Advice re Daughter out of school

[Louisa]

Daughter

 

Our daughter aged 14, who amongst other things, has high anxieties and school phobia was referred seventeen months ago to CAMHS and we were told by the psychiatrist that she was 100% sure she had mild Aspergers.

 

However after many many months of waiting (seeing a psychologist in between), she was referred to Pathway for Children with Social Communication Difficulties (or something like that!) who have now said (they did the DISCO assessment with me but they only met her for fifteen minutes), that she hasn?t got aspergers but significant anxiety problems. They say all her other issues, like sleeping, eating etc, are just coincidence and that they think she would benefit from medication.

 

Because our daughter couldn?t cope at high school, she was referred to a part time medical education centre but she is currently not attending this either as she cant cope being around some of the other more confident girls there (even though there are only about 5). She will only spend time with people her own age if she is really sure of them and because she is out of school, she is having no life.

 

Anyway the previous Physciatrist left and she saw a locum last week who mentioned ?Avoidance Personality Disorder?. He has given her a prescription for Prozac. He says that she may become a recluse if she doesn?t take it and that hopefully it will turn things around for her & she should be able to live like a normal teenager. He scared the life out of me though when he said one of the side effects could be suicidal thoughts!

 

Anyway everybody in the family and work colleagues etc are saying things like don?t let her take it, it?s a cop out as they don?t know what is up with her and that the particular doctor should be sacked for trying to put a 14 year old on Prozac.

 

I am desperate to help her but don?t know what to do for the best. As for my daughter, she sort of wants to take it but has always been scared of any sort of medication and can?t bring herself to swallow the first tablet. I don?t know whether to encourage her or not. Please give your advice.

 

Thanks & sorry this is so long.

[justamum]

You clearly have large doubts so seek a second opinion with regards to her and medication

[darky]

Agree with Justamum, I would ask for second opinion. My daughter is 9 and she was on Prozac for a while and it did help with anxiety, but it made her hypo. She has since been put on Citalopram and it has made such a difference! I will say that before we trialed any medication we had 2 years of therapy to try and help with anxiety but it didn't work, and my daughter was totally unable to function out of the house, and even in it in the summer with the bugs! I do think medication has it's place, but other avenues should be explored first, especially if that is what parents want!

[Thompsons]

I was put on Prozac aged 15, and I'm still taking it. I haven't had any suicidal thoughts since being on it and it's helped me. I feel it just gives me a little boost. The effects of it aren't huge and you won't see your daughter changing over night, but it may just make her feel a little more confident. I don't agree with the suggestion that she'll become a recluse if she doesn't. Medication isn't a cure. It can assist, but really your daughter needs therapy and support.

It's completely up to her though - no one should be pressuring her to take it if she doesn't want to.

 

By the way, I had a big anxiety over swallowing the tablet too! I went back to my GP and they prescribed liquid Prozac. It's got quite a strong minty taste, but it's really not that bad <'>

Edited May 20, 2008 by Thompsons

[darky]

Yes, meant to say my daughter has liquid citalopram and she had liquid prozac.

[Shnoing]

... Anyway the previous Physciatrist left and she saw a locum last week who mentioned ?Avoidance Personality Disorder?. He has given her a prescription for Prozac. ...

 

Oh my, does he mean 'Avoidant personality disorder'? Does he think your daughter is an adult? Look here (from the WHO):

Disorders of adult personality and behaviour

(F60-F69)

 

This block includes a variety of conditions and behaviour patterns of clinical significance which tend to be persistent and appear to be the expression of the individual's characteristic lifestyle and mode of relating to himself or herself and others. Some of these conditions and patterns of behaviour emerge early in the course of individual development, as a result of both constitutional factors and social experience, while others are acquired later in life. Specific personality disorders (F60.-), mixed and other personality disorders (F61.-), and enduring personality changes (F62.-) are deeply ingrained and enduring behaviour patterns, manifesting as inflexible responses to a broad range of personal and social situations. They represent extreme or significant deviations from the way in which the average individual in a given culture perceives, thinks, feels and, particularly, relates to others. Such behaviour patterns tend to be stable and to encompass multiple domains of behaviour and psychological functioning. They are frequently, but not always, associated with various degrees of subjective distress and problems of social performance.

 

 

F60 Specific personality disorders

These are severe disturbances in the personality and behavioural tendencies of the individual; not directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder; usually involving several areas of the personality; nearly always associated with considerable personal distress and social disruption; and usually manifest since childhood or adolescence and continuing throughout adulthood.

...

F60.6 Anxious [avoidant] personality disorder

Personality disorder characterized by feelings of tension and apprehension, insecurity and inferiority. There is a continuous yearning to be liked and accepted, a hypersensitivity to rejection and criticism with restricted personal attachments, and a tendency to avoid certain activities by habitual exaggeration of the potential dangers or risks in everyday situations.

 

I think, too, that you should ask for a second opinion.

[Louisa]

Thank you for your advice all of you.

 

Daughter has an appointment with a new phychiatrist at CAMHS next week so I will see what he has to say or offer. Hopefully something because she is having no life and no education.

 

She has been seeing a phychologist for a year and has done a little bit of cognative behaviour therapy but it hasn't done anything because she is just so negative about herself.

 

As for the medication she wont take liquid because of the taste (even though she hasn't tasted it!).

 

She has been invited this weekend to a friend's sleepover and out the next day (with girls who she met when she was briefly at high school) and she is terrified and sick with nerves from the minute she wakes and she is having nightmares about it. She's worried too about the meals in case she doesn't like them.

 

Anyway thanks again for your replies and I shall see what they have to say next week.

[Louisa]

Hi again

 

Well my daughter saw the new psychiatrist at CAMHS this week. He also thinks that she should take the prozac as there is a good chance it will help her. He said he has a daughter the same age and if it was her he would give it to her.

 

He also said he would ask the ASD team to look again to see if they missed something and he suggests she starts some CBT with a female psychologist whom she might engage with a bit more than the previous one.

 

As for her sleepover ? she loved it!! which was a huge relief because the night before she was saying she wished she could be dead.

 

I am going to try to persuade her to take the prozac and hopefully she might eventually get back into school ? wish us luck.

 

xx