What to say to the psychiatrist

Discussion in 'General Parenting' started by rob#30, Aug 13, 2008.

  1. rob#30

    rob#30 hangin in there

    OK guys, Im meeting with difficult child's psychiatrist (I assume that is the acronym for pediatrician???) Right now he is on 72 mgs of Concerta. I have learned so much from reading what you all write that I feel so informed this visit but I need some help before I go see him. First of all, difficult child is soooo hyper all the time while on the medications. He is definately worse when he's NOT on the medications so I just thought that this was the best we could get for him. I'm wondering if he should be on stimulants at all?? His diagnosis is ADHD/ODD. He started with- Ritalin. Changed to Adderal. Now Concerta. Hes been on Strattera before but I really never noticed any difference with that. School is starting soon & I really would love to start this year off right. If in fact the stimulants are not working, what are the alternatives?? I mean there is no way that he can be medication free right now. Tried that for years and he truly suffered, especially in school. The stims really do help in a lot of areas but the seem to "rev" him up a bit to much. Everyone keeps telling me to get him a pshyc/neuro evaluation. What exactly is that? Like really, somebody actually spell it out for me so I can right it down on my list for the visit. Thanks guys!
  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Hi there.
    As one who was first diagnosed myself with "Hyperactivity" way back in the dinosaur ages (and put on Ritalin), let me give you a few possible scenarios. By the way, the Ritalin affected me like speed. I was VERY hyper both in thought, activity, impulsivity and everything else (still am), but my main problem was never ADHD. That was a misdiagnosis, and it is a very common misdiagnosis. The problem is, when you get a wrong diagnosis of ADHD, stimulants don't really do much to help. Sure, they help everyone concentrate better...college kids who DON'T have ADHD take stims to stay up all night and focus/study/cram. That has always gone on. But with your child's behavior, I would want a more intensive evaluation. He could have a mood disorder, like I do, and stimulants will NOT help that AT ALL. Mood stabilizers are best for that. If you have to keep increasing the stimulants, you are giving this kid tons of speed. If he is in any way cycling in his moods, they would make his cycling worse. I would question this line of treatment.
    ADHD/ODD is often a misdiagnosis for early onset bipolar OR high functioning autism. It was my son's first (but hardly last) diagnosis. A neuropsychologist evaluation is probably going to help you more than talking to a Psychiatrist. I've been to Psychiatrists since I was in high school (I'm 54) and it took them forever to get my diagnosis right. With my son, who is on the autism spectrum, I found I really liked neuropsychologist evaluations better because the professional actually does some very intensive testing, observing, making one fill out a hundred questionnaires (not just one questionnaire aimed at one disorder) and I felt he spent a lot more time with my child before jumping to a diagnostic conclusion. My son was tested for ten hours, in two hour increments. His functionality in every area was looked at and evaluated with care. No stone was left unturned.
    Anyway, that's my experience and .02 and I wish you lost of luck.
  3. mstang67chic

    mstang67chic Going Green

    First...if you go to the FAQ page (see the bar above) you will get definitions of all of the acronyms and abbreviations we use.

    psychiatrist is actually prescribing doctor or psychiatrist. If difficult child is getting his medications from a general pediatrician, you may be better served to get a referral to a psychiatrist that specializes or has experience in dealing with children. Most pediatricians just aren't familiar enough with difficult child issues and the medications to be that effective.

    The evaluation you are asking about is one that a psychiatrist or a neuropsychiatrist can do. Basically, it's a full workup/physical for the brain and mental issues. (Others can explain it much better.)

    I would suggest it also or at the very least, go to a child psychiatrist. A lot of times kids are diagnosis'd with ADHD and there is more going on. Just as an example....some kids are diagnosis'd ADHD and they are really Bipolar. In that case, stimulants alone can cause issues with behavior in these kids. Some can't be on stims at all while others can be on stims with other medications.

    You really need to see a doctor that specializes in kids with mental issues. When warranted, the right medications can make a world of difference and your everyday pediatrician just doesn't have the experience.
  4. busywend

    busywend Well-Known Member Staff Member

    Here is the evaluation you want. The pediatrician may be able to get you a referral - but most pediatrician docs are not that familiar with the medications and their reactions. This is a multi-disciplinary evaluation. Preferrably done at a Children's Hospital. (I took my difficult child to Strong - I see you are in Upstate, too!)


    Next, even though you are informed it is difficult to know how a pediatrician doctor or a psychiatrist will react to your knowledge. Many psychiatrists have been known to get defensive if you start talking about what you have read on the internet...LOL!
    Tread lightly when revealing your knowledge. Ask the psychiatrist for information before you reveal what you 'thought' you read somewhere. Also, your pharmacist is very valuable in helping you understand the medications and their reactions/side effects, etc.