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February 8th, 2011
05:36 PM ET
Should I force my teen to get help after trauma?Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health. Question asked by Aurora Benson of St. Louis, Missouri: My 17-year-old son, Will, lost his best friend two weeks ago; his friend killed himself in a very, very unexpected suicide. His friend was on the phone with my son, and evidently the friend told my son that he was going to kill myself. My son tried to stop him, but the kid shot himself. My son heard it all. My son is showing signs of PTSD along with depression - nightmares, anger and irritability - and he's had at least two panic attacks. I know he needs help that I can't provide, but he adamantly refuses. What can I do? Should I force him to see a psychologist? Expert answer Dear Aurora, I am so sorry to hear about the pain both you and your son have had to endure. This is a real triple tragedy when the death of your son's friend is taken into account. Not everyone will agree with me on this, but I think that yes, you should probably force your son to go see a mental health professional. Even though he is almost an adult, he is likely not to be in the most reasonable state of mind, given what he's been through, and this is a time when it is so imperative for him to get help. When something this horrible and traumatic happens to someone, there is a fairly predictable sequence of symptoms that emerge. First comes a condition known as acute stress disorder - typified by many of the symptoms you describe in your son, but also feelings of spaciness and unreality. If not resolved, these symptoms often progress to post-traumatic stress disorder, or PTSD, which is a chronic condition characterized by re-experiencing the traumatic event, avoiding reminders of the trauma, and increased anxiety and emotional arousal. The reason I urge you to intervene in your son's situation is because the longer his symptoms persist, the more likely he is to develop long-term, disabling difficulties. Treating PTSD-type symptoms as rapidly and as fully as possible is absolutely the best way to deal with the situation. In fact, recent studies suggest that medications that block the stress response can actually prevent PTSD symptoms from developing in the first place, if they are given immediately after the trauma. Given what has happened to your son, he well need both therapy and medication treatment. He will need to work through what happened to put it behind him. But given how significant his symptoms are, he will most likely to benefit from medications that can turn down the heat of his heartbreak and upset.
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PTSD: I had it and found that my symptoms were greatly alleviated with acupuncture. It made all the difference in the world. Then I took a gluten stool test for Celiac Disease and found that the disease had been activated during the stressful event and I was living with depression that was activated each time I touched a CRUMB of gluten. Also, I had the same reaction from SOY. So get off gluten, get off soy (eliminate all TRACES). If that does not work, try acupuncture.
Gluten/soy can cause so many symptoms: Depression, anxiety, crying spells, temper tantrums (in adults too), emotional sensitivity, easily stressed out, reliving bad memories that just "come alive" during the day or night. If you happen to have a gluten/soy sensitivity, then PTSD can be must stronger symptoms. But do not take the traditional Celiac blood test (infamous for inaccuracy). Get a stool test (Google Gluten stool test to find a few laboratories). The tests are about $99.
Yea I had PTSD a few years ago, and it took about a year to recover. Once the year passed, I had been diagnosed with Celiac disease. I also believe there is a connection between the two.
Stool tests are NOT valid for diagnosing celiac disease. The gold standard of testing for celiac is endoscopy with a biopsy.
horrible to hear this and I've been through the loss of a loved one at a young age and I agree that it is important that he seeks help. I was lucky enough to have a strong support group around me and I knew I had to talk about what was going on in my head.
Aurora,
I am sorry to hear about the loss of your son's friend. It must be an extremely difficult time for everyone involved.
I also suffer from PTSD, but know that there is help out there. Being that you are from St. Louis, UMSL is currently doing a specailized study for people with PTSD using a specific therapy called Cognitive Processing Therapy. There are a few psychologists in the STL area that I know of that are trained in this, and UMSL does a pretty good job. They have a center called the Center for Trauma Recovery which you might want to look into. It has been helpful for me to really understand what PTSD is and how it has changed many aspects of my life and how to rethink aobut the way my beliefs have changed. It is a lot of work to figure out how to live "normally" again after something traumatic has happened, but it is definitely possible.
Here is the link for the UMSL CTR. http://www.umsl.edu/divisions/artscience/psychology/ctr/ Hope this helps. Best of luck to you and your family.
I have been suffering from ptsd since october pf 2009. Treatment is a must...at least in my life. I am still looking for survivor groups in the stl area...however I have had no luck. It would be so helpful to talk and meet with others that share the same feelings just to know you arnt alone out here.
As a psychiatric RN, patients don't always develop PTSD related to trauma, and in fact, it sounds like your son is dealing with Acute Distress Reaction since the trauma occured less than 6 months ago. As a result, it would be considered abnormal not to have a reaction to the trauma. Feelings of hyperarousal, sleep disturbance, nightmares, and emotional lability are manifestations of NORMAL response to trauma. Sustained symptoms mentioned above that persist after 3 to 6 months are considered abnormal and that is when PTSD is diagnosed. Having said this, your son is having a NORMAL reaction to trauma. Talking about feelings will greatly reduce these symptoms in counselling. I think if you approach your son with the knowledge that he is a normal person, with a normal response and assist him to see that without further help his symptoms can become pathological. Finally, I think a treatment called EMDR is worthwhile and specific to patients with trauma histories. Medication may be totally avoided or can be helpful just during this difficult period of time to aid in better sleep and reduce the anxiety to a tolerable level. Without persistent symptoms and underlying psychological disorder he will probably not even need medication for long periods of time. The important thing to mention is your son is not at fault and there was nothing he could have said or done to disuade his friend, nor was it your son's responsibility to save him, though he may feel this way. Your son is a victim and is now becoming a survivor with the opportunity to have greater insight into himself through examining his feelings and grieving the loss of his friend. And, you, are a loving mother who is already providing support to him through this difficult time. Be gentle with yourselves.
Agreed. Since the trauma occurred ONLY TWO WEEKS ago, his response is normal, however counseling may be helpful. I am not sure why the psychiatrist is already throwing PTSD out there and suggesting longterm medication. I would suggest that you be available to your son to talk to, encourage therapy, maybe go to therapy yourself, both to help you deal and to show your son that it's OK to see a therapist, but I am not sure how much forcing your son into therapy will help. And I don't meds shouldn't be considered at this point unless he can't sleep at all and is having frequent panic attacks. Just make sure he's not self-medicating. I have read that meds such as Valium and Ativan and help prevent PTSD immediately after or during the trauma but I haven't read about them having the same effects 1-2 weeks out and there's the risk of addiction, impaired driving, overdose,etc depending on the medication.
I agree! I have worked in behavioral health for ten years and when my 17 year old son caused a severe car accident, he had the same symptoms. I did have him see a CISD therapist after several weeks of increasing symtoms. Today he is in college preparing for a law enforcement career and has forgiven himself.
you are a loving mother who is already providing support to him through this difficult time. Be gentle with yourselves.
I am so sorry to hear of this tragic loss. In the wake of this event your son is going to be looking for answers. Consulting with a therapist is probably the best route because the lasting affects of this can be difficult. You and he must understand that there is a natural grieving process that includes many of the symptoms that your son is experiencing but remember that this is NORMAL. The medications that are given in this instance are only going to do more damage than good. Altering the state of his mind with medications and suppressing the symptoms is not the answer. Much the same with panic attacks, anxiety, and depression the medications have serious side effects. Take care and God Bless.
Quite an inconsiderate kid to be on the phone with someone and then pull the trigger which in turn affects another person's life in quite a negative fashion to the point that it could affect them for the rest of their life. Some kids are too young and dumb to understand things like that aspect of it.
Are therapists bound by the Hippocratic Oath to first do no harm to the patient? If so, why would there be such a thing as a therapist who would accept the young man as a patient knowing he's being forced into treatment against his will despite being of otherwise sound mind? Also, why is forced treatment by a mental health professional considered to be a positive thing for a person of any age? I know therapy is very fashionable, and some people like it so much they become dependent on it, but there are times it does far more harm than good especially if drugs are administered to the patient. Unless the young man has committed a crime and forced treatment is part of his sentence, let him alone. Plenty of people just need time by themselves to adjust to bad things. Forced sharing just extends the unpleasant thing, makes it worse, and punishes a person more.
I urge everyone who has expereinced some sort of trauma to get help. When a trama is talked about, felt and dealt with, it does not stay inside of us and do what I call infect us. Psychotherapy is all about healing and growing and the person can learn so much about themselves. This wisdom last all their lives.
No, you shouldn't force him to get help, you run the risk of permanently damaging your relationship with him if you do. Please read up on the side-effects of the medications he could be put on, not just from official literature, but also from the patients who have suffered them; and also read up on serotonin syndrome. It's a serious condition, which is under-diagnosed, and it is a horrible experience to go through. What he needs is someone to talk to, whenever he needs, he DOESN'T need anti-depressants.
I have to say that we put so much emphasis on trauma and so little emphasis on resilience in our society. There is this believe that if you have trauma, you can never recover without extensive psychotherapy. This is a complete and total lie. This I believe has made us weak as a society and has simply functioned to line the pockets of psychologists and counsellors. Generations before us lived through experiences we cannot even imagine. And, do you know what happened? Almost all of them learned to adapt and thrive. As a young woman, I recall talking to an elderly lady who lost her husband. I asked her about how she was coping and if she would like me to connect her to a counsellor. She just looked at me and said. "Oh dear. Thank you. But, I lived through a depression and two world wars." That generation knew how to cope and they didn't need the influx of grief counsellors that seem to hover around every major event like they do today. In fact, new research is showing that all this grief counselling, doesn't really make a huge difference. In the end, people have to learn to embrace life and no one – absolutely no one can do that for you. That is the journey and ultimately, every person has to learn to walk through grief and loss. That is life. Having suffered huge losses and trauma myself I know absolutely of what I speak. Counselling didn't particularly help me. I did not take medications to prevent trauma or to even treat the depression. I made what many considered to be a remarkable recovery. But I didn't do anything particularly spectacular. I did what countless generations did before. I grieved. I cried. I lived through the loneliness and doubt. I forgave. I prayed and I came back to life changed, wiser and able to live and love again. I embraced goodness and faith. And, above all, I refused to give up hope.