So confused

Discussion in 'General Parenting' started by nat73, Jan 15, 2008.

  1. nat73

    nat73 New Member

    Ok so my son had his appointment/ yesterday to discuss his medicine. He was on Straterra for Impulse Control Disorder but he secretly stopped taking it (we later found out obviously)because he said it made him sick......anyway so we go yesterday and she talked to us for a total of 5-6 minutes and tells me that he needs to be on prozac and that he may be Bipolar.............OK so she talked to him for 5-6 minutes and comes to this conclusion??

    I have looked at the symp.'s of bipolar and he is not bipolar.
    Plus he is not depressed either......he just has a hard time thinking before acting......he does the same wrong things repeatedly like he can't stop himself. he even told us this is why he tried to kill himself is because he wants to stop doing the lying, stealing etc but can't stop .........anyway, I explained to the doctor again about how he spent a week in a psychiatric hospital for children & teens, how had all the tests, etc. and that the b.cert. child psychiatric. there diagnosed him with- Impulse Control Disorder but she said that she thinks my son is depressed and he needs to be on prozac. I asked what she thought he should take for the Impulse Control Disorder since he can't take the starattera because it makes him sick. She said nothing that prozac was what he needed to be on or if I preferred a different anti-depressant. I told her I don't have any information about Prozav or any other anti-depressant and she told me that is what she is there for and she recommends prozac.......ok so my son is diagnosed in Nov. '07 (in a different state) with- impulse Control Disorder after being kept and observed for a week . Then we come home and have to find a local doctor to continue with- the prescription and she has only seen my son twice and only talked to him 5 minutes each time and tells me he is depressed, maybe bipolar and will only prescribe an antidepressant......... I did not get the prozac script filled and will not until I talk to the other psyc. that sees my son each week for an hour for counseling to see what he thinks about what this other psch. is telling us.

    I'm so confused!
  2. smallworld

    smallworld Moderator

    Getting a proper diagnosis is very, very challenging. Many symptoms of childhood disorders overlap, which makes it incredibly hard to figure out what is what. You're right that it takes more than two quickie appointments.

    Having said that, Strattera is an antidepressant and so is Prozac (just in different medication classes). Unfortunately, if he has bipolar disorder, both could make him much worse. So it is important to have the right diagnosis before deciding on which medication to choose.

    Do you think the diagnosis of Impulse Control Disorder fits or do you think his issues go beyond that diagnosis? Is it possible that he could have a more thorough evaluation to know exactly what you're dealing with?
  3. flutterbee

    flutterbee Guest

    How confusing and frustrating for you.

    Unfortunately, in the field of mental health this is what many of us have experienced. There are no definitive tests that can say that yes, this is what you're son is dealing with so we tend to get a lot of different opinions. Many of us have also found that some doctors seem to specialize in certain disorders and, therefore, have a disproportionate amount of patients with that diagnosis.

    You're trusting your gut. That's good. If you lack confidence in this psychiatrist, find another. I would really push for a neuropsychologist evaluation (done by a neuropsychologist). We got more answers in a few hours of testing (generally 6-12) then we did in years of tdocs and psychiatrists (therapist is therapist/counselor psychiatrist is psychiatrist). Impulse control is in the frontal lobe part of the brain (if memory serves) and a neuropsychologist might be able to indicate just exactly where he is struggling.

    by the way, if this psychiatrist is suspecting bipolar, an antidepressant is not the way to start treatment. An antidepressant could cause an unstabilized bipolar patient to become manic. I know you don't think he's bipolar, just throwing that out there. Bipolar should be treated by mood stabilizers and only add in AD's when it's stable. Some can never tolerate AD's.

    Bottom line is to trust your gut. If you don't feel comfortable with this psychiatrist, find another.

    Hang in there.
  4. DammitJanet

    DammitJanet Well-Known Member

    I agree with the others however...I would be questioning a diagnosis of Impulse Control Disorder after a suicide attempt. I think that screams being depressed!

    One thing to remember is that depression in children and teens doesnt look like depression in adults. Impulsiveness can be a sign of depression or bipolar.

    Its very hard to say but I would ask this doctor what he/she is basing their opinions on and go from there.
  5. totoro

    totoro Mom? What's a GFG?

    Sorry... I know this is so hard and complicated. These Doctors make it all so much harder, add to it every one else's honest well meant opinion!!! LOL
    I agree with the others though.
    It is hard to understand all of this when you have not had you "brain" in the situation yourself... how could you?
    How could the doctor truly understand... all anyone can do is read, educate themselves and ask questions, and watch your child... OBSERVE!!!! Most psychiatrist's wont take the time for that one...
    For a few of us, we have disorders as well... which helps us understand our children a tiny bit better... maybe. Not better than other parents, but our own children...

    Janet is right, depression looks different in young adults, kids etc. Mania looks different in kiddos... K's mania looks different than mine!
    When she is manic she can not hold it together like I can... barely!!!!

    Only someone who had seen mania before or a pro would see it in me!!! But boy could you see it in K... same with the depression and anxiety...
    I have learned to cope!!! I am on OK medications... I have tools...

    She is young and unstable... I don't know if your difficult child is BiPolar (BP), but he is something!!! and he is most likely unstable and needs tools to help him deal and maybe the right medication combo...

    I would go online and read about BiPolar (BP) maybe...
    read about it here also... read about any other disorders you might think it is... read the DSM-IV criteria for symptoms.... of anything you can think of.
    Throw out any questions to us!!!

    We are here. I would do the Nuero-psychiatric also if you haven't... Great thing to have for many reasons and to bring to any apt!!! And school etc.
    Hang in there... we are STILL struggling but you keep your sense of humor and you trudge forward and look toward tomorrow!!!

    Keep the hope alive!!!
  6. LittleDudesMom

    LittleDudesMom Well-Known Member Staff Member


    I think you are right to question this doctor wanting to put your son on prozac after five minutes! Not only that, but if she really feels he is BiPolar (BP), why would she not try a mood stablizer first. As the other posters have indicated, putting someone with BiPolar (BP) on an ad or adhd medications could very well be the worst thing they could do without the patient being stablized first.

    I would be finding another doctor soon. I think I would be looking for a neuropdoc.

  7. Mrs Smith

    Mrs Smith New Member

    Sorry you're having such a hard time getting help for your son. You must be terrified for him since his suicide attempt. I think if I were you, I would focus on treating the symptoms and not worry too much about getting the perfect diagnosis. For all of our kids, an accurate diagnosis is nearly impossible.

    My son (who doesn't have a bipolar diagnosis) is on a mood stabilizer. Some people with bipolar use stimulants. Some people with depression use antipsychotics. You won't know until you try. Use caution though, do the research, know the side effects and monitor closely. Also don't forget about non-medication interventions. Cover all your bases. Good luck!
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    A suicide attempt, while often impulsive (not always), is most indicative of a mood disorder. I would really question a diagnosis. of "Impulse Control Disorder." That's very vague and doesn't really explain the big picture. IF it were me, I'd take him to a neuropsychologist for a total evaluation and a fresh idea. P-docs and hospitals have differing levels of competence. We've seen the good, the bad, and the ugly. Don't be afraid of a diagnostic label. It's best to know the devil you face and to fight the right devil.
    A good rule of thumb: If it's in the family, look towards it. Most of these disorders are inherited. I don't remember your family history, but it tells you A LOT (as does his father's). in my opinion you won't get much help going on a diagnosis. of impulse control disorder. In fact, if it happens to be wrong and he DOES have a mood disorder, antidepressants can CAUSE suicidal ideation.
    Good luck, whatever you decide to do.
  9. mrscatinthehat

    mrscatinthehat Seussical

    Ok, I believe that I have a slightly differing opinion. With my gfg2s neuropsychologist evaluation one of his diagnosis' was Impulse Control Disorder. I have not changed my signature to reflect this as I have not recieved all of the written reports.

    The things that were discussed with this for us were that suicide attempts with this are very common. The problem is we won't see the warning signs like you potentially can with depression. It can just happen. With my son it means swallowing hazardous things. He does many other things also. But that is one of the ways he tries to hurt himself. He also tries to hurt others and has. I inquired about other reasons for this. This is a vague diagnosis to some but it does explain some things.

    Truthfully you know your son. You should trust your gut on the medications. Personally I wouldn't say an antidepressant would help. I would think some sort mood stabalizer or the atypical antipsychotics would be the direction. But that is just me.

    If you are not happy with things by all means get a change. I would start with a knew psychiatrist you trust.