Young adult with depression/anxiety...what to do next

[lindsy]

Hi everyone
I've posted before about my younger ds, but this is my older ds, just turned 18. He has always been a likeable kid, polite, friendly, good student, good athlete. Some difficulty in connecting with large groups of friends, but always had one or two good friends. Always demo some anxiety (i.e. tests, making decisions) but its off the charts and I'm looking for some ideas of next steps.

He graduated early (jan) and entered a program at local university for culinary (long time passion) that the school district paid for as he was "dual enrolled". He got his driver's license (N here in Canada) and bought a car. From there its gotten crazy.

He did the culinary for 2 months, achieving the top mark...then as they switched modules, he had a panic attack and left campus. Wanted out from program. Definitely panic, full blown. Got a medical leave for him (they don't want to lose him), got into our dr who prescribed Clexa (sp)...after 5 weeks, he wasn't sleeping, eating...bad. Now on effoxer (sp) and have put the dosage up a couple of times. Saw our therapist a few times but she felt he wasn't really "buying" in to the program...more doing it for us. He just didn't show up a few times and didn't tell us. Starting to rage at things, then so sad...crying. I'm thinking depression. Some pretty bad dialogue going on when he finally starts talking. Drives everywhere in his car...especially when upset. Its almost like he burns out, then pulls over and sleeps by the side of the road.

So my question, before I see our dr again...is what next steps should be considered? Remember he just turned 18 which I 'think" is adult for medical purposes here in Canada (another of my questions to the dr)...but I'm getting worried. He needs some help...is overwhelmed by everything, rages when asked about things, just plain bad. He had to quit his job as a dishwasher because of the panic attacks.

So please...any thoughts about directions to consider? Appreciate anything,

Lindsy

[healthy11]

Lindsy, we're so sorry to hear that your eldest is now struggling. My son and husband have both had panic/anxiety attacks before, but nothing that lasted months like you've described.

When you say you got your son into your Dr. who prescribed Celexa, is the doctor a general internist, or a psychiatrist? It really sounds like your son needs a more comprehensive mental health evaluation. I can't help but wonder if there might be something besides depression going on....is it possible he could be using alcohol or drugs? Unfortunately, as you know, once kids have access to cars, they can go places/do things that parents can't always keep track of. In addition, certain mental health conditions seem to emerge in late teen/early young adult years, and so a professional really needs to be involved. I'm not trying to scare you, and I'm not a doctor, but the relatively sudden changes you've seen, from top student to his current attitude, just seem like more than depression to me. www.nbcdfw.com/news/health/The_Real_World__Recognizing_Mental_Illness_in_Young_Adults.html

[dwolen]

I agree with healthy 11. Late adolescence and young adulthood is a time when serious mental health problems can emerge. I have been been warned to watch my dd for bipolar sx, as she experienced some hypomania with certain ADHD medicines and welbutrin. (Welbutrin is the least of the anti-depressants, I just learned, to elicit mania if there is an underlying bilpolar disorder.)

[lindsy]

Thanks Healthy and Dwolen!
I'm concerned...he has been seeing our family dr, who is great....but I am concerned that ds is very good at saying what he thinks adults need to hear because he doesn't want to disappoint anyone. I think a psychiatrist is in order. Also very concerned because he has no appetite. It seems more than just anxiety...certainly depression but maybe something else going on. He doesn't drink much (doesn't agree with him) and says no drugs....but I know how empty that promise can be! He does better when he works out at the gym consistently ....greatest difficulty is he can't settle to anything...cannot commit to any plans more than a couple of hours into the future...with too many discussions...he rages (angry at himself?) then very despondent about his behaviour...he drives everywhere as he has his own car, paid his own insurance and gas...so have had to try to be firm but careful at sparking him off...then he just takes off in his car. Sigh. Hard to be angry and scared at the same time (me!!). I'm going to visit the family dr on monday by myself and then with ds on Wednesday. Wish me luck

[healthy11]

Our thoughts are with you; I'm not sure what it takes to get a referral to a mental health specialist in Canada, but that would definitely be what I'd recommend doing. ((hugs))

[jisp]

lindsy,
Sorry to come to this a bit late. I agree your son needs to be evaluated by a psychiatrist. Ideally I would look for an adult psychiatrist that has experience treating young adults and working with their families as well. You will need to work closely with the psychiatrist to learn strategies for talking and working with your son to get him to be compliant and cooperative with treatment. Because he is a young adult you can not say, "Do this" so instead you will need learn how to guide him, which can be tricky because at the same time your son is also not well mentally. A good mental health professional should be able to support you with this.

It sounds like your son is having a bad reaction to anti-depressants. It is VITAL if that is happening that you work with your son's doctor to remove the antidepressants and rethink diagnosis and treatment. When somebody reacts badly to antidepressants they do not get better with increased dosings and their mood swings, anger and rage will only disappear once the antidepressant is completely out of their system. DO NOT STOP ANY MEDICATION without a doctor's supervision. SSRIs need to be stopped slowly and gradually. Often somebody will get worse rather than better during the process of weaning off of an SSRI. Some will need to be hospitalized during this process. It needs to be done with the support of a trained psychiatrist.

You might want to check out www.thebalancedmind.org or The Balanced Mind on FB. There you will find other parents who are struggling with young adults and mental health disorders.

[jw]

Hi,

My ds has anxiety and ADHD, and my sister has severe depression. They have both had to try several meds to finally get to one that works. At least one of the meds ds tried did not work well, and also caused him to be more emotional and angry. We switched from that med to fluoxetine, and that works for him. I think it is also important to realize that your ds has been going through some major transitions from high school to greater independence, which can trigger a lot of stress and anxiety. He may be feeling the pressure to be more independent than he really needs to be at this point (not because you are pushing him but because he is pushing himself) and if the culinary thing is not working out, he may be struggling to figure out what he is going to do with his life now. These are just some thoughts based on what I hear from my own 17 year old (almost 18 year old)....

I agree with the other posters that you need to see an experienced psychiatrist. When you have what my doctor calls "treatment resistant" anxiety/depression then it is time to get someone really experienced on the case, and they may find additional issues.

Good luck, jw