Hi everyone,

Just wondering how many of your kids end up suffering depression as a result of the anxiety or as a part of and how much this effects what they feel they can and can't do? How much is the not being able to face the morning and get up to go to school just the anxiety speaking and how much is their mind giving up on the day and how do we know the difference?
I find I struggle with which is most dominant at times and therefore the help that comes our way.

My son said to me last night that he hated the world and he just didn't fit in and that nothing made him feel better. I do worry that because this has been going on for so long and he always is 'not bad enough' for medication or intense therapy etc that he will continue to spiral downhill with his moods as he is now 13. He is no longer the smiling boy who was able to step outside his anxiety when in 'safe' situations. Now his mood at home is flat - and I think he is hovering on the edge of depression. He has been there before and it took a long while to move up and out of it. He became like this when he was sick two weeks ago and his mood has not lifted. I have tried talking to the psychologist about how he needs to build up his self esteem and confidence and self worth and then maybe he'd face school better. Her idea is if he just keeps on going to school - that will come. I am not convinced.

Any thoughts on anxiety and depression and how we work on both or whether we work on them separately?
What has worked for others?
Linda

Hi Linda

I really empathise with you as it sounds like you are going through much the same thing as us. Looking back I can see that my son had these feelings of anxiety a long time ago but we kept pushing him to go to school. He wasn't socialising and we kept telling ourselves that it would get better in time. We were so wrong! We can now see that the reason he wasn't socialising and hated going to school was because of his anxiety. This made him pull back from interacting with other children and of course they saw this as him not wanting to be friendly when in fact it was just that he "couldn't". He also sees himself as being "different" and we have always thought that it has been difficult for him to "fit in" with his peers.

Is your son not on any medication at the moment? Our doctor has told us that because we left it so long before we sought help (my son is now 15 and has been taking medication for about 6 weeks now) that it will take much longer to get him back "on track". I know he will always probably struggle with friendships and certain situations because of his anxiety, but we would be so happy if he could just do everyday things easily. He hasn't left the house, apart from being in my car, for over 6 weeks now! At the moment he is trying to pluck up the courage to have his hair cut, but I know we will have to arrange a time when he will come into contact with the least amount of people!!

I suppose it was a good thing that our son completed year 10 because he has managed to take some parts of his GCSE's and I am hoping that we can work through the rest of his syllabus at home and so enable him to complete his exams. Not sure if I am kidding myself here but if I don't think positively I will crack up!

My doctor has kept telling me not to push S as far as work, etc, is concerned and that the priority is his peace of mind and trying to deal with his anxiety and depression first. She tells us that once we get this under control the rest will fall into place.

I believe that the anxiety causes the depression. I don't think that our son was depressed but I think that because his anxiety has stopped him from doing the things he feels he should have been doing or would have enjoyed doing, this has caused him to become depressed. Also sitting at home on his laptop all day is enough in itself to make him feel depressed!

I don't know if I am talking any sense Linda, but I would think that the more you push your son to deal with situations that are obviously making him severely anxious the more likely he is to become depressed. I wish we had been more understanding months ago and maybe things wouldn't have escalated to where we are today! It is almost like S pushed himself to continue with school (most of the time) up until the holidays and then once he had some time away he found that he couldn't face going back, or going anywhere for that matter!

I know I'm rambling on a bit here - it's just so difficult to know what is the best thing for each individual child. You can only go with your instinct as a parent and hope you are doing the right thing. I have accepted the fact that our son is unlikely to return to school this year and we will do the best we possibly can as far as his schoolwork is concerned at home and hope that it doesn't reflect too badly in his exam results. Like I said before I am much more concerned about him being able to just enjoy life a little better.

We have someone from CAMHS coming to the house tomorrow (something else S is getting himself really anxious about - we are probably in for a rough time tonight!!) and we also have an appointment with the psychiatrist to discuss his medication in a couple of weeks. We are hopeful that once he gets on the right medication we will start to turn a corner. Always living in hope!!

Thanks for listening to my ramble - take care everyone xx

Hi Kathy,

Thank you so much for your reply - and so much in there that I can relate to. How did the meeting go?
What is the medication your son is taking? Are there any side effects?
My son has probably been a bit young for medication in the past and I am not one who likes to rush into medication as there is not enough research into its effects - but my son's state of mind is being effected just by not having medication - so I think one outweighs the other.
I remember when he was first diagnosed with an anxiety disorder by a paediatrican and he said very strongly ' he needs medication'. I was totally opposed (and still would be) as my son was only 6. But then last year our doctor and the psychologist said that they thought he needed medication and so we were sent to a psychiatrist who is the only one who can prescribe the medication - but she said she felt he wasn't bad enough. Which in itself should be great news!! But the struggle my son goes through on a daily basis does not seem to be something he should be going through.
Perhaps they feel they need to see how he copes in the next couple of years as he enters teenager years.
Frustrating from my point of view - but what can you do!? We have been from one psychologist to another and in some ways would just love the word 'school' to go away and focus on the other issues of self esteem and socialising. I guess we just keep plodding along for awhile longer.

IT is so great your son did mange to finish Year 10. The medication takes awhile to kick in, doesn't it, so you might find you see results coming soon. It is so hard to see our kids unable to leave the house. And haircuts....my son has managed to get the hairdressers twice. In desperation I have trimmed his hair at other times but he still prefers it long - but that draws attention to himself...something he is trying to avoid. I wish he'd just get a decent hair cut so he can just be like everyone else. I've even booked the hairdressers in the past and then been unable to get him out of the car he was so distressed. Good luck! Maybe all SR boys have long hair!!

Going back after holidays seems to be enormously difficult. I really think that if my son's best friend that went overseas for this term does not come back to go to the same school next year (they want to send him to another school) then my son will just not be able to face going back after the long summer holidays. Why would he want to!? Once you have lost a friend and you feel you don't fit in - there is not motivation to go. Then the anxiety takes over.
Is your son possibly able to go for a drive in the car? Just to get him out of the house. I know someone else on here used to do that and it was also a time their son talked a bit. I think the drives might even have been at night so that no one could see him - but at least he got out of the confines of the house.
My son has also sometimes agreed to a drive, as long as he does not have to get out. The fear of seeing someone they might know is so great that it overwhelms them - not to mention the fear of leaving the safe zone at home.

Good luck Kathy! We battle on. How are you coping with it all?
I have good and bad days. My ex comes and takes my son to school three mornings of the week and at first I found that difficult but now I am so relieved - my son also seems more relaxed. I guess my voice has become a bit of a broken record over the years in terms of what I do and say in a morning in trying to get him out of bed. Having someone else come along helps move the situation forward.
But I still cop the anger and frustration after school - and as I said ...there is an element of depression seeping in that is making him become withdrawn.

Let us know how you go -
all the best,
Linda xx

Hi Linda

I can really understand what you are going through. My daughter suffers from both anxiety and depression as does most of our extended family including myself. I believe she only became depressed as a result of the anxiety however the psychiatrist who treated her initially believes she had underlying depression that caused the anxiety. I don't think it really matters, the end result is the same...a very miserable child. Even at a very young age she would say she didn't want to live and couldn't see any point in living but this was after the school refusal began. She was first prescribed anti-depressants at the age of 7 and the first time around was recommended to stay on them for 12 months. She was then medication free for years 5 & 6 before her school refusal kicked in again in year 7 and has been on medication ever since. Initially she was on Lovan (Prozac) which is the most commonly prescribed for children/teenagers. That worked well when she was younger, but we tried it again in high school and it didn't work. Then tried a number of different SSRI's and moved into SNRI's until we finally found escitalopram which is also recommended for anxiety. Took a while to get the dose right but she is now doing great. We know the medication is not the whole answer, she has had counselling, changed diet, etc but without medication she does not cope at all. The only side effects she suffered were when the dose was too high for her, she can only tolerate the lowest doses. She would have weird dreams, get hyper-active etc but once the dose is lowered she does not have any side effects.

I understand why people are concerned about medications, but after seeing my father suffer from depression all his life (he self medicated with alcohol) and finally finding peace in his 80's with a combination of medication and ect treatment, I know that it can help. I have taken anti-depressants for periods in my life but haven't needed anything for years now.

Most of the newer medications only take 1-2 weeks to work, with the full benefit after 6 weeks. The psychiatrist we saw who was an child & adolescent specialist used to tell us that if she was suffering from a physical illness that was affecting her quality of life and there was a medication that "might" help her we would probably try it to see if it worked and so it should be with mental illness. It's difficult though if you can't find a doctor who is willing to prescribe. Anxiety and depression feed off each other.... until we found the medication she is currently taking, most of the ones we tried would help with the depression but not the anxiety. Everyone is different and the process of trying different ones is frustrating. Glad we persevered though. Hope you are able to find a way forward and if you decide to try medication, that you can find a doctor who will work with you.

Hi Linda

I agree, medication is scary, but we couldn't continue as we were - we felt we had to try it and see if it gave S some relief from his awful feelings. He started taking Citalopram on a very low dose and gradually increasing it, but he didn't seem to be improving. The doctor has now prescribed Half-Beta Prograne (which are supposed to deal with the panic attacks) and Venlafaxine. We are due to see the psychiatrist in about 10 days so he may well change them again if he doesn't feel they are appropriate for our son. It's all a matter of trial and error. I can see a slight change in his mood although this does tend to differ from day to day and is never very good in the mornings!

We were due to have a visit from a Family Therapist from CAMHS today, but my son was getting himself in such a state just thinking about talking to her that we have put this visit off for another few days, much to my husband's annoyance. My son asked me yesterday if we could delay the visit if he tried himself to get out of the house. So we have booked an appointment for a haircut tomorrow and if he can cope with that OK he is going to try to arrange a night at the pictures with a girl who he knows from the school bus. I hope with all my heart that he can do this and I told him yesterday how proud and pleased I would be if he makes an effort himself to start getting his life back (easier said than done I know!). The therapist was OK with all of this and said she would happily come in a little while if S agreed to try and make some tiny steps himself.

This all puts huge pressure on our whole family. My husband is so keen for us to do all the things that CAMHS tell us so that we can get S back to "normal" as soon as possible. I on the other hand want him to take things at his own pace and not risk putting him under any more pressure when I know he can't deal with it. This means my husband and I end up arguing which doesn't help the situation! It feels like we are just existing rather than living at the moment and it's so hard.

Take care everyone xx

Hi Linda,

The medication question is a hard one. We were advised to try it in order to stop his anxiety turning to depression. They are very closely linked. It was always going to be a short term solution for my son. They likened it to having a broken leg. They said that if you break your leg, you have two options. Either rest the leg and don't move it and it will heal naturally or you can put it in plaster to speed up the process. For us, the medication was the plaster. My son was put on Fluoxetine (prozac) and they had to increase the dose twice for it to have any effect. The doctor did say that it was trial and error with each child and often the meds stop working after a while and you have to move on to something else. Once the dose was right, it helped him hugely. We also used to take it first thing but changed this to last thing at night, and this too made a difference. He did return to school but then the bullying started and the rest is history. The only side effect my son had was putting on weight and that was a huge issue for him as he loves his sport. So in the end we stopped and took the long route, took away all stress and as you know he was at home for 18 months. With my son, they said his fight or flight responses were too acute and he needed time to let them calm down. He is still doing well at his new school. He said to me the other day 'I'm just not scared anymore'. I still think his motivation to return to school has come from hating his time at home being homeschooled and I'm convinced the cranium osteopath has helped. He is definitely not as neurotic as he was and sleeps so well.

If my son were to develop depression in the future I would definitely look at meds again. In fact, we were discussing it again as an option if his return to school hadn't worked and his doctor said there are so many more options available now than there were 2 years ago. When we first went to see the psyc, he suggested SSRI's for my son but he did say there were many other options.

Linda, you have to do what you think is right. You know your son better than anyone.

Take care,

sophy

Thanks Sophy, Kathy and Sandy,

I really appreciate your replies and hearing your stories. Knowing what medication does or doesn't work I know is an individual thing but it gives me some idea of the kind of things that are being recommended for children/teenagers. I really have to follow up with the cranial osteopath first though - as that seems like something that almost 'calmed' your son by the sound of it.
Then I can put it back to the psychologist re medication or just go back to the psychiatrist.
My ex seems to think my son is just being a lazy, couldn't be bothered teenager - but as he is only 13 and I am with him nearly all the time - I observe something different. I think if I was him - having anxiety for the past 7 years would also wear me down and make me loose motivation to involve myself in 'life'.

I picked my son up early from school yesterday (he begged me not to make him do a full day) and I met the lady at the front desk who I had spoken with last year (she checks the kids in and out). She had told me last year that she had had agrophobia as a young adult and had also had what she now believes was school refusal as she felt physically sick every morning before school. Her advice at the time was to ensure we got help sooner rather than later. She always gives me a big understanding smile as she knows how we struggle. She said she thought it was great that he had done two lessons that morning and if getting him to school meant picking him up early - then so be it (I am told over and over again by the psychologist and school welfare not to do this - and of course my ex). As we were leaving she said to my son 'you have a lovely weekend, won't you.' Why aren't the so called experts and the school support staff being supportive like this? Are they terrified if they give myself or my son any sympathy that we will then just collapse in on ourselves and do nothing? We need all the understanding we can get! And yet it takes just the lady in the office to make me feel I am doing the right thing. I also note that since my meeting with the school support staff a couple of months ago...not one of them has contacted me.

We have a very famous horse race coming up here in Melbourne on Tuesday (THe Melbourne Cup) and most families take advantage of that and take the four days and go away. I managed to convince my ex to let my son have the Monday off - he has gone up there now and although he didn't want to stay for four days - I think him and I do need a break from each other. He also has more of a chance of getting out of the house whilst up there and going for a bike ride. When he is with me he can be so stubborn on these things that they just don't happen any more. It is hard for us sole parents who don't get the break but it is also hard for you who have a partner who doesn't see things the way you do!
I said to my son 'why can't you talk to your dad about how you really feel but you can talk to me?' and he said 'because he is a man and you are a woman." I thought that was interesting. I sometimes think as a woman I have too much empathy but I guess the good thing is he is still able to talk to me and sadly - knows his dad has more the attitude 'don't give him any sympathy or he will take advantage of that - just jolly him along and make him pull his socks up and get on with life.' He also thinks he puts on the crying (but there is a difference between forced crying and distraught tears). Parenting isn't easy at the best of times - but with SR - we just flounder around a lot I think!! But we do our best!!
Thanks again - you have given me much to think about.
Take care - and may your week be an ok one or in fact a good one. And if it is not so....then there is always another week : )
Linda xx

Hi Linda

I'm so sorry to hear your son has been feeling flat and depressed. I feel the same about medication as you - it isn't something to be taken lightly BUT when our kids are suffering to this extent, like you say the potential benefits outweigh concerns of side effects etc. I struggle here too trying to get our GP and child psyche to consider medication. Similar consensus - it isn't clinical in my d's case which is fair enough I would agree it is reactive to anxiety about school, but that can be medicated too and it might make her challenges easier to face.

"She always gives me a big understanding smile as she knows how we struggle. She said she thought it was great that he had done two lessons that morning and if getting him to school meant picking him up early - then so be it (I am told over and over again by the psychologist and school welfare not to do this - and of course my ex). As we were leaving she said to my son 'you have a lovely weekend, won't you.' Why aren't the so called experts and the school support staff being supportive like this? Are they terrified if they give myself or my son any sympathy that we will then just collapse in on ourselves and do nothing? We need all the understanding we can get! And yet it takes just the lady in the office to make me feel I am doing the right thing. I also note that since my meeting with the school support staff a couple of months ago...not one of them has contacted me."

What a lovely lady, i'm so glad you and your son have her support. Isn't it a breath of fresh air when someone really 'gets it'? Sadly, coming across people like this is rare. I have them for myself in my counsellor and parenting support services but my daughter just has one person outside of me who is like this - a lovely lady who I have been taking her to for acupressure sessions. This lady called me after d's last session and said she could feel how vulnerable she was with no protective barriers at all, she also said that the emotions coming up in her at the moment are intense sadness and she could totally understand why she did not feel the strength for school.

We have great support for ourselves here too, thank goodness for that. Who do our children have apart from us? I get so frustrated with the professionals too - it is so so clear how much awareness and understanding needs to improve regarding children suffering from SR and how to best support them and their families. I have become a broken record recently telling any educator or mental health professional I can that what my daughter really needs is acknowledgement of her pain, validation that she has the right to her feelings and reassurance that she can recover at her own pace and is safe in their care. Why is that so hard to understand and even harder for them to implement?

How is your son doing over the last week? I hope you start to get minds opening up your side of the world. Just know I am bashing my head against a lot of brick walls too