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My daughter is resisting treatment for depression


Mimm
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What do you do when your child doesn't want treatment for mental health problems. She's almost 15 and she didn't want to be on medication but she agreed to give it a try. It's only been a month and it's definitely helping. She isn't experiencing her lows but she's still able to be happy. But yesterday in the car, she told me she gave it a try and now she wants off of it.

 

I asked if part of it was that she enjoyed being sad and she agreed that was probably the case and commented that was probably "kind of messed up." Sadness is her favorite emotion. She loves reading sad books that make her cry. Her favorite book she read recently had her sobbing, actually sobbing, for like 20 minutes during the saddest part. She loved it and when she returned it to the library she said she needs to buy the book "for whenever she feels like crying." She also says she's able to be happy on the medication, but that "it feels different." I pointed out that her depression affects the entire family. She doesn't really care about this part. She's talked to her counselor about this but she said that she thinks counseling has been "kind of pointless."

 

I'm big on respecting my kids wishes for themselves, but I'm also very interested in creating a home life that doesn't make everyone else miserable along with her. It seems really crappy to drug one child for everyone else's sake, but it seems crappy to let her inflict her crazy mood swings on me, her father and her little sisters. She claims sadness is her strongest emotion but really it's anger. At one point in the past (before drugs and therapy) she said, "I'm angry about everything. If I don't feel anger, I don't feel anything." Which is also not true, because she has manic phases of over-the-top happiness.

 

This child has put me in so many no win situations I can't even tell you. This is the one that has me up at night wondering what the hell I'm going to do.

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I  think a Psychiatric evaluation would be useful to you in trying to figure out how to help her.  Someone who is depressed can be a danger to themselves and to others. They can become suicidal.  Getting her to cooperate in her treatment and to want to change probably won't be easy.  

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Wait. She has manic phases and is on medication for depression? What kind of counselor is she seeing? (MD? PhD psychologist? Clinical social worker? Licensed counselor?) It may be time to switch therapists. 

 

I tend to agree with your philosophy that teens should strongly contribute to decisions about themselves, but not with the degree of mental illness you are describing. You are fortunate that she is still a minor and you can make those decisions for her (while respecting her input)  and hopefully get her stabilized before she is 18.

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I  think a Psychiatric evaluation would be useful to you in trying to figure out how to help her.  Someone who is depressed can be a danger to themselves and to others. They can become suicidal.  Getting her to cooperate in her treatment and to want to change probably won't be easy.  

 

We know how to help her. Our current treatment is working, she's just resistant to it... I'm mostly interested at this point what people think about the ethics of forcing a teen to accept treatment she doesn't really want.

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Wait. She has manic phases and is on medication for depression? What kind of counselor is she seeing? (MD? PhD psychologist? Clinical social worker? Licensed counselor?) It may be time to switch therapists. 

 

I tend to agree with your philosophy that teens should strongly contribute to decisions about themselves, but not with the degree of mental illness you are describing. You are fortunate that she is still a minor and you can make those decisions for her (while respecting her input)  and hopefully get her stabilized before she is 18.

 

She has more severe depressive phases than manic. I thought bipolar people were frequently on medication.

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We know how to help her. Our current treatment is working, she's just resistant to it... I'm mostly interested at this point what people think about the ethics of forcing a teen to accept treatment she doesn't really want.

 

 

She is a minor. You have a legal as well as moral obligation to try to help her and protect her.  Difficult situation.

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I think it's pretty typical for teens to be resistant to counseling. I'd give her a choice between inpatient and outpatient therapy, but opting out doesn't seem like a viable choice in this situation. I think you'll just have to make her, she'll resist, it'll suck for you, but she'll be better for it. You may have to shop for a therapist until she finds one that makes her feel more comfortable. It's like high school or personal hygiene . . . she just HAS to take care of her education, body, and mind.

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I would explain to her that it is no different than if she had diabetes or another more physical illness.  Because of your love for her you would not allow her to "opt out" of being treated for that, and you will not allow her to opt out of this either.  It is a real illness, and because of the nature of the illness, she may not be in the best position to judge its the effectiveness or need for treatment.

 

I agree this is very difficult.  But personally I would continue the treatment until she is old enough to legally refuse.  It may give her something to look back on and make a choice to be well. 

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They are but not always with antidepressants - especially by themselves.  Sometimes antidepressants can make it worse. 

 

 

Well, in this case, they are helping. We've only just begun treatment after entirely too long of letting her cope on her own like she wants.

 

I think it's pretty typical for teens to be resistant to counseling. I'd give her a choice between inpatient and outpatient therapy, but opting out doesn't seem like a viable choice in this situation. I think you'll just have to make her, she'll resist, it'll suck for you, but she'll be better for it. You may have to shop for a therapist until she finds one that makes her feel more comfortable. It's like high school or personal hygiene . . . she just HAS to take care of her education, body, and mind.

 

Thank you, this input helps. She's pretty happy with her therapist, commenting that it seemed pointless the other day was the first negative thing she's said about it. It's mostly the medication that she's resisting. Also, her therapist supports medication so she might be annoyed about that.

 

It's a little disturbing to me that she likes feeling sad and is resisting treatment because it's taking that away from her. The fact that treatment is effective and successful is bothering her.

Edited by Mimm
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I would explain to her that it is no different than if she had diabetes or another more physical illness.  Because of your love for her you would not allow her to "opt out" of being treated for that, and you will not allow her to opt out of this either.  It is a real illness, and because of the nature of the illness, she may not be in the best position to judge its the effectiveness or need for treatment.

 

I agree this is very difficult.  But personally I would continue the treatment until she is old enough to legally refuse.  It may give her something to look back on and make a choice to be well. 

 

This is true. She feels very strongly that depression is real and gets upset when people are dismissive of it, I think the comparison to diabetes or some other illness might speak to her.

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Please don't look at it like you are going against your daughter's wishes. She isn't thinking clearly right now. You have to do what is medically necessary to bring her back to health. I'm sorry it's such a tough place to be.

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who's prescribing the rx?  is she receiving counseling along with treatment?  'cause I'd  get her in asap.

 

preferring saddness could actually still be part of depression. - she may feel it's 'safe' and that happy isn't safe.

 

does she every like/enjoy being happy?

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That's a very tough situation. I'd likely insist she kept going to a therapist for some significant period of time. I'm guessing I'd insist on 8-12 weeks initially, but I'd permit her to reject one therapist and try a new one, which would re-start the 8-12 week clock, since I'd expect it'd take about that long to get into the meatier aspects of therapy and know if it was helping (and get over the newness of it and hopefully establish a bond of sorts and also get some good results . . .) If after "giving it a good try" the teen still insisted s/he wanted out, I'd re-evaluate. (I'd make clear to the kid that we can/will change therapists immediately if s/he feels creeped out or uncomfortable . . .)

 

In general, if the kid is in danger, or you think the kid is in danger, you've got to do what you think is best no matter what the kid wants. That's my guiding principle. However, respecting their autonomy is both morally right and also makes it more likely they will grow and heal . . . Sooooooo, I'd want to try whatever I could to gain cooperation. I'd offer bribes. If I were driving the child to therapy, I'd routinely stop at a nice (to the kid) lunch spot after, stop for coffee before (if the kid likes coffee), etc. I'd try to make it as pleasant as possible.

 

I'd frame the therapy as "life coach" and seek to encourage the child to see it as a way to learn techniques not just to change how s/he feels but to change her universe . . . I.e., "I know you want to play x-box (substitute your kid's favorite time-wasters or other desired life circumstances here), which we've forbidden [since kid hasn't followed the rules], Therapist X can help you figure out how to get what you want . . . "

 

Also, be sure to allow for you and your dh changing. "Therapist X can help you figure out how to get what you want from Dad and I. Dad and I are willing to change. We know we aren't perfect and we make mistakes. We are making this up as we go along. I/We are happy to listen to you and to Therapist X. If we need to change a rule or change other things we are doing, we will."

 

So, anyway, it may be too late or too little for those approaches to help. At the end of the day, I'm guessing I'd require a couple weeks of weekly sit-downs with both parents and the therapist and the kid all together before agreeing to a change in medications (unless there were clearly dangerous or disturbing problems that might be attributable to the meds, in which case, one emergency call to the therapist and/or prescribing physician would be all it would take to change/stop the med, but then I'd require a couple sit downs to discuss the decision and next step (i.e., try a different med).

Edited by StephanieZ
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First I would make sure that the treatment course is addressing the entire problem. (ie undiagnosed bipolar) 

 

Then, assuming we were addressing the whole issue, I would work with her therapist to help educate her on how SSRIs work. Including the fact that it can take more than a month to see full effect. 

 

I would, with the MD who prescribed the medication and your daughter, make a checklist of conditions under which medication will be changed/discontinued. Allowing her to have a voice gives her control and may allow a slight easing in the tension of the moment and the transitioning into adulthood.

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She has more severe depressive phases than manic. I thought bipolar people were frequently on medication.

 

Yes, but treatment sometimes differs with bipolar as opposed to depression only. The resistance to medication and enjoying the symptoms immediately made me think of bipolar. I'm no expert but I have experience with people who resisted medication for that reason. Lots of other red flags in your post, too. 

 

With depression, people often fail to seek help on their own because they are simply too tired and depressed to do so. They don't have the energy or motivation, but they are much less likely to resist medication once it is offered. When they do, it tends to be because they have a mindset of thinking that meds are a sign of weakness, not because they enjoy the depression. 

 

So, two thoughts: I have no ethical issues with requiring a teen to take the medicine and attend therapy. It is good for her, and unfair to other members of the family that she not take it so she can 'enjoy' the symptoms that wreak havoc on everyone else. And, I wouldn't be fast to change if this med is working, but I'd start looking into bipolar and making sure that my therapist had experience in it - if not, I wouldn't necessarily change therapists, but I'd look for a doctor experienced in dx bipolar vs depression. 

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 . It seems really crappy to drug one child for everyone else's sake, but it seems crappy to let her inflict her crazy mood swings on me, her father and her little sisters. 

 

you are NOT 'drugging one child for everyone else's sake'. 

 

You are getting treatment for one child for HER sake.  her health problem just happens to be messed up brain chemistry.  (everyone else is benefitting, and. that. is. okay.)

 

I'd do a full work-up if you haven't already.  vit d (affects mood), thyroid, adrenals, etc. etc.

Edited by gardenmom5
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Speaking from personal experience, it can be very disorienting for a teenager to be on mood-altering medications. Parts of your personality are entirely changed, and that can make you feel unmoored, like you don't recognize yourself. It's uncomfortable.

 

I'd recommend some sympathetic talks on that subject and holding the line on the medication and counseling. In my case, I'm grateful for having been on SSRIs for a few of my teenaged years. That gave me a baseline for what my personality should be like when my chemicals are working well.

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I think you're in a hard, hard spot and it's obvious you love and care for her and her opinions. I have no real experience, but wanted to ask how untested depression would affect her ability to drive or move out and attend college later. Those might be carrots she's looking forward to, and an honest discussion about how those might not happen if she doesn't maintain treatment might help. I'm not talking punitive - more an open, mature conversation about consequences. I might frame the driving in terms of untreated epilepsy.

 

Honestly, her enjoyment of being sad would be a huge red flag for me. Does her therapist know this? It seems very troubling.

 

You're an amazing job listening and reacting to her needs. Keep it up. (HUGS) This parenting gig is hard work.

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She has more severe depressive phases than manic. I thought bipolar people were frequently on medication.

 

Most people with bipolar disorder need to be on a mood stabilizer and an anti-depressant. Being on just one or the other can actually make things worse. My dh is on three meds right now, two mood stabilizers and one anti-d. 

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She has more severe depressive phases than manic. I thought bipolar people were frequently on medication.

I could be wrong, but I think the pp is saying that because bipolar patients are treated differently than those with unipolar depression.

 

SSRIs alone can send bipolars into manic states. Many bipolars are initially misdiagnosed with depression.

If she's having manic states this should perhaps be revisited.

 

Finding the right mix of medication can be very difficult.

Just because something "works" doesn't mean that it contributed to a good quality of life for the patient.

 

Going through life on some meds is like going through life in a semi zombie state. Everything is going on, and you react to it, but your not quite attached.

 

As to your actual question, I would say it depends. If my child was danger to themselves, or others; I would absolutely medicate them.

 

If I was medicating for other reasons, I wouldn't want to force it.

 

I would personally seek a second, and possibly 3rd opinion. Find a doctor that is willing to play around with meds to find the right balance.

 

If she truly feels as you describe, chances are that she will cease taking them at the first opportunity. If you can find that right balance before she turns 18, then hopefully she won't.

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It's a little disturbing to me that she likes feeling sad and is resisting treatment because it's taking that away from her. The fact that treatment is effective and successful is bothering her.

 

it could  be she's feeling disconcerted because she's not used to feeling healthy and that is what is making her uncomfortable. 

 

many medications can also have side-effects. you may need to carefully probe to see if it's there are side-effects and those may be that to which she is objecting, but she lacks experience to accurately describe or identify them.  

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Finding the right mix of medication can be very difficult.

Just because something "works" doesn't mean that it contributed to a good quality of life for the patient.

 

Going through life on some meds is like going through life in a semi zombie state. Everything is going on, and you react to it, but your not quite attached.

 

 

:iagree:  Just because a medication removes the bad feelings doesn't mean that it's working. You need to be able to feel the good feelings, too. No one wants to go through life feeling numb.

 

 

OP, has your dd seen an actual psychiatrist? They're much better at pinning down the perfect med than the average family doc.

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I don't have any specific advice, just a reminder that it is very, very common for people with depression to resist treatment and I would certainly not be comfortable allowing a 15 year old with mental health struggles to make a decision to stop medication without medical advice and oversight.

 

I would second the recommendation to work with a psychiatrist, particularly one with experience in treating adolescents, and to consider different medication options.

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Well, in this case, they are helping. We've only just begun treatment after entirely too long of letting her cope on her own like she wants.

 

 

Thank you, this input helps. She's pretty happy with her therapist, commenting that it seemed pointless the other day was the first negative thing she's said about it. It's mostly the medication that she's resisting. Also, her therapist supports medication so she might be annoyed about that.

 

It's a little disturbing to me that she likes feeling sad and is resisting treatment because it's taking that away from her. The fact that treatment is effective and successful is bothering her.

 

That is a valid thing to fear.  Change is difficult. You can acknowledge that and still explain that she needs to stay in therapy and on her meds.  It must be so scary to see things changing in yourself, things that seemed to just be a natural part of you.  Also, she knows how to navigate her world with depression, she has coping mechanisms. To have to give those up is truly scary.  And, then, what if you expect more of her? What if she gives up depression and then the world starts asking more and harder things of her? That is scary.  And even worse, what if the world starts expecting more...and she doesn't have it to give? What if giving up depression exposes that?  That is terrifying.

 

The thing is, depression is a false friend. It lies to her. She is getting stronger and it is trying to lure her back. It promises safety, but really all it offers is half a life. It might try to convince her that half a life is the most she deserves but that is another lie.

 

Talk to her therapist and let her or him know what is going on.  And normalize this.  Tell her this is a NORMAL way for people to feel when they start to get better.  It is happening now, and it will happen again. But the trick is, not to fall for it because it isn't the truth. But everyone who has to take all kinds of medication, not just for mental illness, feels these things and they all work through them. She can feel it, there isn't anything wrong with the feelings, but it doesn't mean she has to act on those feelings. It takes time and it takes work, but she will be able to recognize them for what they are. But they are a normal part of the process. You have to feel them, acknowledge them, and then keep moving on.

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IMO, a month of medication is barely long enough to assess how it's working. They frequently don't really kick in till 4-6 weeks. 

Also I know someone who started an ssri during teen years & they were told that if they decided to start the med, they should plan to stay on for a year minimum (barring unbearable side effects & then the plan would be to switch to a different med). There was something about starting and stopping that was considered medically inadvisable. 

I agree that if her identity is wrapped up in a certain mood/ennui/cynicism/bleakness then it's scary to start to feel happy and optimistic because that's not who you think you *are*.  

I have no problems on insisting on medical treatment for a 15 yo. I think she should be under close care of at least one and possibly more professionals (a prescribing psychiatrist, a counsellor/psychologist/life coach). I think if it's rocky I'd be wanting weekly appointments with one or the other for close monitoring. 



 

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I second getting her re-evaluated for bipolar.

 

The obsession with wanting to be sad concerns me in a different way.

 

Is her therapist a regular therapist?  Can you get her into a cognitive behavioral therapist?  They focus on errors in thinking that can rapidly change the way a person feels, and give her power to change the way she feels. It could help her figure out why she wants to be sad, and change the logical problems with that.

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who's prescribing the rx? is she receiving counseling along with treatment? 'cause I'd get her in asap.

 

preferring saddness could actually still be part of depression. - she may feel it's 'safe' and that happy isn't safe.

 

does she every like/enjoy being happy?

I couldn't tell from the posts if the person prescribing was the same person as the therapist. Maybe I missed a post, but IMO, it can help to see a psychiatrist, so one person is on top of diagnosis, medication, and therapy. Edited by Alessandra
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has she been formally diagnosed by a qualified mental health pysch as bipolar?

 

No, the OP stated that her dd is depressed. Responding posters are suggesting that they make sure it is not bipolar, which is often treated differently. 

 

:iagree:  Just because a medication removes the bad feelings doesn't mean that it's working. You need to be able to feel the good feelings, too. No one wants to go through life feeling numb.

 

 

Agreed, but the OP said in her first post her dd could still be happy, that the meds weren't just taking away the lows. 

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She has more severe depressive phases than manic. I thought bipolar people were frequently on medication.

 

 

No, the OP stated that her dd is depressed. Responding posters are suggesting that they make sure it is not bipolar, which is often treated differently. 

 

 

 

 

No - the OP was the first one to bring up bipolar in post #5.

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No, the OP stated that her dd is depressed. Responding posters are suggesting that they make sure it is not bipolar, which is often treated differently.

 

 

Agreed, but the OP said in her first post her dd could still be happy, that the meds weren't just taking away the lows.

This was the comment from the OP that sparked that discussion.

 

"She also says she's able to be happy on the medication, but that "it feels different."

 

Being numb from meds doesn't mean you feel nothing, it can just be muted.

Edited by momof4babes
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IMO, a month of medication is barely long enough to assess how it's working. They frequently don't really kick in till 4-6 weeks. 

 

Also I know someone who started an ssri during teen years & they were told that if they decided to start the med, they should plan to stay on for a year minimum (barring unbearable side effects & then the plan would be to switch to a different med). There was something about starting and stopping that was considered medically inadvisable. 

 

I agree that if her identity is wrapped up in a certain mood/ennui/cynicism/bleakness then it's scary to start to feel happy and optimistic because that's not who you think you *are*.  

 

I have no problems on insisting on medical treatment for a 15 yo. I think she should be under close care of at least one and possibly more professionals (a prescribing psychiatrist, a counsellor/psychologist/life coach). I think if it's rocky I'd be wanting weekly appointments with one or the other for close monitoring. 

 

when I was on anti-depressants, I read articles that said two years to prevent a recurrence of depressive symptoms.  I did have to stop at 18 mos as the side-effects were getting worse (I only had side-effects as my need for the rx decreased.  so I'd lower the dose and the side-effects would go away.)

 

I couldn't tell from the posts if the person prescribing was the same person as the therapist. Maybe I missed a post, but IMO, it can help to see a psychiatrist, so one person is on top of diagnosis, medication, and therapy.

 

I agree with one person for mental health.  too many GPs/IMs rx antidepressants when the patient actually responds  better to something else.  and they don't provide counseling to be able to appropriately monitor.

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I agree with one person for mental health. too many GPs/IMs rx antidepressants when the patient actually responds better to something else. and they don't provide counseling to be able to appropriately monitor.

And psychiatrists have more experience with a wide flange of medications and understand off label prescriptions. Better able to get it right the first time, better monitoring of side effects.

 

Ime, a good psychiatrist may cost more per hour, but less in the long run, because diagnosis and treatment are more targeted.

Edited by Alessandra
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has she been formally diagnosed by a qualified mental health pysch as bipolar?

 

No one has told me "She has bipolar." I told her therapist that I notice very clear manic and depressive phases, more on the depressive side. So no, no actual diagnosis.

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My niece a bipolar, and I work with a bipolar fellow. Both have indicated that they hate their respective medicines, even though they work as they should, because the medicines don't make them feel as intensely. Both have gone off their medicines, repeatedly, because they "wanted to feel more." As a person impacted by their behaviors, it has been miserable when they go off their meds. I've spoken to both of them about how they affect others when playing with their medicines, and they understand that their actions have consequences, they just don't seem to care or be able to act differently (that may not be a fair/accurate assessment). 

 

In any case, I'm sorry you have to go through this. It is a long, bumpy road.  :grouphug:

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The person diagnosing the medicating is her doctor. The counselor is a Licensed Professional Counselor.

 

Again, this treatment is going well, not really looking to have a discussion about how I'm approaching treatment incorrectly and how I should be doing everything differently. I'm interested in how a parent deals with the ethics of coercing a resistant teen to continue with it. I believe in respecting my teens autonomy and she is the type to feel very violated if I put my foot down and refuse to allow her a say in what she puts in her own body (as far as medication goes). But balancing that against her own needs and the needs of the entire household is so very difficult.

 

Thank you to people who have addressed this and brought up some very good points that will help me in my conversations with her.

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My niece a bipolar, and I work with a bipolar fellow. Both have indicated that they hate their respective medicines, even though they work as they should, because the medicines don't make them feel as intensely. Both have gone off their medicines, repeatedly, because they "wanted to feel more." As a person impacted by their behaviors, it has been miserable when they go off their meds. I've spoken to both of them about how they affect others when playing with their medicines, and they understand that their actions have consequences, they just don't seem to care or be able to act differently (that may not be a fair/accurate assessment). 

 

In any case, I'm sorry you have to go through this. It is a long, bumpy road.  :grouphug:

 

Yes! She's SUCH an intense person and she likes that intensity. So the fact that she's able to feel sad and happy and angry on her meds isn't "good enough" for her. Because she's not feeling things as intensely.

 

What that intensity does to the rest of us and TO HER doesn't seem to bother her.

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It may not be the "sadness" that she misses, as much as she misses being aware of her feelings. For a while, I was put on a mood stabilizer along with an antidepressant. Talk about very weird experience! I literally felt out of touch with myself for a long time. Gradually, that sensation got better as I became more accustomed to the medication and also as I came to the realization that some of my intense physical and emotional reactions were really overblown in general. 

And I can completely relate to the idea of "losing" something by getting rid of depression. I was terrified that I might lose my ability to write if I lost my depression. It's a very valid fear. It might not make complete sense, but there is something to the heightened emotional state of mind and creativity. My fears, BTW, turned out to be groundless. But I did have them.

 

My advice? A month isn't long enough to reach any kind of steady state on medications for the mind. Six months--more like it. But you can tell her from me that you've just got to stay with it. It gets better.

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Catching up on replies and maybe answering things out of order.

 

Thanks whoever said that SSRIs can throw a bipolar person into a manic phase. I did not know that and we definitely saw that when she first started taking them, around the second and third week. Yikes. I mean, don't get me wrong, her manic self is a ton of fun, but she doesn't sleep much and she's really unfocused and extremely high energy.

 

 

it could  be she's feeling disconcerted because she's not used to feeling healthy and that is what is making her uncomfortable. 

 

many medications can also have side-effects. you may need to carefully probe to see if it's there are side-effects and those may be that to which she is objecting, but she lacks experience to accurately describe or identify them.  

 

We've talked about side effects a lot and she's not experiencing anything except difficulty sleeping at first, but that was coinciding with a manic phase as stated above. That went away for now so we'll see...

 

:iagree:  Just because a medication removes the bad feelings doesn't mean that it's working. You need to be able to feel the good feelings, too. No one wants to go through life feeling numb.

 

 

OP, has your dd seen an actual psychiatrist? They're much better at pinning down the perfect med than the average family doc.

 

She feels good feelings. Just not as intensely. To me, she doesn't seem numb. She laughs, gets excited, freaks out when something goes wrong, gets disappointed, cries, is even perfectly capable of overreacting. Which is fine. To me, she still seems like a highly emotional teen. To her, she probably does feel numb compared to what she was feeling before.

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It may not be the "sadness" that she misses, as much as she misses being aware of her feelings. For a while, I was put on a mood stabilizer along with an antidepressant. Talk about very weird experience! I literally felt out of touch with myself for a long time. Gradually, that sensation got better as I became more accustomed to the medication and also as I came to the realization that some of my intense physical and emotional reactions were really overblown in general. 

And I can completely relate to the idea of "losing" something by getting rid of depression. I was terrified that I might lose my ability to write if I lost my depression. It's a very valid fear. It might not make complete sense, but there is something to the heightened emotional state of mind and creativity. My fears, BTW, turned out to be groundless. But I did have them.

 

My advice? A month isn't long enough to reach any kind of steady state on medications for the mind. Six months--more like it. But you can tell her from me that you've just got to stay with it. It gets better.

 

Thank you, it's very helpful to hear what is behind her resistance. She told me she's given it a try like I asked and now she wants to be done, but I am going to argue for more time. 

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And psychiatrists have more experience with a wide flange of medications and understand off label prescriptions. Better able to get it right the first time, better monitoring of side effects.

 

Ime, a good psychiatrist may cost more per hour, but less in the long run, because diagnosis and treatment are more targeted.

cheaper in the long run - and *faster* to feeling "normal/healthy".

at her age - she probably doesn't know what "normal/healthy" actually is, because the only thing with which she is familiar is with her own messed up chemistry.

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She probably doesn't like the way she feels right now. Nobody likes feeling like they are not themselves at all. It's really disconcerting, and the response I had was to try to "fix it". Best advice I got from a dear family member--stop fighting it. I was like a wild animal in a cast, kicking myself to bits trying to get away from everything that was actually there to help me. It took all I had to quit struggling against things and to allow myself to rest and heal. If it helps, depression is every bit a medical condition like a broken bone. A really bad fracture with minimum of many weeks in a cast and plenty of rehabilitation afterwards. And there are going to be times when that splint has to be changed, or things have to be adjusted, and every one of those times is going to feel like there is more pain, or that nothing is helping, or that you'll never use the limb again. But depression lies to you. It lies, and lies, and lies. It tells you that things won't get better. It tells you that you aren't the same person and you'll never be yourself again. As hard as it is to quit listening to it, that really is what you have to do. 

 

ETA: One of depressions favorite lies is to tell you that you are all better now, so you can stop your medications. Really bad lie.

Edited by Critterfixer
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As for the ethics of making her take medication:

 

This is my personal experience with my own family, take from it what you will. My dh has been on antidepressants for about 13 years now; he has tried to wean off a few times and that has always been disastrous.

 

I make sure he takes his meds; I honestly hate nagging him about it, but I hate the effects on the whole family when he is off of meds even more. If I have to put pressure on him to stay on them I do. He is absolutely not able to assess his own mental health status and make good, rational decisions when he is off of meds. And he never has been able to really understand the impact on the family when he is depressed and irritable.

 

The person with the malfunctioning brain is just not the best one to make decisions about care. That sounds awful, but I love my husband intensely and want both what is best for him and what is best for our family, and I have seen too many times his inability to take either of those factors into account when he just wants to be done with medication.

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I'm probably going to get slammed for this, but I would let her go off the medication as long as she continued therapy. She needs to learn appropriate coping mechanisms and how to deal with her emotions and antidepressants don't teach that, therapy does. The change in her behavior may be slower but can still happen.

I just know how much I hate antidepressants and how much I would resent someone for making me take them. This is actually where your therapist should come in. If the Dr thinks she will not a harm to herself or others, then medication should be optional. Depressed does not automatically equal suicidal.

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The person diagnosing the medicating is her doctor. The counselor is a Licensed Professional Counselor.

 

Again, this treatment is going well, not really looking to have a discussion about how I'm approaching treatment incorrectly and how I should be doing everything differently. I'm interested in how a parent deals with the ethics of coercing a resistant teen to continue with it. I believe in respecting my teens autonomy and she is the type to feel very violated if I put my foot down and refuse to allow her a say in what she puts in her own body (as far as medication goes). But balancing that against her own needs and the needs of the entire household is so very difficult.

 

Thank you to people who have addressed this and brought up some very good points that will help me in my conversations with her.

Sorry, I did not mean anything I said in a critical way, just looking at all possibilities. I am glad you are comfortable with dr and therapist.

 

Best wishes to you and your dd.

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