Teen scared of taking Fluoxetine

It’s ok! I am aware myself that as a mum I am just so desperate to find something that helps but trying to step back and ‘partner’ rather than ‘parent’

I want to add to this about my own experience. I started taking a Nootropics blend (a bit like a mushroom salad with Lion's Mane and Reishi) daily. My son is 27 and now feels the benefit from them as well. They take time to work, but a good blend will boost clarity and focus, the immune system and Vit D, they can help heal the gut and lower anxiety. All because they happen to boost the gut-brain axis (GABA). 

However, there are the more rare moments (once or twice a month now) that a song is looping in my head creating such excitement (the other side of the coin to anxiety) or a work project is looping through my head which cannot be resolved immediately because it actually takes a few weeks or months of waking, working, sleep, repeat to get to the end. Things which demand resolution can take over my brain and this is when I  might take a half dose of anti-anxiety medication to sleep. They should never be taken more than a few days on repeat in my opinion. 

My son had tried anti-depressants around the same age as yours and they didn't help. He was on and off for a few years trying different ones and one really made everything worse. I wish I'd known then what I know now, but after Uni we switched to an immune building nootropics blend and it made all the difference. In reality, his father was battling cancer, money was also short, among other things. But I also encouraged therapy, minding nutrition, finding a sport, talking through complicated problems, and engaging in self-directed research for what we didn't know. Along with minding human biology - not sleeping in polyesters (wool bedding regulates temperature), a halogen lamp for reading at night, black out curtains, downloading a decibel reader to better address piercing sounds and having ear plugs, and so on. And then reinforcing one introverted day at least every other week. No interruptions, no questions, just rest. These all help. 

I've posted my findings and experience before on these threads. 

Anti-anxiety medications are designed to boost GABA.

Anti-depressants will lower GABA. SSRIs suppress the heart rate and interfere with hormones - this might be necessary in extreme cases.

A great deal of medical reports are now finding one of the biological differences of Autistic and ADHD is lower GABA. Which acts as an Inhibitor in the brain for pruning pathways and calming down waves spiralling out of control (looping thoughts which need resolution). GABA also helps with the brains ability to Filter incoming signals so they're not 'too real' (Bayesian theory on Autism). In other words, everything will impact with a greater intensity. 

Often, more extreme highs and lows in emotions are part and parcel with this intensity of experience. As we grow we need more protection from external sources and more understanding of our physical and social surroundings to help make sense of them. We need a more grounding. 

Sometimes allowing the self to simply ride out the emotions and work through them can help build a sense of understanding that feelings come and go. However, when the emotions are far beyond our control (this is the opposite of Depression, or being de-compressed) it can cause one to stay too long in Survival Mode: fight, flight, freeze or fawn and can continue to impact our bodies in traumatic ways. Anti-depressants are not helpful for this, they can make it worse, as this extreme stress is Anxiety. Not depression. 

Hi! Of course. I didn’t meant to imply you were rushing him! It sounds like you are doing an amazing job supporting him. I just wanted to say that it can take a long time as I myself have found this very frustrating and it can make it really hard to stay positive and to see the small changes. I hope he can reengage with therapy. 

I have found exercise to have a surprisingly strong positive effect on my anxiety. If he is too anxious to go outside to exercise, can he exercise at home? Although being outside also helps if he can manage that.

Thanks for this -10mg for the first week moving up to 20mg after that.

glad it worked for you

Hello thank you - will check out DBT online.

I think you’re right- one of his concerns is that if he starts taking meds when he’s feeling anxious about the side effects he won’t feel well on them because he will imagine side effects even if they aren’t there! So tricky! 

Hello thanks for your reply and helpful advice. Yes since his burnout all pressure has been off, he’s not even making regular visits to see his dad and there is no pressure to re engage with education and his doing everything on his terms 

He has successfully engaged with therapy in the past and the aim is to help him re engage with that. We are not trying to rush the recovery simply wanting a better quality of life for him. 

Hi, I think whatever your son decides to do, it’s important that it is his decision and that he stands for it. I can understand his concerns- I have myself refused repeatedly to take antidepressants as I am anxious about taking any medication that affects my brain, worried about side effects and crucially I felt that I was feeling anxious and depressed because of my situation and I wanted to rather work on changing my situation than taking medication to make it more bearable. (Though of course medication can also help support someone to take positive steps and change things). I believe that anxiety and depression are not only intrinsic but that there is also a large external component- the environment we are in plays a huge role. Are there any factors in his environment that your son might be able to change? Why has it been difficult to engage with therapy? Is it the way it is delivered (ie phone or video or in person)? Therapy through NHS is often not autism specific which can make it inaccessible and unhelpful for autistic individuals. I’ve found therapy quite unhelpful in past and have become less and less enthusiastic to even give it a try- but recently I had a few sessions privately with a therapist working mainly with neurodivergent individuals who is actually late diagnosed autistic himself- and it has been so so much better- it is so much easier to talk to this therapist and whilst I can’t comment yet on the long term effect , it’s at least not making me more exhausted or anxious and depressed to engage. Could you possibly look for a therapist who is experienced in working with autistic individuals? Your son might be able to engage with therapy (with or without medication ) if it is the right kind of therapy, with the right therapist. 

What you don’t want to happen is for your son to take medication because he feels pressured to do so- it might just create resentment and it will likely increase anxiety. 

I think whatever he decides is a good and valid choice. He has to be comfortable with it. 

It can take a long time to feel better and figure out what works for you- and the changes are often very small so it is hard to notice them- I know it must feel like a long time that your son has been out of school. I just want you to know that it is normal for this to take time and that it can sometimes be hard to see improvement. 

Caution is wise when taking any new medication, especially things that primarily affect the brain as it is often unpredictable. My own experience with fluoxetine was overall positive (very few side effects and eventually I was able to stop and maintain the good habits I built on fluoxetine without medication), but I began taking it for depression rather than anxiety, and was practically begging them for medication to help. I do believe the outlook you have before starting fluoxetine influences the side effects you experience, as the people I know who felt they were in control of the decision to start/did not feel coerced in any way have had minimal side effects- I do not say this to minimise the likelihood of side effects as it is not currently possible to predict how someone will respond, but to discourage you from trying to encourage him to make a decision he is not fully comfortable with (even if you are not being 'intense' about it). 

Have you discussed other medications that may be available? I know the selection for paediatrics is more narrow, but he may feel more comfortable if there is a choice? I would also highly recommend some of the DBT resources available online.

Hi I’m on fluoxetine 30mg I assume you’re on the starting dose of 20mg? Give it a couple of weeks and see how you feel. I found it helped me sleep and quietened my mind I now don’t go without it. I’ve found it’s the only one that helps for me without major side effects but it’s all based on personal experience. Good luck  

Based upon my own personal experience of SSRIs I think your son is rightly cautious. The 'side effects' can be severe and life threatening. The warnings about increased risk of suicide are there for a reason and the risk is increased for younger patients.

If I had not experienced this myself I would not have believed it. I was put on them purely for anxiety and did not have suicidal thoughts prior to taking them. Within a few months of being on them I was experiencing constant suicidal ideation and seriously planning to act. I could not think of anything else 24/7. My anxiety had become significantly worse and and I was severely agitated. It was the most terrifying experience that I would not wish on anyone. It is known as SSRI-induced activation syndrome.

https://en.wikipedia.org/wiki/Activation_syndrome

They do help some people but for others they can be dangerous. That's why it really does have to be the patient choice if they decide to take the risk or not. I was bullied by my GP into taking them and lived to regret it. At least I lived to tell the tale, sadly others do not.

Thanks for sharing and sorry to hear your experience was negative. I am also encouraging him to try and exercise a little. 

I was prescribed fluoxetine when l was 21. It made me feel worse and I took an overdose of them. 

Exercise has helped me for the most part. But l did get prescribed sertraline recently for anxiety. That's also made me feel worse and I'll be binning them tomorrow!

Don't want to sound too negative. Just my experience of medication! 

I restisted taking anything for years and now I wish I'd started taking them a lot earlier, yes there are loads of possible side effects, but there are also lots of possitives too. I found they (paroxitine) made my rational self able to come to the fore a bit more and stop me being so anxious and at times paranoid.

Thank you yes I have explained that. It’s good to hear you had a positive experience

Sorry to hear your experience wasn’t good and thanks for sharing. Unfortunately changes in lifestyle such as exercise are difficult at the moment as he is just so anxious. 

I had a truly awful experience with prozac/fluoxetine.

I found that it removed the carefully installed limititations I had placed on my own behaviour and literally made me more evil. 

After that particular experience, NONE of which went as I was led to believe it would by the medical profession, I realised I was better off working my own problems out.

OTOH I have a friend who takes the prozac and he doesn't seem to suffer ANY of the effects that I did.

All I know is that I started out depressed and then I had prozac and a few days later ended up dealing with what I can only describe as a psychotic ideation which seemed really real to me at the time, but I could see was logically impossible. Against all advice I discontinued the stuff STAT, and my life gradually returned to normal.

I concluded that I'd rather be a bit unhappy struggling with the life I had, than become actually dangerously bonkers. 

30 years later I find out that I am Autistic, and that my depression was not an "illness" but an understancable reaction to the life I had then.

I then made changes to my life, to improve my own situation, including handing the keys back to the house that I was seriously underwater with... 

Perhaps not a particularly helpful post, I know, but MH care is a bit of a lottery, and getting it can ruin your life just as easily as it can make it better. 

I can trot out some M/H "horror stories", whcih underpins my caution when seeking help with my own issues, but all that shows is that some people are lucky and get help that works and some are not and get help that makes things worse for them, as I describe above.

I hear good things about regular excercise being vital to some peoples M/H, Also there's a lot of work being done right now about how dietary deficiencies might play a part in some MH issues.       

yeah... i dont take antidepressives or anything due to that too... if i was offered anti-psycotics id also refuse them due to their side effects...

your son is very smart, trust him, he has seen quite clearly what you have not.

alot of these pills turn you into a monstrosity, they make you gain lots of weight then you will be a person who you hate just for that... imagine being fit atheltic decent shape... like a propper human.... like a main character in a film or game... then you take some god forsaken pill and it turns you into a whale without you the ability to prevent it or turn it back. permanent damage that destroys who you are and your own sense of worth... theres no reason to take pills that do that, the symptoms and personality people call a disorder is more worth embracing, than it is turning into the blob...

Thank you yes perhaps this isn’t the best place to post thanks for the advice. I am realising I need to back off a bit and allow him to process and take it at his own speed.