ISO psychiatrist for complicated depression/bipolar teen -- desperate and worried!

[Anonymous]

OP here. Thanks for all the advice.

My daughter started showing signs of anxiety and depression about five years ago and began seeing the therapist then. We thought it was mostly school related at the time, which it may have been. She saw the therapist for two years. Switching schools seemed to help the most.

She started back with her therapist over a year ago for depression. That's when she told me she had been having intrusive thoughts of self-harm/suicide for years. She said that the thoughts were really annoying -- scary at times -- but that she would never act on them.

She's never taken any medication.

Now, the thoughts are more frequent and she doesn't seem as confident that she wouldn't act on them. So I am focused on keeping her safe until I can find a psychiatrist to hopefully help her.

I don't feel that she's in imminent danger, so I don't think we need to hospitalize...and hope it never comes to that. But I do think I need to find someone as soon as possible, preferably someone who gets her depression. It seems cyclical in nature - similar to bipolar without the mania - because there are times when she seems normal and hopeful about the future, and other times when she feels hopeless. When I ask her if there are any triggers, she says it's random.

I made some calls to a few recommendations, and hope to have something in place by tomorrow. If anyone else has any names they could refer me to, or any advice in general, I would be so appreciative.

10:25, would you mind posting the name of your psychiatrist?

[Anonymous]

The doctor is Dr. Suzanne Griffin up in NW area. I have never met her as out daughter was a young adult who chose her after meeting with a couple of psychiatrists. However, she is spot on in dealing with meds even subtle changes, and I would contact anyone she might refer you to for your daughter if she did not deal with such issues. You might look her up online to see if she has a presence or what her particular interests are. Do not be afraid of medication as you want to help your daughter get things back in balance now while she is still living within the love and support of her family. Also, it will be important for DD over time to learn how to handle her mental health needs as one would a physical health condition because it is hard to say if this may not be a part of her life for some time. For now you are right not to wait, but to do so in as calm a manner as possible. Hang in there Mom.

[Anonymous]

Anonymous wrote:

Now, the thoughts are more frequent and she doesn't seem as confident that she wouldn't act on them.

Watch her like a hawk. Connect with her closest friend, so the friend can reach you at any time. Your daughter might tell a friend if she chooses to self harm before she tells you. Put all meds in the house under lock and key. Advil has been popular choice lately.

Meds will help in time. It will all get better.

[Anonymous]

This sounds very much like OCD. My DD also has intrusive thoughts of suicide, but is not suicidal. Here's a good explanation: http://www.steveseay.com/suicide-obsessions-fear-killing-yourself/

My daughter has done very well on anti-anxiety meds.

Good luck.

[Anonymous]

Yes meds can help, but remember advice above because any medication takes time to get into the body and take effect. It can be as long as a few weeks in some cases. She may need to see her therapist more than weekly, but I remain concerned that this therapist did not act on your concerns and has "no recommendations." From your information on her lack of assistance, you need to contact her directly to see if, in fact, in her practice she does work as "a team" with a psychiatrist in the treatment of some patients. If not, find a psychologist as soon as you can the psychiatrist you choose for DD recommends.

[Anonymous]

Thank you all for the helpful advice and perspective. Honestly, I think I learn more here -- and get more support -- on this anonymous discussion board than I do from the paid experts. Thanks again. I hope to pay it back one day when my daughter is stable and I can help others with my experience.

Thanks for the link, 20:05. I thought about the OCD angle, but it's confusing because all of the pieces don't fit. That's why I want a really smart, thoughtful psychiatrist who can put this all together. Hoping to receive some call-backs today so I can move forward.

[Anonymous]

+1 on other PP's comments about whether a therapist truly is knowledgeable and helpful if a child has been seen for may years for anxiety without a referral for medication/psychiatry consult.

In addition to seeing a psychiatrist, given how old your child was at the onset of anxiety and depression (about 10 years old), I would STRONGLY recommend you also get a full neuropsychology assessment to either 1) rule out any learning disabilities and/or better identify learning/strengths and weaknesses that create or worsen anxiety/depression or 2) better identify how your DD's anxiety and depression are affecting her ability to succeed in school and thus, provide the documentation necessary to get support from school in terms of class accommodations, etc.

Around 8-10 years old (3rd grade) is often a time when academic expectations take a leap and kids who had formerly been able to compensate for learning issues begin to see themselves becoming unsuccessful or less easily successful in school. But, because they are so young, they don't understand why and internalize the conflict they see between their own sense of self (I'm ok, I'm smart, I can do this) and the sense of self that is being reinforced in the classroom (you're not doing this, you're not with the rest of the kids, etc.). This can cause a great deal of anxiety and/or depression.

[Anonymous]

Thanks, PP. Actually we had a private psych-ed done when the anxiety/depression started and there were learning issues. The psychologist said the depression and anxiety was situational. The IEP actually made things worse...and now it's gone well beyond how it started.

[Anonymous]

We see Azin Bekhrad at the Ross Center in Chevy Chase. I know you are looking in Va but I want to put her name out there. She has been phenomenal with our complicated kids. She is extremely thorough and took the time for a thorough intake before prescribing. She speaks directly with my kids each time they have a medication management appointment and never rushes us out. She is very careful with the meds she prescribes and always tells us the pros and cons and makes me feel a partner in treatment decisions. She also consults with our therapists and neurologists. When an issue arises, I can reach her directly.

[Anonymous]

Anonymous wrote:Thanks, PP. Actually we had a private psych-ed done when the anxiety/depression started and there were learning issues. The psychologist said the depression and anxiety was situational. The IEP actually made things worse...and now it's gone well beyond how it started.

FWIW, my child's anxiety and depression worsened after the IEP because the services provided under the IEP were worthless. The "special instruction" was nothing but increased attention and prompts delivering the same general ed instruction. The accomodations were often not provided or if DS asked for them he was treated like he was lazy or a PITA.

When we withdrew him and put him in a private school which could provide the necessary instruction his anxiety and depression disappeared. He is now back in public school and has a strong enough positive sense of self to put up with and self-advocate with the crappy biased teachers (about half of the slate most years.)

Maybe a good educational advocate could help you improve the IEP so it's useful, or maybe it's time to exore other optikns like tutoring or other schools.

[Anonymous]

Anonymous wrote:15 year-old daughter has had anxiety and depression off and on for years and has been seeing a therapist. Depression seems to be worsening and she has been talking about not wanting to live anymore and feeling hopeless. Her depression seems cyclical in nature, so one day she is horribly depressed, and the next day she seems normal. But there is no mania (so not typical bipolar). But there are similarities to bipolar, so I am trying to find a psychiatrist who is good at teasing out what this is exactly. I'd prefer someone in northern Virginia. If anyone has any recommendations, could you please let me know...and also could you say what it is about the psychiatrist that you like and why you trust them? A family member had a horrible experience with a psychiatrist a few years ago, so I know that a bad one can do a lot of harm and I'm really nervous about choosing someone.

Therapist has made no recommendations.

I am really worried about my daughter and want to get her help as soon as possible, but want to make sure it's the right person. Thanks so much in advance. I have always appreciated the information and support for this special group of parents.

OP- Our family is going through a very similar experience with our 13 yo DS. His pyschiatrist recently diagnosed him with Disruptive Mood Dysregulated Disorder (DMDD). Like your daughter, he has moments of extreme depression, but then can be normal but we have never seen mania in him. This is why this relatively new diagnosis has been developed, because it isn't bipolar. All of his symptoms are on the same line as depression and not extreme happiness (that's something that he doesn't display).

He is on medication now, but I am actively trying to find a therapist for him in addition to his psychiatrist who we mostly use for medication visits because she is so far away from us.

[Anonymous]

Sorry, i have to chime in here - Dominion was the worst experience our family has ever had with the medical system. Their philosophy seems to be cookie-cutter, heavy medications that they ratchet up very quickly. This place was a total disaster for my child.

[Anonymous]

We also see a psychiatrist at Child and Family Counseling-Dr Jourkiv. All the providers we've seen there have been very good.

OP, I'm concerned that your therapist has let this drag on without encouraging medication. Its pretty obvious that she would benefit hugely from an anti-anxiety medication, or *something*.

[Anonymous]

Dr. Adele Parr is in Cabin John, MD so close to NOVA. I think she is good figuring out something is.

[Anonymous]

Hey, OP! Since this thread was revived, how about an update? How are things going?