My adult son's anxiety

[LRob123]

Good afternoon,
I'm a first time poster, so I hope I don't end up rambling too much.
I really need some help and am hoping some of you have had this experience or can help me in any way. My son has anxiety. He had it as a teen, saw a counsellor for about a year, he seemed to be ok for about 5 years. Then he started getting panic attacks, he was able to have success with a medication at that time, but stopped taking it (against what people told him) because he felt fine. He again was fine for 3 or so years.
Just over 2 years ago he started daily vomiting through the week. He has been to a psychiatrist and a psychologist as well as having had many stomach type tests and blood work to rule out other issues by a gastroenterologist. He was told by his psychiatrist that it is GAD and panic disorder. He is 27, lives at home, works at my place of work.
They have tried him of a few different medications without much success. He also had CBT for about 4 months. His psychologist had him gradually return to work 5 months ago. The huge issue is that he won't go to work on any kind of regular basis. Half a day one week, maybe a day here and there. He is currently taking 20 mg of Cipralex daily, has imovane to take if he can't sleep and over the counter stomach acid relievers. Almost every work morning he wakes up and is apparently vomiting in his room. I hear the noise, but don't see if he is actually vomiting or just lots of retching and gagging. My husband and I are at our wits end since he can't/won't work and can't pay rent, gives attitude etc. Some days I feel like the worst mother in the world for getting annoyed and sometimes don't believe him, some days I feel very taken advantage of. Is there help for family members? I also have mild anxiety, but my medication keeps it mostly in check. I just don't know how to handle this or help him.
I'd appreciate any help or support info you could give me. Its a very stressful situation. thank you for any advice, tips or education you can tell me.

[AJ]

Welcome to the forums LRob123. You have a lot on your plate. I'll leave the advice to someone who has kids. Feel free to post anytime. Share as much or as little as you are comfortable with. You'll find the people on this forum very supportive.

[Fighting back]

Hi LRob123,

Sorry to say I have and continue to go through what you describe. This is on top of dealing with my own depression issues. I can offer some sympathy, but no real solutions. As a parent, I think it can be one of the most gut wrenching scenarios you may have to deal with. Stressful, absolutely!

We went through many of the same symptoms. Not taking meds, poor work habits, eating disorders, addictions, etc. There will be some who advocate the tough love approach. It may work or it may be the worst action you could possibly take. We did not give up on our son and worked hard to keep the lines of communication open. Eventually, he came to a point where he admitted himself to the psych ward where he spent a week. It was a breaking point of sorts and importantly, it was his decision. We kept up the support and visited daily while he was hospitalized. This has been a very recent development and it may be too early to tell if we will have lasting results.

What we learned through the process is that there are many approaches and not all will be successful. Early on, there was one counselor who believed the stereotype of childhood abuse, (blaming the parents). Not true at all, but eventually we did discover that a lot of his issues were tied to his early public school experience. Basically, he had been bullied, but was labelled himself as a bully simply because he was physically the biggest kid in his class. We knew this was happening and tried our best to stem the tide, but a few uncaring individuals refused to take this seriously. Just prior to his stint in the hospital, he had been receiving counselling and he felt he had a conflict with the counselor. It ended with the counselor yelling at him because he was allegedly not giving it a fair shot in her opinion. That did not work at all, but while hospitalized,he received CBT that seemed to take. Things have been much better in recent weeks.

There are always self esteem issues as well as fear as to what the world may hold for them. Medication can be helpful, but there are many variables here. No sure fire solutions. All in all, maybe not a lot of help, but you have my sympathies!

[dave]

I have been burdened by anxiety since childhood. The panic attacks were excruciating. I have over many years build skills to manage well most of the symptoms most of the time. This did not happen quickly or easily.

Were I to begin the process from the beginning I would first see a naturopath, gradually change my diet to one with lots of fruits and veggies, slowly begin being more active and build an exercise routine, learn to meditate, learn to use visualization, learn progressive muscle relaxation, positive self talk, shame resilience (Brene Brown), boxing or judo or bjj or muay thai (to feel safe and increase confidence, to build endurance), have GP check hormone levels and vitamin levels, take WRAP Level 1 at a CMHA or other community agency, sleep clinic to do sleep study to check for sleep apnea, CBT, DBT, Peer Support. This is much work, it is worth the effort, I know this for certain. Don't give up and encourage him not to as well.

[paul m]

Hello LRob123 and welcome to the forum.Others have given you good advice and some great treatment advice.

I can say that you aren't the worse mother in the world and that caring for someone with difficult to treat GAD (and panic) can be extremely tough and frustrating. Having those illnesses is equally tough and frustrating, so I can also can understand how your son feels. Nor you are rambling too much as it's tough to discuss this complex of a subject concisely. So please feel free to post as much as you want. My own reply will be very long because there is a lot involved here.

Due to anxiety/panic problems I once went about 2 yrs where I barely went outside and I rarely answered the phone. My son deals with the same anxiety/panic problems, but his symptoms are more the retching and gagging type with some antisocial behaviours thrown in once in a while( sometimes a person gets antisocial to block out the world, rather than confront it due to their anxieties). So the disorder can take many forms and be very hard to treat.

The best way to deal with anxieties from a parents point of view is to learn as much as you can about them. The symptoms, the treatments, the alternative treatments, the causes etc. While I'm sure that you've done everything you can to learn about them, I will try and give you a few more resources.

The Mood Disorders Assoc Of Ontario (MDAO) has a fact sheet that may help fill in some info that you may not know, it also has some good links to other resources http://www.mooddisorders.ca/faq/anxi...mood-disorders

The MDAO also has several programs that may be able help you. Not all of them run all of the time, but if you are able to make it to T.O. the MDAO does run some family support programs to help assist family members living with someone like your son. You can find out more @ http://www.mooddisorders.ca/program/...covery-program

Please do not hesitate to contact Shelly Murphy, who runs the program for more info. (her info is at the bottom of the MDAO webpage) and she is a very nice person.

The MDAO also runs FRAP which is WRAP (wellness recovery action plan for families) and the open family forum which features speakers, educational presentations and more, info is available at http://www.mooddisorders.ca/family-matters-programs

All of the MDAO's programs are no charge. If I sound like an advertisement for the MDAO it's because they, like the MDSC(the people who run this forum) do a lot with very little in resources and are also friendly.

In regards to medication, that can take a long time to work out what works best. My own rule of thumb is that if I don't get better in 3 mths, then I change medications. However your son, could be like mine, he has tried a lot of different meds and he just can't find one that works well, but he does do better on some kinds than other. We both use lorazepam(Ativan) in small doses. It's not a magic pill , but it does work for us. It has it's problems and can be highly addictive if used in multiple doses daily, but in smaller controlled doses it usually isn't. I find that it works best if I take it before I get too anxious and that would be a problem with your son as he is already anxious when he wakes up.

Also regarding medication, this may not be happening, but both of those meds have been known to make problems worse for a few people. That doesn't mean much unless you are one of those few people.

In regards to cipralex. For a lot of people it is a miracle drug and works well. For a few people it is known to increase anxiety and for about 20% of the people they will suffer from nausea : source cipralex drug monograph published by it's maker, pages 19 and 28 file:///C:/Users/Valued%20Customer/Downloads/PM00023006.PDF (sorry I can't make a link work here, but if you cut and paste it into google it should take you there)

All meds have side effects, but for a unlucky few, those side effects may be long lasting. Another problem with cipralex is that if a person skips doses or quits taking it abruptly it is known to make anxieties worse.

In regards to Imovane there can be problems with long term use. The drug makers own monograph sez the following: Treatment should not exceed 7-10 days (page 34) http://products.sanofi.ca/en/imovane.pdf . There is little problem if the medication is used irregularly and for short periods only, but over long periods of fairly frequent use it is known to be extremely addictive and to cause all shorts of anxiety related problems (page 33 of mongraph). For other warning please see http://chealth.canoe.com/drug_info_d..._no=2#Warnings

Sometimes talking with a pharmacist can help,especially in regards to possible side effects or over the counter anti nausea meds. My own experience has shown that a pharmacist who owns his own small store will will often spend more time with me than a larger more busy store. I pay a few more dollars in prescribing fees, but I find it worth it.

I am in no way anti medication, I've just taken a lot of stuff that the doctor said was the best available and I've discovered there is no such thing. What's best is what works best for me and some of the medications do not work well at all.

Please do not hesitate to ask more questions, especially if something I've wrote is not clear. Good Luck and Take Care. paul m

[LRob123]

Thank you all for your support, help and insights. I really appreciate it. He's a decent kid and I feel so bad for him but at times I wonder if he's using it as a crutch, then I feel bad for thinking that. He doesn't always follow through with appointments, which upset his one doctor to the point where she yelled at him about it. I was there at that time because I knew he had missed a few appointments and wanted to see if there was something going on. I firmly let her know that in my limited knowledge, not following up all time and not wanting to say much to her seemed to me to be a symptom of anxiety, especially when you feel intimidated by a not so friendly doctor. He has had better luck lately, but his benefits ran out with the psychologist and he deemed him ok to gradually return to work. He is back on a waiting list for a Psychiatrist, I think this will help tweek the medication for him. Some days he wakes up ok, never great I believe, but ok and will go to work, but more often than not he isn't ok enough to go. In the evenings and weekends he seems good, no vomiting etc. This really confuses my husband so he leans to the he is lazy and doesn't want to work idea sometimes. He does know there is a problem tho and with my other son who also works where we work and doesn't understand the disease at all.
The imovane is recent and he only takes it when he is really struggling to put his mind at rest to get some sleep.
I will definitely follow up with the resources you guys have mentioned. I'd really like to go to a family info seminar or something with my husband so he can see that anxiety works in different ways and that it is a long, hard road a lot of the times. We are moving quite a distance from where we live now and both of my sons are planning to move in with their dad and a buddy all as room mates sharing expenses etc. I'm worried he won't be able to work and pay his share. He says he will be fine and they are looking forward to getting their own place. Dad has had a hard time too with keeping work, so hopefully they will all do fine. Its a worry tho.

[LRob123]

Hopefully we are getting somewhere. The doctor has added Xanax as needed with the Cipralex. He was still vomiting this morning tho. Also, he will be going to one of the Anxiety clinics Paul mentioned.
Thanks again. Has anyone used Xanax and had good results?

[paul m]

Hello LRob123 Xanax belongs to a class of medication called benzodiazepines, also known as Benzo's. I'm not sure I've taken this particular one, but I have have taken a lot of different benzos and they all almost are very similar . Benzo's are also known as PAM drugs because so many of them end in pam, or am, such as alprazolam (xanax) ,lorazepam(ativan), diazepam (valium) , clonazepam (klonopin), etc.

There are 30 or more different benzo's and a good primer on them can be found at https://en.wikipedia.org/wiki/List_of_benzodiazepines As a very wide generality , the biggest difference between the various types is: strength, time to onset of action and duration of action. For example if I know that I'm going to a crowded wedding dance, I would take a lorazepam because it peaks quickly, but is out of my system fast. If I was going to an all day event I might take a clonazepam because it lasts much longer.

Xanax is known to be very long lasting. However I find that, for myself and perhaps no one else, that it's much better taking the benzo before I get anxious or at the very least as soon as I start to know I'm going to have problems.

If I was vomiting in the morning and all possible physical causes had been ruled out, I might question my doctor about taking Xanax as it would seem that I am waking up anxious and by than the Xanax may not work as well. I mean of I wake up at 7 and I have awful anxieties and the medication I take has a 1-2 hr waiting period before it kicks into high gear, how effective will it be for me. For myself I might be ok as I know that I will get relief soon from the medication, but newbies aren't always as fortunate. As I said before, it's usually better for me to take it before I start to become anxious. However Xanax does have the benefit of staying in our systems for a long time, so for many people it may work well.

I am certainly not qualified to give medical advice, but as I mentioned I sometimes take clonazepam ( a close cousin to Xanax). I'm much more likely to take it at night before an up coming stressful day than I am to take it in the morning when I'm already partially stressed. It helps me sleep and is already working when I wake up. Of course care must be taken if uses both Imovane and any benzo as they can more than double up the effects.

Some people are super sensitive to benzo's so care must be taken at the beginning until the effects are known. For a very few benzo's can make life worse and benzo's can be very addictive. Booze and benzo's in combination can be deadly.

So after a very long answer to a short question, anyone taking benzo's should be cautious, but for some people like me, they can make my life manageable and allow me to do things that I wouldn't be otherwise able to do. For me they are a wonder drug, but it took me a while to find the right strength, dosage and brand. Take Care. paul m

[LRob123]

Thanks Paul,
He took it at night, but still vomited in the morning, he took it in the morning and he felt very tired/sedated. He said the doctor told him not to work on or even around forklifts. I understand he shouldn't drive, but around??That isn't a viable option, he is supposed to get to the point that he can work, not take a benzo and still not work. So frustrating!

[paul m]

Hello LRob123. I can understand your frustrations. Benzo's only will help if they are the right medication for that person AND (doctors tend to forget the "AND" LOL) the right benzo is prescribed for the right person and condition. I don't know too many people who had severe almost daily morning nausea that was caused by anxieties , that benzo's have helped a lot. That doesn't mean that the anxieties aren't causing the problem, just not a lot of people are affected that way and your doctor may not be a real expert in dealing with it.

In Ontario a person is entitled to get a second opinion by a specialist. While most psychiatrists are thought to be specialists, they are not. When I got my second opinion the doctor specialized in people with bipolar and only bipolar. There are also a few docs that specialize only in anxiety disorders, mostly at CAMH in Toronto. You just have to carefully ask your son's doctor for a referral. I say carefully , because a few docs are a little sensitive about that, most aren't , but a few are. Usually there is a wait period and then your son just goes in for an assessment. Mine took about 3 hrs . My doctor had written the doctor at CAMH about how he was treating my illness and my symptoms and then the CAMH doc asked me a lot of questions. Then he sent a report back to my original doctor with his recommendations.

No benzo should be used when working around anything dangerous until it is seen how a person reacts to it. For one person 1mg of lorazepam is a nothing dose and for the next person 1mg leaves them wondering around in circles.

Plus some benzo's have to build up over 2-3 days to be effective, I'm not sure about Xanax, although a pharmacist may be able to tell you. Good Luck to you and your son. Take Care. paul m

[LRob123]

Thanks again! He is waiting for a phone call for an appointment at the Mood Disorders clinic at St. Joe's in Hamilton. Hopefully they will get him feeling much better. Waiting is the hard part! I don't know much about St. Joe's program, but I'm hoping its very comparable to CAMH.

[Alijay]

Hello LRob123..i read your original post about your son's anxiety.

Thanks again! He is waiting for a phone call for an appointment at the Mood Disorders clinic at St. Joe's in Hamilton. Hopefully they will get him feeling much better. Waiting is the hard part! I don't know much about St. Joe's program, but I'm hoping its very comparable to CAMH.

Hello LRob123...I am reading your original post about your son's anxiety and I felt like I was reading about my life. It was just so similar it was scary. I feel I like I no longer have a life. My son is 27 also and lives with my husband and me and does not work much either, has no money and we have been trying to find him help within a system that has nothing to offer. I am getting him assessed at an Adult ADHD clinic..$1200 to check for underlying causes of his anxiety and depression. He has anger and frustration issues which he usually takes out on me. He has been self medicating since high school and has had many stomach issues for which his doctor has sent him for tests and prescribed morphine and percocet for pain.
He has been trying to get off the pain meds and wants to get help but don't where to turn with out any money.
I would love to find a residential treatment program that could deal with mental health issues and substance abuse.
Feeling lost and hopeless right now..I take meds for anxiety myself but feel I am slipping as this situation is escalating, my husband thinks he is lazy and doesn't understand mental illness. This puts strain our relationship as he is his step dad. Reading all the posts is very helpful...thanks

[AJ]

Welcome to the forum Alijay.

[paul m]

Hello Alijay and welcome. Please feel free to ask questions, answer other people's questions and/or use the forum to vent. Take Care. paul m

To everyone. One of the best places to get better if you have a mental illness and an addiction problem (and live in Ontario) is Homewood in Guelph. The biggest problem with Homewood is that unless you have semi-private or private insurance coverage(or are very wealthy) it is stupidly expense. If you don't have coverage than there is about a 2 yr wait for a bed in one of the few ward beds that they have. Although if you can go any time and on short notice you may get in faster as other people cancel or get kicked out early.

They have an excellent success rate if you complete their programs, but are also super strict in that you do it their way or they kick you out. For more info http://www.homewoodhealth.com/health-centre

CAMH( centre for addiction and mental health) in Toronto also has some good residential programs and is easier to get into . http://www.camh.ca/en/hospital/Refer...s-to-CAMH.aspx

For all residential programs at both places a Doctors referral is needed. Take Care. paul m

[Alijay]

Welcome to the forum Alijay.

Thank you..it is nice to know you are not alone. Good info on this forum