My 11-Year-Old Child is Taking Prozac: Treatment Options and CBT

Reader’s Question

My eleven-year-old daughter has always been slightly anxious. For the most part, however, she has been a happy child and we have been able to work through her fears in the past. One example of the type anxiety she has struggled with is that she used to fear spending the night away from home. She has also had a fear of vomiting since she witnessed her older sister projectile vomit years ago. Recently, she’s become obsessed with the fear of getting sick and vomiting and has “horrible flashbacks” of actually throwing up. Last week, she called from school two days in a row because her stomach was hurting and the smell of food was making her sick. She is very nervous about going to school, and now soccer as well, for fear of not feeling well. Up until last week, she loved both! She has now started to show symptoms of depression — low appetite, trouble falling asleep, not enjoying things she normally does, and worst of all, the horrible thoughts that seem to torment her the most. We have taken her to her pediatrician to rule out anything physical and, after consulting with him and a psychologist, have put her on 10 mg of Prozac. I’m devastated that she is going through this, especially at such an early age, and absolutely cannot believe my 11-year-old child has to take Prozac! Do you think it’s wise to do this? Her psychologist felt that she had spiraled down in just a couple of days and, without help, would soon not want to leave the house or worse, be hospitalized.

Our Clinical Psychologist’s Reply

When it comes to anxiety-based disorders, there’s good news and bad news. The bad news is that sometimes unchecked anxiety tends to fuel a “vicious cycle” of escalating fears and social life disruption and can eventually lead to other problems such as depression. The good news is that anxiety disorders are simply and effectively managed through various time-tested non-medical therapies. Behavior Therapy and Cognitive-Behavior Therapy (CBT) are the treatments of choice for a safe and effective resolution of the problem. Sometimes, especially for acute circumstances, medication is not only helpful but necessary. Medication alone, however, is rarely the long-term solution. Besides, utilizing learning methods to break anxiety’s vicious cycles and to acquire better self-management and coping skills can generalize to other areas of life, giving the person once afflicted a heightened sense of confidence in dealing with a variety of life stresses.

It would be important to consult with your treatment provider about getting your daughter on the appropriate kind of program to combat her anxiety and develop coping skills. She may need the benefit of medication for awhile, and there may be other psychological issues complicating the picture, all of which might need to be addressed. But it will be important that the appropriate behavioral and cognitive-behavioral techniques be employed to help her overcome her anxiety-related problems and to gain a sense of self-mastery and self-efficacy in the process.