figure out which health care professionals you can put your trust in, and which do not seem to have your daughter’s best interest in mind. Please keep in mind that whatever people relate here, are things that have worked for them, but may not necessarily be something that works for your daughter. Unfortunately, it’s often a case of trial and error to find the best treatment.</p>

<p>Friend’s daughter was on Xanax for a month. Went off and is fine. That or Klonopin (another friend’s daughter jsut started on that) may help, although the addition of a daily anti-anxiety med may also be needed. </p>

<p>Shoeboxmom- I PM’d you.</p>

<p>It’s not so long since I was in your daughter’s exact position.</p>

<p>Medication is very much a case of trial and error - it is very unlikely that the first one she tries will be the one that works. They all function differently for different people and if you’re serious about trying, you both must accept that it will take time. Medication is not a miracle cure for any kind of mental illness and it is a commitment. I’m now trying my third (Mirtazapine) after failed attempts with Fluoxetine and Sertraline.</p>

<p>Counselling or therapy will likely be recommended in combination with medication. I’m currently trying cognitive behavioral therapy, which might be useful for your daughter if she can identify any triggers of her anxiety/panic attacks. Again, it depends on the individual and what works for one will not work for all.</p>

<p>I wish you and your daughter the best of luck. I know how difficult this can be and I truly hope that she can find a solution that works for her.</p>

<p>some interesting new research into how ones guts help regulate mood… the new frontier in mental health.</p>

<p>shoboemom - I sent you a PM.</p>

<p>Nothing to add but wishing your daughter the best.</p>

<p>Nothing to add either, except that you are all wonderful parents to recognize these problems and do your best to help your child solve them. That wasn’t the case in the '70s, when I was going through this. I thought I was crazy and the more I reached out for help, the worse it seemed to get. Hugs to all of youl</p>

<p>Develop specific coping strategies. </p>

<p>For example, someone I know very well has tremendous anxiety related to choosing food, particularly at an unfamiliar restaurant. This led to avoiding going out, etc. The coping strategy developed was to check the menu beforehand - thank heaven for the internet! - so a choice or two could be made. </p>

<p>In other words, many anxieties aren’t general but are tied to a specific kind of choice or decision or fear. Many people, for example, have public speaking anxieties - and there’s an industry devoted to coping strategies for those. These can spill into fear of being in crowds, which can become fear of parties. Some people have test anxiety and there are strategies for calming down for that. I know someone who always gets a drink not because it’s alcohol - it’s actually not - but because his coping strategy for party anxiety is that the glass in his hand is a prop that puts him into the party context. It is his relaxation crutch. </p>

<p>I think it really helps to see if a person has a general anxiety issue or a specific type of anxiety that shows in specific circumstances. </p>

<p>I saw yesterday a list of 4 things taught to Navy Seals for teaching self-control. It really isn’t appropriate for anxieties - because it’s general and the group in the Seals is already self-selected for personality type. But the idea is there: even a Seal needs a coping strategy. Many of their tests involved just that: like having to come close to drowning in a breath holding test wearing many pounds of equipment. If you get anxious, you bomb out. So you need a coping strategy.</p>

<p>We all do this to various extents. I had to learn how to act normal and still get it wrong much of the time. </p>

<p>And there’s the neat story of the psychiatrist who was examining brain scans of psychopaths and realized his brain scan says he’s a psychopath. And he realized that explained a lot about his life - and likely why so many murderers have been in his family. He has kids. He was raised in a loving family. His parents took him to a counsellor when they saw signs. And now he’s making more of an effort to try to think like others. That’s all a coping strategy but from the perspective of someone who really can’t understand what coping is.</p>

<p>Anxiousmom, I always had a lot of anxiety and I noticed after many years that when my stomach was upset it would make me feel nervous. I believe that diabetes does that to some people, too. There is something about stomach problems, like irritable bowel syndrome, that affects moods. I am not a doctor but I have really noticed that over the years. I know a lot of people think their nerves affect their stomachs but I think it is the other way around. I now know I have a few food allergies that affect how nervous I get.</p>

<p>“if it means a long term odyssey of meds and side effects, and withdrawals, then that is more troubling. But, if she is going to end up with meds, I would rather she get that figured out now, than wait until she is trying to deal with college.”</p>

<p>She certainly should get it figured out now, not only because of the stresses of college, but because the usual course of panic disorder is to get worse over time (with a cycle of two steps forward, three back). It is best treated aggressively when it has not yet become paralyzing.</p>

<p>I’m not sure what you mean by withdrawals. If you are just talking about tapering on and off of a medication, that is standard for most psychiatric meds. If you are talking about withdrawal symptoms like opiate users get, some medications for anxiety, including antidepressants used to treat panic, are not habit-forming and can be tapered on and off with no experience of withdrawal. Others (benzodiazepines like xanax and ativan) can be habit-forming and have to be withdrawn with more care after daily use. dg44 is right that some trial and error is often necessary. It is essential to find a psychiatrist who has experience with adolescents as well as the ability to make you feel comfortable. </p>

<p>I think it’s worth asking yourself if you would be equally reluctant to try medication if your daughter had a condition like endometriosis or arthritis. Would you have this much concern about the possibility that she might need medication in the long term? Or would you just be happy to find a medicine that works well with minimal side effects?</p>

<p>Good luck to you and your daughter. I’ve been there and (eventually) out the other side.</p>

<p>I sent you a private message</p>

<p>This picks up on Lergnom’s suggestion in post #12. See if you are impressed with Mary Ellen Copeland’s workbook called “Wellness Recovery Action Plan.” An individual works up a personal plan that identifies one’s own specific triggers. (for example, loud noises, or complicated work assignments…) Then list what specific actions help calm them. (for example, phone Mom; take a warm bath; swim; call my therapist…).</p>

<p>They write up a plan of what to do when an attack begins, and what to do a few hours later. There are also pages concerning her daily contribution of activities that improve her coping strength, longterm. The focus is on wellness and recovery.</p>

<p>She develops the plan on a series of worksheets, on days when she’s not so upset, so the plan is her own. With a teen, you might want to offer moral support (high fives, milk ‘n’ cookies, not answers!) as she works on it; it takes time. Later, people around them, like you, can ask her, mid-stress: “What;s on your plan to help with this?” It’s her plan.</p>

<p>I want to emphasize that the people who have found benefit in this work use it in concert with other therapies. It doesn’t replace seeing a mental health professional, or using medications. It’s an addition. </p>

<p>It is very practical to have developed a document that says exactly what to do when in distress.</p>

<p>Also HIGHLY recommend blood tests and endocrinologist to rule out hormone issues.</p>

<p>I want to add I would avoid drugs until and unless that becomes a necessity. They have many side effects and those are often much worse in teens, whether the side effect is rage, over-sedation or suicidal thoughts.</p>

<p>My DD had anxiety from the time she was a little girl. It worsened when she started high school, to the point where it was difficult to go to school. We took her to a number of mental health professionals for therapy. She was treated for anxiety and depression and she was on an SSRI for awhile. It would get a little better but then it would come back. We were at wits end and didn’t know what else to do for her. </p>

<p>Then I came across the following article (below), which described my daughter’s behavior. It was as if the author was a frequent visitor to our home who watched her grow up. I began to realize that the anxiety was not her main problem; that it was actually one of the symptoms of a much bigger problem that all of the psychiatrists, psychologists, and social workers who had worked with her just didn’t recognize. </p>

<p>She was diagnosed properly three years ago, and now is taking the proper medication for her problem. She is a different person. She still has some anxiety, but she understands what it is and is able to keep it under control. It is not ruining her life. She is in college, doing well, involved in activities, has made great friends, etc; everything we all hope for our children.</p>

<p>We can’t believe the difference in her. The right doctor and the right treatment has given her back her life.</p>

<p>I’m not suggesting that any of your children have a problem similar to my DD. But I learned from experience that just because someone has an MD or a MSW or a PHD, they aren’t necessarily right when they diagnose your child. Also, anxiety can be part of many other mental health problems and if a person has one of these other problems, the anxiety can’t be effectively controlled until the underlying problem has been diagnosed and controlled. I suggest that you read and research and think outside the box as you try to help your child.</p>

<p><a href=“http://www.bipolarchild.com/Newsletters/0307.html[/url]”>http://www.bipolarchild.com/Newsletters/0307.html&lt;/a&gt;&lt;/p&gt;

<p>Thank you all for your posts and PMs. I truly appreciate the advice and support. It is amazing how many people seem to be dealing with these issues. She is doing better right now than she was just a couple weeks ago. Today was the last day of mid-terms, so now we get some down time over the holiday break. We have an appointment in January to talk to a doctor about meds, so, we’ll see.<br>
You have all given us a lot to think about and I am looking into the books and links you provided.</p>