Update - Could OCD be the underlying issue? Husband struggligng with reality of longer term Prozac for daugther

[Not_a_Number]

2 minutes ago, Katy said:

Ask him if she suddenly developed type 1 diabetes and would need to be on insulin for the rest of her life if he would feel the same way. It’s not different, it just feels different because he thinks willpower can control brain chemistry. It can’t. 

You can't argue people into things like this. You need to give them time, that's all. Pressure won't help. 

[itsheresomewhere]

25 minutes ago, kristin0713 said:

I would not necessarily jump to that conclusion. The gold standard of treatment for OCD is ERP therapy. It is more successful than medication alone and often has better and quicker outcomes in combination with medication. This does not mean your daughter needs medication for life. She is only 6yo. I would start working with a therapist who is very skilled with ERP. Learn about how you as a parent can avoid accommodating her OCD and get her on the path to crushing it. Check out Natasha Daniels on YouTube - she has a lot of free videos and resources that are excellent. 

I agree. 

[mindinggaps]

31 minutes ago, kristin0713 said:

I would not necessarily jump to that conclusion. The gold standard of treatment for OCD is ERP therapy. It is more successful than medication alone and often has better and quicker outcomes in combination with medication. This does not mean your daughter needs medication for life. She is only 6yo. I would start working with a therapist who is very skilled with ERP. Learn about how you as a parent can avoid accommodating her OCD and get her on the path to crushing it. Check out Natasha Daniels on YouTube - she has a lot of free videos and resources that are excellent. 

Thank you! I appreciate this information and recommendation. We've done a lot of different therapy for her in the past and it frankly wasn't successful. However, I'm much more optimistic on that front moving - with the medication she is doing much, much better and will hopefully be able to actually get something out of therapy and also we now know how to focus the treatment. ERP was mentioned and we're working on that ASAP. Natasha Daniels looks to be an amazing resource - thank you!

On the longer term, personally, I'm not worried and really am just focusing on getting the best treatment at this point in time. Things will evolve as they evolve. However, my husband, is fairly obsessed (ironic or not...I'm not sure) with the longer term and I think the psychiatrist recognizes this and was priming him that for many with more severe OCD, medication is just a reality of life.

[mindinggaps]

44 minutes ago, Not_a_Number said:

You can't argue people into things like this. You need to give them time, that's all. Pressure won't help. 

Also, yes, I'm done arguing and discussing this matter with him at this stage since I don't think it's beneficial for anyone. He needs time and therapy to figure it out. His concerns are fairly circular and repetitive - he feels guilty, feels medicating without her understanding may have consequences, etc, etc, etc. I've made it clear that I totally disagree and am thrilled with the progress we've made - she will take medication for as long as the psychiatrist recommends and will do therapy, that's it. But it's up to him to come to terms with things since I don't think there's anything I can say to make him feel at ease.

Edited March 10, 2023 by mindinggaps

[Not_a_Number]

Yeah. You can check in where he is in a few weeks. That's probably worthwhile. But in the meantime, I think you're just right. 

[kristin0713]

12 minutes ago, mindinggaps said:

for many with more severe OCD, medication is just a reality of life.

That’s a possibility but honestly the psychiatrist is totally jumping the gun here. At 6yo there is no way to predict this. 

Re: different therapy that wasn’t successful - it won’t be successful if it’s not ERP. Dealing with OCD in a way that doesn’t encourage it is very counter-intuitive. It’s different even than how you would coach someone with anxiety. I’m saying this to encourage you to keep trying until you find a great ERP therapist. 

[Not_a_Number]

Just now, kristin0713 said:

That’s a possibility but honestly the psychiatrist is totally jumping the gun here. At 6yo there is no way to predict this. 

Re: different therapy that wasn’t successful - it won’t be successful if it’s not ERP. Dealing with OCD in a way that doesn’t encourage it is very counter-intuitive. It’s different even than how you would coach someone with anxiety. I’m saying this to encourage you to keep trying until you find a great ERP therapist. 

I think at this point it's best for this family to first accept the POSSIBILITY of medication for the rest of the kiddo's life before considering alternatives. This is a big step for them.

[mindinggaps]

3 minutes ago, kristin0713 said:

That’s a possibility but honestly the psychiatrist is totally jumping the gun here. At 6yo there is no way to predict this. 

Re: different therapy that wasn’t successful - it won’t be successful if it’s not ERP. Dealing with OCD in a way that doesn’t encourage it is very counter-intuitive. It’s different even than how you would coach someone with anxiety. I’m saying this to encourage you to keep trying until you find a great ERP therapist. 

2 minutes ago, Not_a_Number said:

I think at this point it's best for this family to first accept the POSSIBILITY of medication for the rest of the kiddo's life before considering alternatives. This is a big step for them.

I actually fully agree with both perspectives. @kristin0713 It's obviously impossible to predict the future and I'm hopeful! We're happy to have a clearer picture to focus on for therapy and will dive into this. On the other hand, to @Not_a_Number's point while I am quite comfortable with that reality, my husband tends to get stuck questioning how long she'll need medication, when can we lower the dose, what happens if she does need it longer term. I just think these questions are not really helpful for anyone and the only way for him to live with the situation and accept it is that yes, it's at least possible she'll need it. Hopefully not, hopefully we can use other treatments and build coping skills, but it's one possible outcome.

[Not_a_Number]

2 minutes ago, mindinggaps said:

I actually fully agree with both perspectives. @kristin0713 It's obviously impossible to predict the future and I'm hopeful! We're happy to have a clearer picture to focus on for therapy and will dive into this. On the other hand, to @Not_a_Number's point while I am quite comfortable with that reality, my husband tends to get stuck questioning how long she'll need medication, when can we lower the dose, what happens if she does need it longer term. I just think these questions are not really helpful for anyone and the only way for him to live with the situation and accept it is that yes, it's at least possible she'll need it. Hopefully not, hopefully we can use other treatments and build coping skills, but it's one possible outcome.

Maybe I'm wrong about this, and obviously your approach is healthier than your husband's, but I'd guess you need some time with this idea, too. You've been thrown into this reality headfirst and right now you have to deal with the practical aspects of it, but I'd wager you could use some time to process this, and some time to feel disappointment/grief about your kiddo possibly needing this. It sounds like it was a struggle for you, too. I know it would be for me. 

Edited March 10, 2023 by Not_a_Number

[mindinggaps]

9 minutes ago, Not_a_Number said:

Maybe I'm wrong about this, and obviously your approach is healthier than your husband's, but I'd guess you need some time with this idea, too. You've been thrown into this reality headfirst and right now you have to deal with the practical aspects of it, but I'd wager you could use some time to process this, and some time to feel disappointment/grief about your kiddo possibly needing this. It sounds like it was a struggle for you, too. I know it would be for me. 

Yes, you are absolutely correct. It's been a difficult, emotional whirlwind over the last month. I originally came here terrified of giving her the Prozac that was prescribed, quite against medication in general and certain it was the wrong choice. I've learned a lot in a few weeks and have done a complete 180 on that - I'm SO happy we started her on the Prozac and she is living the highest quality of life I think she ever has. But it's a lot to digest and certainly the concept that she may need it forever feels heavy. However, I think I am a little better at focusing on the immediate next step than my husband. I can't control the future, but I can control the now. I wouldn't say I ignore the reality of the possibility, but I don't dwell on it. It is a lot to work through though and we all process these things on different timescales.

I also know I still have much to learn!

Edited March 10, 2023 by mindinggaps

[Harriet Vane]

I have some memories I hope will encourage you.

I recall a friend who struggled mightily with the idea of medicating her child. Wrestled with it for years. They finally gave in because they were desperate. He was around your dd's age but I'm not sure exactly how old--somewhere in the first or second grade range. A couple weeks in, their son told them, unprompted and out of the blue that he was so glad the medicine slows him down because he was now able to think about his thoughts instead of his thoughts just whizzing by. It was such a self-aware and on point statement, and they did not expect it from one so young. They kind of assumed he wouldn't really notice. But he did notice, and it did make a huge difference. He's in his twenties now, and he still takes meds, and he's happy and well-adjusted and successful. 

I thought of my friend's little boy years after that when I was babysitting for a different friend. At the time, their little boy was diagnosed with severe ADHD. On this particular morning, he was particularly hyper. The kids and I had walked to a nearby grocery store to get just a few supplies, and this little boy was all over, touching everything, knocking things over, bothering his sisters, and on and on and on. I gave him verbal directions that he could not obey. I asked him to hold on to the cart. He didn't. Finally, I placed his hand on the cart handle and placed my hand over his, and I said, "[Name], I am going to keep my hand here on top of yours to help you remember to keep holding the cart." I will never, ever forget that moment--he turned his little face up to me and thanked me. He was so relieved! He thanked me with total sincerity for helping him obey. He really, actually didn't want to be in trouble all the time and he simply didn't know how to do any better. It was one of those moments when you can almost feel the world tilt on its axis as you feel the perspective shift.

 

My last memory for you is of the years that I lived with untreated seasonal allergies and asthma. My mother used to say, "It's just allergies. There's nothing I can do." I remember carrying around boxes of tissue everywhere, and I remember some days that I would lay in bed utterly wretched with the awful allergies. And on those days, I was scolded ("it's only allergies") and made to keep doing my chores or whatever. I was not allowed to cry in my bed about it--if there were no chores, I had to be up, out of bed, playing or given extra chores. That included yard work chores, which invariably made me miserable with the allergies. (I know now that I am terribly allergic to grass and ragweed.) Spring was a nightmare for me. I remember when I went to a workday at camp and my allergies were flaring badly, the other volunteers insisted that I wash my face and go inside. I said, "It's only allergies. I can help." They wouldn't hear of it. No one had ever given my allergies any importance before. When I was older and able, I had the full allergy and asthma workup. I was given a prescription and was astounded with how well one pill each day affected my life. I was given an asthma inhaler. Everything changed. To this day, I'm still deeply resentful that my mother did not get this addressed when I was younger. 

 

You already know this or you wouldn't have tried meds in the first place for your daughter, but I'll say it anyway. Good for you for keeping every door open and for doing whatever is necessary to help your daughter. I encourage you to hold steady, continuing to give your daughter the care she needs.

[mindinggaps]

11 hours ago, Harriet Vane said:

I have some memories I hope will encourage you.

I recall a friend who struggled mightily with the idea of medicating her child. Wrestled with it for years. They finally gave in because they were desperate. He was around your dd's age but I'm not sure exactly how old--somewhere in the first or second grade range. A couple weeks in, their son told them, unprompted and out of the blue that he was so glad the medicine slows him down because he was now able to think about his thoughts instead of his thoughts just whizzing by. It was such a self-aware and on point statement, and they did not expect it from one so young. They kind of assumed he wouldn't really notice. But he did notice, and it did make a huge difference. He's in his twenties now, and he still takes meds, and he's happy and well-adjusted and successful. 

I thought of my friend's little boy years after that when I was babysitting for a different friend. At the time, their little boy was diagnosed with severe ADHD. On this particular morning, he was particularly hyper. The kids and I had walked to a nearby grocery store to get just a few supplies, and this little boy was all over, touching everything, knocking things over, bothering his sisters, and on and on and on. I gave him verbal directions that he could not obey. I asked him to hold on to the cart. He didn't. Finally, I placed his hand on the cart handle and placed my hand over his, and I said, "[Name], I am going to keep my hand here on top of yours to help you remember to keep holding the cart." I will never, ever forget that moment--he turned his little face up to me and thanked me. He was so relieved! He thanked me with total sincerity for helping him obey. He really, actually didn't want to be in trouble all the time and he simply didn't know how to do any better. It was one of those moments when you can almost feel the world tilt on its axis as you feel the perspective shift.

 

My last memory for you is of the years that I lived with untreated seasonal allergies and asthma. My mother used to say, "It's just allergies. There's nothing I can do." I remember carrying around boxes of tissue everywhere, and I remember some days that I would lay in bed utterly wretched with the awful allergies. And on those days, I was scolded ("it's only allergies") and made to keep doing my chores or whatever. I was not allowed to cry in my bed about it--if there were no chores, I had to be up, out of bed, playing or given extra chores. That included yard work chores, which invariably made me miserable with the allergies. (I know now that I am terribly allergic to grass and ragweed.) Spring was a nightmare for me. I remember when I went to a workday at camp and my allergies were flaring badly, the other volunteers insisted that I wash my face and go inside. I said, "It's only allergies. I can help." They wouldn't hear of it. No one had ever given my allergies any importance before. When I was older and able, I had the full allergy and asthma workup. I was given a prescription and was astounded with how well one pill each day affected my life. I was given an asthma inhaler. Everything changed. To this day, I'm still deeply resentful that my mother did not get this addressed when I was younger. 

 

You already know this or you wouldn't have tried meds in the first place for your daughter, but I'll say it anyway. Good for you for keeping every door open and for doing whatever is necessary to help your daughter. I encourage you to hold steady, continuing to give your daughter the care she needs.

@Harriet Vane Thank you so much - this is such a beautiful, insightful comment which gives me lots to think. Reading this made my day.

[Kidlit]

19 hours ago, mindinggaps said:

Dear all - to everyone who has continued to be a wonderful source of support, guidance and information I wanted to share a quick update. It's now been over a month since my daughter started Prozac and we had an interesting check-in with the psychiatrist. Our daughter continues to do very well with the medication and is performing the best she has in her entire life. With her symptoms more under control, the psychiatrist wanted to do some further testing and exploration to confirm the diagnosis of GAD. In this process, she once again ruled out ASD but did say she thinks a combination of OCD and GAD could be the root issue. In terms of immediate treatment, this doesn't change much, although the optimal form of therapy to be used in combination with the medication may be adjusted. However, she did say that the longer term prognosis for OCD is a little different - medication for life is typically required and she formally recommends that our daughter stay on the Prozac essentially indefinitely.

For me, this doesn't change much. I am thrilled she is doing well and is happy. Many people have primed me for the realities of longer term medication and I am happy to have a clearer understanding and plan. However, for my husband this has been his nightmare. He views this as a worst case scenario and is not coping well. He is engaged in therapy though and I have told him that he must focus on this and at least now we understand the picture. In some sense I view this as good news for him because it gives clarity, now he just needs to accept and process things.

Edit - not too relevant, but also going to try capsules rather than liquid medication and see how that goes.

I'm PMing you, OP