So some backstory. My sister is 15. She’s been diagnosed with depression for a few years now, and her therapist has been constantly adjusting her medication trying to find the right mix for her. Since she’s been seeing the therapist, I’ve noticed that she’s a LOT better. But, she still has mood swings more often and more intense than the average person, so I guess the meds aren’t quite right yet.

A few months ago, I caught her with weed. I was pissed, because she’s promised me that she would never touch the stuff till she’s older. I took it away, and lo and behold, yesterday, I caught her with more. I took it all away again, and threatened to tell our parents if I caught her again, and now we come to today.

She just walked into my room, crying, telling me that she’s been smoking for the last three months, and that it’s been managing her depression better than any drug so far. She says that she hasn’t felt as happy as she has for a very long time, and that she really wants to continue smoking. She mentioned that she’s worried about making friends this coming school year, and no matter what I say, she’s convinced that she won’t be able to make any friends, and I think she’s freaking out about that.

I really don’t think that letting her smoke is a good idea for all of the obvious reasons, but I can’t stand to see her this sad. I’m sure she’ll continue behind my back, too, and I’m sure, too, that I’ll catch her, but I’m worried that I won’t follow through with my threat. I just don’t know what to do.

If she's doing it do manage her depression, just let her. Like you said, she's going to do it regardless of what you do, so there's no point in getting all upset over it. And what are your alternative solutions, anyway? Get her on some other drug with some other crazy side-effects? If it works for her, then that should be a good thing. Maybe not the ideal thing, but a good thing nonetheless.

It's good that you're looking out for her, though. Keep an eye out on her, and talk it out with her every once in awhile. Ask her if she's considered counselling or therapy. If you live in a state where pot isn't legal yet, ask her if she's considered the consequences of being caught. If it's legal only for medical purposes, get her a card (or however that works).

No matter what, it's gonna be fine. Both of you just need to be smart about it.

More often than not, people quit smoking pot on their own, when they feel that they're better off without it. You can't control her, so just try to be considerate and cooperative with her. You sound like a good brother, so everything's gonna be okay.

Thanks for the reply, man. I've talked with her in the past about all of that stuff (I was trying to deter her from being interested), but I'll bring it up again. She's actively going to therapy, and shes still on medication, but I guess it's not working. I doubt she's told the therapist about this, but maybe she should...

Pretty much what Verb said. Although you should keep an eye out. What she's doing is essentially sitting on a teeter totter, playing a gamble. If her depression isn't helped and solved, then she'll no doubt, eventually fall further into drug use and with it, heavier drugs.

While the drug may help her in managing, any fight with depression is a long, uphill battle that wittles away resolve if it isn't fixed. What she finds appealing and helpful at first will eventually fade. Even the drugs the doc is prescribing her won't hold it off forever. Your best bet is to be as supportive of her as you can right now.

Self treatment is dangerous, especially when her doctor is trying to fine-tune her medication. If she hasn't been told it's safe to smoke by her doctor, she shouldn't be doing it. The dulling effects of cannabis will make it very difficult for her doctor to do his job and get your sister on a stable regimen and into remission. Marijuana is not a medication; if she thinks it's helping, she needs to speak to her doctor about getting on a regular prescription so it can be controlled and monitored.

And what are your alternative solutions, anyway? Get her on some other drug with some other crazy side-effects

Verb, I know you mean well, but please don't stigmatize depression medication. They saved my sister's life, and many others, and they do work, often with minimal side effects.

Quote

And what are your alternative solutions, anyway? Get her on some other drug with some other crazy side-effects

Verb, I know you mean well, but please don't stigmatize depression medication. They saved my sister's life, and many others, and they do work, often with minimal side effects.

You mean don't do exactly what you're doing?

If she's been smoking with for three months with nothing but positive effects, I can't say I sympathize too much with your whole "marijuana is not medication" point. Especially when it is medication. I've already recommended that she obtain the stuff legally and with her doctor's recommendation. I'm glad your sister was able to use whatever else to help her depression, but understand that different drugs affect different people differently. My only "stigmatization" of depression medication was that they tend have a laundry list of potential side-effects, whereas pot has basically none.

If OP's sister only begun smoking a week ago, my response would've been a little different. So, sorry, but your whole response just seems very out-of-touch, like you physically became one of those old cheesy anti-drug adverts from the '90s, back when the only thing anyone knew about pot was that it "killed brain cells" when it actually doesn't at all?

I say let her, if it helps but keep and eye and make sure shes not just taking you on a ride. IF shes serious about it consider edibles? Something she can take around with her if need be and doesnt fuck up her longs, and make her smell like shit.

Although making a butter is a hassle and you'd have to work around your parents not being there......or shit, maybe your parents might understand given the circumstance?

Quote from: Verbatim on August 10, 2016, 06:50:03 AM

I can't say I sympathize too much with your whole "marijuana is not medication" point. Especially when it is medication.

It isn't, just like eating willow isn't the same as popping an aspirin. Marijuana comes in hundreds of strains and potencies. The THC amounts aren't consistent, and is just providing a dulling of her symptoms; it's really not unlike those that take pain pills or stronger recreational drugs for the same purpose, and Meta expressed a concern about that. If a doctor is attempting to fine-tune her medication to get her into remission, his work is being undermined by uncontrolled marijuana use that he's likely unaware of; clearly the medication she's on now doesn't work to the desired effect, but if her doctor is only seeing improvement (because the marijuana is masking symptoms), then she's putting herself in a dangerous situation of reliance and potential abuse. This isn't about marijuana being the boogeyman drug from the 90s, it's about how it interferes with her current drug regimen. A patient should be disclosing with their doctor any potentially body or mind-altering substance they intend to use, especially in a case as serious as depression.

Oh, well then absolutely.

But I still don't like your use of terms like "dulling" or "masking of symptoms," as though any other antidepressants could possibly do anything different. While you're right in saying that's all marijuana can do for your depression, that's also all Prozac, Zoloft, Paxil, Luvox, Brintellix, Fetzima, Viibryd, Celexa, Lexapro, Sarafem, Cipralex, and Pexeva can do for you, too. None of these will "cure" your depression--they only mask your symptoms.

The only difference is that they mask your symptoms in a more socially-acceptable way. With a few potential bonuses--like suicidal thoughts, and making you even more depressed. You know, because they have all these synthetic elements in them that make it difficult for your brain to know how to react. I mean, these are just facts.

But I still don't like your use of terms like "dulling" or "masking of symptoms," as though any other antidepressants could possibly do anything different. While you're right in saying that's all marijuana can do for your depression, that's also all Prozac, Zoloft, Paxil, Luvox, Brintellix, Fetzima, Viibryd, Celexa, Lexapro, Sarafem, Cipralex, and Pexeva can do for you, too. None of these will "cure" your depression--they only mask your symptoms.

I'm under the impression that those drugs do "cure" depression by altering the production of the chemicals in your brain that are causing the depression. Weed, on the other hand, doesn't do that, it just makes you feel good for a bit. I guess I could be wrong about that, though.

I really have no idea what you think is rude about that at all. If RC's sister believes THC-based medication will improve her health, she ought to discuss it with her doctor.

I told her what you said, and she claims that she agrees with me and that she's gonna tell her doctor that her meds aren't working and give that a try again. We live in Florida, so it isn't legal, but would discussing this with her therapist be a mistake? I know the therapist wouldn't tell the police or anything, but could she tell our parents?

Quote from: rc on August 10, 2016, 09:11:41 AM

Quote from: Verbatim on August 10, 2016, 07:45:24 AM

But I still don't like your use of terms like "dulling" or "masking of symptoms," as though any other antidepressants could possibly do anything different. While you're right in saying that's all marijuana can do for your depression, that's also all Prozac, Zoloft, Paxil, Luvox, Brintellix, Fetzima, Viibryd, Celexa, Lexapro, Sarafem, Cipralex, and Pexeva can do for you, too. None of these will "cure" your depression--they only mask your symptoms.

I'm under the impression that those drugs do "cure" depression by altering the production of the chemicals in your brain that are causing the depression. Weed, on the other hand, doesn't do that, it just makes you feel good for a bit. I guess I could be wrong about that, though.

Quote from: Fox "Turkey" Mulder on August 10, 2016, 07:30:38 AM

I really have no idea what you think is rude about that at all. If RC's sister believes THC-based medication will improve her health, she ought to discuss it with her doctor.

I told her what you said, and she claims that she agrees with me and that she's gonna tell her doctor that her meds aren't working and give that a try again. We live in Florida, so it isn't legal, but would discussing this with her therapist be a mistake? I know the therapist wouldn't tell the police or anything, but could she tell our parents?

SSRI medications are designed to stop the reuptake of serotonin (the feel good chemical) in your brain so that you feel like you have more serotonin. Problem is, that serotonin will eventually become depleted and you will need to increase the dosage to achieve the same desired effect. They are symptom managers, they do not "cure" anything. They are simply manipulating a single neurotransmitter in the brain.

Don't get me wrong, I'm not anti-drug. They do help a lot of people when it's done right and the patient is tapered off when the symptoms resolve. Unfortunately, a lot of doctors keep their patients on the drug for years or indefinitely and add on other medications to counteract the side-effects caused by the other drugs. The more drugs added, the higher the chances of having to deal with other iatrogenic disorders.

She's been going to the same doctor for a few years now. I saw the progress way before she started smoking, but shes obviously not happy still. Should I push my parents to try a different doctor?

Quote from: rc on August 10, 2016, 09:11:41 AM

We live in Florida, so it isn't legal, but would discussing this with her therapist be a mistake? I know the therapist wouldn't tell the police or anything, but could she tell our parents?

I'm pretty sure that patient confidentiality in Florida is the same as it is here in New York - and drug use doesn't fall under an exception to said policy, even for minors. Unless she is suicidal, homicidal, a victim of abuse (Sexual or not), etc, her therapist is not allowed to disclose anything your sister does not want shared.

Here's more on that policy.

http://www.apa.org/monitor/mar02/confidentiality.aspx

According to this, it's at the doctor's discretion...

Quote from: rc on August 10, 2016, 10:51:16 AM

Quote from: Icy on August 10, 2016, 10:14:20 AM

Quote from: rc on August 10, 2016, 09:11:41 AM

We live in Florida, so it isn't legal, but would discussing this with her therapist be a mistake? I know the therapist wouldn't tell the police or anything, but could she tell our parents?

I'm pretty sure that patient confidentiality in Florida is the same as it is here in New York - and drug use doesn't fall under an exception to said policy, even for minors. Unless she is suicidal, homicidal, a victim of abuse (Sexual or not), etc, her therapist is not allowed to disclose anything your sister does not want shared.

Here's more on that policy.

http://www.apa.org/monitor/mar02/confidentiality.aspx

According to this, it's at the doctor's discretion...

Quote

A compromise was reached whereby the therapist would speak to Michael's mother only with Michael present. The issue of confidentiality became more complicated during Michael's junior year, when the therapist felt that certain information should be shared and Michael refused. The therapist gently explored with Michael the reasons behind this refusal. During some sessions, the therapist was direct with Michael about her discomfort with his behavior, especially the illegal activities, and pointed out the kinds of risks he was taking. Over time, Michael and his therapist agreed that Michael himself would begin to speak to his mother about these issues, and that the therapist could follow up with a phone call. At this juncture in Michael's development, it was important to discuss each and every contact between therapist and mother thoroughly with Michael, as well as to support his independent use of psychotherapy.

Seems like more of a case of the therapist convincing the individual to allow information to be passed along to parents, rather than the therapist simply exercising her judgement and circumventing him. And, even then, would your parents knowing be such a terrible thing? (I don't know, obviously, since I've never met them).

Honestly, I don't want them finding out for kinda selfish reasons, but that isn't relevant. It wouldn't be the end of the world if they found out, you're right. I'll talk to her about telling her therapist b

For you to just assert it isn't medicine when it has been used to alleviate mental and physical illnesses is just ignorant. Cannabis has helped plenty of vets with trauma and depression.

Marijuana, as in the plant you buy from dealers or dispensaries, is not a medicine. It's a recreational drug. THC (or more often) CBD, are chemicals that may be used in medications. The important difference that I'm trying to highlight is that what RC's sister is using isn't regulated or designed to be a medicine. I think I'm being pretty clear that I recognize the medicinal use of those chemicals but nobody in the medical community is going to call a joint "medicine". I'll restate my previous analogy: eating willow bark isn't the same as taking a dose of aspirin.

There's nothing to "believe", that's my point. It's helping her. For you to imply she has no idea what she's doing and just thinks she's better because it "numbs" her while she's high is fucking retarded and rather rude.

Honestly, I have no idea if you're just fucking with me right now. You are completely misconstruing what I said. Any time a patient observes an improvement in their condition (i.e., they believe something they are doing is working), it ought to be discussed with her doctor so it can be safely incorporated into current treatment.

For all I know, her depression isn't life-threatening and while terrible, isn't causing her to want to kill herself daily. I grew up with a sister frequently trying to kill herself and have worked with kids in the same spectrum of the disorder, so whenever someone talks about depression I look at it from a worst-case, don't-fuck-around-with-meds perspective.

she's gonna tell her doctor that her meds aren't working and give that a try again.

That's great man. I'm all for sufferers of depression finding ways to improve their situation and health. Marijuana is not the issue; I'd be concerned about any behavior (eating, drinking, etc) that is potentially being used as a crutch against an illness.

Quote from: rc on August 10, 2016, 09:50:15 AM

Quote from: Dan on August 10, 2016, 09:35:39 AM

Quote from: rc on August 10, 2016, 09:11:41 AM

Quote from: Verbatim on August 10, 2016, 07:45:24 AM

But I still don't like your use of terms like "dulling" or "masking of symptoms," as though any other antidepressants could possibly do anything different. While you're right in saying that's all marijuana can do for your depression, that's also all Prozac, Zoloft, Paxil, Luvox, Brintellix, Fetzima, Viibryd, Celexa, Lexapro, Sarafem, Cipralex, and Pexeva can do for you, too. None of these will "cure" your depression--they only mask your symptoms.

I'm under the impression that those drugs do "cure" depression by altering the production of the chemicals in your brain that are causing the depression. Weed, on the other hand, doesn't do that, it just makes you feel good for a bit. I guess I could be wrong about that, though.

Quote from: Fox "Turkey" Mulder on August 10, 2016, 07:30:38 AM

I really have no idea what you think is rude about that at all. If RC's sister believes THC-based medication will improve her health, she ought to discuss it with her doctor.

I told her what you said, and she claims that she agrees with me and that she's gonna tell her doctor that her meds aren't working and give that a try again. We live in Florida, so it isn't legal, but would discussing this with her therapist be a mistake? I know the therapist wouldn't tell the police or anything, but could she tell our parents?

SSRI medications are designed to stop the reuptake of serotonin (the feel good chemical) in your brain so that you feel like you have more serotonin. Problem is, that serotonin will eventually become depleted and you will need to increase the dosage to achieve the same desired effect. They are symptom managers, they do not "cure" anything. They are simply manipulating a single neurotransmitter in the brain.

Don't get me wrong, I'm not anti-drug. They do help a lot of people when it's done right and the patient is tapered off when the symptoms resolve. Unfortunately, a lot of doctors keep their patients on the drug for years or indefinitely and add on other medications to counteract the side-effects caused by the other drugs. The more drugs added, the higher the chances of having to deal with other iatrogenic disorders.

She's been going to the same doctor for a few years now. I saw the progress way before she started smoking, but shes obviously not happy still. Should I push my parents to try a different doctor?

Yes, if it's been over a year without any notable progress I'd certainly try a different therapist.

The style of psychotherapy might have something to do with it, CBT based approaches are the current gold standard for a reason and if they've been seeing them for a few years then chances are it's not that.

My mom keeps me in the loop with her treatment, and I don't think shes ever mentioned CBT... Could you send some links my way to help convince my parents that they should try a different therapist who will try that treatment?