Christmas Day - Day 3 of Lexapro for Child

Ewen is only 10-years-old and two weeks ago, out of the blue, he started having debilitating panic attacks back to back and saying he would rather be dead than feel the pain of them.

Before this he was just your average straight-A student, genius video game player and awesome soccer player on the Gold travel team. Then two weeks ago he had his first panic attack at a school band concert and that started the spiral downwards.

We ended up in the emergency room...twice. I will put together a schedule of what happened over those two weeks of hell when I get the motivation/time. For now, I will start here at day 3 of Lexapro, and it also happens to be Christmas day.

I give Ewen 2.5 mg. each morning. The child psychiatrist wanted us to cut the 10mg pill in half and start him on 5 mg but I have been cutting it into quarters and giving him 2.5mg instead.

Why have I done this? Because I know anxiety medication well since I have been taking it for 13 years, and I think that what causes the suicidal thoughts is how horrible you feel - worse than without it, when taking the medication for the first 3-4 weeks until it kicks in. So we are going very slowly and very carefully.  Adults can get through the pain of SSRI side effects by taking an Ativan twice a day for 30 days until the meds stop hurting and start helping...and you don't need it anymore. This medicine, Ativan is absolutely forbidden for children. So these poor kids have grown up panic attacks and are given the grown up SSRI for it, But then NOT given grown up rescue medicine to help with the horrible side effects that accompany SSRI's for very sensitive people and children are usually very sensitive people...especially if they are suffering from anxiety and/or depression. This is where the danger is. They are not prescribed Ativan to stop the panic in its tracks, because Ativan is highly addictive and lower the heart rate. It is kind of like, a panic attack can't kill you but a mistake in taking Ativan, can. So Ativan is only given in a hospital setting. What I wanted, however, was for Ewen to be prescribed a very low dose of Ativan as a rescue when he was having a terrible panic attack and has cried for 3 hours saying "why, why why?". My husband and I are very in tune with Ewen and super vigilant. We would never ever let our 10-year-old child get addicted to a benzo or give him too much. So having this as backup emergency tool when he is saying he would rather die than feel like this, seemed like a good idea but was not an option. So the day after that horrible emergency room trip, I asked his psychiatrist for a prescription of beta blockers to stop the panic and they (the resident and attending) said yes.

We decided that since a beta blocker doesn't take away the daily pain of an SSRI side effect, and it can cause sadness, that Ewen will need to just be on a super low dose of his SSRI so that his body can handle the difficult first 1-3 weeks.

Since we started the Propranolol 4 days ago, he is no longer having panic attacks due to either time or the Propranolol. That stops his racing heart and aching chest. But it also makes him feel miserable and weird which sucks. He said that he takes it to "stop the bad thoughts"so thank goodness we have it. It is a "take as needed"meditation. But it doesn't help his tight throat where he feels like he has something "stuck in it" and will barely eat or drink anything. 

We have discovered that what helps him the most with his anxiety is

1. having his best friend over to hang out with 

2. let them do an insane amount of video games together

3. jumping on the trampoline

4. pick-up soccer games with friends

5. friends

4. sleep

The only way to get him to sleep is he is now in my bed (Jake is sleeping on the couch or helping me when I we both need to put Ewen to bed). What we do is read a book that is NOT something from the Percy Jackson series that he loves, but a kid book, specifically, The Wind in the Willows. So he is hearing a calm story. They when he is ready to lie down I pat his back in a fast rhythmic motion, constantly until he finally falls asleep. Last night it only took 5 minutes. Previous night it has taken hours.

Actually, number 1.  on the list of anxiety help should be the hours of soccer he plays during pick up games or practice. We have a pick up game tomorrow and he will see his friends. So that should help too.

He gets depressed when he hasn't had a friend over. He copes by playing video games constantly and we get him out to jump on the trampoline whenever we can. His dad takes him and they kick a soft ball around.

His worst symptom now is that his throat is very tight and he has a lot of trouble eating and drinking. This makes social eating a terrible experience and Jake had to take him home before we had Christmas dinner at my parent's house tonight. He was also just exhausted with the constant anxiety and being with family while feeling that way. There was no way he could sit at the large table for a grand Christmas dinner. No way. So when he asked, Jake took him home (only 10 minutes away) and we brought home some leftovers. It was a sad dinner though.

We are home. The family is all watching "Master Chef Jr." I am currently soaking his old albuterol nebulizer plastic parts in boiling water in a bowl. So tonight when he is going to sleep and starts saying he has something stuck in his throat and starts to panic, we can breath in steam from the nebulizer and I will remind him how that opens up his airways. The slow breathing should help too. We won't use albuterol since that makes you jittery. Water with salt in it will be just fine. I wonder how long I will have to pat his back tonight?

Wish us luck this Christmas night. Our hearts hurt.