<p>I can't believe I'm asking this question here -- I've only ever been on the forum for my daughter's university. But I've looked at similar threads and am thinking maybe there's a broad enough spectrum of people on CC who might have good advice for us. I have an almost 17 year old son who in the past has been in the gifted program, was successful academically, felt comfortable socially, and played soccer. We began to see changes in 8th grade, enrolled him in counseling in 9th grade, and saw remarkable progress in 10th grade as he got very involved in cross country and academic bowl. This summer he lost a long-term girlfriend and asked us for help because he was scared he would hurt himself due to severe depression. He has had 2 psychiatric admissions, started anti-depressants (had a terrible reaction to Zoloft and actually made a half-hearted attempt), and continues in counseling on a weekly basis with a counselor he trusts and likes. He has just completed a full neuropsychological evaluation to look for firm diagnoses, including ADD which he was able to mask due to being a bright kid. The meds, in my opinion, have been a disaster. He is no longer on anti-depressant although his psychiatrist (who has a reputation of being "a saint") has left him on Risperdal to serve as a mood stabilizer. We have pulled him from a large public school (where ex-girlfriend remains) and put him in a private school. He hates it socially but will admit he is doing ok academicallly, including 2 AP courses. I'm just wondering if anybody out there who has gone through similar experiences could suggest other things we might try. Every professional who meets him says "this is not typical depression." He doesn't fit very neatly into any diagnostic category (not manic so not bipolar, has close long term friendships so not borderline personality disorder, etc). I just feel at a loss as a parent, and we'd try about anything at this point to provide him with some relief.</p>
<p>It sounds as if you are doing all the right things, WhitLo. One thing that occurs to me is that if the counseling is helping, maybe increase the frequency to twice a week.</p>
<p>What are his symptoms? How is he different? Is he not really depressed then? Or is it some rare type of depression? I mean is it a phase and we are messing the natural getting over it with all the meds? I am not trying to be snarky, these are real questions. Why medication in the first place? What was happening that was so serious he had to be drugged? I am all for meds and help, but sometimes I feel we jump the gun.</p>
<p>What caused the hospital admissions? Is he suicidal? Is he eating? Does he just feel crudey? Is it hormonal? Was he hospitalized before or after the meds. Meds can mess up a head if given in wrong dosages. I have a friend who had a rough time after his bf died. He was put on meds which made it sooo much worse. Took a year to get back. Not saying this is the issue, but it can make a hard situation so much worse.</p>
<p>The brain changes when medicated and wrongly medicated can cause odd symptoms which are then misdiagnosed.</p>
<p>I think I suicidal thoughts are worthy of considering meds </p>
<p>Has he tried Cognitive therapy? Cognitive therapy gives you a tool box of sorts to help when you get particular feelings.</p>
<p>Other ideas:
exercise -although I know you can’t exercise yourself out of a major depression it may help symptoms (especially if he is not currently getting any activity)</p>
<p>Meditation -has been shown to be effective with teenagers</p>
<p>I feel for you. Having a child who is suffering is hard for everyone</p>
<p>Someone said to me the other day “you are only as happy as your unhappiest child”</p>
<p>Suicidal thoughts don’t necessarily mean hard drugs are given to teen brain. Reading the FDA alerts re zoloft should be something to consider. </p>
<p>Was the kid drugged before he talked to a counselor or was he just medicated?</p>
<p>Again what is happening now?</p>
<p>If your son is not bipolar or schizophrenic or suffering from a mood disorder, I don’t understand the need for Risperdal. I would try to find a psychiatrist who specializes in ADD, sometimes patients present with symptoms that are as a result of dealing with ADD, and oftentimes, there are co-morbid disorders. This may be why the professionals state that your son exhibits atypical symptoms of depression. Was the evaluation done by a neuropsychiatrist or neurologist? I would see if there is a local chapter of CH.A.D.D., (Children and Adults with Attention Deficit Disorder), they can offer wonderful support and advice. Wishing you good luck, it can be a long journey, follow your instincts.</p>
<p>I would also suggest a full and complete physical including blood work. Perhaps there is something else going on, and the depression is a symptom. You are doing all the right things - hang in there!</p>
<p>Apart from Zoloft (which apparently made him suicidal), what were the side effects of other antidepressants tried? Did he become hyper on any of them? Is he not able to take any of them?</p>
<p>Risperdal is an interesting choice. How does he feel on it? Does he mind it? Was there anxiety, or any violence involved? I hear more about Seroquel as an antipsychotic that helps depression, and abilify is also used a lot.</p>
<p>If changes started in 8th grade, there might be a hormonal trigger, and he could have an “activated depression” that is part of the brain sort of reconstructing itself in his now later teens.</p>
<p>Or, your son’s situation could be in flux, and you might be seeing the start of some longer lasting brain-based disorder.</p>
<p>Bipolar 2 can involve long depressions with hypomania that isn’t really that apparent. If that were the problem, then SSRI’s and ADHD meds could both cause problems. Has he tried meds for ADHD? What happened? Has anyone tried Lithium or thought about it?</p>
<p>For brain-based disorders like bipolar or schizophrenia, therapy can be helpful in dealing with the illness but cannot address the cause. These disorders are not emotional disturbances. I think finding someone to diagnose and figure out medications is more important than increasing therapy, unless your son asks for it.</p>
<p>Some people use exercise (which studies prove affects depression), change diet (remove gluten and dairy), do mega vitamins, do yoga or meditation or even self-hypnosis. Of all these alternatives to meds, I think exercise is the best, though a deeply depressed person can have trouble even moving limbs. It does sound as if running was helpful in the past.</p>
<p>Things will become clearer. It is hard to just say that, I know. It is hard to watch your child suffer but it sounds like you are a great parent and he has you on his side. If things get tough, he could always leave school and finish online. That can remove a lot of stress for some kids. Getting a GED is an option too.</p>
<p>There are many other anti-depressants than Zoloft. What else has been tried? What were his reactions to them? People have widely varying responses between the different drugs even within the same class. The suicidal tendencies from Zoloft sometimes come when someone is actually getting better–the patient finally has enough energy to act on their impulses. Exercise raises serotonin levels in the brain which is why it helps in mild depression;however if the levels are too low the brain needs help in replenishing the levels.
I’m trying to figure out the use of Risperdal in your son’s case from what you have told us.</p>
<p>I wouldn’t rule out a bipolar diagnosis based solely on the fact that your son is not experiencing manic episodes. Bipolar can manifest itself in many different ways, and does not always include obviously manic periods. Getting a proper diagnosis is a key first-step. </p>
<p>Our son also had a horrible reaction to typical antidepressants but that didn’t mean that other medications wouldn’t be helpful. (Welbutrin is another med that is prescribed for atypical depression and has been worked well for our son.) Risperdol is often used off-label for anxiety and drug-resistant depression, so its prescription isn’t as odd as it might seem at first glance. </p>
<p>Also, based on our own experience, there are a few things that I would recommend—in addition to getting the proper diagnosis and medication protocol:
• Exercise has been a godsend for our son. He can tell by his mood if he hasn’t been moving enough. “You need a run” is common first-step advice in our household when our son is feeling either down or antsy.
• Cognitive therapy has been a remarkable help to him. It provides tools to deal with moods, and has made our son feel more in control of things.
• It’s important that as parents you keep plugged into his life. While you want to foster independence, monitoring behavior and providing family support to make sure that he isn’t self-medicating with alcohol or recreational drugs and that he isn’t overwhelmed is also needed.
• And, acknowledging that adolescence is hard (especially those last couple years of high school and first year or so of college) and even harder when dealing with a mood disorder. We found that as a family we had to scale back some expectations—fewer ECs and AAU sports, accepting some less-than-stellar grades from a kid who can do the work when he’s feeling fine but has trouble concentrating when dealing with his depression and anxiety, keeping those issues as well as academic goals in mind when making college decisions.
• Keep talking and make sure that his friends are aware and supportive. (Our son’s friends have been wonderfully caring, especially during times of crisis.)</p>
<p>In addition to all of these suggestions, I STRONGLY urge you to find your local NAMI (National Alliance on Mental Illness) affiliate. NAMI offers a 12-week Family-to-Family education class that is FREE. It’s like a college course - you get a thick binder that you fill up with lots of up-to date info on symptoms, meds, coping strategies, problem solving, etc., etc. It helped me SO MUCH as I tried to comprehend what my two sons are going through (one has schizoaffective disorder and one has bipolar disorder). I really cannot stress enough how wonderful this class was - just hearing the experiences of the other family members (mostly parents) meant a lot. I also learned that the process parents go through when their child is diagnosed is very similar to the stages of grief.</p>
<p>Here are two links. PLEASE click on them!</p>
<p>[NAMI:</a> National Alliance on Mental Illness | State & Local NAMIs](<a href=“http://www.nami.org/template.cfm?section=Your_Local_Nami]NAMI:”>http://www.nami.org/template.cfm?section=Your_Local_Nami)</p>
<p>[NAMI:</a> National Alliance on Mental Illness | Family-to-Family](<a href=“http://www.nami.org/Template.cfm?Section=Family-to-Family&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=4&ContentID=85606]NAMI:”>http://www.nami.org/Template.cfm?Section=Family-to-Family&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=4&ContentID=85606)</p>