Depression or other? in teen adamant about no counseling

[woolybear]

Ds is 15. I really am not sure what is  going on with him, but I suspect depression may be a component of it. I really think counseling may help, but he absolutely does not want to go. Perhaps I could "make" him go, but I think it would be so much better to have him at least somewhat on board. Anyone dealt with this and has suggestions?

 

 

Also, just want to hear from others about teen boys and depression. I have read that depression can look different in teens/kids. He rotates between sort of okay, angry, unmotivated, and sad. I think no drugs yet, but it is looming way too close on the horizon.

 

He got acne which got worse this winter and that seems to have exacerbated things, as now he doesn't want to go out because he doesn't want people to see him. He does go to classes at a homeschool program, but he has limited other activities. Unfortunately, he has found one thing he likes to do--an all ages night club. I don't love it, but long story, we are somewhat supporting this. I think he would go anyway even if we said no. He really wouldn't care what we took away, privileges etc. as he seems to "not care about anything." He is reconnected with negative people he met when he went to ps a couple of years ago and with his current frame of mind, this is a big concern.

 

Sorry. I realize this post is all over the place. I am really struggling with this. Although my dh helps, I feel like the main burden is on me. Any advice or sympathy appreciated. Lastly, although I know he is struggling himself, it is hard often to be sympathetic with him when he is fighting help (mine or outside) and is saying things like "Shut the f*** up!" to me. Grrrrr......

[basketcase]

Counseling is only one of the recommended options for low- to mid-range depression. Perhaps he would be more willing to try some of the other options? Exercise, sunlight, fish oil, and probiotics all have worked for many people. Essential oils, even chiropractic care - just a thought, in case he'd be willing to try something other than counseling.

[StephanieZ]

BTDT, have the t-shirt. 

 

My suggestions . . . 

 

Yes, get him help now. Don't wait. This is a medical issue, and the parents have a legal and moral duty to address it. That's what I said (over and over) when the issue arose in my family. It's not optional to do something. You can negotiate on time lines, choice of gender for therapists, changing therapists if child hates one, meds vs no meds vs change in meds . . . But, doing nothing is not an option. 

 

1) Schedule a pediatrician appointment to evaluate to "screen for depression". If you are lucky, and your pediatrician is awesome (as my child's was), the pediatrician can be vitally helpful in setting the stage for the child accepting therapy and/or meds. They can help de-stigmatize it, make it clear that it is typical/common to get some help navigating this, and that it is normal and not bad . . . S/he will also likely be the prescriber for any meds and can refer you to therapists.

 

2) Insist on 8-12 weeks of therapy to evaluate what's going on and see if it helps. 

 

3) Make clear that the therapist can act as a "life coach" and help the teen "get what you want" by helping them negotiate with you, etc.

 

4) Be clear that you and your spouse are open to change and open to meeting with the therapist (or an additional therapist) together to work out family dynamics, etc. 

 

5) Make it as pleasant as possible for the kid to go to therapy. (Buy coffee on the way, go to lunch after, or whatever else makes outings more pleasant for your kid.)

 

6) Meanwhile, encouraging outdoor exercise and healthy sleep habits can help. 

 

Also, meanwhile, definitely take child to a dermatologist and comply with purchasing the slew of expensive medications that will be prescribed. Get rid of the acne. It can make a real difference. (Also, washing sheets frequently is also very helpful.) Again, treat the acne as a "MEDICAL" problem that you, as the parent, have a moral and legal obligation to address. 

 

Google up "signs of depression in teens" and share with your teen. My teen was very forthcoming about signs, and seeing that s/he met *every* clinical sign made it pretty clear that something was amiss. Obnoxious teen angst-y behavior is easy to confuse with depression. 

Edited March 28, 2016 by StephanieZ

[catz]

Cleaning up his health can help with acne too.  I would require him to take steps.  Maybe start with exercise, vitamins, probiotics, fish oil or flax daily, daily acne cleaner (we like a product called Humane available on Amazon).  Give that 4-6 weeks.  Talk about next steps.  I would absolutely be working on this while you still have some control.   Communicate with him. I like the idea of talking about it clinically and showing him check lists.  It's also hard on a body physically over the long term to have depression.  Step 2 would be a dermatologist and a psychologist. 

 

I have a 15 year old who is kind of crabby and negative, but he loves peer interaction and laughs and enjoys life too and is active, engaged, and has come up in motivation level since a HUGE growth spurt.    I have had depression though and I'm quite sure I had it as a teen/young adult and it was untreated.  It came screaming back with PPD/anxiety and I very much have it under control now. 

 

If my DH were regularly saying "Shut the f- up" that would be a huge problem.  I'm pretty sure my DH has never said that to me.

Edited March 28, 2016 by WoolySocks

[Loowit]

Depending on laws where you live, you may not be able to force him into therapy.  When my children have gone I was told up front once they are a certain age they have complete autonomy in regards to mental health.  I can't even have access to my DD's records without her permission once she is 14.  It makes it really hard to help teenagers who are in need of therapy and/or medications for mental health, but who are resistant.

 

Can you move out of the area and connect him into a healthier environment?  Have you sought treatment for his acne with a dermatologist?  Maybe get him involved a group at would be a positive influence?

 

If you can't get him to go to therapy, perhaps you can go yourself and a therapist can help you with ideas of what to try and/or talk to his doctor and explain what is going on. They may be able to help.

[freesia]

Get his vitamin D checked, too.

 

Also, one of my friends, whose dc wouldn't go to counseling had good results going herself to learn techniques to use with her dc. Eventually the dc agreed to go, but there was noticeable progress even with just mom going.

[Katy]

You've gotten great advice.  I would make sure the therapist you take him to is a cognitive behavioral therapist.

[justasque]

...Unfortunately, he has found one thing he likes to do--an all ages night club. I don't love it, but long story, we are somewhat supporting this. I think he would go anyway even if we said no. 

 

Can you build on this interest at all?  Dance classes (at a school with boys) would give him a physical workout and, if it's a serious school, contact with kids who are accepting, work hard, and see a future for themselves.  Theater activities would be another option; in my area there is a great group of teens who act or do crew work on performances at schools and local community theaters. Again, it gives them an accepting social group of friends with whom they can work on a serious project (the show).  Kids usually start out on crew, then move into ensemble roles then larger roles if they have the time and talent for them.  

[Chris in VA]

When I read your post, I get a pretty familiar feeling in my stomach.

 

I would drug test your teen. So sorry to have to say that.

 

I would suspect multiple things going on that he's not telling you.

 

The red flags for me are his disrespect, denial of the problem, the "all ages nightclub," hooking back up with the wrong kids from school, and even the acne (though that's a stretch--but some pretty yucky things can make it worse).

 

I'm not a doctor, nor can I diagnose your dear son. I'm just saying what I would suspect--may be way off base.

[JFSinIL]

Poor kid.  He must be miserable.  I agree, get him to a dermatologist for a start.  Check Vitamin D levels and thyroid function.  He may or may not be truly depressed - teens can get very moody w/o having clinical depression.  Let him know that if he feels it might help, he can see a "life coach" or a doctor, just let you know.  Point out that you are not trying to make him be a certain way or mold him into something he is not, but that he seems so unhappy that you want to be sure he is o.k., and that he could talk and say stuff to a professional that could never be repeated without his permission to a parent.    Then let him think on that for a bit. 

 

Just a thought - start showing up at the all-ages night club and having fun (fake it if you have to) - it may lose its luster for him if his old fogy parents like it.  ;-)  

 

 

Edited March 28, 2016 by JFSinIL

[kroe1]

Get him away from the "friends" even if that means a semester at grandma's

 

Get his face cleaned up.

 

Put him in some sport or activity. Find some sort of passion for him besides clubbing.

 

Working in an ER, I have a jaded outlook. I understand that. But, erratic behavior in a teen is drugs, alcohol, or huffing until proven otherwise.

[StephanieZ]

ps. Re drug testing. You can buy lots of urine drug tests on Amazon. Super cheap. It's an easy way to check for drug use if you don't want to start a medical record. 

[gardenmom5]

we have a genetic predisposition to depression.  I'm homozygous - 2 copies - for the mutation that predisposes members of my family towards depression. (and joint and vascular problems that have been common in extended family.  I hope to avoid those.)  those who are symptomatic do best treating the mutation rather than just symptoms.

 

I go to a ND - and so use more natural approaches. 

 

I had a very resistant young adult who refused to register for even one class for winter quarter (or look for a job) -that was the last straw.  

 

in January, I did put him on a (skimpy) supplement cocktail of things that work for me. (including 10K of d3 -affects mood - as the last time his numbers were checked they were in the low 30's. consider 50 a baseline.)  he agreed to that. 

 

I also *required* him to see a counselor.  I had to find a counselor, and take him to his first appt, but that's okay.  he now goes on his own. I've no idea what they discuss - he wants his privacy. (that's okay - I just want to know he's making progress towards a productive life.)  though I was annoyed when the counselor told him he's bipolar, just with really long  phases.  (one expression of our genetic mutation can mimic  bipolar.  treat the mutation, and symptoms can disappear.)  

 

he took the initiative and registered for spring quarter, and is now working part-time.  his mood is much better, and he's actually happy.  at this time, the trend is forward, so I hope that will  continue.

[gardenmom5]

Depending on laws where you live, you may not be able to force him into therapy.  

 

it does require some cooperation.  my sister admits when she was taken to a child pscyh - she'd lie and make up things.  she says she didn't know what  she was  supposed to say.  

[lanabug]

When I read your post, I get a pretty familiar feeling in my stomach.

 

I would drug test your teen. So sorry to have to say that.

 

I would suspect multiple things going on that he's not telling you.

 

The red flags for me are his disrespect, denial of the problem, the "all ages nightclub," hooking back up with the wrong kids from school, and even the acne (though that's a stretch--but some pretty yucky things can make it worse).

 

I'm not a doctor, nor can I diagnose your dear son. I'm just saying what I would suspect--may be way off base.

I have to agree with the possibility of drugs. This sounds very, very similar to the way my sister acted as a teen when she got into drugs.

 

Whatever the case may be, I hope you are able to get the right help for your son.

 

Lana

[Pink and Green Mom]

:grouphug: We went through an "is he depressed or is this normal teenaged angst" situation with my oldest last year.  Still not out of the woods.  I know how terrible it feels to not know what to do or how to help.  More :grouphug:  :grouphug:  :grouphug:  :grouphug:  to you.

 

 

[woolybear]

Counseling is only one of the recommended options for low- to mid-range depression. Perhaps he would be more willing to try some of the other options? Exercise, sunlight, fish oil, and probiotics all have worked for many people. Essential oils, even chiropractic care - just a thought, in case he'd be willing to try something other than counseling.

 

He used to exercise but stopped because he said the sweat made the acne worse. He takes fish, vitamins. I feel like we have tried a lot before getting to this point.

 

He has been to a dermatologist. Initially we started at the pediatrician for the acne. He prescribed antibiotics and a topical cream. It got worse, so we went back and then to the dermatologist. She talked about Accutane, but I wanted to hold off on that as one of the side effects is depression. She doubled the dosage of the antibiotic and he began to have some stomach issues, but also acting worse. I read that that particular antibiotic can have various mental side effects, including depression. I contacted her and she prescribed a different antibiotic and to take him off completely for a few days. He is still off all (it's been about four days.) I'm holding off putting him on the new antibiotic as well as holding off on the accutain. His skin does look much better, but he is still not happy with it.

 

We also went to the naturopath for both the skin and mood issues. She prescribed several things, including B vitamin complex and several things for the skin. She also ordered blood tests to check for other issues/deficiencies. I have held off on that as I had been considering asking the pediatrician to order a drug test via blood and combine the two. I really don't want to confront ds about this although we have talked about drugs, I think he would feel we really don't trust him. I was hoping to sneak the test in, although I know this is perhaps untrustworthy/unethical on my part. I'm not sure the pediatrician would even be on board with that. As to a urine test, what I understand is huffing (inhalants) cannot be detected by that method.

 

I have gone twice to the therapist and would like to continue for myself as well as him. So far, she has been open to helping this way, but I think it would be good for him to go in too.

 

As to other interests, I have tried. He is not open to new things because 1) he doesn't want to meet new people/ be out because of his skin and 2) (I'm guessing) he is not motivated at the moment to do much at all.

 

He has always had sports, but due to several injuries last year, ending with a broken collar bone and surgery he is not doing any at the moment. He has said he would like to get back to baseball, but has some work to do to get there. I'm not sure he is motivated enough to make it happen. As a matter of fact, I am currently waiting for him while he is doing physical therapy.

 

He did say previously, if he had to go he would lie or sit there and not say anything. I think he needs to be somewhat on board, because he can fake it pretty good and make himself look okay if need be to get it done.

[woolybear]

:grouphug: We went through an "is he depressed or is this normal teenaged angst" situation with my oldest last year.  Still not out of the woods.  I know how terrible it feels to not know what to do or how to help.  More :grouphug:  :grouphug:  :grouphug:  :grouphug:  to you.

 

So, what did you do (if you don't mind my asking) and how did you determine if he is depressed or normal teen angst?

[Pen]

I'd probably say to the child that as a parent I have a duty to help, and am making a group of appointments which would include dermatologist, pediatrician or GP, therapist.

[woolybear]

We talked briefly today and he said it's mainly the acne that is making everything else so hard. He admitted he had other problems before but was able to cope, but just cannot carry it all at this point. I said, well maybe that is reason enough for going. Yes, we are doing what we can for the acne, but in the meantime, he does have that and other things to cope with, so perhaps he could use some help in being able to cope. In a very tiny voice, he said maybe.

 

I also compared this to a time when he had a bad ingrown toenail, that he did not want to go to the doctor for. He basically had decided that he would just live with the pain. That the was how life just had to be for him. Now he can see how much better it is without that pain. I said perhaps this is similar. Maybe he doesn't just need to live with this. And maybe he will be able to see that after.

 

Now. Just because I had a tiny maybe (not the first time) does not mean he is at her office yet.

[gardenmom5]

the fact he's been taking long term antibiotics for acne has me wondering if his gut flora is now totally messed up.  yes - it can affect mood!

 

I would start with a good candida cleanse to kill off any candida (which is very happy to take the place to dead good gut bacteria - which antibiotics also kill).

then start adding in a good probiotic.

also for diet - cut out sugars, and reduce simple carbs.  they feed yeast.  and add in lots and lots of veggies.  (they'll help with the probiotics)

 

you can do that in addition to the acne treatment.

Edited March 28, 2016 by gardenmom5

[hornblower]

maybe you guys are way past this with the skin care but the Paula's Choice acne kits have been quite good at getting things under control, either on their own or with antibiotics &/or accutane. They have a good price on the 2 week trial kit now 

Also maybe consider dropping dairy? It seems to trigger lots of people. 

I don't know how much our exp would help because our dynamic here is quite different. I think that in my house what was important were times when the adults said "you don't have to handle this on your own. We're going to help you & it's ok to need our help, to want our help, and to accept our help & sometimes our help will just consist of giving you a list of possible options to explore, and other times it will consist of us making an appointment for you. We will trust you to tell us if it's totally not right for you, but trust us to make suggestions which we think are good & at least consider them."  I think some kids get it in their heads that they have to be able to handle things on their own...

[woolybear]

maybe you guys are way past this with the skin care but the Paula's Choice acne kits have been quite good at getting things under control, either on their own or with antibiotics &/or accutane. They have a good price on the 2 week trial kit now 

 

Also maybe consider dropping dairy? It seems to trigger lots of people. 

 

I don't know how much our exp would help because our dynamic here is quite different. I think that in my house what was important were times when the adults said "you don't have to handle this on your own. We're going to help you & it's ok to need our help, to want our help, and to accept our help & sometimes our help will just consist of giving you a list of possible options to explore, and other times it will consist of us making an appointment for you. We will trust you to tell us if it's totally not right for you, but trust us to make suggestions which we think are good & at least consider them."  I think some kids get it in their heads that they have to be able to handle things on their own...

I really like this last paragraph. I think this is spot on.

 

On another note, he wanted me to get him various skin and hair products today. And I said okay, but..... he hemmed and hawed and then said Fine! I'll go. Fair enough. I'm willing to get him what he wants and needs for the skin, but I think this is something he also needs. Fingers crossed. He said he'd go, but didn't promise to try while there. I accepted this for now. It's a first step at least. I think I will also use some of what you said above.

[Chris in VA]

That's so encouraging!

 

I would take him off dairy, too, btw. Except--yogurt is really good for healing the gut. Does he like it?

[Pink and Green Mom]

So, what did you do (if you don't mind my asking) and how did you determine if he is depressed or normal teen angst?

 

My son was younger than yours at the time - 13.5.  Now that he is almost 15 I know there is a world of difference between 13 and 15 so I'm not entirely sure what worked for us then would even work for us now, but here is what we did.

 

I know this will not be popular, but we made him go to a therapist.  And even less popular my husband said "and you will go even if I have to carry you in there kicking and screaming."  We told him that he could choose to do whatever he wanted to do for his hour of therapy - participate, stare at the wall, pick his nose.  But not going was not an option.

 

Long story short, my son did not meet the criteria for depression (although there are days when I wonder if there is something else going on).  But even so, we were lucky to find a great no-nonsense male therapist who talked to my son about his crappy attitude and poor choices and how he (my son) had the power to make his home life either wonderful or not wonderful based on his attitude and choices.  I think I got as much out of it as my son did.  Just attending therapy for a few weeks made a huge difference.

 

 

*********

 

I did see what you posted about your son saying maybe he needed some help.  I suffered with depression for years, including a bout of severe depression requiring hospitalization in my late 20s.  That maybe, to me, is a big deal.  Huge.  Admitting you may need help, in my personal experience, is the first step and more than half the battle to being receptive to just talking to a professional.

 

It sure isn't easy.

[woolybear]

 That's so encouraging!

 

I would take him off dairy, too, btw. Except--yogurt is really good for healing the gut. Does he like it?

 

He is off of dairy. He has yogurt occasionally. He was on a strict Candida diet for about a month but I've lightened up a bit. Still no dairy, but I had been told that provolone cheese is still okay. Not sure why, but he's been having that. We were fully gluten free for him, but not now. Low on gluten though. No sugar, mostly just agave, though occasionally honey.

[ktgrok]

FYI, agave is pure fructose, more than in high fructose corn syrup or sugar! I'd stick with regular sugar before using it. And if the actuate would make him feel better, I'd probably do it. Maybe make a deal, if he is in therapy (where they can help monitor his mood) he gets the Accutane. And you and the therapist can monitor him for side effects. 

[woolybear]

Okay. Now I'm confused about agave. I thought it had a low glycemic index. We used Stevie for awhile but it had a weird taste. I'm thinking about the idea of Accutane/therapy deal. Might have him more easily on board, but I still think we should hold off on Accutane if he doesn't end up needing it. The acne really is much better than it was. The advantage of Accutane, though, I guess is not dealing with creams, etc. endlessly.

[Katy]

Try something for one night.  Have him drink a couple of bottles of gatorade before bed and coat his face in neosporin (the clear ointment, not the pasty one).

 

If he wakes up with visibly better skin (already less red, less pimples), that's a sign the acne is caused by dehydration so typical acne treatments make it worse by drying out the surface layer of the skin, which further blocks pores.

 

The answer in such a scenario is to drink a lot more water, use a mild soap no more than once per day, and use a heavy moisturizer.  You can also use a little vinegar as a toner.  He'll need to dilute the vinegar at first because it will burn like crazy, but it will help strip the dry skin and kill the bad bacteria, while restoring proper acid balance so good bacteria can grow.  You don't want to have him use neosporin every night, because of drug resistant bacteria, but a night or two is fine.

 

If that's the problem and he lets himself get dehydrated again, have him use something like diluted gatorade or pedialyte rather than too much water.  Not only is it easier to get down, drinking too much water alone can mess with electrolyte balance.  A quart of water alone is fine, a gallon isn't.  Also, the salt will help him retain a little water and that will make his skin better.

[Haiku]

I don't have time right now to read the whole thread, but I will say this: my oldest dd has depression. She didn't want to go to counseling, either. We made her go. Just as we would make her take care of her physical health, we made her take care of her mental health. "I don't want to" is not an appropriate reason to decline healthcare.

 

She also takes medication for depression. She really can't function without it.

[ktgrok]

Okay. Now I'm confused about agave. I thought it had a low glycemic index. We used Stevie for awhile but it had a weird taste. I'm thinking about the idea of Accutane/therapy deal. Might have him more easily on board, but I still think we should hold off on Accutane if he doesn't end up needing it. The acne really is much better than it was. The advantage of Accutane, though, I guess is not dealing with creams, etc. endlessly.

 

http://www.webmd.com/diet/the-truth-about-agave

 

And it is all fructose, which science is showing is much worse than glucose. It is processed by the liver, and effects the liver like alcohol does. It's like drinking alcohol without the buzz. Fatty liver disease is on the rise because of it. Think about how traditionally societies ate lots of carbs (bread, rice, pasta) but not a lot of sugar. Sugar has fructose. Bread/pasta/rice are glucose. Processed totally differently by the body as far as health effects. 

[NoPlaceLikeHome]

Okay. Now I'm confused about agave. I thought it had a low glycemic index. We used Stevie for awhile but it had a weird taste. I'm thinking about the idea of Accutane/therapy deal. Might have him more easily on board, but I still think we should hold off on Accutane if he doesn't end up needing it. The acne really is much better than it was. The advantage of Accutane, though, I guess is not dealing with creams, etc. endlessly.

Does he have cystic acne? If he does I would strongly consider accutane which was a miracle for me. In fact, the doctor prescribed only one quarter of the normal dose for about 6 months and it was gone.

 

OTOH if he only has occasional cystic with lots of regular acne then here is what we do for my kid:

 

Wash face 3 times daily with foaming face wash by Cetaphil. Use the mild Stridex with aloe vera gel at least twice daily before applying acne medicine. Use grapefruit wipes as an alternative to face wash when in a hurry.

 

Shower daily and shampoo daily with no hair conditioners in shampoo or separately. Keep hair relatively short and off face.

 

Retin A microgel in morning.

 

Half 2.5% benzoyl peroxide mixed with adapalene gel at night.

 

We apply for my son and use the wipes for him since he tended not to be thorough and we have gotten better results this way.

 

It is normal for it to get much worse in the first several months before it gets better with this regimen. You have to religiously do the regimen. His skin is 99% clear now doing this.

Edited March 29, 2016 by NoPlaceLikeHome

[gardenmom5]

my ND just had me start doing a couple protocols with a topical castor oil application.  one fo the many uses for it I found online - is acne.   you'd need to read up on how to use it (it's fairly straightforward but can take some time as after it's applied, you need to cover it with a heat source (at roughly body temperature) for 30 - 60 minutes.), but it supposedly works really well.   here's some comments from acne.org

 

lt's also supposed to work well for heel cracks - so I'm  going to try it on dh.  he's got a couple really really bad ones.

 

oh - use old towels as it  can stain.

[woolybear]

Well. He's with the therapist right now. NOT happy about it and declared, "I only agreed to go once. And I didn't agree to talk when I'm there. " Sigh. It's a start. We'll see.

[minuway]

I have a kid with a mood disorder,  I have it too. Counseling is usually the last thing anyone wants to do when they are struggling - a support person needs to be the scaffolding that gets the hurting person to help. Another thing to be really mindful of is that the therapist / patient relationship involves a lot of chemistry, so if there's not a good rapport, be willing to meet different people until there's a good match.