Any good psychiatrist will start with a full history and intake before prescribing meds, even if you already have a full evaluation from a psychologist. Also, unless they are explicitly operating only as a psychopharmacologist, all psychiatrists also are trained to provide therapy. I find that therapy comes down to rapport with your daughter, whether the therapeutic model works in your situation, etc., whereas working with meds is about having the right diagnosis so that the meds help the patient be more amenable to therapy. My DS's psychiatrist works closely with his therapist, but for us they are at their best when working in their respective areas so we use a psychologist for his therapy and a psychiatrist for his meds. They are just very different (albeit symbiotic) treatments for the same condition, so we always feel like there is a good balance in support.

OP, can you be any more specific about what age anxiety started and what kinds of triggers/situations seem to worsen it?

OP, if you reach the point of hospitalizing your daughter, check out Dominion Hospital. We had to hospitalize our daughter when she was in 9th grade. It was the worst day of my life. But the fact is that it was just what she needed and the program for adolescents at Dominion really helped her. She is doing wonderfully today.

Follow-up to previous post is that I wanted to say a good psychiatrist will be willing to sit down with you or to get in writing a history about your daughter's overall health and mental health especially. If not a formal questionnaire then at least seeking input on how she is relating to you her parents, to siblings, to peers, to school, to any particular pressures, changes in behavior during the year etc. How exercise might impact as is she doing better when on a sports team or out and more physically active in the summer?
Also it would help if both you and DH could provide as much information on any family members who have had mental health issues as sometimes there can be a definite predisposition as one might have to a cancer or heart condition. In our case DD had the predisposition on DH's side for severe anxidty and on my side for a particular kind of cancer and has had to deal with both as a young adult. Very, very hard to see someone who did nothing wrong deal with the family gene pool in two ways. But again as we got the best and most comprehensive treatment for her for the cancer, she was the one when she came to DC who actually changed psychiatrists - why because at a certain point she knew she could get whatever meds she might ask for, but felt she needed someone more attuned to overall health for one who would marry and have a family. Your DD is not at that point so you must choose the psychologist and therapist who is most able to meet her needs. A therapist who would not take such thoughts seriously is one to be questioned very seriously why not and also to have no recommendations for a psychiatrist at all leaves a lot to question???

OP - I can't say your daughter's therapist has been very proactive and I wonder if she as a therapist has a bias against medication use. If so, you really do need to find another therapist. The recommendation for a psychiatrist who does the counseling, too, could be very important if DD was comfortable with him in that he would know first-hand how the medication is going and also be handling the therapy intervention and support, too. It is often a balancing of the meds to stabilize with therapy and then as progress is made adjusting and in time possibly reducing meds as less is needed. If you think DD would work better with a female therapist then maybe stay with the present one as you add in the medical doctor.

Dr. Garland provides therapy, as well.

Whoa, I'm a therapist who works with adolescents and this concerns me. If your daughter is getting depressed and having some suicidal ideation then her therapist needs to be very proactive in finding her a psychiatrist, I don't know why she isn't helping you.

If I were you I would implore the therapist to help you, there are tons of therapist list serves that she is probably on where she can get a few names. Also she needs to work with and collaborate with the psychiatrist.

We just had a great experience with Dr. Sakran at Healthy Foundations Group. He is thoughtful and patient, took a lot of time with us and coordinated with psychologist.

I do agree with pp about not having a psychiatrist work in a vacuum, but that's why they should be working closely in communicating with your therapist. It is possible (and for most people preferable) to have two people serving these distinct roles and making sure that everyone is on the same page with diagnosis and progress.

Has your daughter been on any medication so far? If so under the care of her PCP only?

Whoever you choose as a psychiatrist for dealing with the medication for our daughter, the doctor should be willing and your daughter's therapist, too, to be in consultation with one another at appropriate intervals as communication is key for the MD to see if the meds are working or need adjustment. This is key. I would not go to a psychiatrist who would only want o operate in a vacuum because listening only to the patient about how things are going is not enough at least in the beginning may not be accurate, at least in the beginning until the doctor gets to know the patient.

I do have a recommendation of a woman psychiatrist who is in NW DC and only takes private pay who is excellent. She has worked with our daughter since she was in her late 20s who had similar aspect of being in the bipolar family, but not strictly as not the usual ups and down - more times of extreme anxiety. So maybe start with NOVA doctors who do deal with teens first. If you find no one or would like an initial consult to compare, I will post her name.

Has anyone tried Dr. Joshua Weiner?

Thank you both for taking the time to respond and your recommendations. If anyone else has any other suggestions, I would appreciate hearing them.

I second what the pp said. We also see Dr.Garland. He has been very helpful to us in a similar situation.

I'm really sorry about what you and your daughter are going through. We had a similar experience with my 14 year old daughter and we are finally coming up for air again after she started a regimen of low dose antidepressants. We use a practice in Fairfax called "Child and Famiky Counseling Group." They have both psychiatrists and psychologists. We have a separate psychologist (not from this practice group) but we go to Thad Garland, M.D. at CFCG for medication eval and management. I like him because he specializes in teens and children, is very responsive (especially for a psych doc), and is proactive, but cautious in what meds are prescribed and how much. I was not thrilled with the idea of working with a psychiatrist because I and many others have had not so great experiences wit them in the past, so I understand your nervousness. Most M.D.'s aren't warm and fuzzy (at least in my experience), but my priority in going the medication route was being able to trust the psychiatrist both in their competence and also in the way they approached evaluations and treatment. I found Dr. Garland to be very balanced in offering guidance, but also in listening to how we were most comfortable starting med trials (e.g., did we want to start aggressively, more conservatively, etc.). He takes the parent's view of what their child needs into consideration.

I've also heard good things about the others docs in that practice, so you might want to take a look at all of them and see who seems most suitable for your needs. Best of luck.

http://www.childandfamilycounseling.com/

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.