How do I help my freshman in college child with his anxiety?

[Songbird365]

My 18 yr old son suffers with GAD. 3 weeks ago he started his freshman year of college. He is only 1 hr away and his older brother works on campus. He is on medication but calls me daily begging to come home. He is on the basketball team but wants to quit. He goes to class ( grades are good) and practice but then shuts himself up in room. Will not socialize or even go to meals. Eats in room. I wanted him to live at home and commute to local school but he was he'll bent on going where he currently is. We had to take out loans so I told him he needs to at least finish this year then he can transfer. I am very concerned about his emotional state but also realize he needs to at least try. His older brother does not understand his disorder. He keeps saying get over it.

[Paxiled]

This is a bit confusing.  You say your son has GAD, but the meds he's taking aren't for anxiety.  One is for ADHD, which means it's a stimulating drug that can make anxiety worse, though as an SNRI it also targets serotonin which can help with anxiety.  But if he's this agitated, this probably wouldn't be the first drug a psychiatrist would choose -- or the second.  The other drug is for psychosis such as bipolar, again, not for GAD.  So either he's getting some odd treatments because the usual suspects didn't work or there's a lot more going on here than an anxiety problem or he's just not getting the right treatments.  Assuming GAD is his only diagnosis, the usual suspects would be the use of something like Xanax when needed but the main drug would usually either be an ssri such as Zoloft or a tricyclic or possibly for some Effexor, though again, that wouldn't probably be the first choice.  It's hard to answer your question because if these drugs are properly prescribed his diagnosis is much more complex than just having GAD.  If he does suffer mainly from an anxiety disorder, other meds would be more likely to work, and therapy would have to be part of the picture if he ever wanted to not take medication.  If he has indeed been diagnosed with something like bipolar, therapy, while it might help him cope, couldn't cure him and he would have to be on medication.  It's a very different picture.  If this were just an anxiety problem, I would guess it's possible he gets used to his college and settles in.  With an anxiety problem like his he won't have the usual college experience, but if he's doing well on grades and that committed to going to work, it sounds like he's trying to handle this and perhaps might in time with the right therapy.  But that's only if it's only an anxiety problem.  Before I got my chronic anxiety problem, I always had trouble acclimating to a new school for the first few weeks.  Then I settled in and was fine.  This can happen.  You do need to talk to his brother and explain the difference between a disease and a personality trait -- your son has a disease that needs treatment just as a heart patient would.  Unfortunately, there isn't a right or a wrong answer here.  It would be better in the long run for your son's life if he sticks it out and overcomes this early anxiety, but probably won't be better for him if that doesn't happen, and none of us can predict which outcome it will be.  Dropping out and taking time off would be practicing avoidance, which breeds more avoidance, because in the short term it does work.  But it make it worse in the long term.  For chronic sufferers, sometimes when neither therapy nor meds work very well avoidance can be the best course, but nobody gets better avoiding.  The therapy that is said to work best forces us to face the things that cause us anxiety so we can get over them, but first they teach us a whole lot of relaxation techniques and explain how our brains are working.  Even then, it very often doesn't work.  It won't be easy, but hard work and his young age and adaptability are his allies.  But this again only pertains to an anxiety problem, and again, the meds he's on suggest something far more complex than that.  Peace.

[Paxiled]

I'd also add, the above mentions the possibility of suicide, which is an alarming statement for you to hear.  Someone can have terrible anxiety and not be suicidal at all.  The vast majority of people do not commit suicide, and many who do aren't even necessarily mentally ill, they are often people prone to extremes or are on medication that increases the chances.  I've had acute anxiety for decades and I've never tried to commit suicide.  It's like the talk these days that those who are doing mass shootings are all mentally ill, when in fact being mentally ill does not make one more prone to violence compared to the population as a whole nor are most of those who have committed these acts mentally ill.  Maybe they should be thought of like that, but as of now they don't fit any of the categories.  So if your son isn't suicidal, he isn't suicidal.  If he is, that's another problem.  

[Songbird365]

Thank you. He does have ADHD. He was on Zoloft. for a number of years as well as concerta but he was having explosive bouts of rage and anger ( 10- 15 Yes of age) . We got him in with a new Psychiatry group. He saw a psychiatrist monthly at first then every 3 months. a psychologist bi-weekly and anger management. Bi- weekly. They took him off Zoloft and concerta and put him on stretarra, which is a non stimulant. At this time he was put on Xanax and also Risparidone.  Xanax was eventually stopped bc he was doing well . 2 yrs ago his gf broke up with him the same day he failed his drivers test for liscence. That night he tried jumping out of a moving car. Said wanted to die. We forceable took him to hospital where he was admitted for 3 days.. Went back to weekly counseling for a time until Dr felt he was okay. He was a scholar athlete playing 3 sports all year and that seemed to be a great outlet for him. He still struggled with test taking but not as bad as in past. But now, he seems to be unraveling. His current gf ( 20 months) who is also in college ( sophomore year) 2 hrs away just told him she can't do this anymore. His stress is to much right now. So I'm glad he is home bc now he is sobbing again.

[Songbird365]

Thank God. His best friend ( who attends same college as his gf ( x now) drove 2 hours to come see him. They just left to go get pizza then a movie. My son said he is going to stay at school. ( called boss got today off) I messaged his primary doc to see what can be done med wise for now. Will call psy Monday. I somehow need to find out what services his school offers in way of mental health. I went to clean his bathroom and the toilet was full of vomit.  He said anytime he eats it comes right back up.

[Paxiled]

Okay, this is more info.  Mom is right, you know him better than anyone except himself and his best and oldest friends.  He sounds to me like he's got some toughness underneath all that angst, he ought to know that.  His desire to try to fight through this is really something, because it sounds like he's going through some really rough stuff.  Mom is also right, nobody here has any definitive answers, we can only answer from our experiences.  I've never had a child go through this, but I've gone through this and am going through this -- mental illness and the meds that treat it can be a trial that come and go.  Again, his youth is his strongest asset.  I can tell you from experience, relationships are really hard when they end badly for everyone, but especially for those with emotional problems.  I've also been there too many times.  I wish I'd had the support you and your family are giving your son, in the long run it will help.  I take the greatest heart in your description of your son really wanting to try to somehow do what he wants to do.  I hope that energy and your love and help will out in the end.  I know he's sobbing like crazy, I know what that is, but don't forget to honor his strengths, not just his weaknesses.  Things that might help:  meditation and exercise.  Friends.  Family.  And a really good psychiatrist and psychologist.  We're rooting for you and for him.  

[specialmom]

Oh my gosh.  I feel for you.  I have a son with significant anxiety myself.  He's a high achiever in many ways.  Outstanding grades, school athlete and leader . . .  but has had anxiety since he was in elementary school.  He's now 15.5.  It's so difficult to parent through these times.  Here is my take on it having had two teens commit suicide in our school this past year.  YOU are a safe place and person.  You need to make sure he is okay.  He probably needs to check back in with his psychiatrist and make sure his meds are at the right dose and working properly.  First and foremost is his safety.  I'm not trying to be dramatic but as a parent of a child with mental health challenges myself, I don't take how low someone can go lightly.  You also don't want him to drift to self medicating in harmful ways which college has great access to for everyone but particularly vulnerable, suffering individuals.

And I know, this is also a time in which MOST kids or at least a lot really are challenged. Many are home sick, many struggle and after their freshman year it gets better.  Can he come home on weekends for the time being?  Then he just has to get through the week.  And then perhaps he can sustain the situation without imploding to see if it gets better or if he indeed needs to transfer for his own mental well being.  I understand the finances of it!  I understand not wanting to make a rash decision!  So, slow it down.  Don't make his coming back out of the question but just not yet.  

Does his campus have any services?  I'd get this sorted out and him signed up!  Counselor, mentors, anyone that can help in this situation affiliated with the school.  There is a recent statistic that up to 35% of all college freshman struggle with mental health issues.  Your son is not alone and the school SHOULD have resources to help.  

What medication is your son on if I may ask?  

[Songbird365]

Received a call at 8pm from him. Could barely understand him. He was crying so hard. Has been in school 3 weeks now. Hates it. Been vomiting all day due to stress. He is on a work study program and has to work tomorrow Grimm 11 to 6 but my husband drove out there to check on him. They are on their way home. He said he is a mess. I suggested a visit to the emergency department but our son wants to fulfil his work obligations. Will drive back in morning and then come home again. He is begging us to let him take semester off and commute next semester. I think he should come home and work. Try college in a year or so. My husband wants him to try to finish semester. He has been hospitalized in past ( 2 yrs ago) for extreme anxiety and I am scared of pushed it will happen again. I do admit to being extremely protective of him through out high school due to his condition and maybe it has made him to dependant on me. Idk.  He is on strettera and risparidone right now. Was on Xanax for awhile in the past

[specialmom]

I hear you mother to mother.  This is such a difficult thing.  Your husband would not suggest bringing him home or make you think the ER was possibly necessary if not warranted.  I am so sorry.   I am not pontificating here or turning this into some random discussion about other people and suicide and school shootings but saying plainly from your description, your son is imploding.  Just about everyone has anxiety and many truly struggle that first year away at college.  But you describe a long history of a person who has had issues of mental health trouble being expected not to at a triggering time for lots of people.  I feel for you.  I personally would let him commute the rest of the semester. Trying to get him to stay a night or two in the dorm if he feels he can.  But he's not getting anything out of being there in this state and I personally DO believe it is risky to force him.   We know them best.  Don't go down the  road of questioning your parenting or if he is dependent and all of that.  You sound like a caring mother of a kiddo that has  struggled signficantly.  The terror a parent feels when we see our kids spiraling down is hard to explain but I have been there too.  We  also don't know if your son's medications are right or wrong, we aren't doctors.  So, I'm not going to analyze his medication other than to say that I would absolutely have him in to see his psychiatrist to discuss if the medications are working or if there are any changes in dosage necessary or if he needs anything added or taken out of the mix.

Going away to college is not for everyone.  It is not the strict path to success either.  So, don't feel the pressure of that.

If he stays at school, he needs more support there. I'd get in touch with the school to see what resources are available.

Your a good mom and you are trying to help your son.  This can get better but being flexible with the plan sounds like a must here.  Hugs to you and stay in touch.  (PS:  dealing with my own anxious child and difficulties at the moment too.  It's very draining as a parent.)