Weaning child off SSRIs? Any advice or thoughts?

[Lecka]

I am going to add something that was a factor for me….

There are places on the Internet that are very unhealthy for me.  
 

There are ways that I have gotten real-life experience over the years, because the issue was something where I could meet other parents.  
 

The Internet does not reflect real life, sometimes.  The Internet has certain places where certain views are expressed with no nuance whatsoever, it’s just not what it’s about.  
 

I did want to find out “what happens to kids when they grow up” kind of stuff, and there are people on the Internet willing to fill this role.  
 

But I don’t think these Internet things are 100% good for this purpose, I think there are drawbacks, and ways they are not answering the questions in a full or unbiased way.  
 

Anyway, I think it can be a way to gather some information, but if it’s negative to keep looking at it, it was good for me to quit looking at some Internet stuff.  I still know the information and I still value viewpoints I learned about.  But I don’t have to go and bathe myself in those views.  
 

 

[Mrs Tiggywinkle Again]

I am an adult who is angry(well, more annoyed) that my parents were clueless and did not medicate me, and were pretty awful about it when I needed SSRIs as an adult. So there is a flip side to your concern.

I have a child on an SSRI as well as a mood stabilizer and he will be for life. I take Wellbutrin daily and plan to for the rest of my life. I wish I had been able to start an SSRI or similar medication as a teen; it would have made a huge difference in my life.

It is okay to need medication for a lifetime. Meds are not the enemy.

Edited July 25 by Mrs Tiggywinkle Again

[Ottakee]

13 minutes ago, Mrs Tiggywinkle Again said:

I am an adult who is angry(well, more annoyed) that my parents were clueless and did not medicate me, and were pretty awful about it when I needed SSRIs as an adult. So there is a flip side to your concern.

I have a child on an SSRI as well as a mood stabilizer and he will be for life. I take Wellbutrin daily and plan to for the rest of my life. I wish I had been able to start an SSRI or similar medication as a teen; it would have made a huge difference in my life.

It is okay to need medication for a lifetime. Meds are not the enemy.

I agree.  Meds are just a tool.

my daughter has told her doctor to never ever ever take her off her meds as she feels so much better on them.

Edited July 25 by Ottakee

[mindinggaps]

Thanks again everyone for your thoughts and comments. Chiming in here to provide some further context on a few things which have repeatedly come up.

1. On the topic of my own mental health, which has been flagged a few times (@MercyA @Bambam), as previously mentioned I have been seeing a therapist since her diagnosis to help manage things. I will acknowledge that my own fears regarding the longer term impact of her medication or my daughter resenting me for the decision to medicate her seem to be slightly more pronounced compared to many parents. It's been suggested that I may have mild anxiety and depression and medication for me has been brought up as a topic of discussion. However, I declined and have zero interest pursuing that route for myself. Overall, I live a high quality of life and feel very capable of managing my mental health through other means like exercise and therapy. Medication is something I personally would only consider as an absolute last resort in the event I struggled to function on a basic level.
    
2. Regarding my fear of her resenting me, I do think this is a very real and common phenomena for kids who are started on meds really young. It also ties into questions of side effects brought up by @gardenmom5. There is a huge difference between starting a 5/6 year old on Prozac and someone who is more developed. She doesn't even really have a strong memory of life before meds so it's harder to probe side effects. She doesn't have any autonomy or control in the decision making process. This is something that is easier with older kids and I will make sure she has great involvement as she becomes older. I must make sure she feels like she has some control and input otherwise I think the risk of resentment is massive.
    
3. People have asked if I really think her being on meds for life is that bad. To some degree, if I'm being totally honest, I'd have to answer yes, it's not great. I get it, not a huge deal, but there's still a large stigma in society related to being medicated for mental health issues. It also makes health care more complex. There are unknowns about longer term exposure to SSRIs. There are some indications SSRIs can make you more susceptible to other diseases. Health care providers sometimes question if totally unrelated medical symptoms are related to her OCD - I cannot imagine her dealing with that for life. So, I accept it as a possibility and it's fine if that is what unfolds. But if there are ways to treat the OCD through other manners over the long term, I'd strongly argue that is the preferable outcome. Maybe it's not achievable and that's okay, but it's still what I hope for.

[KSera]

8 hours ago, MercyA said:

SSRI's are about as safe and mild as they come when the brain needs medical treatment. I really think you would benefit, and I think your daughter would as well.

I’m in agreement with everyone else that given the history, I wouldn’t take her off medication if I were MG. Besides the fact that she has destabilized so much when that was tried in the past, I’d be highly concerned with the fact that it’s not uncommon for an SSRI that was working to stop working if it’s discontinued and then restarted again. I don’t think there a good risk to take in this situation. 
 

All that said, I push back on the idea that SSRIs are as safe and mild as they come and MG should try them even though she feels she is managing her life fine without them. There’s enough research finding that depression is more likely to become permanent if someone takes an SSRI than if they don’t that I would reserve it for cases where someone needs it and doesn’t mind that they are quite likely to be on it permanently (or off and on) once they start. There are certainly lots of cases where it’s just needed so that’s just the way it needs to be (like it sounds with her dd), but I wouldn’t pass it off as no big deal and no risk. 

[mindinggaps]

6 minutes ago, KSera said:

There’s enough research finding that depression is more likely to become permanent if someone takes an SSRI than if they don’t...

This is exactly the research I was previously pointing to which makes me hesitant to try medication for myself and frankly makes me concerned for the longer term prognosis for my daughter. There's a lot of compelling research which indicates exposure to SSRIs, particularly at a young age makes you more likely to need them. So, that's what I balance in my mind. For my daughter, now is not the time to wean down, but the notion that there is no risk to these medications and they aren't a big deal is a fallacy. In fact, I'd say we've learned a lot in the last 10 years about some of the issues with SSRIs, including discontinuation syndromes that have made many people a lot more hesitant to use them in young kids.

Edited July 25 by mindinggaps
typo

[Lecka]

10 minutes ago, mindinggaps said:

and they aren't a big deal is a fallacy. In fact, I'd say we've learned a lot in the last 10 years about some of the issues with SSRIs, including discontinuation syndromes that have made many people a lot more hesitant to use them in young kids.

I just want to say I acknowledge this.  
 

I think keep in mind though, people are coming from different places, someone saying a medication is more minor than others, I don’t equate to saying “it’s not a big deal.”  I would also say there’s a context here that people can remember your previous posts.  If you posted about a different situation, I don’t think you would get the same response.  
 

At the same time, I acknowledge what you say here.  This is a major decision to make on behalf of a young child, and a major responsibility.  It’s possible it will have negative consequences in the future, with the possibility of making her need SSRIs in the future, or criticizing your decision making.  I’m sorry you’re in the situation of needing to look at the pros and cons of this choice.  

[AmandaVT]

My DH was very hesitant to start DS on Prozac at 9 for his anxiety. His big concern (he is a therapist) was that it would be harmful to his brain during puberty and that his brain would prune "wrong" or something. Our pediatrician reminded us that, one, Prozac is one of the safest anti-anxiety meds and also the oldest approved SSRI, which means it's been studied more than any other at this point. He also asked why the long-term effects of his brain pruning and reinforcing the anxious connections that existed pre-medication rather than allowing the brain to grow without anxiety. It was a longer conversation that I'm summarizing quickly here, but it was compelling enough that DH felt better about starting him on Prozac. 

When he was about 13, he wanted to try reducing his dosage. We met with the Dr again and discussed titrating down. It was a disaster, and his anxiety quickly returned to levels that interfered with his day-to-day activities. We moved him back up to his original dose (20 mg), and he's been stable since. If he wanted to try weaning off again, we'd do the same thing - hear him out, bring in the Dr., and make a decision from there, but he is glad that he feels like "him" and anxiety isn't getting in the way of him being able to fully live his life. 

[MercyA]

1 hour ago, KSera said:

All that said, I push back on the idea that SSRIs are as safe and mild as they come and MG should try them even though she feels she is managing her life fine without them. There’s enough research finding that depression is more likely to become permanent if someone takes an SSRI than if they don’t that I would reserve it for cases where someone needs it and doesn’t mind that they are quite likely to be on it permanently (or off and on) once they start. There are certainly lots of cases where it’s just needed so that’s just the way it needs to be (like it sounds with her dd), but I wouldn’t pass it off as no big deal and no risk. 

I was not aware of this, although I don't take my SSRI for depression. My doctor has repeatedly told me that SSRI's are very safe. I was thinking more of the benefit / harm ratio. Their effectiveness has FAR outweighed side effects for me and I haven't experienced any serious problems even after being on them for years. That is what I meant by safe and mild, especially compared to other psychotropic medications. 

I admit some frustration about the fact that this child with severe OCD clearly need the meds--her doctor certainly seems to think so--and yet her parents continue to show resistance. I worry for her.

I *strongly* wish my parents had started me on meds as a child. It's no exaggeration to say my life would have been completely different in some very good ways.

However, I see that I was a little hyperbolic and will amend my post.

[prairiewindmomma]

Mercy, I appreciated your sharing your experience and opinion. I dont think you came across as strident.

I think a lot of us are seeing a long pattern of resistance to a medication from which the kid is clearly benefitting. We can all have complex feelings about medication (and I think most to all of us do) while also acknowledging that a person is benefitting from treatment. 
 

Considering a change after 3-5 years of stability is very different than trying to change again 6 months later when the last change caused so much damage.

[AmandaVT]

10 minutes ago, prairiewindmomma said:

Mercy, I appreciated your sharing your experience and opinion. I dont think you came across as strident.

I think a lot of us are seeing a long pattern of resistance to a medication from which the kid is clearly benefitting. We can all have complex feelings about medication (and I think most to all of us do) while also acknowledging that a person is benefitting from treatment. 
 

Considering a change after 3-5 years of stability is very different than trying to change again 6 months later when the last change caused so much damage.

Oh I totally agree - I hope my post was clear. I think what I wanted to convey was that even after 4 years of stability, decreasing his dose was really difficult, caused him a lot of anxiety, and went so badly that he was happy to go back to his original dose and hasn't wanted to try to reduce since. I also take meds for anxiety, and a couple of years ago, I felt like things had been stable and my life was in a good place, so I spoke with my Dr. and discussed reducing down a bit. Within a couple of weeks, my anxiety was high, and I was increasingly irritable and having high anxiety about things that hadn't bothered me in the slightest. The hardest thing was that I didn't realize that dropping down to a lower dose was what was causing the increased anxiety. Sounds really stupid until it's your brain lying to you! 🙂 DH was finally able to convince me to re-up to my old dose, and I've been feeling fine since. 

Anxiety meds don't change my personality or make me feel like I'm "on" something. They allow my brain an extra millisecond to process information and decide what to do with it rather than immediately go into panic mode. I believe they allow me to have a "normal" brain. In all fairness, I'm still an anxious person - one of my friends has given me the superhero nickname Hypervigilant Girl - and I could probably up my dose a bit more, but I'm able to function well in the world and not struggle with the day-to-day. 

[prairiewindmomma]

OP, I hope you have felt support from all of us even when we have spoken directly. In my own life, I have had a hard time continuing to take a medication that has bad side effects for my rheumatoid arthritis. I will take it, go into remission for a year or two and then hope I can go off of it. I have tried twice, over 15 years, to actually go off and each time I realized I really do need this medication to be as well functioning as I am and to avoid the damage that happens when my disease is active.

I may have shared this before, but one of the things that helps me is a note I made to myself during my last disease flare. I wonder if your printing off the February post someone copied above and posting that somewhere in your house may be helpful to you. It is easy to forget in good times how bad the bad times were….sometimes we need to remember clearly so that we can continue on the path we need to be on.

[TechWife]

2 hours ago, KSera said:

I There’s enough research finding that depression is more likely to become permanent if someone takes an SSRI than if they don’t …

This is the exact opposite of what I have heard over the years. Do you have sources I can read? 

[mindinggaps]

2 hours ago, prairiewindmomma said:

OP, I hope you have felt support from all of us even when we have spoken directly. In my own life, I have had a hard time continuing to take a medication that has bad side effects for my rheumatoid arthritis. I will take it, go into remission for a year or two and then hope I can go off of it. I have tried twice, over 15 years, to actually go off and each time I realized I really do need this medication to be as well functioning as I am and to avoid the damage that happens when my disease is active.

I may have shared this before, but one of the things that helps me is a note I made to myself during my last disease flare. I wonder if your printing off the February post someone copied above and posting that somewhere in your house may be helpful to you. It is easy to forget in good times how bad the bad times were….sometimes we need to remember clearly so that we can continue on the path we need to be on.

@prairiewindmomma I am grateful for the comments and support from everyone here. I truly appreciate all feedback even if it sometimes isn't what I may want to hear. Being challenged is healthy and needed sometimes. I am always open to advice and never offended by directness.

[mindinggaps]

• 2 hours ago, TechWife said:

This is the exact opposite of what I have heard over the years. Do you have sources I can read? 

Here are examples of things which concern me:

• SSRI withdrawal: https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html
• Impact of SSRI on brain development: https://www.scientificamerican.com/article/kids-on-meds-trouble-ahead/
• SSRIs may impact normal sexual development: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194463/
  • This is a major concern for me and I'd like her to be off SSRIs during puberty since they can totally change how sexuality develops. This makes sense, how can you know you are suffering from sexual side effects due to the medication if you don't even know what healthy sexuality is?
• Early exposure to fluoxetine makes changes to the brain which may make anxiety worse in adulthood: https://www.nature.com/articles/tp2015145
  • This is in rats, so....
• Long term SSRI use linked to dementia, heart disease and more: https://adaa.org/sites/default/files/New Concerns Emerge About Long-Term Antidepressant Use.pdf and https://www.bristol.ac.uk/primaryhealthcare/news/2022/adverse-health-outcomes-associated-with-long-term-antidepressant-use.html

 

[fairfarmhand]

27 minutes ago, mindinggaps said:

Here are examples of things which concern me:

• SSRI withdrawal: https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html
• Impact of SSRI on brain development: https://www.scientificamerican.com/article/kids-on-meds-trouble-ahead/
• SSRIs may impact normal sexual development: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194463/
  • This is a major concern for me and I'd like her to be off SSRIs during puberty since they can totally change how sexuality develops. This makes sense, how can you know you are suffering from sexual side effects due to the medication if you don't even know what healthy sexuality is?
• Early exposure to fluoxetine makes changes to the brain which may make anxiety worse in adulthood: https://www.nature.com/articles/tp2015145
  • This is in rats, so....
• Long term SSRI use linked to dementia, heart disease and more: https://adaa.org/sites/default/files/New Concerns Emerge About Long-Term Antidepressant Use.pdf and https://www.bristol.ac.uk/primaryhealthcare/news/2022/adverse-health-outcomes-associated-with-long-term-antidepressant-use.html

 

I get that and they’re serious concerns. And yet, if she had cancer and had to go through chemo she may be infertile forever. But she would need the meds. As a mom I can’t get so caught up on potential side effects that I forget about how necessary certain meds have been for my kids. 
 

like all three of my dds were on bcp as teens. Hated making that call. We tried all the natural stuff and yet they were all completely non functional for 5 full days every month due to period pain. Yes side effects and potential long term issues. But doing without was not an option. Mental suffering is just as real as physical suffering. 
 

2 of my dds have been on SSRIs as teens. Same thinking  process. They may be on them forever. But they were so miserable without the meds that I really think they would have taken their own lives . At best hey would have had no functional friendships, would not have attended college, would have burned all their relationships to the ground. So we might have avoided the need for their whole life to need the meds but what would we have gotten in exchange? A couple of kids who were shadows. 
 

I got to where I just stopped researching the potential side effects and long term issues. I made peace with where we were, the need for the meds and the what ifs had to wait. In the future, if there’s an issue, we’ll deal with it then.

Edited July 26 by fairfarmhand

[mindinggaps]

@fairfarmhand Thanks for the thoughtful comment. I do fully agree with everything you are saying. At a simple level it comes down to risk vs benefit. I also acknowledge that some studies can also be hard to parse - is taking SSRIs long term a greater risk for heart disease compared to being depressed? Very hard to decouple those things since generally poor mental health is a predictor of poor physical health.

I think really the only point where I do have a strong opinion is that these medications are serious stuff, especially for children. They do carry significant risks and that has to be factored in. Keeping things where they are with her treatment makes sense for now. I would hope that we can try at least lowering as she enters puberty and seeing how that goes. For me personally, knowing the risks I'd never touch these medications, which is where my bias to hopefully have her come off one day stems from.

[Bambam]

Re the stigma of mental health issues:
For my elderly MIL (91), there is HUGE stigma. 

For folks my age (60), the stigma is much smaller - and fading pretty quickly. I have several friends who are open about their diagnosis and the med they take. I think possibly the fact their kids and grandkids have issues - and many of them do too are contributing to this. 

When one of my kids need help, the psychiatrist asked if I wanted a formal diagnosis. I told him no because I was concerned about the implications of having a formal diagnosis (probably 12-13? years ago). Would that lead issues getting a job if you had to disclose? Would it lead to other issues? BTW, now I realize that was silly, and I should have pushed for one. 

Fast forward to now - kid is in 20s and thinking about going back to get an official diagnosis so they can get accommodations for a few minor things at work (if they want them, they would not have to get them if they didn't want, but they would sorta like to have that option). And I'm like really? But, yes, with the young 20-somethings, mental health issues do not really seem to have much stigma. Many have diagnosis, talk about it, fairly upfront. 

So, I'm thinking in 10-20 years, mental health issues are going to be right there with epilepsy and diabetes. Oh, I'm sorry, that's interesting, but no big deal. Folks will try (hopefully) to work around any issues, but the stigma IMHO is going away.  And that is a good thing! 

[fairfarmhand]

31 minutes ago, Bambam said:

Re the stigma of mental health issues:
For my elderly MIL (91), there is HUGE stigma. 

For folks my age (60), the stigma is much smaller - and fading pretty quickly. I have several friends who are open about their diagnosis and the med they take. I think possibly the fact their kids and grandkids have issues - and many of them do too are contributing to this. 

When one of my kids need help, the psychiatrist asked if I wanted a formal diagnosis. I told him no because I was concerned about the implications of having a formal diagnosis (probably 12-13? years ago). Would that lead issues getting a job if you had to disclose? Would it lead to other issues? BTW, now I realize that was silly, and I should have pushed for one. 

Fast forward to now - kid is in 20s and thinking about going back to get an official diagnosis so they can get accommodations for a few minor things at work (if they want them, they would not have to get them if they didn't want, but they would sorta like to have that option). And I'm like really? But, yes, with the young 20-somethings, mental health issues do not really seem to have much stigma. Many have diagnosis, talk about it, fairly upfront. 

So, I'm thinking in 10-20 years, mental health issues are going to be right there with epilepsy and diabetes. Oh, I'm sorry, that's interesting, but no big deal. Folks will try (hopefully) to work around any issues, but the stigma IMHO is going away.  And that is a good thing! 

This has been my experience as well, with three kids in the 18-25 age range 

[wendyroo]

10 hours ago, fairfarmhand said:

I get that and they’re serious concerns. And yet, if she had cancer and had to go through chemo she may be infertile forever. But she would need the meds. As a mom I can’t get so caught up on potential side effects that I forget about how necessary certain meds have been for my kids. 
 

like all three of my dds were on bcp as teens. Hated making that call. We tried all the natural stuff and yet they were all completely non functional for 5 full days every month due to period pain. Yes side effects and potential long term issues. But doing without was not an option. Mental suffering is just as real as physical suffering. 

Similar but different scenario here...

Spencer has been on stimulant ADHD meds since he was 5. The appetite suppressant side effect has hit him much harder than my other kids, and last year, at age 10, he was officially falling off the growth chart to the point his pediatrician worried it would impact his future height. We were sent to endocrinology, and I worried that he would push to drop the ADHD meds. He did not. We had already unsuccessfully tried a non-stimulant medicine, so the endocrinologist said that it was his job to help mitigate the side effects of necessary medicines, and that keeping people mentally stable and functional was just as necessary as asthma meds and chemo and other drugs that make it hard for kids to grow.

I am very mindful of my kids meds (sooooo many meds), but I don't find myself panicking or obsessing or catastrophizing about them. I have chosen doctors that I trust, and part of that trust is relying on their knowledge and experience to guide me as to risks and benefits of various medications. For example, my son Elliot recently severely injured DH during a tantrum, and that was the last straw for our psychiatrist. At our next appointment he strongly recommended a med overhaul of Elliot's mood stabilizers/anti-psychotics. We all knew the lengthy transition would be hell (especially for Elliot's siblings), and that there is no guarantee that the new med will work better, but the doctor has been down this road more often than we have, and he feels the potential benefits are worth the upheaval and risk. We are in the middle of that transition now, and it is hell, but I'm not dwelling on it or second-guessing myself at all. I feel confident in our doctor, in the decision, and in my ability to look all my children in the eye down the road and tell them truthfully that there were no easy, clear cut answers, but that at every fork in the road we did our very best to set them up for success and balance everyone's short-term and long-term needs.

[mindinggaps]

For those following, I wanted to share an update. We had a regular check-in with her psychiatrist this morning - I had originally created this post hoping to get some insight/advice to better prepare for the appointment. I would say there's a fair amount which I'm unpacking...

Her psychiatrist mentioned she was very happy with where things are at. She asked both me and my daughter a few questions to probe side effects and felt there was nothing concerning. Overall in her opinion it seems like the current treatment is highly effective and she recommended we continue with the current dosage/plan more or less indefinitely, making only slight adjustments as required. I did bring up the opinion of the other psychiatrist and her response was that she strongly disagrees and does not believe weaning down is a topic that should be discussed for the foreseeable future as the risks are very high. I pushed a little bit and asked what in her mind would be required to entertain a trial weaning? She said that she'd like to see a minimum of 2-3 years completely symptom free before this topic could even be considered and even then, it would be very hard to say.

I brought up my concern about her taking it through puberty since I've read some research indicating exposure can impact sexual development and asked if we could set a goal of doing a trial weaning at this time. She basically told me puberty is a time that can exacerbate symptoms and could make no commitment to a weaning prior or during this period. She brushed off my concerns on the sexual development piece, which mildly annoyed me.

At the end of the appointment she asked if she could speak with my privately (without my husband or daugther who were also at the appointment). She outright told me that she has concerns that my desire to lower her medication may have an impact on her treatment. She suggested that this should not be brought up in front of my daughter since it may influence how she feels about the medication and at this stage she needs to be prepared to take it for life. To be honest, this did not sit well with me and I said that involving her in all aspects of treatment was important to me. She then told me that she felt a bit uncomfortable saying this but that she believes my anxiety and fixation on her medication is not healthy. She asked if I was receiving any mental health treatment at the moment. I told her that I am in therapy. She suggested that I may consider treatment for myself - she proposed writing me a prescription for an SSRI and then transferring me to a colleague who could manage the case moving forward without conflict.

I told her this made me very uncomfortable and that my daughter is the patient here and not me. I have no idea if this is normal, but I'm still quite upset by this and felt she crossed a line. I'm truly not sure if I feel comfortable having her manage my daughter's treatment moving forward. I may want to transition to another psychiatrist where I feel I can ask questions and build a longer term plan more openly.

[Lecka]

I can see why you felt uncomfortable and I think it is worth considering changing to a different psychiatrist.  
 

On a totally different note, not related to your concerns, or what was said to you after the appointment.

 

You are an adult and your child is a child.  You make the medical decisions for your child.  
 

I think it’s good to gather information from your child, but to discuss treatment in this way in front of her.  She is too young.  
 

I agree it’s a concern to discuss reducing the medication in front of her.

 

This is just not appropriate for her age.  You and your husband have got to do it!!!!!!  I understand your desire and I think it’s coming from the right place.  
 

I just think it’s not realistic with your daughter’s young age.  She is just too young.  She is still a child here and medical treatment decisions are for a parent to make.  As kids are teens it becomes appropriate to make this transition.  But that is years away for her.  

Edited July 26 by Lecka

[Lecka]

The fact is you are in a situation where you and your husband are making adult decisions on behalf of your daughter.

It’s abdicating your role to include her, because it’s not her role.  
 

Your role is more to present things in a way that your child will feel safe, confident, and secure.  
 

That’s just how parenting can be sometimes.  

[wendyroo]

7 minutes ago, mindinggaps said:

For those following, I wanted to share an update. We had a regular check-in with her psychiatrist this morning - I had originally created this post hoping to get some insight/advice to better prepare for the appointment. I would say there's a fair amount which I'm unpacking...

Her psychiatrist mentioned she was very happy with where things are at. She asked both me and my daughter a few questions to probe side effects and felt there was nothing concerning. Overall in her opinion it seems like the current treatment is highly effective and she recommended we continue with the current dosage/plan more or less indefinitely, making only slight adjustments as required. I did bring up the opinion of the other psychiatrist and her response was that she strongly disagrees and does not believe weaning down is a topic that should be discussed for the foreseeable future as the risks are very high. I pushed a little bit and asked what in her mind would be required to entertain a trial weaning? She said that she'd like to see a minimum of 2-3 years completely symptom free before this topic could even be considered and even then, it would be very hard to say.

I brought up my concern about her taking it through puberty since I've read some research indicating exposure can impact sexual development and asked if we could set a goal of doing a trial weaning at this time. She basically told me puberty is a time that can exacerbate symptoms and could make no commitment to a weaning prior or during this period. She brushed off my concerns on the sexual development piece, which mildly annoyed me.

At the end of the appointment she asked if she could speak with my privately (without my husband or daugther who were also at the appointment). She outright told me that she has concerns that my desire to lower her medication may have an impact on her treatment. She suggested that this should not be brought up in front of my daughter since it may influence how she feels about the medication and at this stage she needs to be prepared to take it for life. To be honest, this did not sit well with me and I said that involving her in all aspects of treatment was important to me. She then told me that she felt a bit uncomfortable saying this but that she believes my anxiety and fixation on her medication is not healthy. She asked if I was receiving any mental health treatment at the moment. I told her that I am in therapy. She suggested that I may consider treatment for myself - she proposed writing me a prescription for an SSRI and then transferring me to a colleague who could manage the case moving forward without conflict.

I told her this made me very uncomfortable and that my daughter is the patient here and not me. I have no idea if this is normal, but I'm still quite upset by this and felt she crossed a line. I'm truly not sure if I feel comfortable having her manage my daughter's treatment moving forward. I may want to transition to another psychiatrist where I feel I can ask questions and build a longer term plan more openly.

For what it's worth, I agree with your psychiatrist.

- I agree that it is incredibly premature to consider lowering your daughter's dose at this time.

- I agree that puberty is a time when many children need more meds to manage symptoms, not less.

- I agree that some vague, possible, hypothetical future side-effects are not worth fixating on or altering course over.

- I agree that there are health care discussions and decisions that children do not need to be, and sometimes should not be, involved in...especially at only 8 years old, but there are still a couple things that I discuss with my 15 year old's psychiatrist with no children in the room.

- I agree that in the time I have "known" you, I have worried about your anxiety about your daughter's medication and treatment.

- I agree that your (perhaps disordered) thinking about your daughter's mental health is not serving her (or you) well in the short or long term.

[mindinggaps]

@Lecka My understanding was that she's very much willing to discuss anything, but would prefer some things be kept between parents and doctor. Basically - let's discuss some of this with no children in the room. Maybe I'm overreacting, but I am seriously considering contacting the office and requesting that we transition to a new care provider.

[mindinggaps]

@wendyroo I appreciate your candidness. I am thinking everything over right now and I do take these thoughts seriously.

I'd love to hear opinions from you and others on this - was there anything weird about the psychiatrist pulling me aside or is that type of thing okay? It felt strange to me, but maybe I'm over reacting here.

Edited July 26 by mindinggaps
clarity

[Terabith]

I can see how what the psychiatrist said would make you uncomfortable.  It would make me uncomfortable. But, I also think she’s right.  I think she is right about your daughter’s medication, and I think she’s right about you speaking in front of your daughter, who not even six months ago was in major crisis because you decided to wean her off meds and it went disastrously and triggered her to think the meds were poisoning her.  
 

I also think that your psychiatrist is hinting that taking your child off her meds would rise to the level of child neglect/ abuse.  

[wendyroo]

11 minutes ago, mindinggaps said:

@wendyroo Based on your experience dealing with psychiatrists, do you consider the interactions weird at all? I'd love to hear others opinions on this. It felt weird to me, but maybe it's totally normal.

In my experience none of this is unusual. In my experience, mental health providers have to consider everything that impacts their patient...including their family.

Whenever our therapists and psychiatrists have broached these types of conversations, they always start with a disclaimer..."You are not my patient, and I am not your doctor, but I am worried because..." or "Elliot is not my patient, but his siblings are, and I am very worried about how Elliot's behavior is traumatizing them."

My kids' therapists and psychiatrist and pediatrician have all urged me to see a therapist of my own to deal with the intense stress and grief associated with raising mentally ill, special needs kids. I have been in therapy for years, and I have signed releases of information for all of our mental health providers to communicate amongst each other as they see fit. I have spent years building and honing an elite team of providers, and the last thing I want to do is undermine their ability to help us. I spend so much time driving home to my kids just how important it is to tell their team the truth, discuss problems with their team, try the strategies their team suggests, etc. I would be a complete hypocrite if I then refused to even consider concerns and suggestions the team makes to me.

As for not wanting to discuss some things in front of kids, I think that is entirely normal. It is not uncommon at all for my kids to wait in the hallway for a few minutes while the adults discuss certain problems or aspects of care. I also heavily utilize MyChart to convey information to doctors that I don't want to mention in front of kids. I am incredibly cognizant and careful about what is said in front of the kids and what unspoken messages are being conveyed to them. I NEVER want to perpetuate any stigma around mental health care, so I would never want them to hear me sounding eager for them to come off of psych meds that are helping them.

[mindinggaps]

9 minutes ago, Terabith said:

I think she is right about your daughter’s medication, and I think she’s right about you speaking in front of your daughter, who not even six months ago was in major crisis because you decided to wean her off meds and it went disastrously and triggered her to think the meds were poisoning her. 

Yes, this was brought up in the discussion. Basically, we can discuss anything you want but I'd prefer some things be handled without the child in the room because we know she has a history of medication refusal associated with the OCD and we don't want to trigger that. Her message to me was - I am fully in favor of having her involved in the treatment but right now she is very young and this has to evolve.

Frankly, I'm fine with feeling uncomfortable, I just don't like feeling like certain lines are crossed and I question if the suggestion of referring me was too much.

[prairiewindmomma]

I agree with wendyroo and the psychologist. I think your kid is picking up on your anxiety around medication and that that is/could be harmful to her feeling safe while taking medication.

I also agree with what Mercy suggested, that perhaps you are dealing with more than anxiety, and that maybe OCD is affecting your thinking process also. I think all parents have concerns, but your thinking processes around medication seem somewhat rigid and disordered considering how her actual experiences on and off medication have been. I also think the psych is right that 3 years is kind of a minimum for a period of instability. 

[prairiewindmomma]

I also, fwiw, think some information should be filtered around kids. My kids are always welcome to share their opinions about how things are going, and some decisions are theirs to make, but other things are discussed privately, without them present…either through mychart or through a phonecall dr makes to me prior to the appointment where we can both be more candid. Around age 15 or so, we let them do more decision making and we transition to them handling their own needs fully by adulthood.

Part of parenting, imo, is not undermining the confidence our kids have in their care team. They need to be able to trust other adults, and while advocacy is important, it needs to be balanced. I havent seen in your posts anything that shows you consistently trust mental health professionals and their competency….you’ve sought out other opinions and talk about switching every time medication comes up. I think they have been accommodating to your opinions, but the changes you have pushed for have been destabilizing every time. I think that is what psych was getting at today—your kid needs stability and you need to address your own issues, which are pushing the instability.

[Bambam]

8 minutes ago, mindinggaps said:

Frankly, I'm fine with feeling uncomfortable, I just don't like feeling like certain lines are crossed and I question if the suggestion of referring me was too much.

I'm going to be blunt. I don't think so.  My situation with my kids was different than yours, but you do seem very fixated on trying to find a way to lower/reduce/eliminate the Prozac.  And if you are discussing this in front of an 8 yo, I'm pretty sure she is picking up on the fact you want her off the meds, which translates to kid-think (or it would have in my kids) to must-be-bad-for-me and is not untypical, they would want to please me, so they might be inclined to try to do that.  

At 8 yo, a child is not involved in their medical decisions. They do not have the understanding nor the maturity nor the life experience to make any reasoned judgements.  The parents make the entire decision. At 8, they can pick out their own clothes, their own books at the library, whatever they want off the menu, but not IMHO life impacting decisions.  For us, we started talking to kid about 13/14/15 - when they were mostly through puberty (ah, the anguish, the drama, the TEARS, the hormones) and were able to think more clearly.  The discussions were gentle and light and general reasoning (that we used earlier) about why, etc, then as they got older, more detailed, more input, etc. 

So, to me, I think your desire for no-meds is coming through loud and clear - and often. So, the doctor is concerned, and IMHO from what I've read, rightly so, that this has the real potential to harm your dd. Not intentionally at all. But if the professional advises leaving child on med, and they have years of experience and have seen what happens to most children, etc - to me - the untutored except for googling and talking a few friends - well, their opinion is worth buckets more than mine, and I'm going to listen to them.  

There is nothing wrong with taking SSRIs if you need them. Nothing. I take a pain med. Yes, I know long term it will likely cause kidney problems, but without it, I have trouble moving, and it ends up causing all sorts of other issues. So for me, it is a risk/benefit analysis that the doctor and I have done, and yes, I'm taking the med. I'd prefer not to, but needs must. If I can't move, then other bad things start happening. Unfortunately, no med is side effect free.  

[wendyroo]

9 minutes ago, mindinggaps said:

Yes, this was brought up in the discussion. Basically, we can discuss anything you want but I'd prefer some things be handled without the child in the room because we know she has a history of medication refusal associated with the OCD and we don't want to trigger that. Her message to me was - I am fully in favor of having her involved in the treatment but right now she is very young and this has to evolve.

Frankly, I'm fine with feeling uncomfortable, I just don't like feeling like certain lines are crossed and I question if the suggestion of referring me was too much.

I would urge you to consider the alternative.

Would you want her to think in her head "My patient's mother is really struggling with what is, in my professional opinion, anxiety. It is impacting her quality of life and her ability to confidently and responsibility parent her daughter." And then for her to not mention it at all or do anything about it?

That would be like me taking my kid to the dermatologist for acne, the doctor seeing a mole on my arm that he thinks is cancerous, and not mentioning it because I am not his patient. That would feel unethical and cruel. Of course he is allowed to warn me about it and strongly suggest I make an appointment to have it biopsied. That is not overstepping or crossing any lines.

And if the dermatology example feels very different than the psychiatry situation, then I would suggest that perhaps that is your anxiety coloring how you view each of them.

[freesia]

I do not think she crossed a line. She did, in fact, agree with your therapist, right?
 

I wonder if you would consider trying an SSRI or supplements.  When I started taking supplements (5-HTP and L-Theanine), I was shocked by how much better everything was. You may not be aware of how your anxiety is shaping your life. I can now see the impact of my un-treated anxiety on my family and wish I’d sought treatment years earlier. In-treated anxiety also has side-effects even if you think you are coping well. 

your child is far too young to be brought into the process of making these decisions. None of your worries should be expressed in front of her. She is too young to understand trade offs in decision making. Please stop. 

[mindinggaps]

5 minutes ago, wendyroo said:

I would urge you to consider the alternative.

Would you want her to think in her head "My patient's mother is really struggling with what is, in my professional opinion, anxiety. It is impacting her quality of life and her ability to confidently and responsibility parent her daughter." And then for her to not mention it at all or do anything about it?

That would be like me taking my kid to the dermatologist for acne, the doctor seeing a mole on my arm that he thinks is cancerous, and not mentioning it because I am not his patient. That would feel unethical and cruel. Of course he is allowed to warn me about it and strongly suggest I make an appointment to have it biopsied. That is not overstepping or crossing any lines.

And if the dermatology example feels very different than the psychiatry situation, then I would suggest that perhaps that is your anxiety coloring how you view each of them.

You are correct. Thank you. The dermatology analogy is very good. Reflecting on this more clearly, I don't think lines were crossed. I was uncomfortable but that doesn't mean what the doctor did was inappropriate. The entire interaction was very respectful and caring and I felt no  pressure. Where things ended was her telling me - just please call me if you ever want to talk about this or get help. She made it clear that she cannot treat me as a patient due to conflict of interest but she can help. When she suggested an SSRI she also said, I can write a script, but this cannot get filled until you speak with a colleague - this is basically a mechanism to expedite you seeing an external doctor in the next 24-36 hours if you want that. So she did handle things with care...She was also clear in her language that she cannot diagnose me but in her professional opinion it would be beneficial for me see someone who has the capacity to do so.

[mindinggaps]

10 minutes ago, freesia said:

I wonder if you would consider trying an SSRI or supplements. 

At the moment, my answer to this is still a hard no. However, I acknowledge that I need to do some serious self-reflection and deeper consideration of the broader situation. I can recognize that even my response to the private conversation with the psychiatrist was not healthy - I immediately assumed the worst when the reality is she was trying to help and did so in a manner which ensured all boundaries were respected.

I am aware that I am not coping as well as I believe I am and that this needs to be addressed.

[dsmith]

I haven't read all the replies, but I would not start weaning off after such a short time of stability. Sometimes it can be very difficult to re-stabilize if it doesn't work out, and it can end up being a one step forward, two steps back situation, even 5 steps back. If you do decide to wean, I would switch to tablets or liquid so that the doses can be reduced very gradually. (I'm talking at least 4 times longer than what most doctors would recommend.)

[Katy]

The psychiatrist was absolutely right. You being uncomfortable about your own anxiety and mental health is impacting your ability to appropriately parent your daughter with regard to her mental health. I’m absolutely certain the same meds that are helping her would help you. 

There is no longer stigma for treating mental health in educated people. There is *A LOT* of stigma towards people with disabling mental health conditions who refuse treatment. And make no mistake about it, your child is disabled when unmedicated. 

[freesia]

I just want to say, I am very impressed by your ability to field and consider all our opinions, even when we disagree and challenge you, with grace and thoughtfulness. I think this quality in you is a strength you carry on this journey with your dd. 

[fairfarmhand]

A couple things—-

it is very good for the dr to pull you aside and give you food for thought about your own mental wellness. My dds docs have done this for me. A child cannot be fully well if their parents are not fully well or at least working toward wellness. Our emotions are deeply influential even if we never say a word about them to our kids. My grown kids have said as much. They knew when things were not well and they could not articulate that. But it affected them.

its normal for a dr of an 8 yr old to not discuss all things in from my of them. Is this your oldest kid? When my oldest was young she seemed so mature and articulate but her ability to digest and handle things was so childish. Her grown up mannerisms and my own inexperience masked her true maturity. 
 

third, as far as studies and statistics. Something can seem like a bad or good idea according to studies and statistics but be a terrible or wonderful things for the individual. Like breast feeding. Statistically and over the course of a population it’s the ideal. But for many mothers and babies it’s a terrible idea for all kids of reasons. So those have formula and it’s the perfect solution for those individuals. Both things can be true, breastfeeding is best for the population and my dd with the milk protein allergy thrived on a fancy formula. So just because “studies say…” doesn’t mean as much when faced with  an individual. The doctor wants to treat your dd as an individual and likely has experience with many children very similar to yours. Trust this experience.

[Lecka]

2 hours ago, mindinggaps said:

Lecka My understanding was that she's very much willing to discuss anything, but would prefer some things be kept between parents and doctor. Basically - let's discuss some of this with no children in the room. Maybe I'm overreacting, but I am seriously considering contacting the office and requesting that we transition to a new care provider.

Just responding to this — I think anyone would want to limit some discussions to the time that the child is not present.  
 

I don’t know if you might be better with a different person because I personally do have “kill the messenger” feelings where I can hold it against someone that they told me bad news, even if it’s not rational.

 

I think there can be times it’s good to do a fresh start for reasons like this.

 

But if it seems like a good idea, I think you have got a lot of history with this person, and this benefits your daughter.  
 

I think it is uncomfortable and awkward that she spoke to you after the appointment… but I don’t think she was wrong to do it.  
 

I think it would be worth trying to move past this and maybe it will even make your patient-doctor relationship better over time.  

But I also think it’s worth considering changing.  
 

I think there is also value to what she said to you after the appointment.  She was willing to have an awkward and uncomfortable conversation with you, and that’s nothing to shake a stick at.  I think it does show she wants to provide good care to your daughter.  I definitely think you could get through the awkward part, I don’t think this is necessarily a burned bridge. 
 

Edit:  I think it could be the right choice to change, too.  But it would be changing because “you” would benefit from a fresh start with someone.  I don’t think you are going to get someone who is okay with discussing things in front of your child or trying to include your child in a way that is not going to be considered age-appropriate.  
 

But I think sometimes a fresh start is what is called for!  I think sometimes the person is too associated with things I just didn’t want to hear.  

Edited July 26 by Lecka

[freesia]

I’m just musing here a bit. This is totally on my own “stuff”. I think when my oldest was the age of your dd, I thought it was possible to raise a child in a way that would eliminate all possible bad outcomes. I somehow thought that the kind of choice you’re making between a possible bad outcome from untreated, mental illness, and a bad outcome from medicine was a rare kind of decision. I now have raised four children, the youngest of whom is 15, and I’ve realize that these kind of decisions are not rare, particularly as our children age. there is no way to make all the decisions in a way that our child will not have some kind of possible side effects/bad outcome in the future. Many, many times there is no 100% guarantee of a good outcome no matter what you decide. For example, my daughter has asthma. It’s giving her trouble now. She’s also a soccer player. Do we stop soccer , which will lower the amount of medication she needs to take? But if she stops exercising, there are lots and lots of bad outcomes from that as well. I can’t think off the top of my head of the other decisions I made over the years. But quite often there’s no clear path or perfect decision. I think my anxiety made me think that was a possibility and for years I tried to figure things out from my kids in a way that would not have any bad outcome. It all came to my head in a situation with one of my older kids where we as parents were actually making all the right decisions, and all bad things kept happening. Waking up tomorrow carries a high possibility of problems  going out in public does, too  

Even if your daughter does disagree with your decision when she is older actually doesn’t mean it was the wrong decision. She, like all of us, has no way to go back and do things over and see what would have been. There is a period in young adults life where they do you seem to think that different choices would have led to better outcomes. I think it’s part of a naïveté about not understanding that life always has ups and downs, and our bodies are imperfect and don’t always work the way that we think. For my son, his critique had to do with our home schooling. He got a 3.6 the first semester in a 4.0 the second semester in college in mechanical engineering . But on his way home in May, he told me he thought he would’ve been better prepared had he gone to a public school. I didn’t really feel defensive about that, because his high school was mostly during Covid and everyone at that point was just doing what they could to get through. His mental health had been suffering, and I basically dragged him through high school. I reminded him that public school wasn’t really an option at that point. It also turned out he didn’t remember classes that he had taken. I had sat on the couch next to him and essentially done the classes with him. So I apologized and said that I too would wish that some of his classes have been more rigorous but with Covid and everything else going on I hadn’t been able to make that happen. ( I didn’t say that I hadn’t wanted him to do some of the classes online bc I had been afraid that he wouldn’t have handled the deadlines and online experience well and I wanted to do it with me so we could work around his mental health issues and make sure he learned the material )I reminded him that he did get A’s in all but one of his college classes . I said he must’ve been working very hard if he wasn’t prepared . He said he didn’t think so. I said well he must be pretty smart. He sad he wasn’t smart. I said so you weren’t well prepared, you didn’t work hard, and you’re not smart. How do you think you got A’s in classes that other children were failing or getting C’s? (I knew this from a parent Facebook page.) he said he didn’t know. He was baffled by that. But I’m trying to say, is that you could look at the story and say that we made the wrong decision to keep homeschooling him in high school. And at the time of that discussion that is probably how he thought too. But as you can see, the rest of his thinking, doesn’t really make sense. And neither he nor I know what would’ve happened if we had made a different choice. And even with any limitations, he still doing very well. I still believe in the choice we made for him in the way that I taught him high school got him through difficult time with as much learning as possible  

 

[Lecka]

1 hour ago, mindinggaps said:

Frankly, I'm fine with feeling uncomfortable, I just don't like feeling like certain lines are crossed and I question if the suggestion of referring me was too much.

I don’t think lines were crossed, or that it was too much.  
 

Are you sure you’re fine with feeling uncomfortable?  
 

These are some thoughts that have helped me in the past:

 

1) Where did my opinions about medications come from?  Could it be there was a bias at play?  Could it be it’s part of overall beliefs that could have an exception for special circumstances?  Could it be you were younger and didn’t know about all the complexity in the world, and thought there would be easy answers?  
 

2) It hurt me for a long time to think/know “there are people out there who totally disapprove of my parenting decisions, and in fact think they are harmful.”  This just hurt my feelings and made me lack confidence in myself.  

 

This is just something I did come to term with over time.  Parenting support groups help.  Maybe you could take a NAMI class.  
 

This helped me see ways that (for me it was particularly the Internet) there could be a lack of nuance, and sweeping conclusions.  And a lot of time the Internet is serving an important purpose to people, and that purpose is not “telling parents they are messing up their kids.”  It’s for those people to feel understood.  But they are not “my adult child.”  
 

3). I think you are re-inventing the wheel way too often.  I think you should consider deciding something like:  in the absence of major, medically actionable new information, we will follow the psychiatrist’s advice for the next 3 years, or until through puberty, and accept the psychiatrist is a medical professional who has our daughter’s best interests at heart, and who is following mainstream medical guidance the best way that is known in the year 2024. 
 

Then when something shakes you — you might feel hurt or have some doubts, but be able to evaluate:  is this major, medically actionable new information.  If the answer is no, this is a “something to think about and have feelings about, and something to discuss, maybe on the WTM boards.”  It’s not a reason to change the decision to follow the psychiatrist’s care, and that can just not be on the table.  
 

4). I do feel like I have had similar thoughts and I don’t think it’s realistic to say “snap your fingers and get over it.”  
 

However I have also had to change my ways to stop modeling some anxious behavior to my children.  I have gotten that feedback and it was new information to me, and I have endeavored to follow that advice.

 

I also agree with other posters who are saying things like…. Kids can tell when parents have doubts, and it does make kids doubt things.  
 

It is not lying to change some parenting boundaries around “what is for adults to think about, what is for kids to think about.”  It can just be changing things around so kids can feel like they don’t have to worry.  
 

What I did was similar to “space treatment for anxiety” but I don’t think they were specifically doing that program.  They were more giving me advice.  But it wasn’t really optional advice, it was like “you really need to do this.”  By how they talked to me they expressed their concerns and opinions in a way that I could take in the information.

 

Did I like it?  No.  I did not.  It sucks.  This was not the kind of parenting I ever intended to do, and it took away my freedom to do things however I wanted or however I felt like.  
 

But it’s a good thing to do.  
 

As far as talking to the doctor in front of your child…. This surprised me, it was unexpected to me.  Is it a new idea to you, that this is considered inappropriate for her age?  I have had things like this, where it’s like — “how come everybody else knows this, but I don’t know it?”  Or maybe I am aware, but I haven’t seen the point.  
 

Frankly I have accepted I’m somebody who should probably listen to advice from people who show themselves to be well-meaning and with professional knowledge and/or experience, that I am not able to have on my own.  

[maize]

OCD is a condition that does not usually resolve over time.

I would be very,  very wary of saying anything in front of your daughter that could make her distrust medication or think she should be able to function without it or that it would be better for her to wean off. That is already an extremely common mindset in people dealing with mental illness, and it is usually a very destructive one that causes years of unnecessary pain and suffering for them and the people around them. Reinforcing such a mindset in a child seems like a way to set her up for a lot of failure and pain in her future. 

If you have a medication that is working with minimal side effects, what an incredible blessing that is.

Imagine the long-term impact on the life of your daughter and of your family had you not found an effective medication and had she continued to be as non-functional as she was without it? What kind of long-term, ingrained pathways would her brain be wiring in as she grows, with such irrational thought patterns driving her emotions and behavior? There are very serious side effects to not medicating a condition that truly benefits from medication.

I know very well that medications are not a magic bullet with no downsides, but mental illness itself has extremely destructive downsides--if we have the means to mitigate those, we sometimes have to accept that those means are imperfect.

I have a sister who suffered from childhood cancer requiring surgery and chemotherapy. Living her life with only one kidney and with the long-term impacts of chemotherapy is not ideal--but the treatment was necessary and overall the balances weighed and continue to weigh in favor of treatment. 

OCD can take over a human brain in a way not too dissimilar from cancer.  If treating it comes with some downsides but those downsides are outweighed by the benefits derived, you don't want to give a kid experiencing such a situation reason to view the treatment as a negative.

Edited July 26 by maize

[Hilltopmom]

3 hours ago, mindinggaps said:

@wendyroo I appreciate your candidness. I am thinking everything over right now and I do take these thoughts seriously.

I'd love to hear opinions from you and others on this - was there anything weird about the psychiatrist pulling me aside or is that type of thing okay? It felt strange to me, but maybe I'm over reacting here.

That is totally normal- to have a discussion without the very young child in the room. That has how it’s been at most of my kids appointments when they were younger and taking meds. Kids do not need to hear every single thing- and for kids being treated for anxiety, OCD, depression parents need to have frank Talks with doctors specifically without the child over hearing. Everyone can speak more candidly that way.

[Lecka]

I prefer to write a note.  Then the doctor might be able to say something to me in a vague way.  
 

There are times I see something in a book or something, and I have to decide “hey, this is a real side issue, this is not pertinent to this appointment, this might even be a bit of a distraction.”

 

Because this is my personality — I review any note I write with that in mind.  
 

Edit:  the number one priority is for my child to receive the best care possible, and for my child to feel confident in the care.  Am I contributing to that, or am I taking away from that?  Sometimes I have thoughts that are more in the “curiousity” category that are not furthering my child’s treatment.  
 

With my kids being older — I will wonder about things and honestly they could only be a distraction to my kids or lead them to wonder “why is mom wondering about that.”  
 

There are other venues, though, like WTM forums, a parent support group, etc. These are appropriate places to take doubts or non-pertinent questions.  

Edited July 26 by Lecka

[Hilltopmom]

I don’t know if it will help to hear this or not, but my 11 year old is also on an SSRI for OCD and is also stable now. She started meds last year. Her psychiatrist recommended she be past puberty (which is a tough time for mental health as it is) and several years stable before we discuss weaning off meds. 

As a special Ed teacher I’ve seen many kids taken off meds as soon as they are stable for a month or three- families think they are “cured” or “outgrew it” but in fact, they are doing well because of the meds. Go off meds, symptoms all come back, often worse. Not just for OCD, but other mental health issues as well.

[City Mouse]

4 hours ago, mindinggaps said:

@wendyroo I appreciate your candidness. I am thinking everything over right now and I do take these thoughts seriously.

I'd love to hear opinions from you and others on this - was there anything weird about the psychiatrist pulling me aside or is that type of thing okay? It felt strange to me, but maybe I'm over reacting here.

I have no experience with psychiatrists, so take this for what it is worth.

I am a long-time public school special education teacher. It is perfect normal for parents and teachers to discuss hard topics without the children present. I would not have wanted to have certain conversations in front of the child at all. Students are not expected to participate in IEP meetings until they are 14yrs old if I am remembering correctly. I am remember specific difficult conversations and meetings when I say this. Sometimes a younger student will participate in part of the conversation, and then leave for the adults to finish up.

The idea that anyone would expect that an 8yr old child must be included in all of these hard conversations is just baffling to me. It does not seem at all unusual to me that a doctor might want to discuss an issue without the child present.

Edited July 26 by City Mouse

[AmandaVT]

As someone with anxiety and a parent of a child with anxiety, one of the things that was most difficult for me was managing my anxiety while trying to help DS with his. 

 

[Catwoman]

2 hours ago, freesia said:

I just want to say, I am very impressed by your ability to field and consider all our opinions, even when we disagree and challenge you, with grace and thoughtfulness. I think this quality in you is a strength you carry on this journey with your dd. 

I totally agree with you! 

@mindinggaps, I am amazed at how graciously you are accepting criticism, and how open you are to considering all of the suggestions people are making. I also really admire your ability to keep an open mind when reflecting on things that have happened, and to take a little time to look back on what has happened and sometimes change your mind about things once you have thought them through.

It's so obvious that you and your dh want to be the best possible parents to your dd, and it's also very reasonable that you might question some of the doctor's opinions and recommendations. I think it would be irresponsible to just agree to everything a doctor says without doing your own research to make sure the recommendations are accurate and that they make sense for your child. 

I can absolutely understand your feelings and worries about medicating your dd. I know it has been suggested that you are overly anxious about it and that you might have your own OCD issues, but I don't know how to make that determination, so I'm mostly seeing you as a mom who wants to do the right thing and not have serious regrets later. That's a ton of pressure, and what it says to me is not so much that you have your own psychological issues, but that you love your dd so much that you want to make the best decisions for her, and because there is so much conflicting information out there about SSRIs, it makes sense to me that you would be very conflicted, and I hope you aren't being too hard on yourself.

I am certainly no expert, but I agree with your decision to leave your dd on the medication and see what the future brings. Right now, it sounds like your dd is doing great, and maybe the smartest thing you can do is enjoy her progress and try not to drive yourself crazy by doing tons of extra research and worrying about what will happen years from now. And maybe you and your dh should think about giving yourselves a little total vacation from the topic and then revisit your concerns 6 months or a year down the road. If you are going to keep second-guessing the medications, eventually your dd will pick up on your anxiety and things could really go downhill fast if she starts refusing the medication. It would seem that the best thing you can do is make the medication a normal part of the daily routine with no extra discussion about it. 

Again, I think you're doing the very best you can for your dd, and I really admire you for it. 🙂