Extreme anger in 5 yo: psychologist or psychiatrist?

[Anonymous]

We are new to the mental health world. Our 5 yo daughter has terrible anger issues and flies into rages at the drop of the hat. This only happens at home and is directed at mom 95% of the time (the other 5% is people getting caught in her way as she rages about). She needs help and we do, too. Whom do we see, a psychiatrist or a psychologist/therapist? Our insurance will only cover treatment by a psychiatrist, but we have the option to pay out of pocket if the psychologist is really the way to go here.

We're in Chevy Chase if anyone has specific provider recommendations. Thanks.

[Anonymous]

As an aside, please take a look at this article, about TrueHope over the counter vitamins/minerals to balance the chemicals in the brain. For anger issues and/or depression. It started in Canada but it's Harvard-backed. It's an amazing story. I saved it just in case anyone ever needed it.

The weird thing is, years later my DH ended up becoming very depressed after switching jobs and was prescribed something; I said before you take that, take these OTC vitamins/minerals first and see if it helps. He now swears by them.

Obviously it could be a placebo effect or just coincidence but I don't believe so. The effect was profound.

You can get them at http://www.truehope.com and no I have no stock in it (I think it's a non-profit; founders are LDS)

[Anonymous]

Anonymous wrote:As an aside, please take a look at this article, about TrueHope over the counter vitamins/minerals to balance the chemicals in the brain. For anger issues and/or depression. It started in Canada but it's Harvard-backed. It's an amazing story. I saved it just in case anyone ever needed it.

The weird thing is, years later my DH ended up becoming very depressed after switching jobs and was prescribed something; I said before you take that, take these OTC vitamins/minerals first and see if it helps. He now swears by them.

Obviously it could be a placebo effect or just coincidence but I don't believe so. The effect was profound.

You can get them at http://www.truehope.com and no I have no stock in it (I think it's a non-profit; founders are LDS)

quack quack

[Anonymous]

I'm an MD, and I would go to a psychologist/therapist first. I think that route would emphasize non-drug interventions first. Since the outbursts is mostly directed at mom, I think this suggests a behavioral source. I would be interested in what others think as well.

[Anonymous]

Anonymous wrote:I'm an MD, and I would go to a psychologist/therapist first. I think that route would emphasize non-drug interventions first. Since the outbursts is mostly directed at mom, I think this suggests a behavioral source. I would be interested in what others think as well.

I agree that you should go to a psychologist first. They cannot prescribe drugs, so there incentivized to try talk therapy. The last thing you want is to go see a psychiatrist and have them just see your kid for 15 minutes and put him on meds.

[Anonymous]

only with mom? something doesn't sound right

[Anonymous]

OP here. I wish that she had outbursts with someone besides Mom! I take the brunt of everything and we are caught in a really ugly spiral. She saves it all up for me. I am also wary of drugs, as I think this is more behavioral than chemical at this point. We have been dealing with things for over a year now with periodic help from educators and need someone with a fresh approach to teach us both new habits.

Just took over the insurance plan searching from DH and discovered that there ARE psychologists on our plan. So, anyone have any BCBS psychologists out there that they like for anger issues? The folks at Childrens and Georgetown are on the list. Our ped recommended a few people, but none of them take insurance (and our plan doesn't reimburse out of network.)

[Anonymous]

I would go to neither. I would take her to a developmental pediatrician. First of all, she should see a medical doctor. I wouldn't assume this is purely psychological, especially in a child this young. There could be an underlying medical or developmental issue, even if it is "only at home." Our DD who has ADHD and mood issues used to keep it together very well at school, but melt down completely when she got home.

I am a huge believer in talk therapy but I think the folks recommending it didn't read that this child is 5 years-old. There is no way that a child that young benefits in the way an older child or adult does from talk therapy. She is way to young to be able to form the insights that is the point of talk therapy.

Much more meaningful to identify the issue first (the developmental pediatrician, or maybe a psychiatrist). If there isn't an underlying medical issue a behaviorist is a better bet than talk therapy.

And for the person who questioned why only with mom -- this is probably the person she feels most comfortable with, and most comfortable releasing the stress she has (for whatever reason she has that stress).

[Anonymous]

Anonymous wrote:only with mom? something doesn't sound right

Nonsense. In a lot of families, one parent often takes the brunt of a child's anger, especially if one parent is the primary one overseeing homework and other "rules" type stuff. We know same-sex couples too where it's inevitably one mom or dad who gets the brunt of it. Could be ADHD (DS has ADHD and one of us definitely bears the brunt of anger at times). Good luck OP

[Anonymous]

Anonymous wrote:I would go to neither. I would take her to a developmental pediatrician. First of all, she should see a medical doctor. I wouldn't assume this is purely psychological, especially in a child this young. There could be an underlying medical or developmental issue, even if it is "only at home." Our DD who has ADHD and mood issues used to keep it together very well at school, but melt down completely when she got home.

I am a huge believer in talk therapy but I think the folks recommending it didn't read that this child is 5 years-old. There is no way that a child that young benefits in the way an older child or adult does from talk therapy. She is way to young to be able to form the insights that is the point of talk therapy.

Much more meaningful to identify the issue first (the developmental pediatrician, or maybe a psychiatrist). If there isn't an underlying medical issue a behaviorist is a better bet than talk therapy.

And for the person who questioned why only with mom -- this is probably the person she feels most comfortable with, and most comfortable releasing the stress she has (for whatever reason she has that stress).

I wouldn't expect a psychologist would do talk therapy with a 5 yr old. They would do age appropriate play therapy and incorporate therapy into activities.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would go to neither. I would take her to a developmental pediatrician. First of all, she should see a medical doctor. I wouldn't assume this is purely psychological, especially in a child this young. There could be an underlying medical or developmental issue, even if it is "only at home." Our DD who has ADHD and mood issues used to keep it together very well at school, but melt down completely when she got home.

I am a huge believer in talk therapy but I think the folks recommending it didn't read that this child is 5 years-old. There is no way that a child that young benefits in the way an older child or adult does from talk therapy. She is way to young to be able to form the insights that is the point of talk therapy.

Much more meaningful to identify the issue first (the developmental pediatrician, or maybe a psychiatrist). If there isn't an underlying medical issue a behaviorist is a better bet than talk therapy.

And for the person who questioned why only with mom -- this is probably the person she feels most comfortable with, and most comfortable releasing the stress she has (for whatever reason she has that stress).

I wouldn't expect a psychologist would do talk therapy with a 5 yr old. They would do age appropriate play therapy and incorporate therapy into activities.

And help the parents as well.

[Anonymous]

I would see a psychiatrist first b/c if medication is needed they can prescribe it. A child psychiatrist can evaluate if it's a behavioral source and/or chemical and can also recommend other therapies.

Even if you get medication, a neuropsych eval would be a good idea to identify any learning disabilities. Behavior therapy with a psychologist would also be helpful if issues persist.

(Some kids can hold it together for school then let it out on the parent they see more often, so it may not be a reflection of the kid's relationship with her mom.)

[Anonymous]

A developmental pediatrician? WTF? To tell you whether the child is developmentally normal? I can't figure that one out.

[Anonymous]

Anonymous wrote:A developmental pediatrician? WTF? To tell you whether the child is developmentally normal? I can't figure that one out.

Please go back to General Parenting.

I would never use the term "normal" since I believe my kids, who have developmental diagnoses, are perfectly normal But if it turns out that OP's DC doesn't have a diagnosable disorder that can be addressed, terrific. Thats a great reason to have an evaluation, to rule things out. But if there is an issue -- and as a parent of such kids I see red flags -- then whats wrong with having it identified and addressed. Obviously OP's child is having some kind of issue and its causing distress to the whole family, including the child. What is so threatening about having an evaluation?

[Anonymous]

Anonymous wrote:only with mom? something doesn't sound right

Yes, your comment isn't.