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DSM-V draft available online for public comment
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<blockquote data-quote="smallworld" data-source="post: 340813" data-attributes="member: 2423"><p>Here are my thoughts about the new label Temper Dysregulation Disorder:</p><p> </p><p>First, I agree with Tessa that I don't like the name because it brings to mind temper tantrums set off by bad parenting. The kind of rages our difficult children exhibit go way beyond any temper tantum a two-year-old throws and have no rhyme nor reason to their origin. From having experienced rages in my household for 5 years, I do believe they emanate from deep inside the brain and are almost seizure-like in their origin. Calling them temper dysregulation diminishes their severity in my mind.</p><p> </p><p>Second, researchers at NIMH in Bethesda, Maryland, have been studying a disorder that they have termed Severe Mood Dysregulation, which I think is similar to TDD (I happen to like the term SMD better than TDD). They think it is distinct from BiPolar (BP) and have been testing whether it responds to medications that BiPolar (BP) doesn't respond to -- ADHD stimulants (like Ritalin) and SSRI antidepressants (like Celexa). Although I believe my own kids might fit better with a SMD diagnosis than a BiPolar (BP) diagnosis, I don't believe they would do all that well with stimulants and SSRIs.</p><p> </p><p>Which brings me to my third point. TDD does not address the whole issue of kids who take SSRIs and become manic. This is an all-too-frequent problem (two just in my family, and a third who became disinhibited), and psychiatrists don't know what to make of it or how to treat it long-term. My son J was rxed Zoloft at age 11 and had a manic reaction after 3 weeks. Even though we discontinued Zoloft that night, he didn't settle down for weeks until Depakote was introduced. He later had manic reactions to four SSRIs/SNRIs, even with mood stabilizers on board. What does this mean for a diagnosis? What does this mean for treatment? </p><p> </p><p>J is now 16 and in an Residential Treatment Center (RTC) in Utah. His Residential Treatment Center (RTC) psychiatrist is not convinced he has BiPolar (BP) (based on psychological testing and history) and weaned him from his mood-stabilizing medications (Lamictal and Seroquel). And guess what? His mood is stable, although he is still struggling with anxiety that he is working on therapeutically. This is by no means the end of the road for J, diagnostically, medically or therapeutically. We are still trying to find our way.</p><p> </p><p>Is it possible that there are kids out there who don't have BiPolar (BP) or TDD? Like mine?</p></blockquote><p></p>
[QUOTE="smallworld, post: 340813, member: 2423"] Here are my thoughts about the new label Temper Dysregulation Disorder: First, I agree with Tessa that I don't like the name because it brings to mind temper tantrums set off by bad parenting. The kind of rages our difficult children exhibit go way beyond any temper tantum a two-year-old throws and have no rhyme nor reason to their origin. From having experienced rages in my household for 5 years, I do believe they emanate from deep inside the brain and are almost seizure-like in their origin. Calling them temper dysregulation diminishes their severity in my mind. Second, researchers at NIMH in Bethesda, Maryland, have been studying a disorder that they have termed Severe Mood Dysregulation, which I think is similar to TDD (I happen to like the term SMD better than TDD). They think it is distinct from BiPolar (BP) and have been testing whether it responds to medications that BiPolar (BP) doesn't respond to -- ADHD stimulants (like Ritalin) and SSRI antidepressants (like Celexa). Although I believe my own kids might fit better with a SMD diagnosis than a BiPolar (BP) diagnosis, I don't believe they would do all that well with stimulants and SSRIs. Which brings me to my third point. TDD does not address the whole issue of kids who take SSRIs and become manic. This is an all-too-frequent problem (two just in my family, and a third who became disinhibited), and psychiatrists don't know what to make of it or how to treat it long-term. My son J was rxed Zoloft at age 11 and had a manic reaction after 3 weeks. Even though we discontinued Zoloft that night, he didn't settle down for weeks until Depakote was introduced. He later had manic reactions to four SSRIs/SNRIs, even with mood stabilizers on board. What does this mean for a diagnosis? What does this mean for treatment? J is now 16 and in an Residential Treatment Center (RTC) in Utah. His Residential Treatment Center (RTC) psychiatrist is not convinced he has BiPolar (BP) (based on psychological testing and history) and weaned him from his mood-stabilizing medications (Lamictal and Seroquel). And guess what? His mood is stable, although he is still struggling with anxiety that he is working on therapeutically. This is by no means the end of the road for J, diagnostically, medically or therapeutically. We are still trying to find our way. Is it possible that there are kids out there who don't have BiPolar (BP) or TDD? Like mine? [/QUOTE]
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