Freshman S-depression, anxiety, panic attacks-withdraw now, or stay and probably fail out?

OP- big hug, this is surely challenging.

But I want to probe your feelings about him not being in college right now.

If he isn’t excited about learning right now (whether because of depression or anxiety or still in active grief over his dad) why pay for him to be in college? Which at the end of the day- is an institution for learning?

Why not get comfortable with the idea that he’s not getting out of it what he could be getting out of it- and putting a pin in his education for now?

Yes to therapy and any other active interventions to get him healthy. But why does this need to be about how to get him back to college as quickly as possible when he’s signalling to you big time that he’s not taking advantage of the oppoortunities???

I think this applies to a LOT of kids out there. They don’t really want to be in college, but they know their future career prospects require it, but they don’t know what kind of career they want, but if they weren’t in college what would they be doing instead, and all their friends are in college, and and and. They go to college because they don’t know what else to do with themselves. But then college is hard work and there isn’t the structure of high school – the knowledge that you’d get in trouble if you didn’t show up to class, etc. – to force them to get stuff done.

He has to find his own reason for being in college – whether that’s an interest in the studies, a career goal, or even just enjoying college life. Plenty of kids get through college not really liking their classes that much, but not hating them either and just sticking with it because they enjoy the rest of the college experience. But . . . they can’t get to that mental place if they’re depressed.

Telling him to put on his big-boy pants isn’t going to help at all. He has to find a reason to WANT to be in college and get his work done – and “because that’s what responsible adults do” is not going to cut it.

I agree that proper diagnosis is the key. It is hard to know if the therapist that recommended medication evaluation was a clinical psychologist. We are fortunate that at the school that my son attends has clinical psychologists on staff, and there is a major teaching hospital with well trained staff available

It doesn’t matter if it’s a clinical psychologist or a clinical social worker. The only person who is qualified to make a meaningful diagnosis in a case like this is a psychiatrist.

I disagree @citymama9 . A clinical psychologist could certainly diagnose depression. A psychiatrist would need to prescribe meds, but a clinical psychologist can make the diagnosis .

My kid’s psychiatrist referred her to a clinical psychologist for testing when she needed more thorough documentation.

A clinical social worker is also trained to make a diagnosis, but in a case like this I think a psychiatrist should be seen. What I’m trying to say is that a clinical psychologist really isn’t more qualifed than a clinical social worker to make a diagnosis, but a psychiatrist is in a better position than the others based on training. Just my opinion as a clinician. @carolinamom2boys

I guess it’s personal preference . I’m also a clinician with experience in mental health including young adults and adolescents.

Then you know that we are all trained to go through the DSM and come up with a diagnosis. However, since he possibly needs medication, a diagnosis by a medical doctor would be best, imo. If he was my client/patient I would want a second opinion. That’s where the psychiatrist comes in.

“Meltdowns that make no sense? This was not a high pressure situation that caused him to curl up on his bed ranting and sobbing-it was simple homework.”

This is what I meant when I use the rollercoaster analogy. Extreme ups and downs. I have seen this with my daughter’s anxiety. Mental illness like this can totally distort the way the person thinks. It can turn pimples into mountains. While the homework appear simple and low pressure to you, that is NOT how your son saw it. To him it was likely highly stressful and overwhelming. Should it be? No but he is not processing things normally right now. On the outside, things can appear normal especially when not under stress. On the inside he could be fighting to keep control. Then stress hits and the pot boil over uncontrollably.

I urge you to take the winter break and evaluate whether he needs to take time off. I would discuss this with this therapist and come up with a realistic plan for going forward. Do not underestimate the impact this is having on your son.

As a side note, it is likely that your son will do everything possible to appear normal and in control in public and then lose it in private. I suspect that this could be part of what you are seeing. Appearing like everybody else to his friends and classmates is likely VERY important to him. This “show no weakness” attitude can be very common on campuses.

I agree @citymama9 that a psychiatrist is needed for medication management and assessment. Sometimes it’s easier to initiate tx with another mental health professional who can facilitate a referral.

First semester freshman year can be overwhelming for many kids, even those without mental health issues or that are dealing with grief. He is doing fine in the remaining classes - which means that even though he says it doesn’t matter, he is still doing the work and plowing forward. Absolutely he needs counseling and may end up needing a break from college. Or he may end up recognizing that he got through this semester reasonably well and be more enthusiastic about going back in the spring.

It is also not unusual for 18 yo guys to engage in magical thinking or to ignore tough issues. However, your son has taken positive steps including going to the counseling center. I am not saying he is not depressed or doesn’t need medication, just that not every thing he is doing necessarily signals some deeper issue.

Hugs to you and hope that finals go well and that he feels more confident in remaining at college when he comes home for winter break. Or that he decides he really needs a break and sets a path for that.

There will be more red flags if he gets all Fs and then tries to transfer with those Fs when he tries again. Those Fs will follow him years later and will always affect his GPA even if he takes a break from school and then tries to go back. There is no “do over”. Always better to take the Ws in every single case!

@carolinamom2boys @citymama9

That’s how it worked for us. Therapist (Psy D) referred us to the psychiatrist. It was reassuring how much respect they have for one another’s practice, and to know they would be in communication with one another.

On a side note, our first foray was Primary Care Physician who referred us to a psychiatrist and that went badly. No communication between PCP and psychiatrist and the psychiatrist would not return a phone call. We felt we weren’t really “under her care”. Therapist helped out with a different referral, which turned out to be excellent.

Point is, don’t give up. Keep knocking on doors until you find a good fit.

I concur with @noname87 Same with my daughter - anxiety and heightened perception. It’s tough. After 3 therapists, D is now seeing a psychiatrist that she likes who could prescribe meds if/when it becomes necessary.

Her prior two psychologists were not helpful and she didn’t like the idea that she would have to “re-explain” everything to someone new to get meds if it came to that. So 6 months later, we found a Psychiatrist that also specializes in Cognitive Behavioral Therapy which seems to be helping because it helps to give her coping skills when situations arise that cause anxiety. She often perceives situations differently than other people and she’s aware of that and asks for help and for tools to help her work through it.

I think you mentioned before @proudmomx3 that he WAS considering taking some time after the semester is over?

Wow, so much information to process.

For what it’s worth I checked the credentials of the therapist he has been seeing. She has a PhD in Clinical Psychology w/ post doc at Harvard Med, is a Licensed Psychologist, is Executive Director of the Center, and an Associate Dean of Student Life. Since there was a lot of discussion up thread (that is Greek to me) I thought that info might help.

Am I correct that only Psychiatrists can prescribe? The PCP is tricky because his Pediatrician left the area and he had to transition anyway since he turned18. I made an appointment with a new Dr. for December but I imagine it will be dicey for S to get that conversation going. So yes, I am planning to have him see a Psychiatrist during break.

@Fishnlines29 Plans for next semester have always been vague. When he is overwhelmed I tell him not to worry about next semester, that he doesn’t have to go back if he doesn’t want to. When he planned his schedule for next semester I went along. I just follow his lead. He has never seriously talked about not going back.

@dustypig Of course I would never actually tell him to “put his big boys pants on.” I hope no one took that seriously! I’m clueless, but aware enough to tread very lightly with my words and actions.

What you and your son are going through is extremely stressful.

The most promising aspect is that he came to you AND you and he are working together. That’s truly a major positive to feel strength and reassurance from.

He’s very fortunate to be seen by the Director of the Mental Health Center. As a clinical psychologist, she’ll be able to evaluate (diagnose) and recommend treatment.

One possible factor that might be contributing to his symptoms is not getting enough sunlight. Some people’s depressive symptoms occur in the winter, when there’s less sunlight, and are diagnosed with Seasonal Affective Disorder. Treatment is light therapy. Response to this treatment is fairly quick.

Feel free to PM me, if you have questions.

I don’t want to highjack this thread, but a quick something, if I may.

@MaineLonghorn & others who have mentioned NAMI here and in other past threads. Thank you. I didn’t know anything about the organization or what it did, but after several mentions, I looked it up. I’m going to be brave and attend a family support meeting this month, for the first time.

Very grateful for those who share their stories and advice on this forum. Helps a LOT. You’re doing good work, people! Thank you!

@Midwest67, that’s wonderful! Thanks for telling us.

@Midwest67 That’s great! There has been so much information dispensed that I can’t begin to absorb it all and I am glad others are benefiting as well.