19 Year Old Tries to Kill Herself on Antidepressant: Her Condition Worsened on Drug for Depression

First two paragraphs read:  "My daughter, 19, is a straight-A student and very smart, but she tried to kill herself a couple of years ago."

"When that happened, a psychiatrist persuaded her to try antidepressants, which she did for six weeks but quit when she started feeling worse. She then went to a psychologist and is now in college, doing better and no longer seeing a therapist, but she says her friends sometimes tell her she needs to start taking antidepressants again, so now she thinks she should."

SSRI Stories note of caution here: The FDA Black Box warning for antidepresants and suicidality covers those aged 24 and under and this girl is only 19.

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/25/AR2010032502499.html

It will take more than sleep, good diet to help daughter's depression

By Marguerite Kelly
Friday, March 26, 2010

My daughter, 19, is a straight-A student and very smart, but she tried to kill herself a couple of years ago.

When that happened, a psychiatrist persuaded her to try antidepressants, which she did for six weeks but quit when she started feeling worse. She then went to a psychologist and is now in college, doing better and no longer seeing a therapist, but she says her friends sometimes tell her she needs to start taking antidepressants again, so now she thinks she should.

I don't think a pill is the solution to the problem. I've read a lot about these medications, and I know that research says they are not effective in most cases because they treat the symptoms, not the cause. There is a lot of marketing done by the pharmaceutical companies, but we tell her to take care of herself instead: to eat well, sleep well, get some physical exercise and think positively.

Not at all. Your daughter has tried to kill herself once, she barely gave meds a chance, and her friends think she needs to take them again. And so, indeed, does she.

Let her follow her own instincts. She's 19 years old, she's smart, she knows how she feels, and she has probably read some of the staggering number of independent studies on depression and how medication can often make it go away, especially when combined with talk therapy.

You may be tempted to wait until doctors have found the exact cause of your daughter's depression — and the perfect cure — but this could be a grave mistake. Good food, good sleep and good thoughts may turn around a pesky case of the blues, and exercise can sometimes be as effective as a drug, but it's mighty hard to go jogging when your world looks empty and gray and you feel helpless, hopeless and worthless, day after miserable day.

It's time for your daughter to find an experienced board-certified internist who listens well and is curious enough to test her for viruses, low thyroid, high cortisol, candida and many other conditions that can cause depression. If she's healthy, she then should be evaluated by a psychologist or a psychiatrist, who will ask her about any trauma or loss that she's had, any history of depression in the family, any bad PMS occurrences or any sadness in the winter, all of which can trigger depression. If these problems didn't cause her depression, she is probably dealing with one of life's sad but common surprises. Although depression often strikes in the late teens or early 20s — like bipolar disorder and schizophrenia — it can hit at other times. Ten percent of men and 25 percent of women suffer from it at some time in their lives.

Brain imaging can show that depression changes the makeup of the brain, but there is still no sovereign test to show that the neurotransmitters are out of balance, or why or by how much. The psychiatrist should be able to prescribe a drug, however, based on your daughter's symptoms. Without medication, she could fall into a clinical depression or even have a psychotic break, and then it would be much harder for her to pull out of it or to prevent recurrences.

There are 20 drugs that can correct abnormal brain chemistries, but your daughter may have to try different doses of the same medication or try two or three medications or take two of them before she finds out what works best. Only her doctor should change the dosage, however, or decide when and how she should quit a drug. If she stops precipitously, she could fall into an even deeper depression.

He may also tell her to try cognitive behavioral therapy, along with medication, since studies have found that a combination of the two is usually more effective than one of these treatments alone, but that isn't the only possibility. Your daughter could check out http://www.clinicaltrials.gov to see if her doctor could get her into a depression study at the National Institute of Mental Health, particularly one of the promising studies that are reversing depression within hours in some patients. You'll be pleased to know that these studies are excellent, free and funded by the government, not by pharmaceutical companies. To learn more about depression, read http://www.nimh.nih.gov and its fine STAR*D study.

Marguerite Kelly is a freelance writer. Questions? Send them to advice@margueritekelly.com or to Box 15310, Washington, D.C. 20003.