F
firehorsewoman
Guest
Please forgive me if this post is not very organized. I am totally exhausted yet eager to share with you guys how the appointments with the tdocs and psychiatrists went over the past two days. Let me preface the update by saying we have been going to neurologists, psychologist, therapists and psychiatrists for the past six out of eight years of my son's life. Today was one of the VERY few appointments where I actually feel we made some progress. I am sure that most of you can relate to how I feel....there is so much frustration along the way in regards to getting a diagnosis and managing the medications...not to mention feeling heard and understood by the professionals managing the case....so, I am going to enjoy the rare feeling of hope that I left the hospital with today.
A different psychology team from the teams that have evaluated my son previously evaluated him yesterday. They met with me separately while my son was evaluated. After that the team discussed the evaluation and parent interview while we waited, they shared their assessment with me at the end.
I told them from the start that most pressing concerns were:
1. Persistent suicidal thoughts and feelings
2. Extreme daily mood swings including depression, hyperactivity, aggression
3. Increasing severity and persistent hyper-sexuality
Yes, there are other concerns but those were my top three that had to be addressed immediately. I also expressed that I want to find a therapy program to help my son with coping skills. I gave them extensive, detailed, examples of my top three concerns. His father was not present and did not provide me with an e-mail or written concerns to share with this group so, I provided them a copy of the e-mail that he sent me last month stating that if difficult child does not "straighten up" by the end of the summer he was going to place him in a Residential Treatment Facility (RTF) or boarding school.
The main conclusion by the team at the end of yesterday's evaluation was that my son's behavior is not consistent with his previous primary diagnosis of ADHD. On the BASC he was scoring very low for ADHD but high for depression and mood disorder. We discussed that many of the behaviors especially the hyper-sexuality is consistent with bipolar. Their recommendation was to re-evaluation his medical therapy. Because his psychiatry appointment was for the next morning (today) it was agreed that the lead psychologist would meet with his attending psychiatrist prior to our morning appointment and we would all discuss the plan together at the appointment. difficult child's dad was to be at that appointment too. I was thrilled with the plan to have us all in the same room at the same time discussing the situation.
As some of you know, I have never been comfortable with his ADHD diagnosis. I never thought it fit and more importantly, he has not responded to medications prescribed for the condition. If anything, he is worse after two years of different ADHD medications and doses of medications. My ex-husband has seen things differently and until recently has not admitted to there being any problems aside from attention related behaviors. The genie was let out of the bottle by him writing me the e-mail last month.
The lead therapist told my ex-husband this am, "My expertise is ADHD and your son did not in my opinion display even the mildest of ADHD symptoms nor score high in that regard." He went on to tell him how concerned he was for a mood disorder. He does not think that it is major depressive disorder but more consistent with bi-polar. My ex-husband wanted to know if ADHD was still part of difficult child's diagnosis and of course we discussed co-morbidity as a a possibility but once again it was stressed that mood disorders in kids cause them to lose attention.
The biggest surprise to me was that my ex admitted that the suicidal and hypersexual behaviors are occurring in his home as well. That was the first time that he has ever been in agreement with me about my son's behavior although at each appointment I have brought up the suicidal and sexual stuff (last appointment he blamed me buying sex ed book for kids.) He also agreed that there are lots of extreme mood swings. The only behavior that he does not see as consistently or severely is the aggression.
The docs agreed that the new working diagnosis for my son is Mood Disorder-not otherwise specified. They are not ready to diagnose him with bipolar disorder just yet. Fine. I'm okay with that. Let's just move on from ADHD as the primary diagnosis. The plan when I left (I had to get to work and let before my ex did with my son) was to start difficult child on lithium and gradually discontinue with Adderall and Strattera. I liked the plan. The ex seemed to agree to it. I hope that things did not change after I left but he has not responded to my messages (yet?) asking him about that.
I feel some hope. Not because of exactly what the diagnosis is or is not...I am not married to a particular diagnosis.....but because what we have been doing for two years is not working. We all agreed that difficult child is in a much worse state of mind than ever and we need a new plan.
A different psychology team from the teams that have evaluated my son previously evaluated him yesterday. They met with me separately while my son was evaluated. After that the team discussed the evaluation and parent interview while we waited, they shared their assessment with me at the end.
I told them from the start that most pressing concerns were:
1. Persistent suicidal thoughts and feelings
2. Extreme daily mood swings including depression, hyperactivity, aggression
3. Increasing severity and persistent hyper-sexuality
Yes, there are other concerns but those were my top three that had to be addressed immediately. I also expressed that I want to find a therapy program to help my son with coping skills. I gave them extensive, detailed, examples of my top three concerns. His father was not present and did not provide me with an e-mail or written concerns to share with this group so, I provided them a copy of the e-mail that he sent me last month stating that if difficult child does not "straighten up" by the end of the summer he was going to place him in a Residential Treatment Facility (RTF) or boarding school.
The main conclusion by the team at the end of yesterday's evaluation was that my son's behavior is not consistent with his previous primary diagnosis of ADHD. On the BASC he was scoring very low for ADHD but high for depression and mood disorder. We discussed that many of the behaviors especially the hyper-sexuality is consistent with bipolar. Their recommendation was to re-evaluation his medical therapy. Because his psychiatry appointment was for the next morning (today) it was agreed that the lead psychologist would meet with his attending psychiatrist prior to our morning appointment and we would all discuss the plan together at the appointment. difficult child's dad was to be at that appointment too. I was thrilled with the plan to have us all in the same room at the same time discussing the situation.
As some of you know, I have never been comfortable with his ADHD diagnosis. I never thought it fit and more importantly, he has not responded to medications prescribed for the condition. If anything, he is worse after two years of different ADHD medications and doses of medications. My ex-husband has seen things differently and until recently has not admitted to there being any problems aside from attention related behaviors. The genie was let out of the bottle by him writing me the e-mail last month.
The lead therapist told my ex-husband this am, "My expertise is ADHD and your son did not in my opinion display even the mildest of ADHD symptoms nor score high in that regard." He went on to tell him how concerned he was for a mood disorder. He does not think that it is major depressive disorder but more consistent with bi-polar. My ex-husband wanted to know if ADHD was still part of difficult child's diagnosis and of course we discussed co-morbidity as a a possibility but once again it was stressed that mood disorders in kids cause them to lose attention.
The biggest surprise to me was that my ex admitted that the suicidal and hypersexual behaviors are occurring in his home as well. That was the first time that he has ever been in agreement with me about my son's behavior although at each appointment I have brought up the suicidal and sexual stuff (last appointment he blamed me buying sex ed book for kids.) He also agreed that there are lots of extreme mood swings. The only behavior that he does not see as consistently or severely is the aggression.
The docs agreed that the new working diagnosis for my son is Mood Disorder-not otherwise specified. They are not ready to diagnose him with bipolar disorder just yet. Fine. I'm okay with that. Let's just move on from ADHD as the primary diagnosis. The plan when I left (I had to get to work and let before my ex did with my son) was to start difficult child on lithium and gradually discontinue with Adderall and Strattera. I liked the plan. The ex seemed to agree to it. I hope that things did not change after I left but he has not responded to my messages (yet?) asking him about that.
I feel some hope. Not because of exactly what the diagnosis is or is not...I am not married to a particular diagnosis.....but because what we have been doing for two years is not working. We all agreed that difficult child is in a much worse state of mind than ever and we need a new plan.
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