March 19, 2009,
J.W. asks from North Reading, MA on March 18, 2009
Need Advice on Getting My Daughter to See a Psychiatrist for an Evaluation
I am looking for anyone with experience in depression in teenagers. My daughter's therapist has told us that she needs to be evaluated by a psychiatrist for Depression. The therapist said that there is no immediate urgency, just that it needs to happen and it needs to happen before she does anything in the Fall (she is graduating from High School this June and has decided to defer college or even not go at all and treck off to Europe somewhere, that is another story...). The tricky part is that although my daughter exhibits most of the signs of teen depression she is in denial about getting help and refusing to even go back to talk to her therapist. Her step-mother is ready to hold her down and force medication down her throat while her father has suddenly become unsupportive of the whole idea of an evaluation after a first appointment with a psychiatrist that did not go very well. After talking to her therapist again, I am sure that I have to keep on this path and encourage her to try another psychiatrist. Her 18th birthday is in mid-May and that makes me very nervous as all of the good psychiatrists are either booked out to end of April or not taking new patients at all. Her therapist suggested waiting for an appointment with the psychiatrist within her own practice that she works closely with even if that means an early May appointment. I am seeking other people's experience with this-- positive, negative-- anything that will help me find the right words to tell her that this is a positive step and will help her to feel better and to be happy with her choices in life.
R.D. answers from Boston on March 19, 2009
What about finding a good psychotherapist or psychologist instead? There my be one available now and at this point it's finding someone that she can trust and talk to. Then if her and therapist decide meds would be helpful she can then go to see a psychiatrist to get a Rx if necessary.
I saw a therapist for depression when I was younger. I did go on Prozac for a while and it did help. 17/18 is a really tough age, especially with parents not being together. I don't think forcing her is going to be helpful- but what if you make a deal like if she tries it for 3 months and still hates it then you'll let it go. And then if she goes for the 3 mos you'll do something special for her like take her and her friend for a weekend trip. (I have no idea what to suggest for the latter part) But hopefully it'll get her foot in the door and she may let down her guard a little about the process and start talking.
J.A. answers from Boston on March 19, 2009
You are wise to be concerned. Although at this juncture it is a bit late to recover the high school years, I think the living one week here, one week there thing is not the best living arrangement. This gypsy sort of living may have interfered with your daughter's ability to bond to one primary caregiver.
It is possible she feels lost and is actually very anxious about her upcoming adult status. As far as I am concerned, I continued to treat my children as minors even after they turned the magical age of 18 because it was clear they were not yet adults. I acted as if nothing ever happened and continued with curfew's, expectation of homework, etc.
Your daughter will continue to need parenting for many years. I would try and stop the one week here, one week there visitation for now and keep her with you full time so you can get a better handle on her mood and behavior. It is possible your daughter may even have a more serious mental health issue that she is able to hide because of her living arrangements. The teenage years are difficult for all children, but is a prime time to see the emergence of chronic mental health conditions and getting a hold of these issues now before she begins to self medicate or seek out people who may take advantage of her is crucial.
Have you tried calling the school guidance department, or school nurse they may have resources you can try. You could also consider the DSS as a resource.
Not every child has specific goals for college, but your daughter does need to be thinking about how she plans to support herself financially. My rule was full time school or full time work or part time each. For dependancy status it is best if she is enrolled as a fulltime student next fall. That way she can remain on your health insurance. Therapy can become expensive and maintaining your health insurance will be important.
As far as education is concerned, if she does not want to seek a traditional degree, what about a certificate program? What are her interests, it is possible to study in every field from art, to forestry to marine biology. Seriously, there is something for every interest. At this point it will be important simple to get her engaged.
In regards to therapy, I would recommend a female therapist if possible and one who specializes in teens and young adults, specifically, young women.
I wish I could give you a more specific answer, I know how hard it is. All I can say is persevere, hang in there even if your daughter resists. She really is just a baby even if she doesn't know it and no one will ever love her like you love her. You are her best advocate.
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E.T. answers from Boston on March 19, 2009
Hi J., I have an excellent referral for you for your daughter. His name is Dr. Richard LeBel, and he is located in Salem, MA at One Chestnut Street. He has a lengthy resume, and his specialty is children and teens. He is quiet and friendly and sees patients in his beautiful home in a relaxed comforting atmosphere. He has a "grandfatherly" demeanor but comes with years of experience and expertise, having served on many boards of Children's Hospitals, etc. He will give you an appointment within a couple of days as he is semi-retired. Please call Dr. Richard LeBel at ###-###-####. I would be happy to fax you a copy of his resume if you like. By the way, I have come to know Dr. LeBel through a professional organization that we both belong to. Feel free to contact me to fax his resume -- E. Taft ###-###-#### ____@____.com
M.B. answers from Boston on March 18, 2009
While I do not have a teenager...yet...I have not had to deal with this directly. But thinking back to being a teenager and having friends that have children up to the age off 22 and hearing their stories of their daughters going through these depressing stages I often wonder if this is just a stage that they seem to others (adults) that they are depressed? Are they? Or are they trying to find themselves, their own identity? You say she has been seeking therapy and that is great but what really seems to be going on? Are you upset she doesn't want to go to college? do you feel she is depressed because she might not be making the "right" choices. While if there is something serious going on it does need to be treated and I think professional help is a great thing but if it is something that she is working through as she is becoming an adult now (even though we all know she is still so young) she might need support from you to talk to her about what she wants in life and what her plans are. I know this is extremely emotional and stressful but try to listen to what she is looking for even if it sounds totally crazy to you. I truly wish you the best of luck.