got girlfriend'gs evaluation results... doesn't make sense

[Jena]

hi to everyone

so i got the results of my little one's evaulation at hospital. weird is all i can say i think. i'm still digesting.

she said that she has Generalized Anxiety Disorder (GAD) generalized anxiety disorder which i pretty much knew forever. then she said taht she is clinically and severely depressed? i said what? she said that difficult child wrote alot of negative things about herself during hte interview questions and stuff which she did it was sad and i did see it. yet that was that week her view of her. she was withdrawn that week quiet a little down.

this week she's up socially doing well in school, etc. and hasn't slept much we refilled chlonidine thank goodnes.

so i said to her so what your telling me is that my difficult child has been depressed since she's about 4? cause that's how long i've been seeing these behaviors?? she said sure it can happen your divorce 7 years ago hit her hard when she realized it happened. she would do anything to have you two back and mentioned it quite frequently. so i saisd ok why is she happy at time sthen and flying on top of a cloud it seems? she said all depressed people have ups and downs. it's not an even flow. yet now left untreated it's getting to a dangerous level.

so i said what about when we ran out of chlonidine at two nights she was up till 5 a.m. adn the third night she crashed at 11? what about that?

she said maybe she has a sleepdisorder. i said if she had one wouldn't her sleep be affected eveyrnight not just certain nights almost in the shape of a pattern? she said no not necessarily.

then i said ok so what makes you think it's not bi polar? not that i want her to have it yet i wasn't feeling her diagnosis. she said it doens't appear to be bi polar because she doenst' exhibit the behaviors in school. she is withdrawn in school from what the school says and anxiety ridden. i said ok did they tell you about hte day she suddenly out of blue decided to do a stand up presentation that was due? she'd never do that normally?

so i dont know what to think at this opint. 4k for what? do i think my difficult child views herself badly? yes wthout a doubt do i thin kshe views herself like this all the time? no not at all. that's just it there are swings up and downs.

so now according Occupational Therapist (OT) her weekly therapy, medications for the depression and a 504 in place at school.

any thoughts i'd love to hear them i'm a little aggrivated. seh also said the sensory issues the focus issues the germ issues are all due to her anxiety disorder because she's hyper vigilant.

thanks
jen

 

[totoro]

Sorry I don't have a lot of time right now... But why would she have to show the signs at school??? Did she explain that one to you? K does not always show all of her symptoms at school... If you read the bipolar child it gets into this, the child holding it together at school... pretty common. There is a link on the website, I think called the busride home... that goes into all of this...
I will see if I can find it later...
Sorry I am having Bipolar kid issues... we must hottub... she needs to relax!!!

 

[smallworld]

Did your difficult child have bad reactions to SSRI antidpressants?

 

[Jena]

hi and thanks, yes ssri's made her manic up for 3 days. and she said that in order for her to see bipolar it would have to be all day rather in school. i think she's way way off and i wasted alot of money

 

[BusynMember]

How long was she tested? How many tests were run? What kind of tests? What sort of professional diagnosed her?
They CAN be wrong. It's not even uncommon. If you don't feel it's right in your gut, I'd go for another opinion. I like NeuroPsychs, however some aren't as good as others. My son was tested for twelve hours. He can be withdrawn, although he's good natured and not depressed. He is on the autism spectrum, which certainly makes kids withdrawn.
Bipolar kids tend to be very hyper and moody, but not necessarily withdrawn. I had a mood disorder as a child and was very chatty, although prone to weeping and feeling sad inside. I didn't have many friends.

 

[Jena]

hi

she was tested for 3 dys 5 - 7 hours each day all sorts of tests were done. all the functioning math reading al that stuff came back that she functions on average level so there's no real learning disability there. yet her social emotional was a wreck totally. yet shes different at diff times. seh attributed it all to or changing life we have had 2 moves within 2 1/2 years and 2 school changes. i get that's alot yet hey she exhibited these behaviors long before that ya know??

 

[totoro]

Sorry you are going through all of this... I don't know what is going on with your difficult child. But I do know how frustrating it can be. Regardless, she needs to be helped to maintain some stability, You know?
Sometimes you have to just work with the person that is available for the time, that can help your child... as long as it does not put your child in danger...
For us psychiatrist3 was overmedicating K and we felt as well as therapist and pediatrician that it was not good for K... nor was she stable. But for awhile it was all we had... and we needed some stability.
Stability in your house is SO important as well. I know things have been up and down for you and you are trying to get things stable, do you think this is making it harder for her? And maybe this is what the psychiatrist is reading into and seeing, and trying to push onto difficult child's diagnosis?
When we moved 2 years ago they were trying to make such a big thing about it as far as K's behaviors, which for most kids would be a big deal. But after lots of observations, and husband and I trying to explain that K is just different and that she was "Like" this prior to the move or husband working out of town...
They all came to the conclusion that yes K is and was like she is... regardless of her environment. BUT it took us, videoing, writing parent-reports, proving that we had implemented parent and behavior modifications, much longer than 2 weeks of mods... taking K to classes, Occupational Therapist (OT), Gymnastics, Hippo-Therapy... therapist. So much to show and to prove to ourselves as well as DOCS that K can not be helped by some one like a "Super Nanny"...
Our Mods have helped us and her, but we and the Docs can really see that there is a real Underlying Mental Illness, most likely BiPolar (BP), and it is not just Generalized Anxiety Disorder (GAD), or Depression. They could see the actual Cycling. When K is unstable her Anxiety gets worse as does her Sensory Integration Disorder (SID)... But when her medications are wrong these things get worse also... SO all the more important to have a psychiatrist who truly understands YOUR child.
Sometimes we just don't agree with the doctor's... been there done that!!!
I would give yourself a couple of days to wrap your mind around it...
You are going through SO much right now, try not to overreact, I tend to do that. Especially if I don't agree with the doctor, If I give myself a couple of days I can usually find something I might agree with??? Or maybe see there point?
Hang in there...

 

[susiestar]

Go with your instincts.

Have you read the Bipolar Child? Seems to me it would be wise to follow the medication instructions in that, esp if SSRI's make her manic.

Sounds like you maybe need to get copies of ALL the test info, not just the reports. I often found that the docs overlooked things that were significant in the results. Push for copies of EVERYTHING, then see what it all looks like.

Just because she tested your child for that long doesn't mean she knows what she is doing.

Hugs,

Susie

 

[janebrain]

it can be so frustrating. All the "experts" we took difficult child 1 to wanted to attribute everything to her dad's death when she was 8 yrs old. I couldn't seem to convince them that she exhibited these behaviors before her dad was even sick. It didn't help that she played the "poor fatherless kid" card either--was a good way to deflect the therapists from the real problems.

Jane

 

[Steely]

Sounds like you had some excellent testing - and although it seems like you did not get much out of it today - in the future you will be glad you have all of that information the tests provided. However, the tests can only rule out things that are actually neurological, tangible disorders - they cannot prove one has a specific mental illness diagnosis or another - it is still a guessing game on the doctors part.

Therefore if you do not feel comfortable with the doctors analysis of the situation, you can take the testing that was done, and give it to another dr for another opinion. However, I can also tell you that at age 8 doctors are still hesitant to use the bi-polar diagnosis. Forever, difficult child had the diagnosis of mood disorder not otherwise specified - because all of the doctors could had one reason or another why he did not exactly fit the bi-polar criteria. Which is fine - it did not really bother me - as long as we were using medications and therapy that worked for him.

If this dr has decided your daughter is depressed, and she needs medications - but she has horrible reactions to SRIs - what is the doctors plan for treating her?

 

[Jena]

the plan is therapy weekly, classifying her in school with a 504, and low dosage medications to assist in relieving some of her symptoms of depression.

so i'll move forward ofcourse and i guess i'll just have to watch her over the course of the next several mos. to see if i see an improvement or not.

 

[smallworld]

Jen, a few thoughts for you:

First, the symptoms of anxiety and depression lie at the heart of bipolar disorder. They come with the territory. So it's good that the evaluator saw them. What's trickier is to determine if there is bipolarity involved (symptoms of mania). A decreased need for sleep is a symptom of mania. When she stays up most of the night, is she able to function fine the next day?

Second, ideally a child psychiatrist should diagnose and treat bipolar disorder in children. But there's a nationwide shortage of child psychiatrists (fewer than 6,500 practice in the entire United States). If you do find one close to home, the child psychiatrist must have a view of childhood psychiatric diagnoses that includes the latest findings in childhood bipolar disorder. This is where many run into trouble because not all psychiatrists accept that bipolar disorder exists in children (and 8 years old is young to make the diagnosis). I imagine you will taking this testing to the next psychiatrist who treats your difficult child.

Third, the neuropsychological testing you did is not wasted because it can rule in or out certain conditions (such as ADHD, Autism Spectrum Disorders (ASD) and learning disabilities). You need to know for certain what is driving her anxiety and depression symptoms because the interventions for each condition are different.

Fourth, trust your mom instincts (but don't be blind to considering other possibilities). Use what you can and lose the rest.

Good luck. I know this has been a challenging time for you.

 

[Star*]

Hi jen,

You know - I have thought/pondered that my son was BiPolar (BP) for years. His biofather is, his biofathers mom was. What I see my son do - can be classified into so many different things. At one point when he was 10 I had someone one day say "He is most definitely BiPolar (BP)" and then the next test with a different doctor "He is a budding schizophrenic." If I pulled out all the paperwork from years gone by and lumped them together his diagnosis would be -

ADHD, Depression due to divorce, Severe ADHD, PTSD, Depression, Severe PTSD, Budding PB, Budding Schizoprhrenic, Possible Borderline PD, Reactive Attachment Disorder (RAD), Sensory Integration Disorder (SID), CD, CDD with ADHD and severe PTSD, CDD with emerging BiPolar (BP) with narcissistic traits and possible borderline tendencies. And last but NOT least - Child fine mother needs psychiatric help. THEN the most recent psycho. evaluation. He is Severe ADHD, Severe PTSD, Depression, Oppositional Defiant Disorder and budding Sociopath/Anti=social personality disorder.

Who are you going to believe? When I got the first BiPolar (BP) diagnosis I thought - (slap head) well THAT explains it - and some classes of SSRI's made him very angry and violent, others were tolerable. Ritalin made him aggressive, and I can list 5 dozen plus medications. that we tried in a carousel fashion and none helped. Not even a little bit. if I had to pick one that seemed to help him at all - Clonodine for sleep. But he has such severe PTSD about biofather coming to kill us - it took .10 to .20 to knock him out and then I got so worried I had to put a mirror under his nose to see fog if he was breathing or not. And after that he couldnt' function during the day.

I am surprised your doctor didn't mention the effects of Post Traumatic Stress Disorder. It's a very real, very life -altering disorder. What your daughter is suffering from sounds more to me like that - than anything else. She has had SO MUCH stress in her life that she just kept putting it back and putting it away and hiding in or not knowing it was bothering her and because of that she can maintain at school - and explodes at home because at least there - she knows she has someone that cares about her. Dude (my son) was ENRAGED at me for years and supressed it because I paid the bills, the mortgage, bought the food and he knew that on a subconscious level but deeper yet - blamed me for abandoning him with his crazy bio father (not) and allowing horrible things to happen while I lived the life of a princess - (what bio dad told him) and didn't care about him at all. So when I took him - he hated me. It took him years to blurt out I hate you and mean it. Then fall apart and say some of the things that were bottled up inside.

Kids don't have the ability to deal with stress at young ages so they develop their own coping skills to survive. The divorce probably DID affect her more than you know. The fact that you've moved a couple of times, the fact that financially it's been hit and miss (all same things here) and over the years - kids sometimes with Conduct disorders or PTSD are able to hold it together in school but not home or not at school but an angel at home...leaving you to wonder what they are doing to her in school.

So my suggestion is not to be too hasty to dismiss this doctors findings. Stress manifests itself in so many ways. THE GOOD NEWS is that your daughter is still young and would benefit GREATLY from talking to someone either in Cognitive Behavior THerapy (alters bad logic) and/or play therapy. Play therapy was awesome.

Just thought i would share a different point of view - I never believed Dude even had ADHD - and today I still don't think he has it. I DO know that PTSD has dominated his life due to the circumstances in his life and childhood and it nearly wrecked him as a person. He wasnt' able to hold it together at home or school and slept in the closet, under the bed, between the wall and the bed, or under the mattress for years - and with a butcher knife. THAT is stress. Up all night down all day - up all night and all day with no rhyme or reason and sometimes me BEGGING HIM TO PLEASE just lay down for 10 minutes so I could recoup? Stress.

I feel for ya.
Hugs
Star

 

[Jena]

hi

i see both of your points I truly do. you are correct i will have to trust my "mom" instinct on this one yet at the same time leave my mind open. it truly is a juggling act of sorts.

Star hi regarding the ptsd thing i too thought ok maybe. it just doens't fit becaues difficult child's symptoms have been apparent since pre-k. that is before the 2 big moves in her life (moving from queens to the island and then further into the island).

she has demonstrated for years extreme anxiety even as a little baby i always felt it, she could never soothe herself, etc. it just came out in different ways later on as she began to develop. she has no memory of ex husband and i married we split prior to her 2nd birthday so there aren't any memories of dad sleeping with her on his chest etc. sure their might be emotions without a doubt but concrete memories there aren't any.

i noticed an increase in her anxiety symptoms upon moving out to the island two summer's ago. then they subsided once she made friends, etc. and adjusted. yet the everyday anxiety that goes with the territory for her is always prevelant. it's just part of her i am so used to dealing with it the constant checking, the needed routine, the constant questions of stuff that is mine to worry about ie. did you get the mail, did you remember to do this and that? lol ofcourse i tell her that's mommy's job silly not yours.

i'm sorry to hear that you have gone through such difficulty and worse with so many different' diagnosis's it's just never ending. yet i do feel confident that depression and anxiety are at the heart of it. she said my difficult child's demeanor or what was presented taht day was of a depressed withdrawn child. to me tha'Tourette's Syndrome just her.

the sleep she didn't explain very well and taht was disturbing to me. the doctor's answer as to why difficult child can remain up until 5 a.m. was because depressed people have sleep issues. i siad ok i'll buy that. yet she isnt' sitting there crying or scared or wanting me she's down there tv on on her labtop with webkinz trying to sneak potatoe chips she's having a party the nights i pass out and dont stand guard.

she said well maybe it's a sleep disorder of some type. i said ok than if that's to be a posisbily than why is it we went and can be for mos. at a time with above average functioning, minimal anxiety, sleeping well, eating normally academically excelling socially doing well and then boom it hits the black cloud i call it? her answer to that was depression isn't a straight run it has peaks and valleys and maybe for her the work load at school 3rd grade is hard started to hit end of october beginning of november and taht pressurized her and made her go on a downward slope so to speak.

the school was so horrible with what they told the dr as well. you know it's funny if i was one of those parents who didn't care what my child was going through who turneda blind eye and put my own emotional and financial needs of the family first i could see it. yet their impression of rin and her lack of focus and also incompleted tasks, etc was a problem at home. this upset me greatly. my boyfriend and i have really tried so hard we have. we slip up a times like alot of couples do and there have been a few arguments yet for the most part we stay on course. when there's a problem its off to the truck downstairs with cig. adn tea until we work it out.

the school doesn't get it they dont know they didn't then. when m y almost 90 pound 9 year old is clinging to furniture and won't go to school what crane should i use to pry her and lift her out? or should i even? (hence her lateness they were complaining about) if she sits at our kitchen table for 3 hours and is totally unable to focus during homework time to the point where the rest of the kids are off and playing and there she is i now make her write a note to her teacher so she is held accountable herself for not doing it she also doens't get tv time or snack that night.

they so easily judge situations its disturbing. i got so aggrivated between my ex nightmare saying well she's moved 2 times and switched schools 2 times. i'm sitting there thinking yes you jerk the first time my older one was kicked out of school gpa fell below 80 in an acclereated program, and we moved out Occupational Therapist (OT) long island. then i kept it together for while but asked him repeatedly for help with difficult child with days off i kept taking for various dr appointments and he kept saying no no no. so ofcourse i ran out of money eventually adn the sh*t hit the fan he takes no responsibility for that at all hence our 2nd move.

i am more than willing to take blame where i need to as a parent for choices i made no problem. yet when everyone's pointing the finger at me and not looking at themselves at all tehn i have cause for issue and definite "atttitude" on my part

ok clearly i rambled enough. i'm hoping that if she is wrong and this child is BiPolar (BP) that the approach im about to take will assist with that as well.

 

[smallworld]

Jen, I think you may have missed my point. A child can have anxiety and depression as the predominant symptoms and still have bipolar disorder. I'll ask again: When she stays up most of the night, is she able to function fine the next day? A decreased need for sleep is a symptom of mania. And if the evaluating doctor thought your difficult child had a sleep disorder, did she suggest a sleep study?

Ideally, a child psychiatrist should diagnosis bipolar disorder. In December 2006, a neuropsychologist diagnosed my son with Major Depressive Disorder with a rule-out on Bipolar Disorder. The reason: In spite of the history provided about my son, the neuropsychologist didn't see mania (just depression) and so he couldn't diagnosis BiPolar (BP). A year later, my son entered a day treatment program at a local psychiatric hospital, where staff observed him 6.5 hours a day for 6 weeks. The staff saw the mania as well as the depression, and therefore, were able to diagnosis BiPolar (BP).

by the way, depression in children can look different from depression in adults. Childhood depression looks like irritability, reactive impulsivity and demoralization.

 

[Jena]

hi

i m sorry i didnt' miss your point lol i was just rambling you know i do that. once i start it's just goes and goes......

i do see your point. difficult child does not require addtl. sleep when she's up all nigth she can function next day. if she falls asleep at 5 a.m. she will get up by 10 a.m. but she goes all day without a problem.

she did suggest sleep study. she also said that she couldn't diagnosis bi polar because she didn't see the mania. i said you won't in 3 dys 5 - 7 hours each day.

 

[klmno]

Hi, Jen! I think all the diagnosis's mentioned here are in the same "category" or mix. My difficult child had the complete neuropsychologist testing done 2 years ago. Like you, I thought it was a farce and that I had wasted my money after I read it. I'm extremely grateful that I held onto that report though. difficult child's diagnosis is different now- one psychiatrist says BiPolar (BP), the other says not. But, they both agree that he cycles with episodes of stability, mania, and depression. They both recommend the same treatment. I have started explaining the difference in diagnosis's to most people like this- the BiPolar (BP) diagnosis means the psychiatrist believes it is likely that difficult child will have to deal with cycling the rest of his life to some degree (qualifying for the BiPolar (BP) diagnosis) and this is the psychiatrist who is prescribing mood stabilizers, which my insurance company is paying for. The other psychiatrist believes that with adequate therapy and treatment now, with mood stabilizers, that at some point in time the cycling might stop- not qualifying as a "true" BiPolar (BP) diagnosis.

Now, the test results and report play into this because even though it lists a different diagnosis, the psychiatrists diagnosis kind of "over-rides" the psychologist diagnosis because we are talking about a psychiatric disorder that there is really no test for. But, the areas difficult child showed weak in are consistent with weaknesses that are common for BiPolar (BP) kids- like memory and consistently scoring "borderline" adhd, yet teachers will be the first to say they don't think he's adhd because he's not like that (hyper and trouble with focus) most the time. These test results give evidence that I just used at the school to prove that cycling is not only a disorder that effects behavior. And when difficult child can't accomplish things quick enough or do exactly what they expect of him without intermittent periods (we're talking weeks- not minutes) of needing some help, it is not a result of being a "bad kid" that a good BIP will fix.

in my humble opinion- hold on to the report, start logging whatever signs you see in difficult child, and history- when did it start, how did it start (any primary trigger or there forever), etc.- try to find a good certified child and adolescent psychiatrist, and take all this to him/her. I would be skeptical of anyone else prescribing medications for your difficult child (other than a psychiatrist)- especially with a questionable diagnosis. But, the test results will prove invaluable now and in the future at school and for others doing evaluations later on.

 

[Steely]

What medications do they want to start her on?

I have major depression, and sleep issues are actually one of the pre-dominant features. I have every sleep disorder you can think of! It is horrible. I swing in and out of depression - but never into mania. However, I still have huge issues with insomnia, nightmares, anxiety etc. It is all very complicated. Again, it does not really matter what the diagnosis is, what matters is if the issues she is having are being addressed and treated.

So what was the doctors game plan. Again, what medication? That is the most important component to this part of solving the puzzle.

 

[Jena]

hi

we haven't discussed medications yet i'm trying to find a weekly therapist and also trying to get a mtg set up with her pyschiatrist who i haven't been able to reach surprise surprise lol.

i'm sorry to hear that you suffer with depression it is very hard it truly is i have been also a little lately and everyday can be a struggle at times. how is your sleep affected? can you be up till 5 a.m. on certain nights but up without being openly upset just awake?

and yes it is important that i treat the issues.

thanks jen

 

[BusynMember]

I'll give ya my .02
As somebody who has always had serious mood problems and who has a child on the autism spectrum, I can tell you for certain that often professionals are wrong. That includes Psychiatrists and even NeuroPsychs (my favorite) can be wrong. Certain children baffle them to death, thus you get more diagnoses than you can write on a roll of toilet paper because nobody really knows what the problem is. I agree with you that it likely isn't PTSD because it started before the incident. That could have made her symptoms worse, but, in my opinion (a layperson) probably isn't the cause.
I think you are getting 100 different diagnoses because you have a kid who fits into so many notches, like my son did. We never felt right about his diagnosis. until he got older and things got clearer so we never stopped looking for help. Psychiatry isn't an exact science and there are no blood tests. I was uncomfortable knowing this yet having psychiatrists throw medications at my son, but I let them, even though I sensed he did not have bipolar disorder. My gut was correct. Maybe yours is. I'm big on Mom Gut, even over what a professional may say.
Now myself. I have mood disorder not otherwise specified, but I have been called:
unipolar depression, manic depression, bipolar II, borderline personality disorder, I heard "How did ANYONE diagnose you with borderline" as well, I was told I have anxiety disorder, panic disorder and Obsessive Compulsive Disorder (OCD). The truth is, now that I know more, there is a mood disorder spectrum that includes anxiety, Obsessive Compulsive Disorder (OCD) and anxiety. On top of that, mood disorders (including childhood bipolar) often mimic Autism Spectrum Disorders (ASD) and vice versa. And many times people have symptoms of both. I don't even CARE about the name of what I have anymore because, at 54 years old I don't think anyone really knows exactly what makes me tick yet, nor will they ever know.
I would take your child to another neuropsychologist. I still think they are the best diagnosticians and it would be good to compare notes. Then I'd decide what made sense to me and what didn't. I'd decide how to treat her based on my instincts. You probably won't get one set answer. We were very lucky that the neuropsychologist actually hit the right diagnosis. for my son at 11 and thus we could treat it and he improved. However, as I said before, I'm 54 and I could still probably get ten different diagnosis. from ten different professionals. The only thing I care about now is that I know what works for my son and I know what works for me. I know better than to expect a 100% correct diagnosis.
I'd be cautious about heavy medication until I got another Neuro. The first Neuro who saw my son was useless. We got an alphabet soup list: ADHD/ODD/bipolar/autistic traits, blah, blah, blah.
The second Neuro. was much better and now so is my son. Good luck. I realize it's not easy (and that's first hand).