Thank you! I appreciate this information and recommendation. We've done a lot of different therapy for her in the past and it frankly wasn't successful. However, I'm much more optimistic on that front moving - with the medication she is doing much, much better and will hopefully be able to actually get something out of therapy and also we now know how to focus the treatment. ERP was mentioned and we're working on that ASAP. Natasha Daniels looks to be an amazing resource - thank you! On the longer term, personally, I'm not worried and really am just focusing on getting the best treatment at this point in time. Things will evolve as they evolve. However, my husband, is fairly obsessed (ironic or not...I'm not sure) with the longer term and I think the psychiatrist recognizes this and was priming him that for many with more severe OCD, medication is just a reality of life.

Dear all - to everyone who has continued to be a wonderful source of support, guidance and information I wanted to share a quick update. It's now been over a month since my daughter started Prozac and we had an interesting check-in with the psychiatrist. Our daughter continues to do very well with the medication and is performing the best she has in her entire life. With her symptoms more under control, the psychiatrist wanted to do some further testing and exploration to confirm the diagnosis of GAD. In this process, she once again ruled out ASD but did say she thinks a combination of OCD and GAD could be the root issue. In terms of immediate treatment, this doesn't change much, although the optimal form of therapy to be used in combination with the medication may be adjusted. However, she did say that the longer term prognosis for OCD is a little different - medication for life is typically required and she formally recommends that our daughter stay on the Prozac essentially indefinitely. For me, this doesn't change much. I am thrilled she is doing well and is happy. Many people have primed me for the realities of longer term medication and I am happy to have a clearer understanding and plan. However, for my husband this has been his nightmare. He views this as a worst case scenario and is not coping well. He is engaged in therapy though and I have told him that he must focus on this and at least now we understand the picture. In some sense I view this as good news for him because it gives clarity, now he just needs to accept and process things. Edit - not too relevant, but also going to try capsules rather than liquid medication and see how that goes.

@Spryte Thank you - I appreciate this. It's been really helpful for me to read about all of the success stories people have had across various stages of life. I've learned so much from the helpful folks here and am always happy to gather any further advice or guidance. Certainly with each passing day, I am more and more seeing medication as part of her longer term treatment plan. I am very happy we went in this direction and hope that things continue to stay positive. @MEmama I've really wondered if he is feeling bad about the situation because he sees some of her symptoms in himself and then this is in turn making him guilty since he feels responsible. I've reassured him countless times that we're on the right track. Yes, I really don't want to discuss the topic much more with him and have made this fairly clear. The plan right now is that we will follow the guidance of the doctor, which right now if for her to take the Prozac for 2 years before any further assessments regarding longer term steps. Unfortunately, he is the one that remains fixated on things which is why I am encouraged him to seek therapy. I don't want to keep going around in circles with him because there is not much to be gained. He also needs to work to connect with her...much of this is out of my control for now, but I am hoping for the best. Again, I am happy my daughter is doing well and I think if my husband can get through this patch we will be in clear waters.

I've actually personally had both - metal braces when I was growing up and invisalign as a young adult because I foolishly didn't wear my retainer. Unfortunately, they both kind of hurt! I'd make the decision based on what is best for the treatment case, because I think discomfort is inevitable when moving teeth.

Yes, it continues to frustrate me that this isn't somehow obvious to him. He continues to ponder the decisions of the psychiatrist even though during the last appointment she explicitly told him that it is our responsibility to ensure she receives proper medical care. She explained to him that if she had broken her arm there would be no questioning of the treatment plan and in this case her medical recommendation is that medication is required and that without it, we are compromising her health and future. She is continuing to do incredibly well, but my husband has been visibly more distant with her and I am very concerned about the impacts of this. Yesterday I told him that I think he needs to talk to a therapist to work through things on his end because we cannot continue in this stasis. Ironically, in the back of my mind, I'm also wondering if he himself needs medication. The symptoms he is displaying and his handling of the situation do seem governed by anxiety rather than reasoning. I dare not suggest this right now, but I do wonder...

I'm not a medical expert, and this should be discussed with a doctor, but to the best of my knowledge the concept that SSRIs are unsafe to take if you have high blood pressure is quite false. We discussed side effects and risks of SSRIs extensively with an expert psychiatrist before we started on daughter on them and not once did blood pressure come up as an issue. Mind you, she is young, so perhaps this is relevant for older folks, but I don't think so. For example, below is a link to a recent medical study which directly states: In general, SSRIs did not significantly affect BP levels and are considered safe in patients with and without preexisting cardiovascular disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370473/

@Atlas This is slightly peripheral but a related situation in many ways. We recently went ahead with medicating our 6 year old daughter who has extreme anxiety - certainly a different symptom set than ADHD but ultimately manifests in similar problems such as being unable to get things done. It was a pretty excruciating decision for us, but the results have been nothing short of transformational. Her performance across all aspects of life is superior. We had serious doubts, but I can honestly say that it's clear for us that the risks of NOT medicating were becoming extreme and already it's clear that medication was the right approach. I cannot say what is right or wrong in your situation, but I can empathize with the struggle and certainly say that it's something to consider.

Thank you, I really appreciate this and actually shared it with my husband. All of the feedback we have received is that her taking an active role in the process is completely positive. Also, I don't think my husband realizes how lucky we have also been here - we have tried one medication and found a dose to which she has responded ideally with no side effects, and it has transformed her life. She has never been as happy as she is now in her entire life. A month ago she was having daily meltdowns and now she is doing normal age appropriate activities. I personally recognize that getting this point can be really hard and can take months or years of testing different medications and sometimes can still be a struggle. He is getting there, perhaps just not as quickly as I'd like. Today he did give her the medication and she thanked him which was a moment I could tell was helpful in their bonding. He still remains somewhat fixated on the longer term implications of things and to this point I've mostly told him we can just control what we can now. However, last night I was frank and said that while we don't know what will happen we do have to accept that it is a possibility that she will need medication for life. He needs to come to terms with this and move on. And I get it, it wasn't easy for me, but seeing how well she is doing and thinking about risks vs benefits, hearing stories from others, etc. has helped me a lot. We sill have lots to learn, but we must just keep moving forward.

Yes - I fully agree, I do not want any negative thoughts my husband has to influence our daughter or make her feel ashamed or embarrassed about the medication. We've discussed this and there is an understanding that any discussions of this nature must happen privately. He definitely still has his opinions, but seems to understand this. I've also asked him to occasionally give her the medication as I think this would be beneficial for all involved. Thanks for sharing. We definitely went into the process perhaps a little bit more naive and not inherently thinking about longer term, but hearing from others it's more and more clear that this is a possibility and while our psych doesn't really want to dive into this, when pressed she said "yes, there is certainly a non-negligible chance she'll require Prozac indefinitely". For now at least the plan is clear - 2 years before any adjustments.

This sounds incredibly challenging and stressful. It really must have been a lot to carry. I hope DH comes around and I think he is, but sometimes there are random situations that are hard for me to wrap my head around. I forgot to give DD her Prozac one day and it was not good - every since then she's often asked me for her medicine in the morning because she doesn't want to miss it. DH told me he doesn't like how she asks for her medicine and he think it's a negative sign. I was pretty confused by this to the point I actually asked our psych who said in fact she views this as a positive since it is a sign she feels it is working, isn't having bad effects from it and is taking an active role in her treatment. DH eventually came around, but still prefers if I give her the medication each morning. So he is getting there bit by bit, but there are oddities every once in a while for sure.

Yes, I do think he feels some shame and embarrassment. I personally struggled but really have come around to understand that the medication is essential treatment akin to glasses. It took me a while to get there and I am hoping DH will come around. The psych tried to explain to him that while the brain is highly sophisticated, from a medical perspective, it is government by biochemistry like all organs - balancing neurotransmitters in the brain isn't that different from balancing chemicals to reduce blood pressure. I think logic is not yet there on this for DH. He acknowledges that she needs the Prozac but at the same time doesn't seem to fully grasp why. Thanks so much for sharing! Do you mind me asking how long he's been on the Prozac? Also, when did you realize it was likely lifelong? She's only been on it for a month or so, but I keep reading here about how most people tend to stay on longer term and I am more and more adjusting to the concept that the Prozac may be part of her life.

This is an interesting suggestion. DH is definitely bothered by the fact that he feels she needs the Prozac to function. While I do empathize with him, I've come to realize that dwelling too much on this is not really relevant. The reality is the medication is dramatically improving her quality of life, she herself feels it is helping and quite frankly, yes she does kind of need it right now, however you define that. I think DH needs to come to terms with this but he is very scared she will be on it long term. I'm not sure how to alleviate this concern for him - like you said it is a treatment and while we hope that she can use coping through therapy as she grows, I do think we need to accept that there is at least the possibility she'll be on Prozac or other meds indefinitely...potentially for life. Personally, I'm trying to focus on the here and now, not worry too much about the future and make the decisions that are best for her longer term development. We can't really control anything outside of that.

Again, thank you - this is reassuring to hear. Both of these points are consistent with the message we received from our psych, especially during the phase when we were pretty hesitant to proceed with medication. She mentioned Prozac is a go-to for young kids because it has been established to be a highly safe and effective medications over many years of research and study. She mentioned that it's been around for decades, is extremely well researched and has been clinically shown to be one of the best first-line treatments for children. This helped ease our minds, but knowing that others in the medical field share this opinion is comforting. Indeed, this point was mentioned by our doctor. My husband wanted to do a 6 month trial and the doctor said there's risk to stopping and starting - she recommends 2 years minimum before we even try a downwards adjustment. Frankly, given how well things have gone, I'm in no rush to mess with things. I want to follow the guidance of the doctor for sure.

Thank you again - this is very helpful and reassuring. Based on experiences from others, it doesn't seem too uncommon to find a dose that works over the longer term, so we're optimistic she can stick with 20mg for a while. The psych also says she thinks this will work for the foreseeable future. When she initially increased to 20mg she was definitely more energetic than normal, but this subsided quickly and any lingering effects are a positive as she is able to focus better. @Ottakee@Terabith Thanks to you both! I guess only time will tell. Interestingly though, she is definitely already aware of them helping her. We actually missed a dose one day and it wasn't great - she had a tough day, lots of anxiety and a breakdown. Since then she's often asked for her medicine in the morning and once told me she really doesn't want to miss it because she didn't feel good that day. I was somewhat surprised she is able to tell, but it's obvious she feels it helping.

Thanks so much, this is really helpful and informative. I'd definitely rather have her doing well on the Prozac than dysfunctional without it because as you said, I'm personally more worried about the impacts of the anxiety on her development than the medication. It sounds like periodic checks with lowered dosages are a good and simple way to check. Do you mind me asking, over his time on the Prozac, did he require many dosage adjustments or has it been pretty steady? Also, I'm assuming no longer term side effects? We asked the psych about this and she said, it's hard to study, but there's no evidence to suggest longer term exposure to Prozac causes issues and usually the risks of not medicating are far more severe. Anecdotally, she's had patients start as young as 4 or 5 and continue into their late teens or 20s. Apologies for the questions, we're just working through the reality that medication may be a longer term thing for her.

I agree, I think that if the stigma was less pronounced we may have medicated her sooner and with the benefit of hindsight, that likely would have been the right choice. Can I ask if there was a particular point in time, indication or realization that pointed to the fact that your child would need medication longer term? While my husband is seeing the benefits and currently has positive view of things, he still doesn't want her on meds longer term. I'm trying to just focus on the here and now because that is what we can control. We did speak to the psychiatrist and she said it's just too hard to say at this stage what the future looks like - she recommended we leave her on Prozac for at least 18-24 months before any further evaluations. When pressed on what happens beyond that she said it's possible she could wean off and not need the meds, there's also a non-negligible chance she'll need them for life and it could be anything in between.

Yes, thank you! The psychiatrist said she is responding ideally and so things really could not have gone better. Getting the right dosage also wasn't too hard, but I know adjustments may be required in the future.

Several weeks ago I posted about my struggles with what was a very agonizing choice to medicate my 6yo daugther who was diagnosed with severe GAD with Prozac. As a brief summary, she's been struggling for a few years with extreme anxiety that has caused meltdowns, violence and general dysfunction. After trying all sorts of therapy, about a month ago we decided to proceed ahead with the recommendation of her psychiatrist to start Prozac. Since then, it's been a complete transformation. We started her on 5mg and slowly titrated to her current 20mg dose - at 20mg her daily anxiety induced meltdowns are completely gone. She is happier, calmer, doing better academically, able to focus better and is integrating better with other children her age. We did notice some mild side effects at 20mg, but these subsided and have been manageable. On the whole it's been only positive. She herself says the medicine is making her much calmer. We are relieved that this was the right choice and appears to be helping her. Longer term, our hope is that we can rely less on medication and more on therapy, but for the time being, it's clear she does need the medication to function. I was so hesitant to go down this path, but I can certainly say to other parents faced with this dilemma, if the doctors recommend it, give medication a shot. Edit - I should also say, I've asked a bunch of questions and everyone has been so amazingly helpful. If anyone was questions for me, or is in a similar situation, please feel free to ask as well 🙂

This is fantastic, thanks so much! I know that CBT is the gold standard for anxiety and many other situations, but at the moment she seems too young and immature to really utilize it. However, I appreciate these resources which introduce things in an age appropriate way and build the framework to benefit from CBT to develop coping skills. Hopefully we can start at this level, achieve some initial success like your son and then implement new things as she learns and grows. She's been on Prozac for 2 weeks now and I don't think it's too early to say it's been pretty life saving for us. Far from perfect, and there are still issues but she's just much more functional on pretty much every level. I don't know enough about how things proceed over the longer term - our hope is to phase in therapy and rely less on medication but I know from reading that for some medication is pretty much indefinite.

I'm honestly not too worried about a smoke alarm - what's it going to do, record our conversations and send the data to Google to sell us products? Our smartphones already do this. A risk I am willing to take to not have the smoke alarm go off every time I cook something.

You don't need to link it in with home security at all. It does use the same app as their cameras and other products but you don't need to use them as a suite. It's possible to just have the Nest fire alarms and that's all you'll see on the app. Before the alarm goes off, it gives you a voice warning and sends an alert to your phone. You have the opportunity to silence all the alarms in your house before they start beeping. Further, whenever the alarm does go off, you can silence it provided you are home - if the smoke does not increase in intensity, it won't go off again. It will also alert you when the battery is low via the app. Honestly, they are great products and I would highly recommend. I suppose there are always some security concerns with the smart home products, but Nest is fairly state of the art and I think the risk of someone hacking your fire alarm is basically zero. For me, they are an example of something which just works well.

Nest Protect. The smoke detector product everyone wants exists. We have them, they are great (but expensive).

Thank you, you are kind. Indeed her anxiety was completely disabling and she's doing better already. I know medication was the right decision but I still occasionally feel the slight stigma and guilt about having a 6 year old on Prozac. But as I see her do better, I am also feeling more confident about things. I'd LOVE to understand from those who have successfully implemented therapy with kids how it was done. Like you say, it just doesn't seem easy for children to grasp it, get behind it and benefit from it.

She mostly engaged in "play therapy" which involved using toys, play, drawing, etc. to share feelings, interact with them and learn methods to cope with them. The therapist often lead play which was designed to learn ways to reduce anxiety. One example I can think of was using dolls to act out problems they are having and then the therapist would work through ways the doll could deal with it. Frankly, this particular method didn't seem to do a lot. We tried other types of therapy, but I think she was just too young to really grasp what was going on or learn coping skills. After a couple years of failed therapy, we did resort to medication. She's been on Prozac for just over a week and it's already been night and day. I was terrified to go the medication route and there's still a lot of unknown but as of right now, it seems to be a positive choice. My hope is that as she develops, we can rely on therapy since she'll have the maturity to grasp it more.

I certainly must admit that our attempts to date were not super successful which led us down the medication route. I guess there is still hope that we can leverage other resources and rely on alternative treatment options over the long term, but I suppose time will tell how realistic that is.