psychiatric appointment today

Hi, everyone-

I went to my appointment with difficult child psychiatric today. One thing I found out that I did not know is that he has diagnosis difficult child with ODD. I brought up to him the fact that from everything that I hear and read, ODD does not stand alone. He said that he has not been given evidence of anything else. He believes the compulsiveness and the sensory issues are all related to extreme anxiety, which I do know that he has.

We talked about the fact that difficult child had two major meltdowns in the past 2 weeks and he is increasing the Tenex from 1.5mg daily to 2mg daily. He wants to see if this improves anything at all. He said that if this does not work, we may try a very low dose of Haldol. The very name scares me. He actually said that he thinks this is where we are heading.

On the way back from psychiatric I stopped to do some shopping and got a call from difficult children principal asking if I could pick him up. He was chasing kids around with sticks at recess and refused to come in when the teacher told him to. It never ends.

I actually have more to say-a big bedtime issue but I will post later.

Thanks for listening.
 

smallworld

Moderator
Anxiety and sensory issues can fuel ODD behaviors. If he has those dxes, then the ODD diagnosis is not standing alone.

FWIW, you have a LOT of medication options before resorting to Haldol, which is a heavy-duty antipsychotic (rarely used on kids today). I would strongly recommend a second opinion before trialing Haldol.
 

LittleDudesMom

Well-Known Member
Hi Chris,

Sorry it has been such a stressful day for you - I understand the dreaded call from school!

If I were you, as both Small and Terry said, I would proceed with caution regarding the haldol. It's a pretty serious medication for such a little guy and has some scary side effects. Do some research yourself if you have some time this weekend.

I hope the remainder of your day, and this evening, are a little more low key.

Sharon
 
Thanks for the responses-

I agree with u on the Haldol-it shook me up when I heard it. We had tried Risperdal but it seemed to make him more anxious. Do u think that the very suggestion of Haldol makes him a bad doctor?
 

smallworld

Moderator
Chris, none of us can judge whether this is a good or bad doctor. But you, as the parent, should question him very carefully about why he thinks he needs to use such a powerful medication on such a young child. If you don't get a satisfactory answer or feel unccomfortable with his rationale, then I'd certainly recommend finding a new doctor who will be a better match for you and your son.
 
F

flutterbee

Guest
Ditto the others about the Haldol. Also, all psychiatrists and tdocs we've seen (and there have been many) consider ODD to be what they called a 'garbage bin' diagnosis. Meaning it was a catch-all diagnosis. My difficult child definitely has ODD behaviors, especially when her anxiety is high, but not one person has given that diagnosis.

I'm not saying ODD doesn't exist because it does. I think it is important to have a thorough evaluation to rule out anything else, though, before settling on it.
 

BusynMember

Well-Known Member
First off, I'd be leery and afraid of a doctor who prescribed Haldol. THat's really for schizophrenia--as far as I know it's not used off-label for other stuff--maybe it is. I've been in psychiatric hospitals for my own problems and Haldol has really bad side effects. I've seen adult patients drooling and having involuntary movements from it. I don't know anything about your doctor except what you've told us, but I wouldn't feel comfortable with my own child seeing him.
Anxiety and Obsessive Compulsive Disorder (OCD) can also be part of the autism spectrum. Did your child have any speech delays? Did he understand socializing with peers? A psychiatrist could easily not see high functioning autism. They aren't trained to see that--it's a neurological problem, not a psychiatric problem. Many Autism Spectrum Disorders (ASD) kids are misdiagnosed and put on psychiatric medication because of that. I'd wonder about a cluster of anxiety/Obsessive Compulsive Disorder (OCD)/sensory issues as being possible Autism Spectrum Disorders (ASD). My poor Autism Spectrum Disorders (ASD) kid was misdiagnosed with bipolar and put on heavy medications for three years. His psychiatrist had no real understanding of Pervasive Developmental Disorder (PDD)-not otherwise specified or Aspergers. He just assumed his strange behavior was a psychiatric issue. It's not. My son is doing really well now. Have you ever seen a neuropsychologist for a long, intensive evaluation?
I have (if I spell it out) bipolar II/generalized anxiety disorder/panic disorder/mild Obsessive Compulsive Disorder (OCD) and had all that since toddlerhood (my mom says infancy, but I just remember toddlerhood). The moodswings made me act out far more than the anxiety. The anxiety just made me nervous and withdrawn and I bit my nails until they bled (I still do--figure I don't smoke or drink, may as well continue this one vice...lol). I had more Obsessive Compulsive Disorder (OCD)--"bad thoughts" I called them than obsessive behavior. The Obsessive Compulsive Disorder (OCD) thoughts would fuel my anxiety and make it worse. However, I also have neurological problems and learning disorders. The reason I like NeuroPsychs is that they look for everything and can explain things better than other professionals. Very seldom is there one problem--and neurology and psychiatry are closely linked. Good luck. Sorry to ramble :smile:
 
You know, I asked the psychiatric about a multidisciplined evaluation and he said "this is the evaluation". Then I said that I meant with a neuro and he said he has no neurological problems. I also brought up Autism Spectrum Disorders (ASD) and he said that he couldn't have that because autistic kids have problems with attachment and socializing with peers and difficult child does not have that.

As far as speech delays, difficult child had some delay with certain letters-he was given therapy and now that's over.
 
Good morning to everyone-

I am jealous of all of u that live in an area that is getting snow today- I moved to N.C. and it is just too warm for me here- especially at Christmas time.

Lots of screaming as usual at my house last night before difficult children bedtime. husband just cannot stay calm and impose consequences for freshness and disrespect- he starts yelling which I know just adds to difficult child anxiety. I get so frustrated with that.

Thinking alot about difficult children psychiatric who is talking about Haldol. I am not going to put him on that. I would like to go somewhere else but difficult children health insurance does not have mental health coverage (husband self employed and constantly changing plans to save money) and this facility is writing off 90%. I am going to have to wait until I hopefully finish school(3 classes to go) and can hopefully get a job with good coverage- hopefully by summer.

Does anyone have a recommendation about where to take difficult child for a multi disciplined evaluation? For those who have done it, what was it like and was it covered by ins?

Thanks for being here.
 

smallworld

Moderator
A multidisciplinary evaluation is usually done at a children's or university teaching hospital. If you can't locate that, you might seek out a neuropsychologist (NOT neurologist) at the same facilities for an evaluation.

We've had to private pay for neuropsychological evaluations. Some on the board have had it covered by insurance. It really depends on your coverage.

I think we're all relieved you're not going the Haldol route.
 
I think the others have already given you good advice. I really don't have anything to add. I just want to let you know I'm thinking about you.

I'll gladly box up all of the snow around here and send it to you!!! :cold: :blizzard: Although I have to admit, it does have its good moments... :snowman: :skate:

I hope you have a great weekend, "melt-down" free!!! WFEN
 

Sara PA

New Member
Now wait, now wait.....this doctor said that he doesn't see anything but ODD, that he has seen no evidence of anything else but then goes on to say that he believes the compulsiveness and the sensory issues are all related to extreme anxiety???? What does he think extreme anxiety is?
 

Wiped Out

Well-Known Member
Staff member
I'm sorry things are so stressful. Definitely time for a new psychiatrist and I would definitely get him to a neuro-psychiatric if possible-I know it's hard when you don't have good insurance. As for the school calling, they need to start handling some of that on their own. Inform you, yes, but you shouldn't have to keep picking him up. Sounds like he needs an IEP and a BIP.
 
Top