25
Mar 26

Your Teen’s Medicine Log

Medication log“In addition to providing an important history, the medicine log can also give you insight.”

If your teen takes medicine,I highly recommend keeping a medicine log. It’s easy to forget that a particular medicine was used for four or five days and produced an unbearable side effect. Why waste time on the wrong medicine down the road? The medicine log is like gold to the next psychiatrist who treats your child. Even if your teen’s current condition proves to be a blip, it could recur in ten or twenty years. You think you will always remember the names of the medicines used, but it’s so easy to forget.

Keeping track of medicines on the computer has the advantage that you can easily print it and bring a copy to a new psychiatrist or to the hospital if your child is being admitted. But anything is better than nothing, even if it consists of nothing more than a loose-leaf sheet of paper scribbled with dates, names of medicines, and reactions to them. I actually maintain two types of logs: one is written in paragraphs and includes events and details about my teen’s condition; the other is a simple list of the facts. I keep the first log for myself and the second to hand to the doctor or hospital. I also keep a file folder into which I stuff any pertinent papers such as blood work reports or hospital discharge directions. You will be amazed at how important a seemingly useless piece of paper will be in the future. Keep everything.

In addition to providing an important history, the medicine log can also give you insight. For example, you may notice that your teen is most likely to experience a side effect eight days into a new drug trial. Or you may see that most of your teen’s hospitalizations for depression occur in the spring.


23
Mar 26

Could This be Something Besides Mental Illness?

Mom-and-daughter-outside.jpg“Some illnesses mimic mental illness…some medicines can incite symptoms like depression, anxiety, and even psychosis “

Let’s say you’ve been told that your daughter has been thinking about suicide. You may find it impossible to believe. Your bright, outgoing teen always seemed happy before. Why would she suddenly feel suicidal? You wonder if there is a medical cause for her depression or if something traumatic happened to her that you don’t know about. Let’s examine these two possibilities.

Some illnesses do mimic mental illness. The doctor will often order blood work to rule out something physical, such as a thyroid condition. Some medicines can incite symptoms like depression, anxiety, and even psychosis. Before you begin treatment, make sure your doctor performs a physical examination, blood work, and a careful appraisal of any medicine your child currently takes.

The second possibility, that there’s something she isn’t telling you, is equally worth pursuing. Even if you don’t suspect that anything could be amiss in your child’s life, follow up with some gentle questioning. I have often been astounded at the things my kids told me when I respectfully asked. Here is an example of the type of dialogue I mean, between a mom and her uncommunicative daughter, Chelsea.

Mom: Chelsea, I know you’ve been depressed and you say you don’t know why, but I want to make sure there isn’t something else going on.

Chelsea: Like what?

Mom: Sometimes teens hide things from their parents because they feel like they’re responsible for what is happening, when in fact, they’re actually being victimized.

Chelsea: Mom, what are you talking about?

Mom: Will you bear with me while I throw out a few wild guesses?

Chelsea: Sure, let’s hear what your wild imagination has conjured up.

Mom: Sometimes a teen is bullied at school and feels so ashamed she doesn’t tell the parents. Bullies know how to psychologically browbeat their victims into making them feel like it’s their fault. Other times, a teen might think she’s gay and is so worried about what the parents would say that she feels she has to hide it. Or maybe a teacher or a neighbor is sexually abusing her.

Chelsea: Mom, you read the newspapers too much.

Mom: Either that or I just haven’t named what’s troubling you.

Chelsea is silent.

Mom: I just want you to know that whatever is going on, I promise not to judge you or blame you. I promise not to overreact.

Chelsea remains silent. Now that she has stopped objecting, Mom suspects that her instincts were right.

Mom: Do you want some time to think about whether you can trust me? I hope you can.

Chelsea: This isn’t something you can handle, Mom.

Mom: Then let’s find someone who can. Someone who has heard it all and knows how to help. Will you see a therapist?

Chelsea: If I can’t tell you, I sure as hell won’t be able to tell a stranger.

Mom: You like to write though. Would you be willing to write me a letter?

Chelsea: Maybe. No, probably not.

Mom: Then I’m going to make an appointment for us to visit a therapist together. I’m not going to allow you to suffer when I know there’s help available. I’m also hoping that you’ll find the courage to take me up on my promise not to overreact or judge you.

If nothing else, at least the door has been opened a crack. Teens don’t want to keep their troubles to themselves; they believe that they must.  We start with tiny steps in building their trust. While we’re on the subject, the phrase, “I promise not to overreact or judge you” can really open the door to communication.