Psych/ Anxiety

Jules A, MSN · Sep 6, 2015

This is a tough one. Some of these issues are real. My son began vomiting every morning in 2nd grade. It would go on from first day of school for months... then still sporadically. Had him checked at dr. None of us are morning people and my whole family has touchy stomachs. By 6th grade he had reached a point where he was vomiting into a barf bag as I waited in drop off line in the car. The scariest thing is that he began feeling this way just leaving the house at other times... even for fun outings. At that point I started therapy and zoloft for him... at age 12. It was an agonizing decision. Nobody wants to put their 12 y.o. on Zoloft. He is nearly 15.... is on a minimal zoloft 25 mg... and doing well. He started high school this year. First few days he felt ill in the mornings but worked through it and did not vomit. We have no idea why this got so bad... except anxiety runs in both families esp mine.

Wow this is severe and although no one wants to have to medicate their child it sounds as if you tried everything to avoid it. As you said anxiety absolutely does run in families. Zoloft and Prozac are among the mental health medications that have been around a long time and are FDA approved for certain indications in children. I prescribe them for children as indicated and always in conjunction with therapy.

Oedgar · Sep 6, 2015

Gosh yes I tried homeopathic remedies... Calms Forte and other things..Tried to put up with it... talk him through it. But when he began having issues just going out for fun or out to eat I had to do something. It took us a month to be able to get into local psych. Tried texas childrens which was an even longer process. While we waited for his appt we began therapy. It helped....a little? Zoloft is what turned this around.

PhillyRNtoBe · Sep 6, 2015

From personal experience with family members and close friends, I believe that most of these children are not taught the proper coping skills at home or in school. When the problems become obvious many parents get overwhelmed and seem more resistant to initiating proper treatment.

Basically, I think the entire mental healthcare system is failing and needs to be reformed. It's no longer meeting our needs as a society.

I also think that the field of medicine is failing the mental health community especially the parents of mentally ill children. They (Doctors and some parents) are not catching the warning signs early enough, then turn to meds as the first & only option. (Not saying certain cases don't need meds, certainly some do.) Many parents are unprepared to handle this and their stress feeds back into the cycle of anxiety in the home. Certain parents need to be taught coping skills too. This is why I agree with those who think family therapy is a crucial part of this.

Oedgar · Sep 6, 2015

Jules ... one interesting thing happened... which to me pointed out that this whole business of medications for mental issues really is trial and error.. As we began to wean down his zoloft... the psych PA, who has a very ... natural medicine aspect to her... recommended we give him high dose fish oil in addition. After a few months of that, I realized his mood had worsened. Took him off the fish oil and it's improved. We are probably going to wean him completely off the zoloft soon. Wanted to get him started at school before we made any big changes.

VicChic20 · Sep 6, 2015

It does feel like anxiety and mental issues as a whole has been surrounding us more and more each year. It just feels like everyone has an anxious-filled mind lately, but it is probably a number of influences that is making kids and teens more anxious, depressed, etc. The pressures at home with parents seeking out the best in their kids, the pressures of staying on top of their academics and grades , and pressures coming from other peers to seek out less productive and more harmful things to do like do drugs and smoke. It is no wonder kids are struggling and seeking counselors more. It is a hectic time.

Kooky Korky, BSN, RN · Sep 6, 2015

While we do have an increased awareness of mental health problems now I think some of the increase in all psych complaints coming out of school is multifaceted. Some of it possibly comes from our present expectations in society that everyone is a future rocket scientist, no one is allowed to get their feelings hurt and a discomfort score of Zero is the only one acceptable for the special little snowflakes we are raising. There are some people who are naturally more anxious than others and I hate the implication that this immediately needs to be identified, scrutinized and usually medication is demanded. That children as young as 7yo are getting a bipolar diagnosis and are being placed on meds like Lithium and Depakote because they are aggressive and oppositional makes me sick. You are fortunate to have a great therapist and hopefully she takes the grains of salt as grains of salt and is able to identify the true psychopathologies which you will see are the exceptions rather than the rule. Rule outs always include trauma, neglect and abuse. Something as obvious as a child not getting sleep because the household is up all night doing drugs and fighting can result in behavioral disturbances and often gets overlooked. Children are now kicked out of daycare for biting?? Really? Don't all kids go through the phase where they are exploring the world by biting? Which usually abruptly ends the minute a peer bites back? Maybe I'm just too old and out of touch but some of this stuff makes no sense to me.
On the flip side I'm also seeing a very limited tolerance for any behavioral disturbances in class. I have done ED assessments on kids EPd for throwing a book, hitting a peer and just being generally disruptive. I have seen patients in my OP practice who have been sent by the school for an evaluation and psych clearance prior to being able to return to school for the above "infractions". Sadly many of these children are also those with IEPs so I'm left wondering WTH? While I know having disruptive students in a classroom isn't ideal I think we are going to need to decide, are we "all inclusive"? Imo expecting children with behavioral problems to be integrated into classrooms with children who don't have these problems does a diservice to both types of students. I get that this is politically incorrect in a time when everyone who shows up for school is awarded a high school diploma but I think we need to rethink our strategies.

What do your abbreviations mean, Jules? ED IEP EPd Thanks.

Jules A, MSN · Sep 6, 2015

What do your abbreviations mean, Jules? ED IEP EPd Thanks.

Emergency Department

Individualized Education Program

Emergency Petition

:)

Jules A, MSN · Sep 7, 2015

Jules ... one interesting thing happened... which to me pointed out that this whole business of medications for mental issues really is trial and error.. As we began to wean down his zoloft... the psych PA, who has a very ... natural medicine aspect to her... recommended we give him high dose fish oil in addition. After a few months of that, I realized his mood had worsened. Took him off the fish oil and it's improved. We are probably going to wean him completely off the zoloft soon. Wanted to get him started at school before we made any big changes.

My concern with fish oil is that it can cause increased bleeding risk as can Zoloft so I'm not sure I would have gone that route but very interesting that his mood worsened. I haven't seen data that to my satisfaction

supports fish oil as especially helpful for mood or anxiety. As I'm sure you know Zoloft can have withdrawal side effects and in someone with anxiety that can be extra uncomfortable so keep that in mind as you start the taper. Good luck!

Farawyn · Sep 30, 2015

Suicidal 16 year old boy. He has a plan. He had the pills in his hand last night, but he didn't do it. He came here instead. He's in with SW, we just spent an hour with him. He's shaking and crying, he said he's scared. He let me hug him. His sister just got here. His parents are on their way.

Guys, I feel like crying.

WKShadowNP, DNP, APRN · Sep 30, 2015

I'm tearing up reading this.

Nurse Leigh · Sep 30, 2015

Suicidal 16 year old boy. He has a plan. He had the pills in his hand last night, but he didn't do it. He came here instead. He's in with SW, we just spent an hour with him. He's shaking and crying, he said he's scared. He let me hug him. His sister just got here. His parents are on their way.
Guys, I feel like crying.

So sorry for you, the student, and his family. Very glad he had the strength to put down the pills and come speak with you.

Farawyn · Sep 30, 2015

Thanks. We kept telling him how great it was that HE did that.

On his way to the hospital now with his parents.

How do you all do this for years? It's very humbling.