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Question:

From Delta, Pennsylvania, USA:

Four to five years before my 16 year old daughter was diagnosed with type 1 diabetes (about eight months ago), she had occasional lows, and along with the lows, she started being severely depressed. Thus far, no drug seems to help. I am considering low dose hormones since there are worse episodes at specific monthly periods.

She has also recently been diagnosed with a non-verbal learning disability, and this previously vivacious, creative, Presidential Fitness Award Winner, Student Council member has fallen apart. She has been hospitalized twice for severe depression, and once for dehydration from a weird virus, RSV. She also takes medications also for allergies and acne.

She is withdrawn, non-participatory and always feels sick, and she has become frail and is underdeveloped for her age. She has also developed a curvature to her back. Her blood sugar is controlled to a normal low. Her endocrinologist wants her to gain weight. I want her to live! Help or suggestions would be great!

Answer:

The immediate picture in my mind is that of severe depression. You indicated that she has been prescribed drugs for this which have not been helpful, and I hope that she is under the care of a psychiatrist to oversee transitioning to various drugs. Many antidepressants do lead to increased appetite and weight gain, and I think there might be things to explore.

Are you certain that she does not have an eating disorder and is manipulating her diabetes to control her weight? Again, the psychiatrist should help. You may even want the input or second opinion from a couple of psychiatrists, hopefully those with experience with young people with diabetes.

I am not completely certain what you mean by "low dose hormone medications" to control the cyclic nature of the mood swings, but assume you mean estrogen/progesterone as might be used in birth control-type pills. RSV is not a "weird" virus -- it is quite common and tends to cause very pronounced upper respiratory symptoms. Such infections are more often worrisome in infants, but adults get RSV also.

I do not know the significance of her scoliosis (curvature of the back) -- a not too uncommon condition in adolescent girls -- that should likely have little bearing on her diabetes. However, it usually occurs in time with the adolescent growth spurt, and, at age 16 years, I would think your daughter is near the end of that. However, you describe her as being "underdeveloped for her age." Maybe you mean physically underdeveloped and not yet in rip-roaring puberty. Poorly controlled diabetes, poor weight gain, eating disorders, and depression can all lead to delays in physical growth and development. For example, there is a serious complication of poorly controlled diabetes called Mauriac syndrome that leads to poor puberty, poor growth in height, and enlargement of the liver. If you meant that she has poor mental development, and that you think her various skills of intelligence and cognition are deteriorating, that is a completely different matter and she would require a consultation with a neurologist. I presume you really meant physical underdevelopment.

DS

DTQ-20030528142319
Original posting 6 Jun 2003
Posted to Behavior

  
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Last Updated: Tuesday April 06, 2010 15:09:46
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