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<blockquote data-quote="Martie" data-source="post: 112290" data-attributes="member: 284"><p>smallworld (and all),</p><p></p><p>I think your psychiatrist is taking the correct course. Although my ex-difficult child is not altogether "grown" (since research indicates brain development continues at least until 25,) he is not a young adolescent who presented in sequence with anxiety, depression, and ODD, but not ADHD as a child. He was medicated with a very high dosage level of Prozac because "oldest is best." This and Wellbutrin saved his life (at 80 mg of Prozac and 450 mg of Wellbutrin per day.) He was on a rule out bipolar at 14 because he was cycling beyond "normal," but never had a full-blown manic episode. He trialed 5 major mood stabilizers at EGBS (consulting psychiatrist was very good with medications and LISTENED to kids about side effects!) and not one did anything for ex-difficult child. </p><p></p><p>I was driven a bit nuts by the rule out bipolar because I wanted it "ruled out" or "ruled in." However, when I asked psychiatrist how one "got rid of "rule out BiPolar (BP)," he said, "make it to 40 without a manic psychotic episode." That seemed a bit extreme to me but he had a point: the longer ex-difficult child took high doses of SSRIs without a mood stabilizer to "buffer" and the older he got, the less likely it seemed that he would ever meet the diagnosis criteria for BiPolar (BP).</p><p></p><p>I consider it "ruled out" for all practical purposes. HOWEVER, in my less magnanimous moments, I am quick to point out that ex-difficult child is very "moody," and has classic "artistic temperament," which is not a diagnosis, but is very real to deal with some days. I guess it is fortunate for ex-difficult child that he lives in a world where this temperamental style is quite common....it might not go over well in some other occupational arenas. What this means to me is there are no definitive answers prospectively. Only retrospectively does the picture become clear(er)to me that all of this stuff is on a continuum and to call one thing a disorder and another a "tendency" is arbitrary and depends upon the psychiatrist's level of conservatism in Dxing. </p><p></p><p>From my perspective, the chances of functioning as a young adult are much better than as an adolescent in school. I believed this when ex-difficult child was young, and every year he has aged, he has made progress toward being more and more functional. I realize that difficult children on the more "conduct" end do not necessarily "improve with age" as they have bigger and better acting out opportunities. My comments are limited to adolescents with mood and other internalizing disorders. Stated a bit less formally, "it is the pits to be an adolescent with a mood disorder and things CAN get better." Even though I do believe that whatever is going on with ex-difficult child is life-long, the manifestations of it have changed over the years.</p><p>Best to you all,</p><p></p><p>Martie</p></blockquote><p></p>
[QUOTE="Martie, post: 112290, member: 284"] smallworld (and all), I think your psychiatrist is taking the correct course. Although my ex-difficult child is not altogether "grown" (since research indicates brain development continues at least until 25,) he is not a young adolescent who presented in sequence with anxiety, depression, and ODD, but not ADHD as a child. He was medicated with a very high dosage level of Prozac because "oldest is best." This and Wellbutrin saved his life (at 80 mg of Prozac and 450 mg of Wellbutrin per day.) He was on a rule out bipolar at 14 because he was cycling beyond "normal," but never had a full-blown manic episode. He trialed 5 major mood stabilizers at EGBS (consulting psychiatrist was very good with medications and LISTENED to kids about side effects!) and not one did anything for ex-difficult child. I was driven a bit nuts by the rule out bipolar because I wanted it "ruled out" or "ruled in." However, when I asked psychiatrist how one "got rid of "rule out BiPolar (BP)," he said, "make it to 40 without a manic psychotic episode." That seemed a bit extreme to me but he had a point: the longer ex-difficult child took high doses of SSRIs without a mood stabilizer to "buffer" and the older he got, the less likely it seemed that he would ever meet the diagnosis criteria for BiPolar (BP). I consider it "ruled out" for all practical purposes. HOWEVER, in my less magnanimous moments, I am quick to point out that ex-difficult child is very "moody," and has classic "artistic temperament," which is not a diagnosis, but is very real to deal with some days. I guess it is fortunate for ex-difficult child that he lives in a world where this temperamental style is quite common....it might not go over well in some other occupational arenas. What this means to me is there are no definitive answers prospectively. Only retrospectively does the picture become clear(er)to me that all of this stuff is on a continuum and to call one thing a disorder and another a "tendency" is arbitrary and depends upon the psychiatrist's level of conservatism in Dxing. From my perspective, the chances of functioning as a young adult are much better than as an adolescent in school. I believed this when ex-difficult child was young, and every year he has aged, he has made progress toward being more and more functional. I realize that difficult children on the more "conduct" end do not necessarily "improve with age" as they have bigger and better acting out opportunities. My comments are limited to adolescents with mood and other internalizing disorders. Stated a bit less formally, "it is the pits to be an adolescent with a mood disorder and things CAN get better." Even though I do believe that whatever is going on with ex-difficult child is life-long, the manifestations of it have changed over the years. Best to you all, Martie [/QUOTE]
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