Question:

Kashee writes: I recently found out my 6 year old has been fabricating a detailed story for the last 2 weeks to her teacher and class.It involves us getting a dog including its name, breed, and day we were picking it up. It seems to have started when the above-described dog showed up on our lawn as a stray. It was actually a neighbor’s dog who we returned it to. Since then she has gone to play at the house with the dog several times. She has wanted a dog for many months. It has been explained several times to her why we can’t get a dog right now. When confronted about her fabrication she said that everyone in her class has a pet and she wanted to be “special” like them. Do you think this is normal for a child to make up such a detailed story? I have concern because there is a history of depression on my husband’s side of the family; and I want to know if I am jumping to conclusions or if this was some type of precursor to depression? This is very different behavior for her as we have provided her with many creative experiences such as Karate, Brownies, swimming, camping, and a 2 year old sister whom she gets along with very well. This concerns me on several levels because, to our knowledge she has never told elaborate lies and always tells us about things she is interested in and we try to provide them, such as Karate, etc. We believe that had her teacher not asked about the dog, we may never have known she was making this up. Any direction you could give would be appreciated.

Answer:

Dear Kashee,

Children have rich fantasy lives and it is quite normal for your 6 year old to have come up with such a detailed story; children have an ability to suspend reality in order to explore and understand their environment and it’s possibilities; children do not use logic the same as us adults and thus, trying to logically explain to them the reasons why something can or cannot be done (i.e. not getting a dog) can require multiple attempts and still at the end of the day remain unclear to them.

Your 6 year old’s desire to be “special” brings a few things to mind; first of all, I think that in our society most kids get taught that their external reality defines their internal reality; i.e. if you have the latest toy or clothes, that somehow makes you more special); I see this work it’s way into adulthood, where adults seek to feel better about themselves via accumulating material wealth (which is usually on credit cards; average debt for a U.S household = $30,000); children need to be reminded that they are special just the way they are; they need to be reminded that we are all equal and that they have been special since the day they were born; I think that this leads to a greater resilience as adults and less vulnerability to the woes of everyday life.

Question:

My primary care doctor prescribed Prozac for me but I am afraid to take it. What are the side effects that I should be worried about when taking this medication?

Answer:

Prozac belongs to a class of medications that are based on their mechanism of action; medications belonging to this class are called selective serotonin re-uptake inhibitor’s or and SSRI’s; low serotonin levels in the brain are thought to play a significant role in mood and anxiety disorders; this group of medications increase serotonin levels in the brain by selectively inhibiting the uptake of serotonin after it has been released; bottom line, serotonin levels are increased which in turn is correlated to an improvement in symptoms related to depression and anxiety disorders.

The most common side effects of this class are:

• Allergic or Toxic — Rash, Pruritus (skin inflammation)
• Neurological — Headache, Tremor, Dizziness, Asthenia
• Behavioral — Insomnia, Anxiety, Nervousness, Agitation, Abnormal dreams, Drowsiness and fatigue
• Autonomic — Excessive sweating
• Gastrointestinal — Nausea, Disturbances of appetite, Diarrhea
• Respiratory — Bronchitis, Rhinitis (inflammation of the nasal mucous membranes), Yawning
• Endocrine — Weight loss
• Musculoskeletal — Muscle pain, Back pain, Joint pain
• Urogenital — Painful menstruation, Sexual dysfunction, Urinary tract infection, Frequent micturition
• Miscellaneous – Chills

Keep in mind that not all SSRI’s cause all the above side effects and that different individuals respond differently to different SSRI’s; your doctor and you have to work together to see which medication suits you the best; always check with your doctor if you have any side effects (symptoms that were not present prior to starting a particular medication) and ask him or her if other options are available; also, keep a small journal of how you feel when starting any new medication; note down any changes in mood, appetite or energy; be sure to bring your notes to your visits with your physician; make sure to address your questions during your follow up visits; don’t be afraid to ask questions related to your working diagnoses and treatment plan; you have a right to ask questions of your health care providers and deserve answers if they are known; Lastly, only take prescription medications under the supervision of a physician. Take care of your self and keep the lines of communication open.