where do i go from here?

[pepsichic9115]

Hi everyone. I've been missing for awhile bit am so glad to be back!!

But anyways I have a bit of a dilema. I know my signature isn't up to date right now so I'm gonna give a little info. I took difficult child to a neuropsychologist this fall. He wrote in his report that difficult child is "emerging bipolar".
psychiatrist took that info and changed her diagnosis fron depressive disorder not otherwise specified and odd to mood disorder not otherwise specified and odd. difficult child is currently on depakote (1000 mg total daily). a month ago psychiatrist added vistaril (I don't know the dose as she is at my sisters with her medications) to help her sleep.

We went back to psychiatrist today and I brought up the fact that the vistaril doesn't help her sleep because difficult child can fight thru it and stay awake. psychiatrist says that her sleep problems are behavior and not medical because difficult child doesn't.WANT to sleep so I should take her off medications and let her sleep whenever she wants (she is 11, goes to school, and does not stay in her room reading as she tells psychiatrist she does-not to mention I NEED me time to recover). Then when I address the problems we are still having as far as her being mean to everyone, threatening her siblings, refusal to do things she needs to do,ect-psychiatrist says she doesn't know what to do because difficult child appears to enjoy being miserable and making others miserable!!

I'm at a loss here. What did psychiatrist mean by that?? I am not going to just give up and let her make everyone miserable--but what can I do now?? There are no other pediatric psychiatrists locally that I'm aware of.

 

[nvts]

Have you looked into a Developmental Pediatrician? Also, check under your medical insurance for "mental health" professionals. Your difficult child sounds exactly like my 11 year old (difficult child 1) and he's got Aspergers Syndrome. A real joy to be around let me tell ya!

You can also do a websearch by looking for Mental Health Professionals + your city and state.

Beth

 

[GoingNorth]

I'd lose this psychiatrist in a hurry. First of all, Vistaril is an old line antihistamine and can make a lot of people very agitated and irritable instead of making them drowsy. Benadryl, actually is sold as the ingredient in OTC sleep medications and that too can have the opposite affect.

Also, it is commonly known that "sleep hygiene" is crucial to the well-being of those suffering from mood disorders of any kind. This means both getting enough sleep AND sleeping and waking at the same times each day.

The worst thing you can do for a bipolar person is to let them sleep whenever they want to. In fact, this often leads up to outright mania or hypomania.

It is why so many of us are on medications for sleep

 

[Andy]

I agree with GoingNorth! OMG - let the child set the rules? Sounds exactly what happened when I took Diva to a therapist at about that age. Our therapist at that time was assigned to us through the "employee help program". He had NO experience with kids AT ALL. He told me that after the few visits our employer group allowed, if we needed further help, he would refer us to a therapist with experience with kids. (I wrote a letter to our HR complaining that when an employee's child needs help that the child needs to be referred to a therapist who actually works with kids on an everyday workcase.)

Basically, what Diva's first therapist told us was to let her set up the household schedule for bed time routines. Our daycare provider told us that was so wrong! It was important for Diva to respect what Mom and Dad set up and for Mom and Dad to learn what was best for Diva.

I think that some tdocs who do not normally deal with kids are dealing with adults that live on their own and they are trying to give these adults control over their own life, "Set your schedule and stick to it." With kids, you have to have some stricter boundaries and the rules of the house set up by the parents need to be enforced. Therapist can encourage Mom and Dad to include child's input, but the child does not set up these time schedules.

Also what GoingNorth said about "sleep hygiene" is right on. For a person to get control of how/when/where they sleep is so important to their overall health. Do you ever experience lazy days of laying on the couch watching t.v. and notice how hard it can be to get remotivated after you allowed yourself to relax so deeply? In a way, that is what is going on with people with poor sleep hygiene, they are letting their shutting down moods rule their life. They are telling themselves that they will wait until they "feel" like getting up to get up. That feeling doesn't come around that often or easily. We need to teach our bodies to get the proper sleep at the proper time in the proper way to stay healthy.

If something doesn't feel right to you, feel free to follow your instincts and get a second opinion. I would be interested to know if this psychiatrist actually has real life experience dealing with kids. I would think advice such as she gave you is so unhealthy. It sounds like she has given up on your difficult child. Do you have a therapist that can work more often with your difficult child to help with the sleep hygiene issue? My current difficult child's psychiatrist would refer "behavioral" issues back to therapist to help work out - no way would he ever say, "Oh, just let it be" - he knows that medication and therapy both are needed to overcome these issues.

 

[busywend]

Is this a counselor or a psychiatrist psychiatrist? I am guessing psychiatric since he is prescribing. I think your difficult child should see a psychologist for therapy and keep the psychiatrist for medications.

Or change psychiatrists all together - he/she is not helping!

 

[ksprincess]

When our son was at a mental health hospital, he was having trouble sleeping and so they gave him melatonin. Once he came home we didn't continue it because he sleeps fine (other than he only sleeps when he wants to). I've heard that the melatonin won't work long term though, but it could be worth a try.

 

[pepsichic9115]

Thank you all for your responses. I was able to do some research into other possible psychiatrists last night. There is another option here locally that will take our insurance so I will be calling them shortly. I also looked into the pediatrician office here that has grown to more than triple their original size in the last 10 years. They do have a developmental pediatrician on staff and they have several doctors who specialize in difficult child's so I will be calling them also to see if I can get her in there even if for nothing more than a 2nd opinion. Our current dr is family practice and pretty much just passes mental health issues off to the psychiatrist we have been seeing. So there are more resources than I thought and I'm off to utilize them.

I have given her melatonin in fact I tried that before I brought up the option of sleeping medications to the psychiatrist. It works to put her to sleep but she wakes up within 2 hours and then can't get back to sleep!! It does work wonders however for my high energy easy child who has a hard time shutting off at night. Thanks for the suggestion!!