New Controversial Diagnosis

Discussion in 'General Parenting' started by pasajes4, Oct 20, 2012.

  1. pasajes4

    pasajes4 Well-Known Member

    My 16 yr old difficult child has carried the diagnosis of bipolar not otherwise specified since he was 8 yrs old. He has been treated with every medication and combination of medictions for Borderline Personality Disorder (BPD) with no change or improvement. He has been hospitalized over 15 times = more than 2 years of his life. He has been in counseling and every therapy known to mankind and nada. I have altered my parenting over the last 16 years to make sure that I have left no stone overturned....again nada.

    Fast forward.....Due to changes in ins., I had to change psychiatrists and tdocs. New guy does extensive interviews and studies all medical records. He calls us in tells us that after examining all the records and notes from hospitals and juvie and tells me that my son is not bipolar and in fact has DMDD. What is this you say? DMDD stands for disruptive mood dysregulation disorder charecterized by constant irratability which gives way to horrific explosions to even minor events. It will not be helped by bipolar medications or adhd medications and these in fact will/can make it worse. It is not in the "book" of recognized childhood mental disorders. It is being considered. It makes more sense than anything else I have been told. It is a brain disorder and not a chemical imbalance. There is a push to get it into the "book" so that treatments can be researched and ins. companies cover it.

    We have been in limbo for years, but at least it has a name. If your children fits this bill or think they might, I invite you to google it and see if that is a more accurate description of your child than Borderline Personality Disorder (BPD).
     
  2. TerryJ2

    TerryJ2 Well-Known Member

    Sounds like something my son would have, my son is on 150 mg of lithium and 800 and up seems to be the "normal" dose for bipolar, and I really don't care what it's called, as long as we can get interventions and medications! I will look up that diagnosis and find out why someone thought it was important to separate it out. I mean, I see that you explained that it is a brain disorder and not a chemical imbalance, but I don't know how a dr would make a definitive diagnosis with-o fMRIs etc. and few parents would want to go through that.

    I can see why you'd be surprised and unnerved.

    Bottom line: do you like the new dr and is this going to get you anywhere?
     
  3. pasajes4

    pasajes4 Well-Known Member

    He will have an MRI. I do like the new doctor and his commitment to doing everything he can to provide the most effective treatment. In looking at the research being done, more psychiatrists are beginning to question a bipolar diagnosis for people who never experience the manic episodes and for those that the typical and atypical Borderline Personality Disorder (BPD) medications in any combination or dosages have not provided any relief. I feel relief in that it was not my "imagination" that the medications were not changing anything except his weight. My son would constantly tell his psychs that "he did not feel any different on them then off of them". It remains to be seen what the outcome will be.

    He will continue to have a BiPolar (BP) diagnosis because ins. pays for that diagnosis.
     
    Last edited: Oct 20, 2012
  4. TerryJ2

    TerryJ2 Well-Known Member

    Good! Let us know what the outcome of the MRI is. Then, of course, I'll wonder whether we should have it done ... :)
    Yeah, these medications do mess with-weight. Luckily, my son was thin so now he's pretty normal, although I think he should do situps.

    I've got to run but will look up that info later. Now you've got me interested.
     
  5. DaisyFace

    DaisyFace Love me...Love me not

    I could be mistaken, but I believe DMDD is the new name for Borderline Personality Disorder. It's been changed because "Mood Dysregulation" is a more accurate description of the disorder than the term "Borderline"...
     
  6. pasajes4

    pasajes4 Well-Known Member

    My understanding is that it is not. I think (and I could very well be wrong) that much like autisim which used to be only attributed to children who exhibited specific behaviors and now includes a whole spectrum, that a diagnosis of BiPolar (BP)-not otherwise specified will have more meaning and possible options than just being in a gray area.
    It would be wonderful if it kept more people from falling through the cracks and allowing for more research and possible treatments.
     
  7. TerryJ2

    TerryJ2 Well-Known Member

    This clarifies it a bit. But it's still confusing to me.
    *****

    The behaviors do not occur exclusively during an episode of Major Depressive Disorder and are not better accounted for by another mental disorder (e.g., Autism Spectrum Disorder, Posttraumatic Stress Disorder, Separation Anxiety Disorder, Dysthymic Disorder). (Note: This diagnosis cannot co-exist with Oppositional Defiant Disorder or Bipolar Disorder, though it can co-exist with Attention Deficit/Hyperactivity Disorder, Conduct Disorder, and Substance Use Disorders. Individuals meeting criteria for both Disruptive Mood Dysregulation Disorder and Oppositional Defiant Disorder should only be given the diagnosis of Disruptive Mood Dysregulation Disorder. If an individual has ever experienced a manic or hypomanic episode, the diagnosis of Disruptive Mood Dysregulation Disorder should not be assigned.) The symptoms are not due to the effects of a drug or to a general medical or neurological condition.
     
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Daisy, I think you are right. They have been wanting to change Borderline Personality Disorder because it is so misleading. Borderline is very much mood regulation. Instead of changing every week or month though...it can be every minute! It is very much a mood disorder.
     
  9. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I dont think they want to change borderline to disruptive but to mood dysregulation disorder. There is nothing disruptive about it. Now there is the new TDD which is Temper Dysregulation Disorder which is what we firmly believe Cory had/has. He really never had any sort of mania but medication does seem to help him and if the difference in DMDD and TDD is the efficacy of medications, well...you would have to say that DMDD cannot be TDD or even borderline because both of those respond to medication.
     
  10. TerryJ2

    TerryJ2 Well-Known Member

    Interesting. I looked up Temper Dysregulation and that sounds a lot like my difficult child, except that the APsychiatricAssoc says you cannot be diagnosed with-autism at the same time.
     
  11. InsaneCdn

    InsaneCdn Well-Known Member

    There's a number of dxes that cannot co-exist with Autism Spectrum Disorders (ASD). This would be another one...

    Developmental Coordination Disorder (DCD), specifically, is the motor skills problems that typically go with Autism Spectrum Disorders (ASD)... without the full-blown Autism Spectrum Disorders (ASD) diagnosis.
    ADHD overlaps, though not specifically (or didn't use to specify that it couldn't co-exist with Autism Spectrum Disorders (ASD), maybe it does now?)
    Auditory Processing Disorders (APD) does not specify... but is not uncommon with Autism Spectrum Disorders (ASD).
     
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