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

[Anonymous]

Anonymous wrote:You cannot diagnose a child with bipolar.

OP again, Our psychiatrist is concerned about emergent bipolar. He was saying that if that is what it is and nothing is done, then in a few years things could get quite serious.

Of course the suicide attempt means its already serious.

I am very concerned about a misdiagnosis as well. Being treated for Bipolar that isnt there would be very bad. Somehow MISSING bipolar would also be bad of course.

I need people who will look and consider ALL the data we have, and we have quite a bit, and not cherry pick to favor a diagnosis.

I also definitely want a neurological opinion.

[Anonymous]

My kid has autism and schizophrenia. He’s also had anxiety, ADHD, depression, sensory issues, etc. at various times. At this point in time I just focus on what impedes his life quality.

I’ve met several parents where both autism and bipolar happen together.

I feel like you’re hoping for the right diagnosis, but mental health science just isn’t there yet. The patients shift around a great deal. Meds work poorly for many. I haven’t seen many concerns with permanent damage from treatment itself, except for bad ECS. More of a concern is permanent brain loss from the illness, criminal record and loss of friends.

Good luck on your journey.

[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/

Can you advise how much the evaluation costs?

[Anonymous]

Anonymous wrote:You cannot diagnose a child with bipolar.

OP's DC is 16. I think that's around the time, the diagnosis starts to become more apparent especially if there's a family history.

[Anonymous]

If you are willing to travel to Charlottesville, or live in VA (he’s not licensed in MD), go to Russ Federman. You can also read his articles on psychology today to see that he really specializes in this.

When DC was diagnosed with bipolar 1 and DC wanted a second opinion, we went to him. He works a lot with adolescents with bipolar. It was a few hundred dollars.

DC had a horrible year before we got the right diagnosis and medication. Now doing well.

Wishing you the best.

[Anonymous]

Anonymous wrote:If you are willing to travel to Charlottesville, or live in VA (he’s not licensed in MD), go to Russ Federman. You can also read his articles on psychology today to see that he really specializes in this.

When DC was diagnosed with bipolar 1 and DC wanted a second opinion, we went to him. He works a lot with adolescents with bipolar. It was a few hundred dollars.

DC had a horrible year before we got the right diagnosis and medication. Now doing well.

Wishing you the best.

So what was the correct diagnosis in the end?

[Anonymous]

Anonymous wrote:

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.

Curious how the two present similarly. Ssri activated my daughter as teen and she has a tentative bipolar 2 diagnosis but she also has things that seem like ASD. also has adhd. What are med differences for ASD?

[Anonymous]

Anonymous wrote:My kid has autism and schizophrenia. He’s also had anxiety, ADHD, depression, sensory issues, etc. at various times. At this point in time I just focus on what impedes his life quality.

I’ve met several parents where both autism and bipolar happen together.

I feel like you’re hoping for the right diagnosis, but mental health science just isn’t there yet. The patients shift around a great deal. Meds work poorly for many. I haven’t seen many concerns with permanent damage from treatment itself, except for bad ECS. More of a concern is permanent brain loss from the illness, criminal record and loss of friends.

Good luck on your journey.

Permanent brain loss from what?

[Anonymous]

Anonymous wrote:

Anonymous wrote:If you are willing to travel to Charlottesville, or live in VA (he’s not licensed in MD), go to Russ Federman. You can also read his articles on psychology today to see that he really specializes in this.

When DC was diagnosed with bipolar 1 and DC wanted a second opinion, we went to him. He works a lot with adolescents with bipolar. It was a few hundred dollars.

DC had a horrible year before we got the right diagnosis and medication. Now doing well.

Wishing you the best.

So what was the correct diagnosis in the end?

Bipolar 1

But previous diagnoses has been bipolar and ADHD and anxiety - DC had three separate hospitalizations and different medications.

I don’t necessarily think that the previous doctors were bad, each trates the symptoms they saw, and the medications are trial and error.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You cannot diagnose a child with bipolar.

OP again, Our psychiatrist is concerned about emergent bipolar. He was saying that if that is what it is and nothing is done, then in a few years things could get quite serious.

Of course the suicide attempt means its already serious.

I am very concerned about a misdiagnosis as well. Being treated for Bipolar that isnt there would be very bad. Somehow MISSING bipolar would also be bad of course.

I need people who will look and consider ALL the data we have, and we have quite a bit, and not cherry pick to favor a diagnosis.

I also definitely want a neurological opinion.

Untreated mental illness is dangerous. Unfortunately there is some guessing and ruling out illnesses in mental health. My daughter was diagnosed at age 14. It required two hospitalizations, medications, weekly therapy and keeping her busy with what she loved which was her outside activity. It’s gotten better over the last theee years. She was lucky we found a therapist she loved, she was a lifesaver. It also took me quitting my job to “manage” her and make sure she was where she was supposed to be. Her high risk behavior was boys. She can self report when her symptoms are too much for her and we call the doctor.

[Anonymous]

Anonymous wrote:My kid has autism and schizophrenia. He’s also had anxiety, ADHD, depression, sensory issues, etc. at various times. At this point in time I just focus on what impedes his life quality.

I’ve met several parents where both autism and bipolar happen together.

I feel like you’re hoping for the right diagnosis, but mental health science just isn’t there yet. The patients shift around a great deal. Meds work poorly for many. I haven’t seen many concerns with permanent damage from treatment itself, except for bad ECS. More of a concern is permanent brain loss from the illness, criminal record and loss of friends.

Good luck on your journey.

Pardon my ignorance – what is ECS? Is this the electrical stimulation?

[Anonymous]

Anonymous wrote:

Anonymous wrote:My kid has autism and schizophrenia. He’s also had anxiety, ADHD, depression, sensory issues, etc. at various times. At this point in time I just focus on what impedes his life quality.

I’ve met several parents where both autism and bipolar happen together.

I feel like you’re hoping for the right diagnosis, but mental health science just isn’t there yet. The patients shift around a great deal. Meds work poorly for many. I haven’t seen many concerns with permanent damage from treatment itself, except for bad ECS. More of a concern is permanent brain loss from the illness, criminal record and loss of friends.

Good luck on your journey.

Pardon my ignorance – what is ECS? Is this the electrical stimulation?

Yup. It seems much better now but there are some cases of memory damage.

Schizophrenia causes some brain shrinkage if left untreated. I’d say some people seem to be hopping between lots of diagnoses.

Current understanding of serious mental illness like bipolar and schizophrenia is just very limited. I see a lot of people thinking “correct diagnosis”. But really most every doctor is just running through a bunch of meds hoping something works. What works for one person doesn’t work for the next at all. And even on meds a lot of the illness is untreated, or there are side effects.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My kid has autism and schizophrenia. He’s also had anxiety, ADHD, depression, sensory issues, etc. at various times. At this point in time I just focus on what impedes his life quality.

I’ve met several parents where both autism and bipolar happen together.

I feel like you’re hoping for the right diagnosis, but mental health science just isn’t there yet. The patients shift around a great deal. Meds work poorly for many. I haven’t seen many concerns with permanent damage from treatment itself, except for bad ECS. More of a concern is permanent brain loss from the illness, criminal record and loss of friends.

Good luck on your journey.

Pardon my ignorance – what is ECS? Is this the electrical stimulation?

Yup. It seems much better now but there are some cases of memory damage.

Schizophrenia causes some brain shrinkage if left untreated. I’d say some people seem to be hopping between lots of diagnoses.

Current understanding of serious mental illness like bipolar and schizophrenia is just very limited. I see a lot of people thinking “correct diagnosis”. But really most every doctor is just running through a bunch of meds hoping something works. What works for one person doesn’t work for the next at all. And even on meds a lot of the illness is untreated, or there are side effects.

Thanks a lot for this information. Are there any promising treatments on the horizon for bipolar? New medications or approaches that hold promise for the next 5–10 years? Or realistically, is the best treatment just going to be things like risperidone?

[Anonymous]

Many people tolerate the medications well. Our DC has bipolar and while they gained some weight, they are not overweight, and otherwise don’t have wide effects from the medications.

[Anonymous]

Anonymous wrote:

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/

Can you advise how much the evaluation costs?

OP here, I can answer that one. I inquired and received an email. THis is from that email:

Our comprehensive, self-pay, three-day evaluation is conducted at Sheppard Pratt’s campus in Towson, Maryland, and provides patients with an accurate diagnosis and an effective treatment plan. Each evaluation is personalized based on the patient’s distinct life circumstances and needs. The evaluation costs a minimum of $15,000.