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

@ProudMomx3 Feeling for you right now!!! I’ve been through this, and come out on the other side. We knew nothing of my oldest’s anxiety disorder until freshman year. Turns out a lot of high-achieving kids fall apart when they move away for a variety of reasons. I was completely taken by surprise when my “golden child” became a person who needed to talk to me for hours a day (I also dreaded the phone calls at 2 a.m.) Mine made it through freshman year, but found an excellent counselor on campus. She transferred to a new school things were great… but then anxiety came back. That’s when I learned it wasn’t about the “school” it was about her. We got her the help she needed including counseling, medication, and psychiatrist. She’s now in med school, and doing amazingly well. But… the anxiety is still there and comes at very unexpected times. Over 4 years, with a lot of work, she has learned how to deal with it. The panic attacks and the long downward spiral have lessened over the years and become less severe. It is a truly an issue that is not overcome in a few weeks. Please get him help. Don’t be embarrassed by mental health issues or let him be embarrassed. It’s too big of a gamble to “wait and see” if it gets better. Mental health awareness in this country is so poorly understood. The symptoms you are describing are classic depression and anxiety. He is CRIPPLED by how bad he feels. Get him in with a Dr. Ask for referrals for counselors who work well with young men. If you are in a church, you can ask your pastor for recommendations, call your family physician for referrals, or (gasp) ask friends. You’d be surprised how many are already using a great counselor. Last, ask your son OFTEN if he feels like hurting himself or feels hopeless. Studies show just by ASKING this question reduces attempts, and opens a dialog for help, and he knows the subject is not taboo. Lots and lots of prayers and good thoughts coming to you.

Please push treatment, and if you are somewhere where there are decent treatment options, push to get him appointments. This can be treated.

Most of my adolescent and 20’s patients resist SSRIs. When they finally give them a chance, they wonder why they waited so long.

What we’re dealing with now is that D is feeling better on the meds and wondering if she can stop them. I think I’ve convinced her that the reason she’s feeling better is that she’s taking the meds. Since she had a MAJOR panic attack in February, I’m not willing to chance her going off of them yet. She’s seeing a counselor at school every week, but I think I should make an appointment with her psychiatrist during Christmas break.

I just share this, OP, to give you something to think about if your son gets to this point. It’s a common occurrence.

^Agree. We try to make any major adjustments to medicines only when our daughter is home. She has had some bad reactions so we feel more comfortable if we are around in case of adverse reactions. We have also noticed that if she skips a dose by accident that the anxiety increases. I suspect that she will be on her medicine for quite a while.

@noname97 (and everyone else) I have no idea what kind of medication she is referring to. He said she mentioned there is short term/fast acting? but that she doesn’t think it is very effective, or the long term? He had no details and didn’t speak with her on Friday (UGH), but says he has an appointment Monday. I plan to call and speak with her on Tuesday. Now that she has seen him a few times perhaps she can give me some informed advice on how to move forward. (He already signed the waiver)

@ProundMomx3, understand that my comments relate to Anxiety. I have no experience to share for depression. However, I know some of the drugs used to treat depression are use to treat anxiety.

I can say that for anxiety, short term/fast acting can be very effective for short term relief, to alleviate/stop a panic attack or for relief while waiting for a long term medicine to take effect.

Right. There are fast-acting anxiety drugs. I don’t think there are any medications for depression that make you feel better in an hour. (Not legal ones, anyway.)

Thanksgiving break is right around the corner and it is short, and De is going to be a very high stress period with finals. I would make sure he gets to see some good doctors while he is home and have them make a determination whether it would be a good idea for him to go back to school.

We’ve got a love-hate relationship with psych meds. Yes, they help a lot, but then they cause sleep issues, so more drugs. And after a while, the weight gain and the lost libido start to matter to the kid taking them. For those who get it right the first time and are lucky enough not to have to be on them for life, they rock, but I understand the trepidation, too.

SSRI’s have been life-changing for two of mine. Bipolar and depression run in the family and both have clinical conditions which responded to Lexapro. I will say, whatever the med, to start very low. MD’s often start highish with what a standard dose is and it really isn’t one size fits all. It is good to take the lowest dose possible that is still effective.

Please please get your son to take- at least try- an antidepressant (that also helps with anxiety, or start with more than one med, an SSRI and something short term or immediate for anxiety). The results can be quite surprising in terms of effectiveness.

There are methods like EMDR, tapping, Reiki and of course yoga and Tai Chi which can be tools, but right now your son is not doing well.

I don’t want to scare you but this kind of situation can be life-threatening for a young person who doesn’t comprehend that things can turn around. It sounds very biochemical, honestly.

I’ll weigh in on medications both as a family member of someone who has a mental illness and as a health professional who worked with adolescents, young adults and adults with mental illness . My niece was first diagnosed with bipolar disorder when she was 19 years old. She had a very serious break with psychotic features which required hospitalization . Of course this sounds much more severe than OPs son’s condition , but there are also a lot of similarities and things to consider in tx. Thankfully , her first break occurred while she was home for summer break, and she received help quickly . She has several subsequent episodes while away at school in which she could’ve easily died . She is a gifted flutist and artist , both tasks require excellent fine motor skills .She was a young , attractive adult searching for social acceptance at a school approx four hrs from home. She also has a twin sister who was attending the same university . She intially responded well to medications, and she had begun to improve over the summer . Against my advice, my sister allowed her to return to school that Fall. She had no local mental health support in place when she returned, they tried to manage it from a distance. Her twin system was given the daunting task of supervising her while at school. I think most of us would agree that this plan was not the best thought out option . Within 6 weeks, she stopped taking her medications because she had started having weight gain and tremors. Her grades dropped , and she was rehospitalized. She was stabilized again on meds and returned to school. This cycle continued several times until she finally found a psychiatrist who specialized in the treatment of adolescents and young adults . He told her and my sister that until he found the right medication that would not produce the side effects , she would never continue to consistently take her medications and relapses were to be expected . He tried several meds before finding a medication regimen that was acceptable to my niece . She also received psychotherapy every 2 weeks with this psychiatrist . He was local to her college, and was available to her before things escalated to crisis mode. He continued to treat her after graduation , and she managed fairly well while under his care.

My suggestions are as follows : 1. Have a thorough evaluation completed by a psychiatrist who specializes in adolescents and young adults . Young adults have different psychosocial issues than older adults which need to be considered In their treatment 2. Do not minimize the severity of his symptoms or think that things will get better in time without some sort of treatment , they may temporarily , but usually not permanently. 3. Be open to medication as a treatment option. If you are not willing to consider it, your child won’t either. There are so many new medication options that can be tried until a desirable outcome can be reached. 4. While attending school is important , it doesn’t supercede a healthy life. There are many ways to get an education that don’t involve attending a distant university . If he does return , please make sure the supports are in place before he goes back. This can be managed and successful , but it usually takes integration of a number of supports. Good luck to you family in getting him the support that he needs to succeed in life, not just academics.

The medication aspect is very unsettling for me, especially without direct supervision. (And from all of your comments it seems I should be fearful) We haven’t really discussed it, but for awhile I assumed that he would not return to school after the semester break and that in December we would address this full time at home. That is why I have been taking things one day at a time, just trying to get to the finish line. Now he has been mentioning “next semester” so it seems he plans to return. We will need to have that conversation when he gets home.

For clarification the therapist did tell him he has both depression and anxiety.

Although everyone keeps telling me that this is not just going to be okay unless I take extreme steps, I just can’t wrap my head around it. I barely keep afloat myself after losing my husband and I can’t believe this is happening as well.

@hanna I appreciate the levity! “(Not legal ones, anyway.)”

@ProudMomx3 Medications for anxiety and depression should not worry you . They treat a chemical imbalance in the body just like medications for a heart condition or any other physical condition . The medications that gave my niece difficulty were ones that she was prescribed for the psychotic symptoms she had from bipolar disorder . There are many medications out there with very few , if any side effects . You probably have encounters with people everyday who are on medications that you don’t even realize are on them because they are properly medicated. While the medication side effects for my niece were not ideal , they were better than the alternative of no medication. Many times young adults do use other nonprescribed drugs to treat their symptoms as well.

We have a similar story to carolinamom’s in our family, with the child in question going on and off meds, hospitals etc. I would say that her ultimate med combo does have side effects, but she has learned she must accept them. Lithium is tolerable even though the window between therapeutic and toxic is small. People with disorders like bipolar or schizophrenia DO have to live with side effects.

It does not seem as if your son will be diagnosed with bipolar disorder, which requires some heavy duty meds at various times, and over a lifetime. I just wanted to say that. I do not think, generally, that SSRI’s have side effects that people are bothered by, at least if the right one is found. Some are activating, some are sedating. Starting with a low dose, playing around with timing, that kind of thing, can help.

He may be having an “adjustment disorder” over transition to school, a late reaction to his father’s death (this happened to me two years after), or he may have developed a depression and/or anxiety condition that is more long term than just the adjustment situation.

In any case, to me, the best argument for SSRI’s or whatever works for him, beyond relief of pain, is that they can prevent his life from going off on a tangent that can be prevented with meds. We were told that SSRI’s actually heal the brain over a year’s time. And taking them in a situation like this can prevent lasting bad decisions that can affect a life.

There really are many ways to finish school but it would seem he wants to continue, or return, where he is. That is a huge argument for medication, honestly.

OP, what several of us are telling you is that we wish we had taken STRONGER action when these young adults started having trouble. I let my son stay in Austin too long, because he (and we) were convinced he would be OK. He wasn’t. He became very suicidal, in fact. The downside of bringing him home would have been MUCH less than what happened. Believe me, we all know how you feel. It’s overwhelming. But in the long term, it’s better to deal with everything now, before tthe situation gets worse. And if it is just temporary, he can go back with no difficulty.

Maine Longhorn, yes, wishing I/we had “gotten it” earlier. I sometimes thing that clinging to normalcy is exactly how kids end up losing that normalcy. More “normalcy” by dealing with it now and returning than persevering, perhaps. Meds truly help support normalcy until (if and when) it becomes natural again.

What @MaineLonghorn said. We really understand how much you want to believe that it’s going to be ok, that you’ll get him to the doc and he’ll get some meds, do a short course of therapy, and everything will be fine. but a month home, over Christmas, is not long enough to have any kind of certainty that it will. Now, you don’t have to keep him home doing nothing. There are community colleges, part time jobs. There’s a lot of space between back at a distant school full time and home doing nothing

I would not be fearful of medication. The reality is that the right medication can turn your son from someone who is just trying to survive the day into hopefully someone who is looking forward to the day.

I don’t think anybody here wants to scare you with our war stories. The advice given for better or worst might help you avoid some of the mistakes that we have made.

I am glad that you are strongly advising you son to take time off. My daughter was adamant that she wanted to finish her semester when this started. After discussing it with the doctor, we agreed. After surviving (yes that is the proper word) the semester she said NEVER again would she attempt it in that mental state. The tools gained (both medication and therapy) during her time off have enable her to return but the struggle continues.

OP - what you describe with your son is exactly what my son was experiencing at the end of his freshman year. We were lucky to have the summer. My very independent, social, happy son spent many nights snoozing with his momma - he didn’t want to be alone. He went through talk therapy and then we decided on medicine. He is on Lexapro - 10 mg and he only started it 2 weeks before he went back to school. He is doing great and his grades are great. The only side effect is some weight gain which doesn’t seem to bother him too much. He is home for Thanksgiving now and has an appointment with his psychiatrist to “check in” but he said he has not had any “episodes” of feeling sad or high anxiety. His diagnosis was major depression and anxiety which is very odd because he is very happy, social person. The doctor told us that about 60% of people with depression are happy! I really think this is a chemical imbalance that the meds are fixing - not unlike a physical ailment. I would highly recommend seriously considering a low dose medicine.