I asked our psychiatrist once for a diagnosis - can't remember which kid - and he said "I don't do diagnoses - I treat symptoms." This science is so new, and the DSM is so political, and there's no guarantee that any one kid has only one diagnosis - even if they did get it right.
Does anyone ever wonder if the professionals REALLY know what is wrong with our kids?
- Thread starter BusynMember
- Start date
hearts and roses
Mind Reader
We had, I think, a total of three psychiatrists for difficult child as she progressed from age 10 to 17. Her initial diagnosis was tourette syndrome manifested as ADHD and anxiety. Later, Obsessive Compulsive Disorder (OCD) was added, then the ADHD was a dropped and mood disorder was added.
I think doctors are right to treat symptoms, as pajamas said, because why wouldn't they? Brain disorders have so many varying symptoms that cross over one another that to simply diagnosis and treat a diagnosis would be an injustice. difficult child has tourette syndrome for sure. When her anxiety is amped up and at changes in the seasons, her tics are increased. However, a more predominant manifestation of her Tourette's Syndrome is apparent with ADD and Obsessive Compulsive Disorder (OCD) behaviors. Her anxiety level is always up, but not through the roof. If her dr only treated the Tourette's Syndrome diagnosis, he would likely give her clonidine or risperdal. Those medications would not help with her more apparent and bothersome symptoms...so IMVHO, I agree with treating the symptoms rather than the diagnosis.
Have I ever wondered if the professionals really know what is wrong with our kids? ALL THE TIME. In fact, I still wonder about this whenever I leave the doctors office. For me, this is the reason I choose women doctors who are in my age range-so they can relate to me with a better understanding of what it means to be a 49 year old perimenopausal woman. One of the reasons we dropped difficult child's first psychiatrist is because she was young, just married and had no children. I felt all she wanted to do was experiment with difficult child by prescribing and constantly tweaking her medications. The next psychiatrist was older and had children, but she was vague. She kept saying difficult child had a mood disorder and when I asked if she meant difficult child was bipolar, she always beat around the bush and kept saying she didn't like that term and continued to call it a mood disorder-she too was a drug pusher. Finally, of all people, our local regular dr/aprn is the one who treated difficult child for her symptoms rather than her label and we got good results. Unfortunately, at that time, difficult child was off the charts with typical teen behaviors (combined with impulsivity from her disorders) that she refused to take medications. In retrospect, it's good she stopped the medications because she was drinking and drugging...not a good combo. Eventually, our aprn suggested the depo shot. That worked like a charm for difficult child!
No matter the amount of education, I think when faced with a difficult child,it's a guessing game and doctors can only do so much.
Sorry for any typos!!
I think doctors are right to treat symptoms, as pajamas said, because why wouldn't they? Brain disorders have so many varying symptoms that cross over one another that to simply diagnosis and treat a diagnosis would be an injustice. difficult child has tourette syndrome for sure. When her anxiety is amped up and at changes in the seasons, her tics are increased. However, a more predominant manifestation of her Tourette's Syndrome is apparent with ADD and Obsessive Compulsive Disorder (OCD) behaviors. Her anxiety level is always up, but not through the roof. If her dr only treated the Tourette's Syndrome diagnosis, he would likely give her clonidine or risperdal. Those medications would not help with her more apparent and bothersome symptoms...so IMVHO, I agree with treating the symptoms rather than the diagnosis.
Have I ever wondered if the professionals really know what is wrong with our kids? ALL THE TIME. In fact, I still wonder about this whenever I leave the doctors office. For me, this is the reason I choose women doctors who are in my age range-so they can relate to me with a better understanding of what it means to be a 49 year old perimenopausal woman. One of the reasons we dropped difficult child's first psychiatrist is because she was young, just married and had no children. I felt all she wanted to do was experiment with difficult child by prescribing and constantly tweaking her medications. The next psychiatrist was older and had children, but she was vague. She kept saying difficult child had a mood disorder and when I asked if she meant difficult child was bipolar, she always beat around the bush and kept saying she didn't like that term and continued to call it a mood disorder-she too was a drug pusher. Finally, of all people, our local regular dr/aprn is the one who treated difficult child for her symptoms rather than her label and we got good results. Unfortunately, at that time, difficult child was off the charts with typical teen behaviors (combined with impulsivity from her disorders) that she refused to take medications. In retrospect, it's good she stopped the medications because she was drinking and drugging...not a good combo. Eventually, our aprn suggested the depo shot. That worked like a charm for difficult child!
No matter the amount of education, I think when faced with a difficult child,it's a guessing game and doctors can only do so much.
Sorry for any typos!!
I find that one interesting... because I've used it in reverse.
For some kids, there's an elephant in the room - but all that is seen is the "pieces". Nobody is putting the pieces together.
For other kids... there is NO elephant. The pieces are actually accurate... but everybody is spending their time "looking for the elephant" rather than solving problems...
BusynMember
Well-Known Member
In the US...no elephant...no supports.
The problem I see with treating the symptoms (and I see this a lot) is that child X may have four labels and two drugs for every label in an attempt for Dr. X to medicate away every single symptom rather than addressing the big picture. I am against overmedicating, and I think a lot of our kids are on enough medications to knock out an elephant. In rare cases it's probably necessary (such as if a child has childhood schizophrenia), however in most cases, I really flinch at a kid who takes one pill for attention, one for sleeping, one for irritability, one for rages, one for allergies, one for impulsivity, etc. etc. etc. Those are powerful drugs (I have taken many of them) and even one can knock you out or make you very spaced out. I wish they'd medicate the worst symptoms (such as depression) and try to teach coping skills for the other ones. I also wish they'd use medications as a last resort. They don't do that enough in my opinion.
We have so much still to learn.
The problem I see with treating the symptoms (and I see this a lot) is that child X may have four labels and two drugs for every label in an attempt for Dr. X to medicate away every single symptom rather than addressing the big picture. I am against overmedicating, and I think a lot of our kids are on enough medications to knock out an elephant. In rare cases it's probably necessary (such as if a child has childhood schizophrenia), however in most cases, I really flinch at a kid who takes one pill for attention, one for sleeping, one for irritability, one for rages, one for allergies, one for impulsivity, etc. etc. etc. Those are powerful drugs (I have taken many of them) and even one can knock you out or make you very spaced out. I wish they'd medicate the worst symptoms (such as depression) and try to teach coping skills for the other ones. I also wish they'd use medications as a last resort. They don't do that enough in my opinion.
We have so much still to learn.
In Canada... no diagnosis, no supports. But not every diagnosis = support. (ADHD doesn't get you much.)
Elephant dxes get bigger support. But... there is a way around the non-elephant cases. As long as you have the knid of dxes that have a logical case for certain supports...
Developmental Coordination Disorder (DCD) or dysgraphia will get you technology and other standard supports (note-taking, that kind of thing). Auditory Processing Disorders (APD) of any sort gets some form of FM system... and some standard supports. Most LDs have a standard-support list.
Mood disorders? harder. Behavior problem? they will throw lots of stuff at the kid, but none of it will be the right stuff. Unless these are part of an elephant (such as Autism Spectrum Disorders (ASD)).
If it takes an elephant diagnosis to get support in the US... then it's a good thing we live in Canada, or we'd have lost difficult child long ago. Not that our system is perfect either... just some cases work better with different systems, and we can't pick and choose which system we are in based on our needs.
The problem with hunting for the elephant if it doesn't exist is that it wastes years and years of time... when symptomatic intervention would have worked miracles.
The $64 question is... how can you tell if you're dealing with an elephant, or just a raft of "other" stuff??? If we knew... the approach would be simpler.
Elephant dxes get bigger support. But... there is a way around the non-elephant cases. As long as you have the knid of dxes that have a logical case for certain supports...
Developmental Coordination Disorder (DCD) or dysgraphia will get you technology and other standard supports (note-taking, that kind of thing). Auditory Processing Disorders (APD) of any sort gets some form of FM system... and some standard supports. Most LDs have a standard-support list.
Mood disorders? harder. Behavior problem? they will throw lots of stuff at the kid, but none of it will be the right stuff. Unless these are part of an elephant (such as Autism Spectrum Disorders (ASD)).
If it takes an elephant diagnosis to get support in the US... then it's a good thing we live in Canada, or we'd have lost difficult child long ago. Not that our system is perfect either... just some cases work better with different systems, and we can't pick and choose which system we are in based on our needs.
The problem with hunting for the elephant if it doesn't exist is that it wastes years and years of time... when symptomatic intervention would have worked miracles.
The $64 question is... how can you tell if you're dealing with an elephant, or just a raft of "other" stuff??? If we knew... the approach would be simpler.
keista
New Member
I like the concept of treating symptoms, but there's still a problem with that - not all symptoms are created equal. As an example, irritability due to a mood disorder responds to different medicines than irritability due to sensory overload. Distractability due to ADD responds to different medications than distractability due to sensory issues. What looks like lack of focus could be attention deficit as in ADD or it could be perseveration as in Autism Spectrum Disorders (ASD).
OR it could be Auditory Processing Disorders (APD) which is totally different again.
Which is why, I think, the professionals around here are wary to treat symptoms without a diagnosis... but WILL treat a string of dxes. But that doesn't prevent dancing around an elephant.
confuzzled
Member
interesting you just happen to mention that.....
http://www.nypost.com/p/news/opinio..._false_autism_epidemic_jfI7XORH94IcUB795b6f7L
"So where do we stand, and what should we do? I am for a more careful and restricted diagnosis of autism that isnt driven by service requirements. I am also for kids getting the school services they need.
The only way to achieve both goals is to reduce the inordinate power of the diagnosis of autism in determining who gets what educational service. Psychiatric diagnosis is devised for use in clinical settings, not educational ones. It may help contribute to educational decisions but should not determine them'. -Dr. Allen Frances, now a professor emeritus at Duke Universitys department of psychology, chaired the DSM IV task force
Tiapet
Old Hand
I don't know if I won't quantify it as "trust" for the professionals, though in some cases it clearly IS a matter of trust and I DON't trust some of them at all! Let me give some examples of our road:
With difficult child#1 who is 20 now - at 5 when I began with her it was with her primary care doctor and he hadn't a clue what as going on nor did he know where or who to refer me to for her as I sat in his office in tears. He was, however, clearly invested in my concerns and trusted me and didn't judge or jump to conclusions that I was an abusive parent at all. Thank god because over the next several years I would need him as back up to prove through different times of trials and tribulations that she wasn't as she lied (a case during "sharing" in psychiatric hospital inpatient group therapy), another with a rogue school therapist who didn't like that I filed a complaint against him who in turned filed a false allegation against me (had not only dr but advocate back me up and prove what he did as well as difficult child's own medical records), etc.
Moving on, she has seen numerous psychiatrists and Tdocs as well as counselors over the years. These docs threw so many different medications at her it's incredible. The only ones that worked were to help with her ADHD component of symptoms. The rest paradoxed or created far worse problems. Counselors have been so far off base in their recommendations of how to handle her (lots of bad parenting or "try this" when we've already done so, or just flat out bad advise "your 16, the best thing you can do is move out!????" really?)
With difficult child#2 - Pretty much along the same lines except NONE of them have been able to figure her out at all, notta, zip not even close to what's going on. Same type of advise given. No one can reach her in counseling as she won't even talk and the worst part is in one case they continued with her not even talking for 2 years!! Who continues on with it for that long if you are going no where??? Again, medication ADHD control and mildly sleep help but not great as she doesn't fully get sleep like it's suppose to do. Everything else we've had serious problems with from toxicity issues to paradox. Mostly bad issues of toxicity. Not watching doses or testing, etc. Oh yeah, in older difficult child case one psychiatrist didn't do lithium testing for 3 months! You are suppose to test level minimally once a month!
With youngest difficult child- a little better result because he's a little easier. ADHD medication pretty much dead on good results and sleep medications help him. No help for behavioral effects from food allergy, I had to figure out combination of medications to help with that and only sometimes can it work right the first time. I "think" we are close in diagnosis for him but again, he's pretty straigh forward in what's going on as in "easy" to figure out. As for therapy....well he has not had consistency nor continuity at all. In fact he has had the LEAST consistency out of the 3 of them. I don't know why all his workers have been a problem or have had issues but they have and therefor I think has lead to why he hasn't been helped to the level I think he could have been as he WILL work the program if he has consistency and I can only do so much with him. With support for and with me, he does very well. Without, he faulters.
Bottom line, and I think I've said it before, this board has given me more of a life and information and help then I've been able to get in all these years from professionals (sans the medications that need prescribing and even at that it's given me directions to seek certain types at times). There is such a broad base of REAL life situations that apply that are like my difficult children that I can see and say "hey, that's like mine maybe, just maybe this is that or I can try this". The professionals seem to stick to the books or what ever the run of the mill at the time is going on I think.
Any more I use the professionals as my "support" team and backup and have them there for prescribing and paper trail so that when the time comes, and it usually does, I have the paperwork to prove that yes....these kids do have issues and here is the proof! Always have to cya because if you don't.....ugh...been there done that and no more will I ever not do it again...
With difficult child#1 who is 20 now - at 5 when I began with her it was with her primary care doctor and he hadn't a clue what as going on nor did he know where or who to refer me to for her as I sat in his office in tears. He was, however, clearly invested in my concerns and trusted me and didn't judge or jump to conclusions that I was an abusive parent at all. Thank god because over the next several years I would need him as back up to prove through different times of trials and tribulations that she wasn't as she lied (a case during "sharing" in psychiatric hospital inpatient group therapy), another with a rogue school therapist who didn't like that I filed a complaint against him who in turned filed a false allegation against me (had not only dr but advocate back me up and prove what he did as well as difficult child's own medical records), etc.
Moving on, she has seen numerous psychiatrists and Tdocs as well as counselors over the years. These docs threw so many different medications at her it's incredible. The only ones that worked were to help with her ADHD component of symptoms. The rest paradoxed or created far worse problems. Counselors have been so far off base in their recommendations of how to handle her (lots of bad parenting or "try this" when we've already done so, or just flat out bad advise "your 16, the best thing you can do is move out!????" really?)
With difficult child#2 - Pretty much along the same lines except NONE of them have been able to figure her out at all, notta, zip not even close to what's going on. Same type of advise given. No one can reach her in counseling as she won't even talk and the worst part is in one case they continued with her not even talking for 2 years!! Who continues on with it for that long if you are going no where??? Again, medication ADHD control and mildly sleep help but not great as she doesn't fully get sleep like it's suppose to do. Everything else we've had serious problems with from toxicity issues to paradox. Mostly bad issues of toxicity. Not watching doses or testing, etc. Oh yeah, in older difficult child case one psychiatrist didn't do lithium testing for 3 months! You are suppose to test level minimally once a month!
With youngest difficult child- a little better result because he's a little easier. ADHD medication pretty much dead on good results and sleep medications help him. No help for behavioral effects from food allergy, I had to figure out combination of medications to help with that and only sometimes can it work right the first time. I "think" we are close in diagnosis for him but again, he's pretty straigh forward in what's going on as in "easy" to figure out. As for therapy....well he has not had consistency nor continuity at all. In fact he has had the LEAST consistency out of the 3 of them. I don't know why all his workers have been a problem or have had issues but they have and therefor I think has lead to why he hasn't been helped to the level I think he could have been as he WILL work the program if he has consistency and I can only do so much with him. With support for and with me, he does very well. Without, he faulters.
Bottom line, and I think I've said it before, this board has given me more of a life and information and help then I've been able to get in all these years from professionals (sans the medications that need prescribing and even at that it's given me directions to seek certain types at times). There is such a broad base of REAL life situations that apply that are like my difficult children that I can see and say "hey, that's like mine maybe, just maybe this is that or I can try this". The professionals seem to stick to the books or what ever the run of the mill at the time is going on I think.
Any more I use the professionals as my "support" team and backup and have them there for prescribing and paper trail so that when the time comes, and it usually does, I have the paperwork to prove that yes....these kids do have issues and here is the proof! Always have to cya because if you don't.....ugh...been there done that and no more will I ever not do it again...
