Anxiety in teen - finally dealing with it

[CaitlinC]

Hi,

 

My ds  (ADHD inattentive, dysgraphia) has been seen by a psychiatrist for assessment on his levels of anxiety.  They have always been there, but with the teen years they have really ramped up.  His anxiety affects his learning (ex. his neuropsychological report of 2013 notes that anxiety interferes with his executive functioning) and his social interactions.  After four sessions with him, the psychiatrist, who is considered the top specialist in the city for children/teens anxiety floated the idea of medication (Prozac) with him (the age of consent where we live is fourteen, he's going on fifteen).  He is very keen to try the medication.  I am not thrilled with the idea (he is already on Concerta) but not adamantly opposed either.  The problem as I see it is that the psychiatrist will not give him therapy in conjunction with the medication.  He is not particularly open to the idea and the psychiatrist told us that this is very common in teens.  She did say that sometimes taking the meds can make the individual more open to therapy, but not always.  She made the point that teens' schedules are very full and that fitting in intensive CBT, which is what is needed for it to work, is very difficult.  She told me privately that his anxiety is very, very high.  She also told us that untreated anxiety can lead to depression (something I can attest to having lived it myself and I am not actually that anxious a person, it was mostly situational).

 

Boy am I ever sorry that we did not tackle this before the teen years.  I guess I didn't really appreciate how anxiety was contributing to his issues.

 

I am wondering if anyone would be willing to share some btdt stories of coming to terms with anxiety for the first time in the teen years, and thoughts on medication without CBT therapy?  He does occasionally talk to a psychologist but she isn't specialized in CBT.  

 

(Please don't quote as I may delete certain parts of this message for privacy)

 

Thank you so much.

[Sandwalker]

I am not a fan of antidepressants in teens, but understand that the benefits do outweigh the risks at times. Unfortunately, it seems that psychiatrists just diagnose and prescribe meds these days, only following up on the medication's effectiveness, side effects, and dosage adjustments.

 

If you want therapy, you have to go to a psychologist type.

 

I would try the CBT before the prozac, and I would also suggest daily meditation and exercise for ds. Preferably yoga, but I know how some boys are about doing yoga.

Edited January 7, 2018 by Sandwalker

[Pawz4me]

DS19 (ASD-1, GAD) has been on generic Prozac for (I think) about three and a half years now. It has been absolutely fantastic for him. He had a marked improvement in his ability to function once he got on a good maintenance dose. The only negative side effect at all has been some weight gain, but for him that was actually a good thing. My only regret is not getting him on it a year or two sooner. At his psychiatrist's recommendation he did have some therapy a few months after he started on it. It wasn't CBT but was aimed at giving him tools to deal with the anxiety like deep breathing, etc I think it was very helpful for him, but part of that was likely due to the fact that he "clicked" very well with the therapist. I'm not clear on what you mean by the psychiatrist "will not give him therapy in conjunction with the medication." Psychiatrist aren't therapists, or at least around here they certainly don't do therapy. DS's psych has several therapists in her office. He saw one of them in addition to seeing her for medication management. You don't need her for therapy, unless (perhaps) you need the referral for insurance purposes?

 

ETA: I've had my own struggles with anxiety, and while I've never had professional therapy I can tell you that all the usual self-help recommendations were absolutely worthless to me until I got on medication. Once my mind was calmed a bit then I think things like meditation, yoga, increased exercise added to the effect. But none of them touched my anxiety one bit w/o medication.

Edited January 6, 2018 by Pawz4me

[hornblower]

btdt  

Cipralex was totally life changing for us. No neg side effects, it's been ALL GREAT.  It is known to kick in fast (2-4 weeks) - we saw the beginnings of results within about 10 days -  so you'll know if it's working.  No personality changes or dimming of the person or anything - it's just the person, still cranky & annoying af sometimes, but just able to cope. 

btw, there is an online evidence based cbt program which used to be free but now costs a small fee (I think it's like 40 AUD for the year). CBT is really a skill you learn, not therapy, so it's quite efficacious even done online (though I think a skilled irl practitioner is better; it is only 10-12 sessions so if you're thinking of scheduling it IRL, it's not a huge long time commitment, kwim?) 

https://moodgym.com.au/

best wishes!!!! This sucks but when treated well, it fades into the background so be hopeful for a quick and easy solution. 

[CaitlinC]

On the role of the psychiatrist, I think that she does or has in the past done CBT with her patients, but actually what I meant, and it is somewhat poorly phrased, is that he won't be getting therapy in conjunction with the medication (because he isn't open to it at this point) ie. I wasn't disturbed by her, it's the idea of him taking meds without learning strategies in conjunction with them.  When we were in the office with the psychiatrist, it all made sense,  but once we got home and I started thinking about it, well that's when the doubt started seeping in.  So I'm very grateful for all your feedback.  It's given me food for thought and reassurance.  Thanks

[Heathermomster]

My DS worked with a CBT for EF. Are you wanting a CBT for talk therapy or EF because the purpose of the therapy will affect who you see. BTW, our CBT for EF worked with us 1 hr every 3-4 weeks and worked in the same office as the local child psych, so they could work in tandem

[CaitlinC]

I'm looking for the EF (executive function?) piece.  He has (occasional) talk therapy already, and that's one of the things that lead him to the psychiatrist for evaluation.  It came out in therapy that he thinks he's autistic. His psychologist thought that we should treat the anxiety first before or instead of going down the road of assessments for autism.

That's interesting that the CBT could be done like that.  I was under the impression that it had to be intense.  Definitely, something that could be done in tandem on an occasional basis, or at home on-line would appeal more to him.  He seemed to be getting stressed over the thought of having to add one more thing to his plate, which I understand.

[PeterPan]

Wow, I'm in a really bad mood or something, but when the psychs defer on diagnosing the autism, it's such a load of crap. They do that, asking what difference would it make, blah blah. And yet, if you go back and go NOW it would make a difference, then they're like oh yeah, now I'll tell you. It's the weirdest psychology I've ever seen.

 

If the guy is visibly on the spectrum, tell him. Stop pussyfooting around. If you want him to understand himself and use good tools and make better choices, tell him the TRUTH.

 

Hoopmann has good books on this. Social Thinking has all kinds of stuff. When psychs do this, they aren't acknowledging the pervasive way it's showing up or the AMAZING resources and tools he could connect with if he had the right words for his problems. Go to Social Thinking.com and start reading. Find somebody new to work with. Find him a BCBA or SLP specializing in social. His he anxious and aggressive? Has he had an OT eval? For many people an OT eval is LIFE-ALTERING, an epiphany. It doesn't have to lead to lots of therapy. You just go find somebody who is SIPT-certified or really bang-up with autism and you put him in a room with them for enough hours and they sort through things.

 

Until you have the right words, you can't problem solve. When you go ok autism plus aggression or autism plus depression, you might get different answers from just googling depression, kwim? Then you start to read about methylation issues and sensory and some of the better approaches out there right now (5 Point Scale, Social Thinking, etc.). 

 

Not getting the diagnosis is shutting the door and saying oh that whole facet of you is there but just throw a blanket over it and pretend it doesn't exist. Meanwhile, the tasmanian devil is under there, whirling round and round. Absurd.

[kbutton]

I'm looking for the EF (executive function?) piece.  He has (occasional) talk therapy already, and that's one of the things that lead him to the psychiatrist for evaluation.  It came out in therapy that he thinks he's autistic. His psychologist thought that we should treat the anxiety first before or instead of going down the road of assessments for autism.

That's interesting that the CBT could be done like that.  I was under the impression that it had to be intense.  Definitely, something that could be done in tandem on an occasional basis, or at home on-line would appeal more to him.  He seemed to be getting stressed over the thought of having to add one more thing to his plate, which I understand.

 

If he has ASD, then he might not benefit from CBT as much as something else, or he might need a psychologist that is really skilled at using it with individuals on the spectrum. I think CBT requires a certain level of self-awareness and then ability to change with your own best interests in mind (from what I can tell). My son has great self-awareness, but the ability to just change without some external system or help is just emerging. I would want to know what makes a person ready for or a good candidate to do CBT--not just by diagnosis, but by personal qualities, maturity, etc.

 

ASD brings a number of areas of challenge with it, and while anxiety can be comorbid with ASD (and often is), sometimes it's the constantly trying to live typically without understanding yourself, others, and your own blend of challenges that is really anxiety-producing. 

 

I think that anxiety treatment needs to go along with a diagnosis, but if ADHD is already identified and treated, and he's still struggling this much, I don't think it would hurt to at least find an ASD-literature professional who is really good with kids who've slipped through the cracks, and get on an appointment list. 

 

I would also be sure you get some language testing--TOPS 2 and some kind of narrative language test. Those are often overlooked. Also some combo of autism questionnaires and adaptive living questionnaires--like the updated GARS and the Vineland.

 

Be sure that you bring up all the issues you can think of--we often discard something like ASD when a child has had an eval already, but sometimes, their difficulties are with more complex things and take time to come to light. They wear the diagnosis a little differently, so to speak.

[PeterPan]

Not to point out the obvious, but everything under Social Thinking is CBT based. 

[Pen]

We are also dealing with anxiety--probably not as bad as your ds's.  Am finding  "self-help" therapy as good or better than a not very good therapist ds had last year. And it was really hard to get to appointments on top of everything else which in some ways added to rather than helped anxiety. Also some research I saw suggested that the results of self help CBT etc. may last longer than when depending on a therapist.  

 

So you don't necessarily need to have no CBT, just because the psychiatrist does not provide it.  

[Pen]

https://www.psychologytoday.com/blog/think-act-be/201609/therapy-without-therapist

[CaitlinC]

Thank you, I am processing all this ... 

[kbutton]

Not to point out the obvious, but everything under Social Thinking is CBT based. 

 

Sure, but that doesn't mean that a child or other person with ASD might not need reinforcers or other things in order to get themselves to do it--basically, some kids need some ABA techniques in order to implement this sort of stuff. In my mind, that means that someone super skilled with working with kids on the spectrum needs to be able to implement CBT. Not just any psychologist.

 

I am sure people do find ways to offer themselves incentives with CBT, but I know my son, until recently, couldn't do this himself--it needed to be more external no matter how hard he wanted the change or understood the CBT principles. It's been a huge switch in his brain that he can basically want something to change and devise a way to get himself to change. It still needs to generalize a little better, but it's very, very different from the past. 

[Lecka]

I’m cautiously wading in..... on the ASD question, I think there is a big question of self-awareness. Some people with ASD might not be self aware enough to pretty independently recognize and associate themselves with ASD. A lot of people will have it brought up to them first, or have a close association with a relative, and only then think of that.

 

But there are different levels of self-awareness and some people have higher levels of self-awareness and still would be on the autism spectrum.

 

I feel like there’s probably a question there though about — if you’re self-aware enough to realize you have ASD, are you too self-aware to realize you have ASD.

 

But I am going to link an article about different levels of: from my understanding, basically Aspergers. And in this there are people with the higher level of self-awareness who would be able to notice it or realize it.

 

But people can also think they have autism or identify with things about autism and not necessarily have autism.

 

Jerry Seinfeld got in trouble for this a few years ago. He ended up apologizing and not talking about it anymore, but I think maybe he really does have autism and just doesn’t want to deal with the autism community. But maybe he also just found out some about it and thought “I can identify with this†but it didn’t mean he had autism. It was an interesting story to me anyways.

[Lecka]

https://www.socialthinking.com/Articles?name=Social%20Thinking%20Social%20Communication%20Profile

 

Levels of Social Mind. Unless someone has brought it up to him or you have a relative with autism or something like that, if your son has autism he would be one of the higher levels in this (i think).

 

 

http://time.com/3596612/jerry-seinfeld-autism-spectrum-aspergers-syndrome-neurotypical/

 

This is about Jerry Seinfeld and has his quote about autism “I related to it on some level.â€

 

I think that’s possible too. It could be relating to some associations about autism, or some specifics.

[Lecka]

I have a sister who is probably on the autism spectrum. She has got a cousin and a nephew diagnosed with autism. Some others in the family have wondered at this point “what does that mean for us.â€

 

But my sister never wonders! At all! Really!

 

So that self-awareness part is something I have thought about.

 

I do think it’s something where — there could be more difficulty to getting diagnosed if he comes across self-aware. But it shouldn’t matter I don’t think. Like — it shouldn’t matter but people go off of impressions sometimes and so maybe it will matter.

[exercise_guru]

We had a lot of family medical stress at the same time my daughter became a teen. She went to counseling and had a lot of anxiety and stress partly due to coping with our family medical stuff but also just teen life in general. The counselor recommended prozac and and some point we may revisit this.  In the short term we had the family dog sleep with her. Animals are very effective in helping vets with PTSD so we thought it was worth pursuing. We even considered getting a second dog to act as a therapy animal but our dog proved to be cooperative and soothing. She has been resistant to learning coping strategies but the dog wins her over and soothes her. We also are working to help her with other outlets and coping strategies. 

 

We also pushed hard to get her in an athletic program. I would personally recommend a Karate that also focuses on mindfulness.  this proved wonders for a friend who had a son with a lot of anxiety and anger issues. Even though she does not have many sensory issues I have thought of making her a small weighted lap blanket to soothe her. 

 

Also I read about anxiety in the add magazine and found it fascinating and very helpful even though my daughter most definitely does not have adhd. They also had  an article about anger and over reacting to criticism that I found so helpful . It was called Rejection Sensitive Dyphoria but I found it very helpful in understanding how another one of my child over reacts to every little recomendation. I am keeping an eye on that for sure. In any case you might like researching that website. I also liked the Webinar "He's not lazy" on that website. They bring in some awesome specialists.

https://www.additudemag.com/anxiety-attack-panic-attack/

https://www.additudemag.com/category/parenting-adhd-kids/webinar-parents/

 

 By recomending this I am not implying in any way that your child may have ADHD its just an awesome awesome site and everything I read there helps to me to understand one of my children or friends. 

 

 

I am also reading zones of behavior and social thinking but currently working to keep her sleep schedule tight and improve her diet. 

 

I suspect we may circle back to antidepressants but she is still very young. I know she will need them in college maybe high school. My strongest concern would be good monitoring because withdraws or not taking medication or just in general can have some very very nasty results. I have a friend that committed suicide . We later found out she went off her adhd medication and did not tell anyone. 

Edited January 8, 2018 by exercise_guru

[Terabith]

I don't understand why he can't do both medication and therapy.  That just doesn't make sense.  I mean, psychiatrists don't usually do the therapy, but the standard is to do BOTH. 

 

Honestly, while we started medicating at five for anxiety, I just want to weigh in on the anxiety/ ASD question.  We've had numerous ASD evaluations.  It's always been ruled out.  But when her anxiety is well controlled, she looks MUCH less autistic.  When the anxiety is an issue, I see ASD symptoms galore.  But she's always had theory of mind.  It was amazing when we first started medicating her.....within a week she got in trouble at preschool for talking.  All of us (including the teacher) did happy dances.  She just started interacting SO much more.  When she's having an uptick in anxiety symptoms even now, she looks much more autistic.  I wouldn't swear she's not, because I look at the DSM and I think, "Yep."  But they give her the ADOS or other evaluations, and every time, it rules it out.  So I think that the ASD/ anxiety question might be more fluid than commonly thought. 

[lmrich]

How much physical activity is he getting? I know it is so hard to get a kid who is struggling out the door to exercise, but it helps. Every kid is different, but I hold a lot of stock in outdoor therapy. Going for a hike, sitting by a lake, a long bike ride all have been helpful for our family. 

[Ravin]

I would start the meds, and then look for a psychologist or counselor for him to work with on a regular basis if/when he is willing.

[PeterPan]

We've had numerous ASD evaluations.  It's always been ruled out.  But when her anxiety is well controlled, she looks MUCH less autistic. 

 

And just for a laugh, I'll toss out that my ds, who *is* diagnosed on the spectrum, actually has MORE autism behaviors when you get the anxiety and emotional stuff tamped down with supplements, etc. More humming, more repetitive behaviors. It's almost like he's a gleeful autistic because he isn't overwhelmed by the irritability and other stuff. 

 

So I definitely put stock in what you're saying. I just thought it was ironic that my ds was so the opposite. 

[Heathermomster]

I need to mention this. CBT work for EF requires willingness. Think about it. EF involves goal setting, sustained attention, goal directed persistence, and other fancy names. No one but the patient can apply and practice EF skills. As the parent, we help set up successful models and help our kids with follow through, but we cannot force them to change or use accommodations. We are helping them to work around their cognitive deficits. The CBT visit may last 1 hr every 3-4 weeks, but the EF practice is daily until steps are internalized and become healthy habits. The practice is difficult.

 

My DS is not on the spectrum, so the work that he had with CBT may not be appropriate for an individual with ASD.

[Paige]

Anxiety could be convincing him he has ASD when he really doesn’t. Anxiety can convince kids that something is wrong with them. Not saying he isn’t ASD, but w/ high levels of anxiety, I wouldn’t assume a self- diagnosis is accurate.

[Pen]

What are the reasons (things about himself, etc, that he has noticed or that others have said, or that he has read and seem to fit himself)  that your ds thinks he has ASD?

[CaitlinC]

He's not very clear about why he thinks he may be autistic.  When the conversation is on an emotional subject, it can be hard to get him to discuss it, even if he's raised the issue himself.  He tends to be a feeling avoider, although I would describe him as quite passionate.  We have had discussions around how autism is a spectrum on the spectrum of human experience, that anxiety and ADHD symptoms can be quite similar in appearance etc.  Like a lot of kids these days, he's quite well informed on the panoply of diagnoses out there.

 

That being said, when he was younger, an autistic child joined his class and he noticed her stimming and said that sometimes he wanted to do that too.   I have never actually seen him do that in any situation though, even in unguarded moments.

He is also fairly sensitive to sounds.  This is something that has diminished as he gets older, but is still present.  

But I think that the thing that triggered it recently is the social difficulties that he sometimes has with his peers.  He can be quite judgemental and irritable with them and in one instance, was told that he was just like someone's autistic cousin.  I would say though that that was something that confirmed his own self-doubt rather than a revelation.    

 

I'm still trying to process all this (what can I say, I'm a plodder :-) ), but I will say that he is not obviously autistic.  I'm not saying that he isn't, but it's not something that was flagged by the psychologist who saw him in grade 2, nor the neuropsychologist who saw him in grade 5, nor has anyone around us (friends, teachers, coaches etc.) suggested that we should investigate further.  He had OT for about a year for his dysgraphia, but at a clinic that treats autistic children and nothing was said there.  The fact is that I could probably prepare a list of autistic-type behaviours (avoiding eye contact, occasionally missing social cues) and a list of attributes/behaviours that suggest not.  He's also quite mature, serious, curious and can be, when he's relaxed, quite charming and non-irritable and is able to meet new people and make friends quickly with kids who have common interests (but since he has a very broad range of interests, and then certain well defined passions, this isn't all that difficult for him).   I think that he can be very perceptive.  (Actually, I just looked back at the neuropsychologist report and I see that she assessed his abilities in critical and social judgment as high average.)

 

At this point, I am leaning towards starting the medication to see if that will bring the anxiety down a bit.  For the posters that suggest physical activity, he has increased his physical activity somewhat in that he does curling on the weekends.  I do encourage walks outdoors.  He needs to be encouraged in that direction though, he does not like to move.  I'm definitely not going to push therapy at this point.  As several people have pointed out, he has to be motivated and I can see that this is especially true for a teen. Meanwhile, I will read through the materials that I've been directed to here and look into the sorts of resources that we have available locally and try to get a handle on what he actually needs.  

 

 

 

Edited January 9, 2018 by CaitlinC

[PeterPan]

Socialthinking - Articles Did someone already link this? It's basically an article that explores what you're saying, that there are levels of social thinking and ways to have deficits without getting a spectrum diagnosis. You could read the article with him and see where you think he might fall in it. It's also pretty normal to do some social thinking interventions, read some social thinking books, etc., even without a spectrum diagnosis. So you might find some books, etc. on the site that would be useful to him. 

 

I think that's really concerning if he's being told by other kids that his behaviors are unacceptable, that he's acting like so and so, etc. Even if the labels are different, SOMETHING is going on there. 

 

Pragmatics testing is not considered very reliable before about age 11, and in fact that 10/11 range is a really common time for that higher functioning aspergers profile to be diagnosed. I'm not saying he is, just that the reassurances you're giving yourself aren't totally valid. My ds "passed" a pragmatics test at (I forget what age, 6 or 7) and failed several more one and 2 years later. It really depends on when it was done, what was done, whether it was a standardized tool or impressions. 

 

If you get him in for testing before 18, you have a lot more tools. Like the SLDT probably is normed through 18. Once he goes over that, it gets really vague. It's something you could think about. Right now, believe it or not, SLPs are at the forefront with social thinking intervention, pragmatics testing, etc. 

 

The anxiety treatment doesn't change the social thinking issues. I would be pursuing that as well. Sometimes a well-chosen person (SLP specializing in it, a behaviorist specializing in teens, whatever) could be just the thing.

[CaitlinC]

Thank you.  I didn't know that about SLPs, that's very interesting.  Just got back from my DS's music lesson.  His teacher is amazing - he explains things so well, makes it fun, and seems to really get him.  He's made a lot of progress.  I wish it were possible to clone him and convince his double to be that amazing therapist that I'll be looking for.  Anyway, for now, he's getting music therapy.  :-)

[Terabith]

I think it's definitely worth medicating to see how that impacts things.  Like I said, we medicated at five/ in preschool, and it was the best parenting decision we ever made.  I had sworn up and down that I wasn't going to medicate, given that I'm bipolar, and I was worried about the impact of medication kicking that off in someone with a genetic propensity.  If anything, we should have started earlier, probably around three when it was first brought u. 

[Pen]

Since your son is open to the Prozac, and it may help, it sounds reasonable to give it a try with monitoring.  Given that he is  wondering about ASD, would he like to be evaluated for that?  If so, then moving forward on that seems like it would make sense too.  If he is determined to have it, steps can be taken to deal with it as much as possible. If not, it could help ease one piece of anxiety for him.

 

Would he be open to working on some CBT on his own?  Or other skills for anxiety reduction on his own?  Meditation?  Disputing negative thoughts?  If he is open to trying some things like that 

 

MovingOn gave a title of an Anxiety Book for kids at one point that could help.

 

I think Great Courses has a CBT course.  And there are some free online resources also.  As well as some things in books dealing with positive psychology, that might be relevant.

 

 

Edited January 10, 2018 by Pen

[CaitlinC]

Thanks Pen.  Yes, once the dust has settled and we have some experience with the meds, I think I'll talk to him again about whether he would like to pursue an evaluation and some of the possible interventions and approaches.  

 

I so appreciate everyone's thoughts, experiences and suggested resources.  I may not have responded individually, but I will be following-up on the links and no doubt re-reading your responses.  You are an amazing group.

[geodob]

If the Prozac helps, then this will identify the underlying issue.

Prozac effects the use of Serotonin.

Serotonin is a part of signalling process between neurons.

While signals are sent back and forth between neurons, along nerves.

 

A most important part, is the recieval point ?

When a signal is recieved?  A molecule of Serotonin is placed at the recieval point.

This causes a signal to be sent back.

Which basically communicates,  'message recieved, stop sending signal',

Then when no further signal is sent.   The Serotonin is removed, and actually stored in a 'sac' that neurons have.  As Serotonin is used over and over again.

 

But a critical factor with this?   Is that their can be a problem with this process?  Where the Serotonin is removed too quickly.

When this happens, it causes the signal to be sent again.  As the Sender interprets this, as the signal hasn't been recieved.

Which can happen over and over again, as it isn't recieving confirmation of the signal being recieved.

With anxiety being a symptom of this.

 

Though what Prozac does, is simply temporarily delay the removal of the Serotonin. To carry out its normal function.

(Technically, this preventing removal. Is termed as 're-uptake inhibitor'.)

 

So that if the Prozac helps?   Then you will know that this is causing the problem..

Edited January 10, 2018 by geodob

[8filltheheart]

My ds suffers from severe anxiety but he also experienced side effects with different medications and they also adjusted doses..  I would recommend keeping med trial diaries where both you and your ds keep daily records of your observations of his behavior and his personal notes on how he feels.  As they try different medications and adjust doses, those notes will help you both assess the situation more accurately.  It can be hard to remember and time blurs side effects.  I was incredibly thankful that we could pull out concrete records of how he had reacted to different meds vs trying to rely on our memories.

[exercise_guru]

I have a nephew who had a lot of anxiety. Someone might be able to clarify why this worked but B-complex was profoundly helpful to them. 

 

Please report back if you do try the prozac or another medication. I think it would be helpful for my high strung teenager. 

[PeterPan]

The b-complex would contain niacin. There's sort of the irony there that those are different populations. A b-complex, unless it is methylated, is going to drop methyl levels. So you can have kids who are over-methylators with anxiety, and you put them on the b-complex and you're like wow they improved! But you put an over-methylator on a methyl donor, and you're going to get WORSE behavior. You read about those kind of funky reactions too. Then you can have the undermethylator + anxiety profile. Put those kids on a methyl donor (sam-E or I assume antidepressants, not sure) and boom they do better. But it's not like this homogenous response, just because they all have anxiety. Depends on the underlying chemistry and gene issues.

[CaitlinC]

 

Please report back if you do try the prozac or another medication. I think it would be helpful for my high strung teenager. 

 

Will do.

[Sandwalker]

I have a nephew who had a lot of anxiety. Someone might be able to clarify why this worked but B-complex was profoundly helpful to them.

 

Please report back if you do try the prozac or another medication. I think it would be helpful for my high strung teenager.

Year ago, my niece with anxiety and ADHD took a product called SAF for kids by Natrol. Unfortunately, they discontinued the product. It had B6 and folic acid, some amino acids, and a couple of herbs. It was an amazing product. If she forgot to take it in the morning, she would remember by noon because she felt so anxious.

 

She is now in her 20s and takes Natrol Stress and Anxiety tablets and does well on them, and is handling her adult life pretty well. Her parents tried Prozac, Zoloft, and Lexapro for her in the past: none did anything except give her diarrhea. And they were horrible for her to come off. She said she had "brain shocks" for weeks after.

[Pen]

nm

 

Edited January 12, 2018 by Pen

[Pen]

nm

Edited January 12, 2018 by Pen

[geodob]

If taking the B complex makes a profound difference ? Then it indicates a significant deficiency in one or more of the B vitamins.

 

Of particular concern, is an ongoing B12 deficiency.  As this can result in permanent nerve damage. 

Edited January 13, 2018 by geodob

[PeterPan]

I'm looking into that now. I got back ds' genetics, and it does look like he has issues with folate and maybe b12. His anxiety is still present, even with the niacin, so my next step is to see if it goes down with these other b vitamins. Still looking for info on dosing. Once I have a dose, I have to have a way to get it into him.

[Pen]

 

If taking the B complex makes a profound difference ? Then it indicates a significant deficiency in one or more of the B vitamins.

 

 

 

 

Or also maybe, one of my doctors used the word "dependency" to indicate, I think, that there may be more B vitamin than is considered an "average" normal amount, so not technically a "deficiency."  But a particular person may have needs that are different than average for it, perhaps due to use, or metabolism, or other factors.  Some of the B vitamins have role in synthesis of neurotransmitters also, as I understand.

[PeterPan]

The genetic testing we're getting back is showing genes involved in folate and b12 metabolism. So they're actually able to pinpoint and say yes some people have genetic issues behind it.

[geodob]

Niacin will only help with anxiety, if their is a niacin deficiency.

Niacin helps keeps the blood vessels dilated, to allow a normal blood-flow.

But a niacin deficiency, can cause blood vessel constriction.  That contributes to anxiety.

 

Though only the RDA recommended daily allowance should be taken.  As excess Niacin, can cause liver damage, stomach ulcers, and low blood pressure.

 

With B12, a deficiency can be identified with a simple blood test.  Which can be resolved with a short series of injections.

 

 

[Sandwalker]

The genetic testing we're getting back is showing genes involved in folate and b12 metabolism. So they're actually able to pinpoint and say yes some people have genetic issues behind it.

That is really interesting.

 

Edit: autocorrect

Edited January 14, 2018 by Sandwalker

[PeterPan]

Geodob, people are taking niacin to bring down methyl levels on the theory that they are over-methylating. So if you look up niacin and autism, niacin and bipolar, there's a lot of data there. And then the dose of the niacin needs to fit the person specifically who is over-methylating. For my ds, it has brought down his aggression from extremely significant levels to bring his body to calm. There's a lot of discussion of this online. Some of the crazy high doses people are using is because they're using no-flush. 

 

So to me, it's actually pretty pertinent whether the anxiety is being caused by the over-methylation still or whether there are more pieces to deal with. If you drop someone's methyl levels TOO much, they feel sluggish. Also I try to keep the doses small and spread so he doesn't flush. If he catches on that the flushing is from the vitamins, he might refuse them. He hasn't yet, because his autism short circuits his cause/effect connectors. But when that happens, he could refuse them, sigh. And I don't want to make him sluggish trying to bring down the anxiety if the overmethylation isn't the cause. 

 

The anecdotes online are nausea being your early indicator of too much niacin. I've been taking it at these levels and my blood pressure has not dropped. So I think it depends on the population.

[PeterPan]

That is really interesting.

 

Edit: autocorrect

 

Yes, absolutely it's interesting! And the methylation defects. Think about this. If someone is an under-methylator and has anxiety, then taking niacin would be a TOTALLY WRONG MOVE. Like you'd really mess them up. My dd is like this. Niacin makes her WAY WORSE. So I hope nobody is reading this thread going Oh I think I'll try that! They actually need to take the time to sort out the issues. I've been running genetics on both my kids (and me) and am just waiting for the results. My ds' finally came in yesterday. It's taking time to sort out. The overmethylation we were pretty confident on with him, and the niacin has been like a MIRACLE. But my dd is not, definitely not, an overmethylator. When someone is an undermethylator you use a totally inverse protocol, bringing in supplements like sam-e that are methyl donors.

 

Yeah, you can run the testing with 23andme and then run the results through promethease. That's what I'm looking at. I'm not sure it's everything, but for the $79 sale price it is a lot of info. I sent my stuff through a university study and am still waiting for the results. I'm hoping maybe they look at even more genes. That will be interesting. There are some blanks in the promethease report with 23andme. 

 

To me, when we're talking serious stuff like putting young kids on medications that cross the blood brain barrier, putting teens on anti-depressants that have a high risk of suicidal thoughts, etc., it's really reasonable to stop and want to pursue these things. I'm all for meds, sure, take 'em, do it. Some kids are going to have the issues even with the meds. Ds is in that population. If someone is an under-methylator and you're looking at prozac, you could also be looking at sam-e. Just options.

[Pen]

Niacin will only help with anxiety, if their is a niacin deficiency.

Niacin helps keeps the blood vessels dilated, to allow a normal blood-flow.

But a niacin deficiency, can cause blood vessel constriction.  That contributes to anxiety.

 

Though only the RDA recommended daily allowance should be taken.  As excess Niacin, can cause liver damage, stomach ulcers, and low blood pressure.

 

With B12, a deficiency can be identified with a simple blood test.  Which can be resolved with a short series of injections.

 

 

There are people who seem to be helped by niacin who do not technically have a "deficiency."   Anxiety, if related to B3 level, may go along with a sub-optimum amount for a particular individual.  A "deficiency" state results in "Pellagra ... a disease characterised by diarrhoea, dermatitis and dementia. If left untreated, death is the usual outcome. It occurs as a result of niacin (vitamin B-3) deficiency. Niacin is required for most cellular processes." (Googled for definition.)

 

Liver damage may be a particular issue with time-release formulations.

 

 

 

 

 

 

"About Megadose Niacin

 

"The factoid niacin causes liver damage is analyzed thoroughly by William Parsons Jr, who shows that niacin will often increase liver function tests but that these increases do not arise from liver pathology. Since I began using megadoses of this vitamin in 1952 I have seen a few cases of obstructive-type jaundice which cleared when niacin was stopped, and in one case I had to resume the use of niacin because the patient's schizophrenia recurred. He recovered and the jaundice did not recur. "  Abram Hoffer, MD

[PeterPan]

Besides, even if it affects their liver, reality is so do the other meds the person would need to be on. 

[geodob]

Slow release will cause a quicker accumulation of Niacin in the liver. But taking excessive amounts of quick release, will just take longer to reach toxic levels in the liver.

Here's a link to an article that explains the process:

https://www.ebmconsult.com/articles/niacin-mechanism-liver-hepatotoxicity-flushing

Edited January 16, 2018 by geodob