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School Refusal
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Medication

Dear All - After 6 months of trying to get our 14 year old daughter to school she is still too anxious to get out of the car on a morning. Her anxiety does not seem to be reducing when it comes to school and she is too worried to try any of the CBT techniques.

We are considering medication and have spoken with her doctor. He has said that if she were to go on medication, it would be 50 mg of Zoloft (Sertraline).

Does anyone have any experience of this or views on taking medication? We have tried CBT, hypnotherapy etc and all to no success.

Thank you.

Sharry

Re: Medication

Hi Sharry,

The main thing I came to see about medication is that there comes a time when our son/daughter are not doing themselves any good health wise by the anxiety they suffer - and so they do need to have something to help them take some steps forward. I used to be against medication - until I realised that nothing else was going to help my son move forward. So I think you have come to the right conclusion. You have tried other things. It might now mean that the medication helps your daughter work towards CBT as it might help her feel more able to do this.

I do not have experience with Zoloft - but I know there are others on here who do.
My son takes Luvox (Fluvoxamine) 50mg. Although it did not do what I thought it might and enable him to leave some of his anxiety behind - I do believe that if he had not taken this then he would not have been able to continue to hang in there and try and go to school as much as he does.
We had to go and see the psychiatrist today as I couldn't get him to school (nor did I last week) and she said that even if she increased the dose or changed the type of medication - in the long run it would be up to my son to make the decision that he wants to take the steps to learn CBT and become stronger and more able to move forward. She put the ball back in his court today and said that she is happy to see him when in a crisis (as in today) but that she wants him to think seriously and make a decision whether he wants to see her on a regular basis and learn some skills with her or whether he just wants to keep arriving when in a crisis and deal with it on the day but be aware that this does not help long term.

I am hoping that maturity kicks in and he realises that he does have to put in effort to work on his anxiety more than he does. He took a huge step forward when he accepted his anxiety a number of years ago (and maybe your daughter is still struggling with that) and he often does recognise it - but like your daughter - he still finds it hard to work on any strategies when he is anxious and just 'give in' and lets it take over or says 'who cares'.

Sorry I think I have raved on a bit here - but I believe that medication can help when you are finding that there is just a block in moving forward.
I didn't reply to your post when you mentioned that your daughter wasn't able to get out of the car as I was having quite a few of my own issues with my son at the time. But I also don't know that I had much advice.
I do know that sometime when I drive my son to school and he begs me to drive around the streets first or says he can't get out - I just pull up and threaten to get the welfare coordinator or teacher to come and get him. He has sworn at me - got out - and actually managed the day and been thankful!! But then there are other days where he doesn't get out of the house - or he says he just wants to cry when we are in the car - and it gets to a point that I know that even doing the 'hard' thing and pushing him out as such - just won't work.
So I am not sure that driving up to the school actually helps as they can just cope with the driving there - but it is the crossing over from the safety still of the car and into the schoolyard that is the actual problem - and no amount of 'being close to the environment' seems to help. My son also now doesn't just have the 'getting there' issues but has convinced himself that he hates school so much that he really also just doesn't want to be there.
The psychiatrist told him that he is actually going to have to recognise when he 'just doesn't want to' go to school and when 'anxiety' takes over as she believes the two are in operation at the moment and have met half way and made it a much larger issue. HE wasn't too happy about that but he agreed with her that sometimes he just didn't want to go to school and it wasn't really a full anxiety issue.

So it is hard, isn't it - to know what is going on in our kids heads when they can't pinpoint themselves what it is that makes them feel so bad. But I really hope medication can help your daughter. It takes at least 6 weeks to kick in properly and the side effects of most of these drugs goes away after the first week or so.
Let us know what you decide to do and how things go.
Thinking of you -
Linda

Re: Medication

Hi Sharry - I agree with all that Linda has said - our situations are very similar. Yes medication can help but it's not the answer we all wish it was. Most of our school phobic kids have become very depressed as a result of their anxiety and the medication mostly helps with the depression although can have an affect on the anxiety as well in some cases. The key is if you are going to try it, you need to be prepared to give it a good shot, ie it will take 2-6 weeks to notice any real difference, you may need to try a different type of medication or play around with doses. My daughter did try Zoloft and it wasn't very effective for her, however I have taken it in the past for severe depression and it worked well for me. Lovan (Prozac) is the usual first try drug in Australia for this type of anxiety in children but I would be guided by your doctor. Hoping for a good result for you and your daughter xx

Re: Medication

Hello Linda

Thank you so much for your message - you are always so kind in your response and always take the time to put in a thoughtful message - it really is appreciated. I am so sorry to hear that things aren't going great for you at the moment. It really is a rollercoaster isn't it?! I do think that at the end of the day, we know our own children the best and you must do what you feel is right for your Son and be guided by your own experience of his SR and what he is able to tolerate.

I do think that as maturity kicks in our children will view things differently and be able to handle situations in a more positive way.

I have to say, this week has been rough already and we're only half-way through it. My daughter's school had put together a new timetable which was only a few hours here and there and meant going into a different building (still on the school grounds, but not too close to the other classrooms). We thought this may have worked as she was also just going to have 1:1 sessions for a while. However, just the same - just couldn't get her out of the car. Just had a call from the Ed. Officer asking where she was.

I know everyone had worked hard to get this new timetable in place, but I did say that I couldn't guarantee my daughter would be able to make it.

Anyway, my latest thinking is perhaps I should go in with her to start with until she feels ready for this step and do some work with her in that environment - not sure if the school will be happy about this, but just trying to break the process down even further.

Still thinking about medication, but I can see we will have to give it a go very soon.

Really hope things improve Linda.

Kindest regards.

Sharry

Re: Medication

Hello Sandy

Thank you for your message. Abit of a rough week, this week, but I'm learning to cope with the ups and downs as they come. I think we probably will give medication a go, as my girl really does seem to have a block and just can't move forward.

Hope things are continuing to go well for you and it really is encouraging to know that we can all move forward from our current position, at some point in the future.

Here's hoping for a smoother few days.

Regards.

Sharry

Re: Medication

Hi Sharry

I hope I can offer some support to others who are just starting this journey - but as you can see - I still have hiccups myself.
Sorry to hear how the morning was.
Can someone from the school come out and meet you at the car? It might sound hard on your daughter - but it might just push her that bit more to not want to fall down in front of someone else.
My son begged me to drive around this morning and got really stressed when I refused - which makes me feel so awful as i just don't know what is right or wrong sometimes - but I knew he just had to get there. He threatened to not go in the school gates if I made him get out. I stopped in front of a whole bunch of other kids walking in late - and so he felt pressured into not falling down any further and so got out and slammed the door.
I felt awful....but he got there....and I have now been through this scenario many times. Doesn't make it easier but just does make me a bit tougher each time. Not sure that toughness works in most of these situation but I do know that if your daughter needs to try the timetable - then she is going to need someone other than you to get her out of that car - for your sake and hers. You are not as far into this road as I am - so I know how incredibly emotional it is on you. You get a bit more able to turn off later on - but only to a certain degree- but it does help.
So see if they will meet you at the car or you can drop your daughter off in front of her peers.

If this doesnt' work. Don't feel awful....your daughter is trying her hardest by the sound of it.
Is there any way you would consider home schooling?
Hang in there - see how far you want to push in one direction and then at what point you want to accept it is either happening or not happening.
Take care
Linda xx

Re: Medication

Thank you Linda - Some great advice there as usual. You sound like you're definitely doing the right thing - I don't think I have as much confidence as you at the moment in doing that!

We have suggested other people/peers come to collect my girl from the car, but she says she feels under too much pressure then.

However, really thought we were going to make some progress yesterday, but didn't really work out as we would have liked ...

I went to the School with my daughter (after school had finished for the day - pre-arranged) with the view that we were going to go in together to this different building, away from the rest of the school. My daughter was really brave and managed to get out of the car with me and go into this building. However, their were quite a few members of staff in there (NOT as we had arranged) and they clearly weren't expecting us and said that if that building was full my D would have to work over in the main school. I could see my D was horrified at this prospect.

I have now sent an e-mail to the School saying that under no circumstances must she be asked to go over to the main building, until she is ready for that step, but she now has it in her head that this idea isn't going to work. I know she shouldn't be as sensitive, but she was so brave to even get out of the car, this has now been overshadowed by what the staff said to her.

I am not sure how we move this forward for next week, as the school haven't exactly gained her trust with comments like that. I am also aware that it is very difficult for School staff to understand how fragile our SR's are.

Anyway, let's forget about School for this weekend.

Thank you again for your kind comments. Your Son is lucky to have you x

Re: Medication

Anxiety is a medical condition. Medicine may work better than any other solution. This is true especially in teens.
If the Zoloft doesn't provide any relief after a month or so try something else. SSRI's are hit and miss. The child might need more than one drug. Just keep trying.

Re: Medication

Hi all
Gosh Sharry, schools never fail to astound me. The staff are there to work/deal with young people every day and some just can't seem to manage basic common sense.

Your daughter was after screwing up all her strength to go to this building and to be let down like that by so-called professionals is sad.

When they are training as teachers I really wish they would learn that while they will have many students, every one of them is different, and needs to be dealt with individually and, at times, with sensitivity.

The way forward maybe mediciation. They're no shame in it and speaking to her GP and maybe having to try a couple of different ones may be enough to get her started on going back to school.

But like you say, almost the end of the week, so enjoy the weekend everyone.
Here in Southern Ireland, it's a Bank Holiday on Monday so a three day weekend

Take care

Virginia

Re: Medication

Thank you Virginia. I am beginning to wonder if my daughter will ever feel strong enough to get out of the car, as I am aware that the longer she avoids this, the harder (in her mind) it becomes.

We have been on half-term holiday this week and I did manage to get one of my daughter's friends to come over and I took them to a WaterPark and out for lunch. They both really enjoyed it, though it really was touch and go whether it was going to happen. However, my daughter did say that she knew she would be so disappointed if we had to cancel, so she kept herself busy until her friend arrived. I have really praised her on this achievement and asked her to think about which strategies she used, so that she can perhaps apply these to going to school, when she is ready. This all sounds good, but I fear the reality will be different come Monday morning, but I did feel it was a good step forward for her.

We are now going to visit the doctor next week with regard to medication, so we'll see how we go.

Thank you so much for your comments.

Regards.

Sharry