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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18773
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am very concerned for my 21 yr old son who has experienced

Customer Question

I am very concerned for my 21 yr old son who has experienced difficulties with anxiety for past 4-5 years. he lacks confidence and what people may think of him. He has had numerous jobs in hospitality, completed yr 12 and is bright and good looking (takes after his mum of course) only lasting 4-5 months in each position before experiencing a crisis and then does not go back to work. He has attempted uni last year doing a Bachelor of Arts specialising in Psychology lasting 6 weeks. he says he does not know what he wants to do in life and feels useless. We do not apply too much pressure as we are very understanding parents, I am also a registered nurse. I had a personal consult with my son's GP last year and was basically advised to keep out of my son's business as he will either sink or swim down the dark lane! Not a very good GP !!

MY son has had x2 mental health plans now (only attending 5 sessions last year and 1 so far now) and is back consulting with a psychologist (once in the past 8 weeks) as he was fully booked and then went on holidays
MY son commenced antidepressants 8 weeks ago, fluvoxamine 100mgs daily. He has no F/U with his GP booked and does not consult with the psychologist until next week.

We have a very stable home just my husband and son and myself only. However we feel as now my son is not working he is up all night until around 5-6 am usually playing army computer games then goes to bed and refuses to get up mostly before 4pm does very little exercise and smokes. He once weekly or so heads to the pub with mates and binge drinks and we have also found empty wine bottles under his bed and in his closet.

We are very lost in who to contact or what to do as we feel our son is not being honest with himself, the GP or psychologist about the above actions. he totally ignores any help and when he was working always ran late or just did not turn up. He did have glandular fever at some stage in his teenage years as blood tests showed this and when he was 18 his Vit D was 23. His Gp is not concerned with the above and has not ordered further tests. I feel my son is looking down a black deep hole but what can we as parents do or what help is out there for him. Thanks for taking the time to look at this
regards
Sharon
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
Thank you for using JustAnswer, although I'm sorry that you are going through such a difficult situation.

Unfortunately, there is no good answer for this situation. There is very little that a parent or other family member can do to help a person with mental illness if they do not want to seek care or are not being honest with the professionals that are being seen.

It certainly would be appropriate to be supportive in whatever treatment program that he is willing to undergo. However, as you have discovered, there is little that these professionals can do directly with you, since he has the right to privacy, even from parents.

It would be appropriate to define specific limits, but this would only be effective if you are truly willing to enforce those limits. For example, one limit would be to expect him to be awake at certain hours of the day if he wants to continue to live in your house. The problem arises with what you can do if he refuses to abide by the rules, and that would depend upon the situation.

It also would be appropriate to withhold any support that is being used by him to perform negative activities. For example, if you are providing him with any financial support that he is using to go out with his friends (since he is not working), it would be appropriate to withhold that financial support.

On the positive side, the fluvoxamine and the counselling are appropriate interventions to try to help him with these difficulties, although the dose of the fluvoxamine may need to be adjusted to a maximum dose of 300 mg per day.

If you have any further questions, please let me know.

Dr. D. Love and other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Thanks Dr Love for your advice it is good to get the advice for an increase in his fluvoxamine to 300mgs but how can I suggest this to his GP or should I say to my son you need a review of your medication and for him to book the appointment.I do feel this medication is not working as well as it could be as he takes the tablet anywhere from 3-5pm daily as it is prescribed for am dosage. I do check the box daily and a tablet is gone daily so I presume he is taking them.


Also my son smokes roughly a packet every 3-4 days and expects us to pay for them. I know they are a habit so should I just cut out all financial support for these too as im worried about the consequences of the withdrawal symptoms/actions. He has just applied for the disability allowance as his own GP suggested this until the end of April. I not sure if this is a good idea as he will just use the money for alcohol and smokes


many thanks again I am very pleased with your response as it is nice to get out my feelings and concerns to someone whom I don't know


regards


Sharon

Expert:  Dr. D. Love replied 3 years ago.
To clarify, the fluvoxamine can be adjusted up to 300 mg per day. The dose should not be increased suddenly from 100 mg per day to 300 mg per day. Dose adjustments are typically done by 50 mg per day increments.

It is difficult to make a specific suggestion to his doctor, but you can encourage him to be seen in follow-up to assess the effectiveness of the drug.

Yes, it would be appropriate to withhold money for the cigarettes. The withdrawal is not dangerous, but it may be sufficient fir him to become more motivated.

You are correct that he may use the disability allowance for cigarettes or alcohol, but there is little that you can do to prevent the disability application.