Recommend (or warn against) an adolescent psychiatric specialist- Bipolar

[Anonymous]

DD16 has suspected emerging Bipolar II or other mood disorder. Her biological dad was never diagnosed, but now that I know more about Bipolar II, I am beginning to think this was one of his issues.

Her psychiatrist has basically said that she no longer has just depression, that this is clearly something more complex. (This is following her suicide attempt which I have posted about in another thread). He suggested finding a university program for a team approach to what will likely be a complex case and a life long set of issues. He also gave some encouragement in the form of stories of people who lived into adulthood successfully with bipolar without the benefit of a diagnosis until later in life.

He is near retirement, has been in psychiatry for 50 years. He didn't have any direct recommendations. He suggested starting with the University of MD.

UMM does not take private insurance, only medical assistance/medicaid.

So Im now investigating Hopkins, Krieger, Childrens.

Currently she is in an intensive outpatient program for the next 7 weeks.

[Anonymous]

https://www.sheppardpratt.org/

[Anonymous]

My child is also diagnosed with Bipolar II and had multiple suicide attempts. I wasn’t a fan of Children’s. As a teaching hospital, there is so much staff turnover. And it takes forever to get off the waiting list. We got lucky in that regard because after hearing my child’s story, the scheduler took pity on us and gave us the first cancellation.

The best doctors have been the inpatient ones at Adventist and they provided longer term treatment plans. They also consult with the outpatient ones at Adventist. So we’ve stayed there. But there has been a lot of staff turnover there as well - we’re on the sixth one in five years. But it’s also really hard to find someone with openings and by staying with Adventist, when a provider leaves they find us another one.

[Anonymous]

Excellent doctor for med management
https://www.childandfamilycounseling.com/ella-peresechenski-m-d/

[Anonymous]

OP here, I think what I am looking for is a diagnostic opinion.

From there, I think I can find a practitioner for med management....

I think step one is getting a proper diagnosis, or a proper set of opinions.

Im not sure my daughter fits in any box neatly, and of course that's often the case.

She has a lot of symptoms of Bipolar II and Borderline personality disorder, but she also has ADHD _and_ some interesting neurological symptoms like silent migraines and hypersensitity at times to textures on her skin, sound, lights. But not all the time.

Im most concerned about starting her on any neuromeds that may affect her adversely....yet equally concerned about NOT getting her on neuromeds in time to avoid affecting her adversely.

[Anonymous]

Not covered by insurance, but I don’t know of this thorough of an evaluation this is unless it is an inpatient program (and none around here): https://www.sheppardpratt.org/comprehensive-outpatient-psychiatric-evaluation/

[Anonymous]

Anonymous wrote:My child is also diagnosed with Bipolar II and had multiple suicide attempts. I wasn’t a fan of Children’s. As a teaching hospital, there is so much staff turnover. And it takes forever to get off the waiting list. We got lucky in that regard because after hearing my child’s story, the scheduler took pity on us and gave us the first cancellation.

The best doctors have been the inpatient ones at Adventist and they provided longer term treatment plans. They also consult with the outpatient ones at Adventist. So we’ve stayed there. But there has been a lot of staff turnover there as well - we’re on the sixth one in five years. But it’s also really hard to find someone with openings and by staying with Adventist, when a provider leaves they find us another one.

Agree. Avoid Childrens inDC

[Anonymous]

I think McLean Hospital in Massachusetts is the gold standard, if you are willing to travel.

https://www.mcleanhospital.org/child-teen

[Anonymous]

Has she seen a neurologist? The atypical migraines would make me concerned there is something neurological going on that is causing bipolar like symptoms.

[Anonymous]

PP here whose kid has Bipolar II. Best diagnostic we got was through a neuropsych. We did full testing and added in additional mental health testing. It added an additional 10% to the bill. The other big piece was response to medications. And due to the number of hospitalizations, PHPs, IOPs and crisis visits, there were a lot of clinicians diagnosing separately and reaching the same conclusion. But honestly we were really sure about the diagnosis. The only hesitation was diagnosing at my kid’s age, which if I’m remembering correctly was 15-16.

[Anonymous]

Anonymous wrote:Not covered by insurance, but I don’t know of this thorough of an evaluation this is unless it is an inpatient program (and none around here): https://www.sheppardpratt.org/comprehensive-outpatient-psychiatric-evaluation/

This is amazing. Thank you for sharing. I had no idea this even existed.

[Anonymous]

Anonymous wrote:OP here, I think what I am looking for is a diagnostic opinion.

From there, I think I can find a practitioner for med management....

I think step one is getting a proper diagnosis, or a proper set of opinions.

Im not sure my daughter fits in any box neatly, and of course that's often the case.

She has a lot of symptoms of Bipolar II and Borderline personality disorder, but she also has ADHD _and_ some interesting neurological symptoms like silent migraines and hypersensitity at times to textures on her skin, sound, lights. But not all the time.

Im most concerned about starting her on any neuromeds that may affect her adversely....yet equally concerned about NOT getting her on neuromeds in time to avoid affecting her adversely.

Hi OP. I’m so sorry for what you are going through. I am not trying to be an armchair physician but wanted to share our story. My ADHD DD became depressed, anxious, and emotionally dysregulated as a teen. She would feel “high” but not for days, but hours. She would feel extremely low also for hours - literally crying saying that her emotional pain was so intense that it felt physical. The depression and anxiety were always there but then there were the hours of emotional dysregulation. We have a family history of bipolar so we were concerned about that and she also had some borderline features. She ended up being diagnosed with high functioning autism. You taking about the textures and sensitivity made me think about my DD. Her SSRI has almost eliminated her emotional dysregulation (that coupled with a lot of life changes). If she gets upset (which is extremely rare) she will still have a very outsized reaction. She had a neuropsych when she was in elementary that only identified her ADHD. We had an updated one while in the throes of her mental illness that identified autism. One well respected ADHD psychiatrist said she didn’t think it could be autism at that time and it is very, very subtle. Of course, if you look back you can little things. But girls with autism present completely different than boys (and often against the stereotypes). My DD was extremely verbal, hit all milestones, and was extremely imaginative and had friends. It was after COVID and the increased social demands of MS that it became apparent. GL

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here, I think what I am looking for is a diagnostic opinion.

From there, I think I can find a practitioner for med management....

I think step one is getting a proper diagnosis, or a proper set of opinions.

Im not sure my daughter fits in any box neatly, and of course that's often the case.

She has a lot of symptoms of Bipolar II and Borderline personality disorder, but she also has ADHD _and_ some interesting neurological symptoms like silent migraines and hypersensitity at times to textures on her skin, sound, lights. But not all the time.

Im most concerned about starting her on any neuromeds that may affect her adversely....yet equally concerned about NOT getting her on neuromeds in time to avoid affecting her adversely.

Hi OP. I’m so sorry for what you are going through. I am not trying to be an armchair physician but wanted to share our story. My ADHD DD became depressed, anxious, and emotionally dysregulated as a teen. She would feel “high” but not for days, but hours. She would feel extremely low also for hours - literally crying saying that her emotional pain was so intense that it felt physical. The depression and anxiety were always there but then there were the hours of emotional dysregulation. We have a family history of bipolar so we were concerned about that and she also had some borderline features. She ended up being diagnosed with high functioning autism. You taking about the textures and sensitivity made me think about my DD. Her SSRI has almost eliminated her emotional dysregulation (that coupled with a lot of life changes). If she gets upset (which is extremely rare) she will still have a very outsized reaction. She had a neuropsych when she was in elementary that only identified her ADHD. We had an updated one while in the throes of her mental illness that identified autism. One well respected ADHD psychiatrist said she didn’t think it could be autism at that time and it is very, very subtle. Of course, if you look back you can little things. But girls with autism present completely different than boys (and often against the stereotypes). My DD was extremely verbal, hit all milestones, and was extremely imaginative and had friends. It was after COVID and the increased social demands of MS that it became apparent. GL

Coming here to say the same thing.

My DD was misdiagnosed as Bipolar, and now years later, it turns out it is ASD. The sensory thing is big clue.

[Anonymous]

OP here. Thank for the inputs regarding the sensory issues.

My husband (stepdad) has a now adult daughter who was plagued with atypical seizures and we have wanted to get her to a neurologist but there has just been so much going on.

I have always rejected ASD as a possibility but she definitely fits in the description of a highly sensitive person. A colleague who was dx'd with Aspergers late in life said its a common joke among his fellow Aspies that Highly Sensitive Person is the label people find better than autism.

Im very concerned about something being missed and I dont want anything to make her worse.

[Anonymous]

You cannot diagnose a child with bipolar.