prozac for teenagers-climbing related


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Juan Maderita

Trad climber
"OBcean" San Diego, CA
May 3, 2013 - 09:50pm PT
Wow, you got an entire half hour with the doc? !!! Must have good insurance (insert humor here). Unfortunately, that is what psychiatry has come to. Follow-up appts are even shorter.

Oops, re-reading this, I missed it when I wrote my last post:
My daughter is a runner, so no issue there, though they say she is anorexic.

Does she exhibit symptoms of anorexia nervosa?
Any body dysmorphia?
Does she additionally have exercise anorexia? (aka: exercise athletica, compulsive exercise, hpergymnasia, sports anorexia)
How many miles does she run in a day or week? Does she carefully keep track of her miles and/or times. Is she agitated if she misses a workout? Depressed or angry over a slower time/less mileage?

It all points to brain chemistry problems in the area of OCD, compulsive, anorexic. Onset of those symptoms is most likely to occur with females, and in their teens/early twenties. While OCD is most commonly treated with SSRI's, I've heard that the effectiveness of Prozac on anorexia is poor. That study was several years ago. Sorry, I'm not up on current research with anorexia.

Your daughter will benefit by supportive psychotherapy to deal with the burden of constant and repetitive thoughts. Cognitive Behavior Therapy (CBT) has been shown to be effective with OCD. Look for a therapist who specializes in OCD and eating disorders.

In my limited experience, anorexia combined with compulsive exercise and OCD is hard to treat. The person who suffers from that combination might reject medication or any attempts to help. Because they really believe (ego syntonic thoughts) they are "fat" and that the exercise is healthy, they will argue to maintain their over-exercise and non-eating regimen. In a sense, they like where they're at, even if it's damaging their body. Adding to the problem is that some people gain weight on SSRIs, particularly Paxil. For the exercise-anorexic, that pill is "dealing with the devil."

The suicidal ideation may be the result of years of struggling to cope with the OCD, anxiety, body image and consequent low self-esteem. Depression may not have been the primary issue, but is it now due to the risk of suicide. Depression is often "cured" without relapse. Your daughter's syptoms are likely to be a chronic problem which must be managed.

Not trying to be pessimistic about her prognosis; just pointing out the need for highly skilled and knowledgeable psychiatrist and therapist in those specific areas.

No abuse/neglect-though it does make us wonder.
She should be interviewed by a skilled professional to rule out a history of sexual abuse. Firstly, because the prevalence is so high. Secondly, the co-occurrence with anorexia is high.

Social climber
joshua tree
May 3, 2013 - 10:05pm PT
Medication of ANYKIND is NEVER the answer to ANY problem. . Period. Period. Period. .

ALL ur answers r in the Bible!

Get a clue

May 3, 2013 - 10:07pm PT
get that sheeit and send it to me.

Social climber
It's Ault or Nunn south of Shy Annie
May 3, 2013 - 10:08pm PT
Hope you're hanging in there. So sorry to hear about Jennie-glad her med. is helpng. My opinion,(and it's just that,an opinion), is purely anecdotal based on 30+ years of experience of myself and my wife in and out of the medical field.

Take care man,
joy bar

Topic Author's Reply - May 3, 2013 - 10:17pm PT
"She should be interviewed by a skilled professional to rule out a history of sexual abuse. Firstly, because the prevalence is so high. Secondly, the co-occurrence with anorexia is high."

I agree.
Jebus H Bomz

Peavine Basecamp
May 4, 2013 - 09:59am PT
My best friend and paramedic partner offed himself on Prozac!

Like overdosed? They generally don't turn the trick as well as the tricyclic antidepressants, but in quantity.... Sorry to hear you lost a friend that way though, I can't imagine how bad that must feel.

I'm torn on the issue. Antidepressants work for some and not for others. Some supplements like fish oil have proven to work as well as antidepressants! But if you are worried (as you have the right) I would have your daughter go to therapy. Docs love to prescribe and don't always do the right thing concerning therapies that will solve the underlying issues. This is true even in regards to physical therapy.

SF bay area
May 4, 2013 - 11:13am PT
Diet changes can help. Reduce junk/processed foods, more fruits, veggies and greens. If she is a runner, she may be interested in fueling her body properly.

Also, just not getting enough calories can cause mood problems. My world looks much better to me when I'm fully carbed.
joy bar

Topic Author's Reply - May 4, 2013 - 11:58am PT
The docs keep trying to pressure us into prescribing prozac.

Therapy and some natural supplements does seem a better approach for the
situation. The one medication for all approach really freaks us out.

(not OCD-doesn't keep track if how much she runs, doesn't need to run everyday)

Social climber
It's Ault or Nunn south of Shy Annie
May 4, 2013 - 11:23pm PT
Not OD'ed, he hung himself.

Mountain climber
Anchorage AK, Reno NV
May 5, 2013 - 01:52am PT
If you can find a very good in house longterm facility that you can afford I would recommend it.

Meds can help. DO not fear any of them if supervised properly with a willingness to adjust until properly fitted is the plan.

The brain is a sensitive organ. Chemical imbalances can create very destructive behavior for no other rational cause. For youngsters this is often a temporary issue but a critical one while it is in effect. Life is sooo good that even at the worst of times there is no reason to be so deeply upset. If they can't see that fact something is very wrong. Anytime anyone young and basically healthy is considering suicide it is time for whatever measures to protect them until whatever needs fixing is fixed.

If you keep getting the same answer over and over from several professionals then it would seem a good idea to take that advice. The key is observation and supervision over time and if that cannot be done with confidence at home then it should be done at an inhouse facility.

Seriously all this handwringing over Prozac? Compared to so much stuff you yourself have probably done at some party prozac is a lightweight. Like perhaps alchohol.. thats one hell of a nasty drug.

Not that any of that stuff is a joke.

But again observe supervise and adjust. It is basically keeping your kid on toprope while they try something difficult. Worst that happens if properly supervised is a six inch fall.

All this hand wringing over properly prescribed drugs for serious psychiatric issues is not reasonable. They are tools that one uses like any other tool. An skilled expert tries the number 5 nut and it's just a bit off so he goes for the number 4 and it fits.. like any serious climb one does not take the first assessment of conditions for granted and continually upgrades their judgement based on new input. Weather changes and decisions must be made.. different tactics and actions applied.

Prozac may just be the first piece of pro selected.. it may not fit or it might be bomber... but doing some bounce testing should give a good indication.

While I understand being concerned about side effects, I do not understand being so terrified of them that one does not take multiple trained experts concurring advice due to the anti-science fad of distrust of experts. There is a whole industry of diet supplement pushing snake oil salesmen with no scientific basis for their claims out there. They are predators who actively seek out and prey on vulnerable desperate folks with serious issues. One of their best weapons is this over distrust of science and doctors.

Doctors are not perfect, psychiatry is not a perfect science but it is MUCH better than guesswork and kneejerk one size fits all that it might appear to be. It is the best organized group of people and knowledge specifically for the purpose of helping if depression is an issue.

Not to say that nutrition is something not to look at. I would if it were my daughter. But I would not disregard the advice of multiple doctors and go first to diet. While occasionally diet has dramatic outcomes regarding depression it is not the most common cause. Dolt's daughter who posts here certainly has a very direct specific diet issue related to severe depression. Her sharing of it and the solution that finally worked for her is amazing. Unfortunately for many folks that solution only works in specific situations.

Patrick Sawyer

Originally California now Ireland
May 5, 2013 - 05:48am PT
alchohol.. thats one hell of a nasty drug.

Climbski2, I agree. One of the worst. I have posted this before but I believe it is still worth posting again.

In 2011 the World Health Organization did a study on 30 abused substances. There were two categories - firstly, the harm to the individual, and secondly the harm to society.

Guess what substance came in number one in both categories.

In moderation, alcohol is okay, but it is still a neurotoxin.

I know that this has nothing to do with Joy's post, so please excuse the thread drift.

When I first met Jennie, she suffered from pretty severe depression. She doesn't as much now, but about a year or so ago I asked one of her GPs if she still needs Citalopram, that she isn't as depressed as she used to be.

"Yes, she still needs it," was the reply. And she does. It helps.
Bad Climber

May 5, 2013 - 09:08am PT
We're all a bunch of climbing bums on this here Taco stand, but I would proceed with extreme caution. These psych drugs are the most over-proscribed pills out there, and there are plenty of stories of people having severe, life-changing, life-ending side effects.

Some reading:

Death Grip by climber Matt Samet

Prozac Nation

The Emperor's New Drugs

Right now on my nightstand is a book my wife just finished. Frankly, she was horrified at what she read, and it backs up our recent reading of Death Grip. Check it out:

Anatomy of an Epidemic by Robert Whitaker.

There is also a particular nutritional deficit that teenagers especially can suffer from--I think it's one of the B vitamins, although I'm not sure. My wife is a nutritional educator with a master's degree and has a clinical practice as well as writing curriculum for a college. She's away right now or I'd get you the nutrition info. I'll check back ASAP. Seriously, this is the real deal. Whatever you do, I would exhaust all non-med options FIRST. Drugs work for some people, but you don't want her to be one of those who are messed up on them. Remember, psychiatrists do ONE thing: proscribe drugs. And when you have problems because of the drugs they proscribe, what do they do? Proscribe more drugs. It can be a damn death spiral.

I wish you wisdom and your daughter a clear path ahead.

Oh, I don't think Scientology is the answer! Ugh.

Bad Climber

May 5, 2013 - 09:11am PT
Looking at one of the posts up thread mentioned she's a runner. DO look into her nutrition big time. A super low cal diet is what pushed Samet over the edge.

Bad Climber

May 5, 2013 - 09:40am PT
Okay, I've got a little info:

First off, here's a person who works with depression and other disorders using therapy and nutrition. Check out her credentials, articles, etc. The book might be useful, too:

My wife says that there are many possible supplements that can help with depression, but some to check into are good foods to start with, especially sufficient protein during the day. Morning is critical.


Vit. B6 (p-5-p variety)
Magnesium and zinc
Vit. D
DHA/fishoil/omeg 3's
and "bioactive" folate

Of course, each person is unique. Do some serious homework. Be prepared for MD's to scoff at nutrition. Most have almost no education in the field and quickly discount its importance. One thing we've read is that long term outcomes for therapy are much better than for drugs.

Wish you all the best in this tough time. We're pulling for you and your family.

Patrick Sawyer

Originally California now Ireland
May 5, 2013 - 10:25am PT
There is also a particular nutritional deficit that teenagers especially can suffer from--I think it's one of the B vitamins

Bad Climber and others

The B complex vitamins is/are so important to the brain and nervous system. Thiamine (B1) deficiency (due to alcoholism) is what caused Jennie’s Korsakoff’s Syndrome.

I agree that Joy should look into other avenues, but I am not a medical professional any longer.
joy bar

Topic Author's Reply - May 5, 2013 - 10:56am PT
Thank you all kindly.

It would be great if there was one cam, say a number one (red) camelot, that fit every crack, but like climbing people are all different. So by simple math, since all the docs are suggesting the same drug I can't help but think it is just a "learned" reaction and not a thought out recommendation.

Nutrition does seem to be a key. Our diet is very healthy, but we can
all use a nutritional boost.

Mountain climber
Anchorage AK, Reno NV
May 5, 2013 - 11:19am PT
However like different climbers all inspecting the same crack it would be normal for them to agree that the red camalot is the best fit. If indeed the crack is that size. One may realize that A metolius cam or a Wildcountry cam could also work but all would agree that the red camolot is just fine. Is this a learned reaction or thought out? Both of course.

Please look at it this way and what is happening will make more sense.

If a friends comes to you with a mild headache what do you recommend? An NSAID (class of drugs) of course. Be it Tylenol or Aspirin or perhaps Ibuprofin. It's so basic you don't have to give it much thought.

Prozak is merely the most well known well studied of it's class of drug. Sure a doc could choose something slightly different that works basically the same way but why not just go with.. take two asperin and call me in the morning. Maybe he could have said take two tylenol and call me in the morning.

Later if prozac seems close but not quite the doc might try something related to prozac but prozak is a reasonable starting place.

Mountain climber
Anchorage AK, Reno NV
May 5, 2013 - 11:31am PT
"we now see a host of young folks who have been on these mind drugs for some time. They are in their early twenties now.. Some of them have made the news recently with their horrific acts against society."

We now see young people who have eaten sandwiches from port of subs for some time who are in their twenties who have committed terrible acts..


Perhaps they needed more drugs ron? Perhaps a small percentage of people in this world are really f*#ked up and it's hard to save them no matter what you do? Considering that young people have done some messed up stuff throughout history your statement is just what i was referring to..

There is reasonable skepticism and caution then there is just plain paranoia regarding science and medicine.


Mountain climber
Anchorage AK, Reno NV
May 5, 2013 - 11:51am PT
Yep you have one experience and you have seen some other crappy folks who abuse drugs to control their kids.

Trust me this stuff is not a placebo. Its affect can be wonderful or terrible or some mix therin.. thus why it's use should be closely observed and supervised., But it should not be disregarded when every expert opinion you have diligently and with deep love and concern for your childs well-being keeps coming to the same answer.

It would be like questioning 3 climbers about what to use for pro They all quickly recommend the red camolot but you insist in asking about slinging a chickenhead that is not visible.
joy bar

Topic Author's Reply - May 5, 2013 - 11:54am PT
ex. Prozac is not the right drug (according to the interweb) for anxiety.
What raised the flag in this case was an anxiety attack.

So would be like trying to use a #4 Camelot on Jam Crack. Wrong tool for the right crack (and for the left one for that matter).

I gather all SSRI's are not the same, and they are not just slightly different.

Just as Tylenol (poison don't take), Aspirin (thins your blood), and Ibuprofen (anti-inflammatory) are all very different.

aside: Death Grip looks like a useful book, thnx for the recommendation

of note: These docs have only seen our daughter for single short visits/evaluations. We are not against medication,
just as we are not against surgery for a torn knee, but we want second (and so on) opinions based on evidence/experince, so the discussion here has been great.

edit: ah looking for the chicken head, on a dark night, on a dark slab, where there may or may not be a chicken head, ah an oldie but a goodie
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