Prozac and Zoloft and Therapists, Oh My! or, OCD Stinks: Homeschool Edition

[Hadassah]

Ds (13)'s OCD has been quite challenging lately, so I'm just going to share and vent and rant. Bear with me, please.

 

About four months ago, ds was formally diagnosed with OCD. His therapist recommended a psychiatrist, who placed ds on Prozac. The Prozac built up in ds's system and caused hyperness and insomnia. After one full week of staying up until 5 am every night, he was taken off the Prozac, given a week's break, and then placed on Zoloft. The Zoloft didn't cause any side effects at first, but it wasn't really helping with his OCD either. After a while the Zoloft began causing insomnia too, but less severe - only to around 2 to 4 am. He suffered two and a half weeks of this insomnia before being taken off the Zoloft. All last week he was Zoloft-free but still having the same insomnia, likely because his sleep schedule is quite delicate and once it is disrupted it's hard to bring it back to normal.

 

On Wednesday we had a psychiatrist appt. and he was very surprised to hear that ds was still having sleep issues. The psychiatrist gave us sleep meds to use as-needed.

Wednesday and Thursday nights ds took the meds but they didn't really help. Ds asked

not to continue taking them because they gave him a headache and made him feel funny. Last night he went to bed meds-free but STILL didn't fall asleep until 3-ish am. Tonight he is still up reading a book while I sit with him because I can't sleep either.

 

The psychiatrist is starting to suggest that perhaps ALL OCD meds will cause ds insomnia, but he wants to try one more, so ds will start that as soon as he's back on track. But right now, ds has no semblance of a normal sleep schedule, he's terribly behind in his

schoolwork, he hasn't been to Scouting or Sunday Schhool in ages, and he still has awful OCD. He doesn't really like his therapist, so we've got to find a new one. And to top it all

off, I think ds may be mildly depressed, because he's constantly sleeping, has no appetite

whatsoever, and is uncharacteristically grouchy and irritable, which were all my symptoms when I had depression. Of couse, those issues may just all be stemming from his sleep issues.

If you're still reading, thanks. You are awesome.

- Hadassah

[tex-mex]

Some thoughts as to the late nights...

 

Is your ds up late due to classic insomnia OR is he trying to cope with ruminations? As a fellow OCD sufferer, I too have late nights and for many years, my family was confused thinking it was insomnia. Rather, I disliked the idea of bedtime as my mind tended to "ruminate" with endless thoughts over and over again. I was fatigued but my mind could not shut off and sleep. It was torture.

 

So, I tended to stay up late with self-coping mechanisms like tv or books to relax and exhaust my brain to sleep. But overall, it was ineffective. Much like trying to put a band-aid on a wound the size of the Grand Canyon. ;)

 

Cognitive Behavior Therapy sessions and SSRIs like Fluvoximine (Luvox) really help with controlling the ruminations. After more than a decade on Luvox, I'm still a night owl as it fits my lifestyle (I detest early mornings), but the ruminations are long gone. I struggle with staying awake during the day -- hubby teases me that I can fall asleep at the drop of a hat. It is due to the meds. But not as bad as in comparasion to stronger psychotrophic drugs for those who deal with schizophrenia, for example, where they do sleep "all day and night" and weight gain is a huge concern. I have to keep busy. Errands or just getting out of the house helps. The irritability will ease in time -- that is normal too. Remind yourself in addition to the OCD dx, your ds is going thru adolescence which is hard on the brain and body by itself. Think of all of this as a transition and in time, dealing with his OCD will be more stable. Depression with OCD is a co-morbidity and quite common. But any extra stressers, he can have a relapse or a need to up dosage in meds. It is like walking a tightrope in the beginning.

 

Transitioning to a new med and getting the right dosage is a pain. It will be 4-6 weeks before you see any improvements. I recall starting Luvox and the first 2 weeks were miserable. Headaches, nausea, and more. I am rambling, but hopefully some of this is helpful. Feel free to PM me if you like.

 

P.S. Have you located a support group for teens with OCD?

Edited January 15, 2012 by tex-mex

[Hadassah]

Some thoughts as to the late nights...

 

Is your ds up late due to classic insomnia OR is he trying to cope with ruminations? As a fellow OCD sufferer, I too have late nights and for many years, my family was confused thinking it was insomnia. Rather, I disliked the idea of bedtime as my mind tended to "ruminate" with endless thoughts over and over again. I was fatigued but my mind could not shut off and sleep. It was torture.

 

So, I tended to stay up late with self-coping mechanisms like tv or books to relax and exhaust my brain to sleep. But overall, it was ineffective. Much like trying to put tape on a wound the size of the Grand Canyon. ;)

 

Cognitive Behavior Therapy sessions and SSRIs like Fluvoximine (Luvox) really help with controlling the ruminations. After more than a decade on Luvox, I'm still a night owl as it fits my lifestyle (I detest early mornings), but the ruminations are long gone. I struggle with staying awake during the day -- hubby teases me that I can fall asleep at the drop of a hat. It is due to the meds. But not as bad as in comparasion to stronger psychtrophic drugs for those who deal with schizophrenia, for example, where they do sleep "all day and night" and weight gain is a huge concern. I have to keep busy. Errands or just getting out of the house helps. The irritability will ease in time -- that is normal too. Remind yourself in addition to the OCD dx, your ds is going thru adolescence which is hard on the brain and body by itself. Think of all of this as a transition and in time, dealing with his OCD will be more stable. But any extra stressers, he can have a relapse or a need to up dosage in meds. It is like walking a tightrope in the beginning.

 

Transitioning to a new med and getting the right dosage is a pain. It will be 4-6 weeks before you see any improvements. I recall starting Luvox and the first 2 weeks were misereable. Headaches, nausea, and more. I am rambling, but hopefully some of this is helpful. Feel free to PM me if you like.

 

P.S. Have you located a support group for teens with OCD?

 

Thank you.

I've never really considered that his insomnia could be related to ruminations... but that makes perfect sense, especially since he told me his anxiety is worse at night. It is encouraging to hear from a fellow OCD sufferer. I also have OCD, but it didn't really start to manifest itself until my late 20s, so I don't know what it's like to be a teen with OCD.

[tex-mex]

Thank you.

I've never really considered that his insomnia could be related to ruminations... but that makes perfect sense, especially since he told me his anxiety is worse at night. It is encouraging to hear from a fellow OCD sufferer. I also have OCD, but it didn't really start to manifest itself until my late 20s, so I don't know what it's like to be a teen with OCD.

You're welcome.

 

Try locating a therapist who specializes in CBT (Cognitive Behavior Therapy). If it is ruminations (anxiety based) then both meds and CBT can offer relief and long-term strategies to overcome it. For myself, I began showing symptoms of anxiety/compulsions/obsessions at around age 14. My 10th grade year in high school was a nightmare as I had severe anxiety and ritualized OCD behavior -- my peers thought I was odd. In college, my roommates did not know how to deal with my symptoms and I just had a tough time fitting in. Never had it dx'ed until I was 33 after a long hard road with OCD. Now I am 45 and doing great. I think it is tougher to deal with it as a teen as you are just trying to figure who you are and developing independence. With support and encouragement, I know your son can succeed. Hang in there. :grouphug:

 

ETA: I also deal with a rare liver disease that if not treated with daily meds and low protein diet -- can build up ammonia to toxic levels in the brain. So, for myself, my brain's mylelin (white matter) in the frontal lobe have been deteriorating all my life and causing my frontal lobe to be like "swiss cheese". LOL I sometimes wonder as in my demographic for the rare disease has 1:80,000 births having the genetic mutation -- and all of our demographic having co-morbidities like OCD/anxiety, Autism, Aspergers, non-verbal learning disorder, PDD-Nos, mental retardation, etc -- as if OCD is more of a symptom of a more serious matter (not to panic you -- I'm sure you and your ds are fine) or what science will find about mental illnesses being more metabolic in nature, kwim? Hmmmmm.

Edited January 15, 2012 by tex-mex

[Hadassah]

 

ETA: I also deal with a rare liver disease that if not treated with daily meds and low protein diet -- can build up ammonia to toxic levels in the brain. So, for myself, my brain's mylelin (white matter) in the frontal lobe have been deteriorating all my life and causing my frontal lobe to be like "swiss cheese". LOL I sometimes wonder as in my demographic for the rare disease has 1:80,000 births having the genetic mutation -- and all of our demographic having co-morbidities like OCD/anxiety, Autism, Aspergers, non-verbal learning disorder, PDD-Nos, mental retardation, etc -- as if OCD is more of a symptom of a more serious matter (not to panic you -- I'm sure you and your ds are fine) or what science will find about mental illnesses being more metabolic in nature, kwim? Hmmmmm.

 

I've wondered the same thing. Both my son and I have other "issues" ( for lack of a better term :lol:) and it feels like it's got to be related.

 

Yes - ds's therapist does specialize in CBT. I think the main issue is that she's a 55-year-old (I'm guesstimating) woman, whereas he's a 13-year-old boy, so he feels like he can't really relate to her, KWIM?