Appointment with psychiatrist - what to expect?

[tryingtocope]

I finally got an appointment with a psychiatrist for my difficult child on Monday. What should I expect? We had an appointment with a psychologist 3 weeks ago and she just asked me a lot of questions about him and barely spoke to him. Is the appointment with psychiatrist going to be the same? Is there anything I should do to prepare?

Thanks. They psychologist didn't have many answers. She said it could be a lot of things so hopefully I'll get more answers from the psychiatrist.

 

[jal]

Our first appointment with the psychiatrist was about 2 1/2 hours. Ahead of time per his request I mailed all the info I had on difficult child. At the appointment we went over difficult child's developmental history, behavioral history, our family histories and difficult child's medical history. This psychiatrist was the only one that interacted and took time with difficult child. Medication was prescribed at that meeting. We went back to psychiatrist once a week for 3 wees, had a break last week and had our 4th appointment last night.

 

[jal]

We also filled out the Conner's rating scale and were given one to have daycare fill out. Also had to fill out another type of rating scale and that was for the BiPolar (BP).

 

[tryingtocope]

Jal, did you already havea diagnoses before your first appointment? My difficult child has not been diagnosed yet. Three weeks ago we met with a psychologist in his office who reviewed a lot of the history with me.

I guess I'm concerned about how he evaluate my son. This weekend I'm also mailing forms to a local Children's hospital but their waitlist is 8-10 weeks.

 

[totoro]

I think it depends on how "good" the psychiatrist is... Our great psychiatrist in Chicago took over 4 hours with us, we spent time with the resident, lots of questions and lots of time observing difficult child and talking to difficult child, we did already have multiple diagnosis's and a nuero-psychiatric report and video. The psychiatrist spent over and hour taling with us and difficult child as well.
Our time would have been a lot longer if we did not have the prior stack of evaluations and parent report and video. Also difficult child managed to exhibit a lot of symptoms during this length of time, which was good.

Our new psychiatrist took 2 hours. We already have the diagnosis, so we just filled her in on new info and old. And discussed medications and our concerns.

Neither one rushed us... which was nice
good luck

 

[SRL]

I'm sorry to say that it's rare that a child psychiatrist will take the kind of assessment time that yours did, Totoro. From the reports of parents here it sounds like most move to suggesting medications fairly quickly as a means of addressing behaviors. Most will not do extensive diagnostics but will take into account what you bring in.

 

[jal]

tryingtocope,

By the time I had gotten to this psychiatrist I had been told by a psychologist that difficult child was ADHD. After a bad response to stims, same psychologist said BiPolar (BP). When I questioned BiPolar (BP) diagnosis after a few weeks via e-mail he stopped responding. So we went to a child psychiatrist. She said not BiPolar (BP), but ADHD. Stims again. Calmed him in am but by 11am major meltdowns and behaviors.

Needless to say this psychiatrist would not listen to our concerns, spent only 15 min at a time with us, never interacted with my son or took blood pressure and weight like whe was suppossed to. So we dumped her and the new psychiatrist was recommended. He came up with an evolving diagnosis as BiPolar (BP).

So we had some ideas going in...ADHD had always been in the forefront of our minds, but with the response he has had to the Abilify, leads me to believe that we are on the right track.

FYI - if your psychiatrist recommends medications, make sure they do a blood panel on your child first. Neither the psychologist nor the 1st psychiatrist did. The new one started off just right with doing blood work and an ekg.

 

[tryingtocope]

Hmm...I don't feel comfortable with someone just asking me questions and then suggesting medications from the first time they meet him. I thought there would be some testing or at least observing him or talking to him.

I've only filled out a questionnaire and discussed it with the pediatrician and talked to the psychologist once. Ughh...now I'm really scared. I hope the psychiatrist takes the time to talk to us and to my difficult child.

 

[SRL]

I don't mean to scare you but to prepare you for this possibility. They usually will talk to you and your difficult child to get a feeling for what is going on but treatment via medications is often their area of speciality.

You may find yourself with an exceptional psychiatrist like Totoro did but thorough evaluations usually come through neuropsychologists or developmental pediatricians.

 

[tryingtocope]

Okay. Can the psychiatrist recommend a neuropsychologists or developmental pediatrician? Or do I have to go to the Children's Hospital?

Thank you for preparing me. The pediatrician had mentioned to me that now I have to figure out how to navigate the system and advocate for him. The last two months I have spent calling places and being told that he doesn't qualify for their services because he is too young or he is on a lenghty waitlist. Anyway, I hope tomorrow goes well or I'll be back on the phone trying to figure something else out.

 

[jal]

It does sound scary, but after all the different roads we tried - Birth to 3, Child Guidance Ctr, in home behavioral counsoler, a top ADHD doctor, 3 different daycares...I was ready to try the medications. But again only you know your child.

 

[totoro]

Remember it is your decision to go the medication route., Ultimately you make the choice!!! We were so freaked out, our psychiatrist in Chi. said well I would suggest Risperdal, but it is up to you... here is the script use it or don't...
We went over the good and the bad, the prose and the cons. She didn't really push us. So when we left we were kind of freaked out because we had to decide what to do... good and bad. We had to make that choice all by ourselves and it was hard.

Our new psychiatrist is kind of non-chalant about medications. which kind of bugs me... she doesn't seem to take them as seriously as we do... but luckily our pediatrician goes over everything with us and will tweak the medications if we need to...

Between this board our pediatrician and lots of research we try and make smart decisions for our difficult child... but it is always scary.
You can do this.

 

[tryingtocope]

Jal, thanks for sharing your experience. I have only tried discipline at home which hasn't worked since he got kicked out of his pre-k in January. This is the first time that I reach out for outside help. I am open to hearing what the psychiatrist recommends. I guess the diagnosis will evolve over time.

Thanks totoro. I am taking my husband with me which should help because we can each ask questions.