Please Help! Is My Son's Pediatrician's diagnosis Correct?

[newly worried parent]

Hi there everyone! I am brand new to this site and have been reading a bit on some of your posts. I'm not really sure which direction to go right now but figured I would start here and get some suggestions. I will try to explain my son's (D) situation in as few words as possible, so please bear with me.

D is 10 and has just (2 days ago) been diagnosis with Severe Mood Disorder/possibility of Bipolar Disorder characteristics (medications:Lamictal: 1st Day on it). He was also recently (1 1/2 mnths ago) diagnosis with Tic Disorder (medications: Guanfasine: 5 wks now). Prior to about 1yr ago, D was a very typical boy: happy, sincere, caring, Very Creative/artistic, loving, great student at school...Normal anger/frustration with younger brother, very intelligent but a little low on the maturity level compared to kids his age (probably about a year or 2 behind:not in how smart he is,rather in the things that interest him:toys, etc...) However, in the past year, he has taken a dramatic turn from his typical self: seems very unhappy, sad, depressed, irritated, frustrated, angry, thin skinned most of the time. The good moods, happiness, smiles,etc..all are far shadowed by the bad times. My husband and I usually say quietly to each other "wow, he's in a good mood/he playing with his little brother for once-Let's write this in the record book!" He can't stand his little brother C(6) and probably 80-90% of his mood is directed at him at home (C loves D to death and would do anything for him, however he really knows how to pester and push Ds buttons, and he does!) D also makes a lot of statements like "I always get in trouble even if it's Cs fault" "C never gets in trouble, but I always do" etc...(I have spoken to D about this several times and have to admit he probably was targeted to get in trouble more than C because we were un-intentionally quicker to punish the one that is grumpy and complains all the time rather than the one that is always silly, funny, and is rarely in a bad mood at all. We have been working on correcting this on our end.) This year at school D barely passed:unable to focus,very forgetful,spacey,not listening very well,horrible grades, in "Lala Land" per his teachers,etc...) He also has had trouble making friends due to his maturity level. He is very over bearing when he is excited or interested in something. He has things that he's interested in at stages in his life and they are all encompassing:when he was younger it was Trains, then Titanic, then Pokemon, then Bakugan, now Bay Blades. But he doesn't just like each thing, he is infatuated with them. He thinks/talks about them all day every day in every aspect of his life. His imagination is endless and he is extremely creative and loves to draw draw draw! However, his imagination tied in with his infatuations tend to run away with him sometimes and he starts to make unrealistic things tie into reality. Ex: "Mom, do you think a Bay Blade would beat Dad in a battle?" "Do you think this Pokemon is more powerful than God?" These things become almost all he talks about to kids and they find him annoying, however he doesn't see that they are annoyed. He also can't stand to lose. When he plays games, he will make up rules that make him win. He gets very upset if he loses. He also insists on being whichever character he wants to be, regardless if another kid wants to be that character, etc...Basically, he makes the rules and he always ends up on top. Not very much fun for the other kids. He also has trouble listening to other kids talk when he is playing with them or talking about something he is interested in:He talks a million miles per hour and does not give them a chance to talk, acts very silly (ex:talks like a baby,acts wild/hyper,etc...) and doesn't pay attention to their signals to see if they are interested in what he's talking about, annoyed, etc...So he is also picked on at school and kids try to avoid him because he annoys them, which has really bothered him. He feels nobody likes him and he has no friends. However my biggest concern is the sad, unhappy, depressed, angry mood he seems to be in majority of the time. This is so very uncharacteristic for him! And his moods change drastically, constantly and suddenly. One minute he's up (although not often),then suddenly and for little to no reason he is way down.

A little history: My mother had lots of issues with anxiety and depression and was an alcoholic. My brother was diagnosed with Bipolar disorder and even though not diagnosed with it, I believe was at least borderline paranoid schitzophrenic (sorry if I spelled that incorrectly.) He tried to commit suicide (slit wrist);heard voices in his head(and even spoke very quietly to them one day while I was at lunch with him and he didn't even realize he was doing it); thought McDonald's was poisoning his food;Thought people he worked with were going to poison his water cooler so he wanted to put a chain over the top so they couldn't get it open;etc...Alcoholism also runs on my dad's side (his father.) I am not on any drugs, but have been in my younger years and have a very addictive personality. I always say the only thing that saved me from being a drug addict was getting pregnant with D There have been no tramatic events (that I can think of) that have happened to him, his father and I have a very strong, very happy marriage. We do not smoke, drink (except on rare occassions, but never in front of our kids), do any illegal drugs, etc...

I'm just worried about Dr's being so quick to diagnosis things such as depression, Bipolar, mood disorders, etc... and then shove medications down throats! I'm not opposed to medications, AS LONG AS THEY ARE TRUELY NEEDED! I just want to make sure they are treating him for the right diagnosis. Any suggestions/advice/opinions would be greatly appreciated! I just want my son to be happy again!

Thanks so much,

Amber

 

[newly worried parent]

I forgot to mention...aside from the mood disorder/ Bipolar Disorder diagnosis recently, his Tic Disorder (as per his pediatrician)started about a year ago. He constantly would roll his head (like if someone is trying to pop/crack their neck) stretching his jaw (hard to explain), and clearing his throat (even while drinking!) He was doing these things constantly: at least one of these things every minute or two. He saw a chiropractor for a couple of months, but they persisted. They seem to worsen when he is stressed,deep in thought,tense, etc... The Guanfacine stopped them completely for about 1 1/2 wks. But then he pulled a neck muscle while jumping on the trampoline, and they started back 5xs worse than ever. Once his neck got better, he is now still doing his neck and jaw thing, but not as much as he used to. No more clearing the throat. This seemed to be when everything started to slowly come about: the tics, the moods, the problems at school, etc... Over the year they got progressively worse.

 

[BusynMember]

Ok, I have a question about the tic disorder? Did you take him to a neurologist? I would want him checked for Tourette's Syndrome.

Children AND adults with Tourettes (although Tourettes can get better with age) tend to have a very, very high percentage of bipolar and Obsessive Compulsive Disorder (OCD). It goes along with this very real medical disorder. I have no experience with Tourettes myself, but developed an interest in it and read a few books on kids and adults who had the disorder. They all had Obsessive Compulsive Disorder (OCD), at the very least. This is again a MEDICAL disorder that causes some mental illnesses.

Do you feel the medication is helping your son? Are you sure it's not the medication causing the tics? I would not trust a pediatrician to diagnose a tic disorder. I would take it to the Big Guy...the Child Neurologist.

 

[HaoZi]

The tics might also not be tics but a way to create or release stimulation. All-encompassing interests and what teachers define as a "lack of maturity compared to peers" might also point to a Pervasive Developmental Disorder (PDD)/Autism Spectrum Disorders (ASD) issue, which can be co-morbid or include all the things you mention.
You need more than the pediatrician looking at him for sure, get referrals to a neurologist, neuropsychologist, and psychiatrist.

 

[crazymama30]

I would definately go to a child psychiatrist or neuropsychologist. He needs more specialized evaluations. While he could have a mood disorder, he could be dealing with something else and the symptoms tend to overlap so it can be hard to piece it apart, and that is best done by a good psychiatrist or np.

 

[newly worried parent]

Wow, thank you all for the suggestions. This is wonderful! To answer your question Midwestmom, no I have not taken him to a neurologist yet. To be honest, this past visit we had was to see if he had ADD. That's when he gave him the current diagnosis. His pediatrician "specializes" in ADD/ADHD. What does "specialize" mean? I don't know. This has all happened so quickly and I don't really know anything about it all, so I really didn't know what steps to take or what to look up. That's why I decided to get online lastnight to see if I could get some feedback from other Moms that have been through the same things. That seemed more reliable to me than banking on whatever his pediatrician says. I guess my biggest fear is I don't want to start him on medications because this is what he "appears" to have, because then I may be medicating him for a condition he doesn't even have. I feel like messing with the chemicals of the brain when there is nothing wrong with them is just asking for something to go wrong with them.

As far as the guanfasine is concerned for the tic disorder...It's kinda working. Like I said earlier, at first it stopped them altogether. Then when he hurt his neck they came back worse than ever. Now that his neck is feeling better he is not doing them as much as he was originally and the throat clearing has gone away completely. However, he is still doing them some. So....

But what do you all think about the Lamictal? He took 1/2 a 25mg pill yesterday morning and 1/2 at night and 1/2 this morn. Should I stop this before he really gets into it to much? Maybe get him into a neuro 1st? Here's the thing: I know how most of these medications (such as antidepressants;stimulants;etc...) work. They from what I know any I have ever heard of always take 2-4+ weeks to see any effects from it. Well, I know this sounds crazy and it's probably just a coinsidence and not the medication, but yesterday and today have been the best days he's had since probably before all of this started! Literally! He's not cranky in the least; Is, OMG get ready for this, being super nice and patient with his little brother; Is just in a happy go lucky mood. Literally it's like I have my son back! Is it at all possible for him to be having these effects from the medications already? If this is possible and this is what we have to look forward to, then I really don't want to stop it. This is wonderful for us all!

Anyhow, please keep the suggestions coming. I'm gonna look into them all!

Thanks Again

 

[BusynMember]

An ADD specialist (obviously he self-appointed himself one) is just a pediatrician who thinks he can spot ADHD. The problem is, many disorders mimic ADHD and if all he knows is ADHD, everyone he sees is going to have ADHD in his eyes. I would take him to a neuropsychologist. It is unlikely that is whole issue is ADHD. Pediatricians are pretty much trained mostly to take care of colds, flus etc. They do not really have the training needed to make accurate diagnoses.

Good luck and keep us posted

 

[DDD]

Welcome. I agree that your son should not be diagnosed solely by a Pediatrician. I had such a caring and wonderful Pediatrician that it took me awhile to realize that he is not a specialist in mental health disorders. My first reach out was to a child/adolescent Psychiatrist. Secondly I had a neuro/psychological evaluation (takes six hours or more and done usually be a team) that for us really nailed the problems on the head. Once I was confident in the diagnosis. then it was possible to get the right medications from the Psychiatrist.

I'm sorry you are going through so much stress. There are no easy answers. Often even the best professional prescribes medication that just doesn't work. It usually takes awhile to find out exactly what you are dealing with, the right medications and then finding the supports necessary. I wish you the best of luck. Sending caring thoughts and hugs your way. DDD

PS: Once you have those results your child will be able to get appropriate educational supports that will help him do his best.

 

[busywend]

Welcome!

My gut feeling is your boy just started to realize he was different from others and that is why the moods kicked in. I bet he is frustrated with himself. Can't control those tics. My difficult child had multiple tics, too, but she has grown out of them. Now and then I see one or two when she is super excited or upset. But, nothing to worry about.

I do not get ADD at all from your description. Glad he did not diagnosis him with that.

I do sense with the hyper focus on the current favorite theme - some Obsessive Compulsive Disorder (OCD), but that is also a sign in Autism Spectrum Disorders (ASD). There are many levels of Autism Spectrum Disorders (ASD) (Autism) and he seems pretty high functioning. But, he is different. And that is OK. It is hard to accept that you are different at this age. You want to fit in of course.

Not sure if that medication can work that quickly or not. I would call pharmacist and ask. Did school just end for your boys? If so, that can relieve a ton of anxiety for our kids, so that could be a reason for the change if it is not medications.

 

[TerryJ2]

Welcome, and I'm glad you're beginning to uncover some clues.
I agree with-the others wholeheartedly: take your son to a neurologist. He's got more than a mood disorder. And it could be comorbid, but still, you need more info. Thanks for joining us and stay with us! Welcome.
Best of luck.

 

[whatamess]

This totally sounds like Asperger's to me!

 

[newly worried parent]

Seems like there is a leaning towards or at least mention of Asperger's from most of the replies. Doesn't a child with that usually have through the roof energy and just bouncing off the walls? Almost like they can't contain themselves most of the time?? D is not like that though...he does have his moments of being really hyper if he gets excited or is really interested in something (like one of his obsessions: like Bay Blade.) Other than that, like in class and other regular activies, he is a normal energy level. He definately is not like some of the children that I've seen that you can tell are just all over the place. Is this still something characteristic of Asperger's??

 

[newly worried parent]

To add: He is also not defiant. He is very respectful to adults and other kids (with the exception of if a child is picking on him: then he of course will get defensive such as the typical "I am not!" etc...) Rarely is it physical (like a push or hit.) He has only had 2 instances at school where it turned physical. One where a kid kept teasing him (literally went on and on teasing him) and finally he just hit him once in the shoulder. Even though I don't agree with hitting, this was very minor. He didn't even get a referral or anything. Then there was another situation where he was playing hide and seek and hid in a place another kid wanted to hide. That kid pulled his arm to try to get him out and D pushed the kid down. He again never got a referral because wasn't an out and out violent erruption or fight. Other than that he has very typical 10 year old boy reactions to others. He is a very sweet and nice kid and cares how others feel.

 

[BusynMember]

My son is on the high end of the autism spectrum. He is a nice, polite young man and his teachers LOVE him. He is eager to help others and DOES have a sense of humor. His eye contact is ok with the family, not so great with strangers. He is NOT hyper. When he was a toddler he was hyper. Now he is a couch potato and we have to force him to ride his bike or just do anything. He can sit still in class, although he can be fidgety. Many Aspies are not physical and don't hit. My son would be more apt to be the one getting hit than doing it. His is naive...way too trusting.

The man symptom of Aspergers/high functioning autism is a lack of ability to socially interact appropriately and often a cluelessness about life skills. An example of an Aspie who is friendly (yes, there are friendly Aspies), is a child who goes of up everyone/anyone, whether or not he knows the child, and starts talking about whatever he wants or starts asking inappropriate questions, often standing too close or using a loud voice. They are then depressed when they scare off the other child or put the other child off. They need social skills training BIG TIME. And often they need life skill nudges too, such as forcing them to understanding that showering is a GOOD thing...that others don't like to be around smelly people.

I think he sounds Aspie too, but you should get him evaluated.

 

[newly worried parent]

Wow! Ok. Then I will def look into it more. That may be right along his lines then, because otherwise it sounds like him. I just misunderstood the hyper disrespectful side of it I guess. Thanks so much!

 

[HaoZi]

Even with Aspies (am one, have one), there's a range. We're all different. Kiddo can be very courteous, polite, etc. She is also capable of being an extreme terror. She's just now starting to really get the gist of "personal space" and there's a 50/50 chance I have to remind her to lower her voice in places where it's expected, like the library.

 

[DammitJanet]

Autism can be all over the board...it is a spectrum disorder. I was thinking that more when I was reading your post more than mood disorder to be honest. Now I do think they can be pediatricians that can be excellent with ADHD, we had one when my boys were young, however I dont think you are dealing with simple ADHD. I think you need to get in to see a child psychiatrist and request a team to do a battery of testing on your son. Hopefully you can get that done at a good children's hospital.

 

[Hound dog]

Second opinion is definitely in order with docs who (honestly) specialize in behavior/neurological disorders, child psychiatrist, neuropsychologist, neurologist........not a pediatrician doctor. Not saying a pediatrician doctor can't be observant enough to say Hey, maybe this is what is going on.....but to diagnosis it? No. To medicate it, oh HE!! NO.

My son Travis is on the lower end of the autism spectrum, yet he never bounced around ect, could be very social with adults.....other times just be in his own world. Each child is unique. Symptoms listed for a disease/disorder are what you could see, does not mean you have to see all of them for them to have the diagnosis because everyone is different. Travis also has Tourettes, it goes along with his cerebral palsy, yet he's not Obsessive Compulsive Disorder (OCD) nor ADD. He was extensively evaluated for both.

Trust yourself. You spend more time with your son than anyone. No one knows him better than you do. If you don't feel a diagnosis fits, then don't give up.

(((hugs)))