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General Parenting
Disappointed with 2nd psychiatric opinion today...
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<blockquote data-quote="smallworld" data-source="post: 57285" data-attributes="member: 2423"><p>I'm sorry if you've covered this at another point, but are you taking your difficult child for a neuropsychological evaluation? It makes a lot of sense given that you're struggling with diagnosis and medications.</p><p></p><p>Another question: Has your difficult child ever been on an SSRI antidepressant without any other medications on board? If so, what was his reaction?</p><p></p><p>I ask the latter question because I co-moderate a listserv of parents of BiPolar (BP) children. One of the kids in the group tried just about every combo of mood stabilizer/atypical antipsychotic over the last 3 years and was still raging. It got so bad that she was hospitalized about 10 days ago. After testing and observation, the psychiatrists now believe she has severe Obsessive Compulsive Disorder (OCD) and not BiPolar (BP). She has started a trial of Prozac and is doing much better.</p><p></p><p>My point is that the symptoms can look like a lot of different disorders, and treatment is based on diagnosis. ADHD is treated one way. Anxiety and unipolar depression are treated another way. The medications for ADHD and anxiety/depression can make a child with BiPolar (BP) worse. The medications for BiPolar (BP) will likely do nothing for a child with anxiety. </p><p></p><p>This is all my long way of saying that a differential diagnosis is frequently not reached without a lot of testing and observation over time. Both my older children J and A have had extensive neuropyschological testing over the last several years, and they both see psychiatrists weekly for medication management and psychotherapy (no tdocs involved). M also sees a psychiatrist weekly for medication management and psychotherapy. She has not had neuropsychologist testing because hers is a more straightforward case of anxiety. Only through this systematic approach to mental health care have we been able to make any progress at all.</p><p></p><p>Good luck. Believe me, I know through my own experiences with my kids that this stuff is not easy.</p></blockquote><p></p>
[QUOTE="smallworld, post: 57285, member: 2423"] I'm sorry if you've covered this at another point, but are you taking your difficult child for a neuropsychological evaluation? It makes a lot of sense given that you're struggling with diagnosis and medications. Another question: Has your difficult child ever been on an SSRI antidepressant without any other medications on board? If so, what was his reaction? I ask the latter question because I co-moderate a listserv of parents of BiPolar (BP) children. One of the kids in the group tried just about every combo of mood stabilizer/atypical antipsychotic over the last 3 years and was still raging. It got so bad that she was hospitalized about 10 days ago. After testing and observation, the psychiatrists now believe she has severe Obsessive Compulsive Disorder (OCD) and not BiPolar (BP). She has started a trial of Prozac and is doing much better. My point is that the symptoms can look like a lot of different disorders, and treatment is based on diagnosis. ADHD is treated one way. Anxiety and unipolar depression are treated another way. The medications for ADHD and anxiety/depression can make a child with BiPolar (BP) worse. The medications for BiPolar (BP) will likely do nothing for a child with anxiety. This is all my long way of saying that a differential diagnosis is frequently not reached without a lot of testing and observation over time. Both my older children J and A have had extensive neuropyschological testing over the last several years, and they both see psychiatrists weekly for medication management and psychotherapy (no tdocs involved). M also sees a psychiatrist weekly for medication management and psychotherapy. She has not had neuropsychologist testing because hers is a more straightforward case of anxiety. Only through this systematic approach to mental health care have we been able to make any progress at all. Good luck. Believe me, I know through my own experiences with my kids that this stuff is not easy. [/QUOTE]
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Disappointed with 2nd psychiatric opinion today...
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