PP here. Also, you can try fish oil gummies and magnesium gummies for general mood improvement.

Shocked at how many people would give their children benadryl off label. Or at all. Our allergist warned us never to use it because it crosses the blood brain barrier and can cause cognitive impairment over time.

Melatonin is a natural hormone your body already makes, also induces feelings of calm and sleep (if you're tired) and doesn't have the same negative effect as benadryl.

Anonymous wrote:Use the Benadryl if you need a quick calm. That’s what they use inpatient. Also, a Popsicle to suck on can help calm kids quickly. You should let the school know now what is going on so he get an IEP over the summer.

Be careful with Benadryl. While it does make many kids sleepy, it can have a paradoxical effect in other kids, making them more hyper and some times contributing to mania. https://www.healthline.com/health/can-benadryl-cause-anxiety

TBH, it’s hard to get medication into a kid in a rage.

I am so sorry. My son is 10 now, but he had explosive episodes at that age and it’s terrifying.

We go to:

https://www.bloomhealthcenters.com/

We had no wait time getting in, and all appointments are virtual. I hope that helps.

We also use potomac pediatrics for well visits, and we use children for other appointments. I have used potomac pediatric lactation service when DS was infant, and I did not like it. They have recommended me their social skill group and psycharist services but we have not used them yet. I find them liking to send us off to other specialists whenever there are any possible signs. I am fine with that because both of my children end up being special needs and we are thankful it is better to know earlier than later even though it was a tough journey with tons of evaluation & re-evaluations. It seems like that no one likes Potomac pediatric's other specialists services, and I will keep that in mind.

Op, wish you good luck, and i hope that you start on IEP application. My kid got into any troubles with a strict & a not understanding kindergarten teacher, and I am glad that he has IEP to protect him. He has a disability of asd and adhd. When k teacher called or emailed me to complain, I always thanked her for letting me know. And, I always reminded her again that he has IEP, and she could talk to his special educator at school, and I would also talk to his private therapist to work on this and that. Some of her complaints were ridiculous. She complainted that she would not help him to open his water bottle at K. I told her that he has low muscle tone, and his private OT therapist has been working on this for more than 1 year. She complained that my kid wiggled too much in his chair, and I reminded her that he has adhd. She complainted that he used bathroom too frequently. And, I reminded her that he has a children hospital urinologist letter in school record file that he could use as many bathroom as he wanted. And, she caused a lot of anxiety for my kid. I told him that teacher could not stop him from using bathroom because he had a doctor's letter for it.

Use the Benadryl if you need a quick calm. That’s what they use inpatient. Also, a Popsicle to suck on can help calm kids quickly. You should let the school know now what is going on so he get an IEP over the summer.

Are you able to deal with someone that doesn't take insurance? If so, Steven Pankopf might be an option. He's great, but doesn't take insurance. You can submit the bills yourself. Our deductible for out of network is so high it's not generally worth it for us to bother submitting though.

Anonymous wrote:My family is it a breaking point with our five year old son. His violence and aggression are terrifying. Everyone in the family has had bruisers, black eyes, scratches from his rages. We are guessing it’s a neurological condition but haven’t been able to get anyone but a play therapist to see him. The wait lists are many months long.

To say we are desperate is an understatement. We have him on a dozen waitlists for a full psychiatric evaluation but we need intervention now as this is unsafe and untenable for the family. We took him to the ER at a children’s hospital this week following a fit of injury inducing rage and they refused to admit him or prescribe or recommend medication.

At this point we need to find a new pediatrician at the very least. We’ve heard some peds will prescribe adhd medication for the interim until we can see a psychiatrist. His current pediatrician has been so unhelpful it’s down right alarming. They refuse to see us unless it’s a scheduled well visit for a milestone birthday; otherwise it’s a 3 to 4 month waitlist to see her. I could go on about how awful this practice is but that’s for another post.

So a few questions - can anyone recommend a pediatric practice that would be willing to meet us on this level? Can anyone share the name of a psychiatrist that they’ve been able to get in with that doesn’t have a 10 month waitlist? We are in the Rockville area but would be willing to travel to DC, VA, etc.

Thank you for any assistance.

I’m probably wrong, but strep can make kids act out.

I'm so sorry OP for all that you are going through. BTDT. Our pediatric practice was of zero help. We recently saw the pediatrician for a physical and he rolled his eyes when it came to the question on which meds is your DC taking. DC is on two meds -one for ADHD and one for anxiety. We were in a similar situation. We ended finding a psychiatrist who was out-of-network to help get DC on meds and stabilized. That took about 1 year of trying different meds and doses to finally get to a combination of two meds that significantly reduced DC's symptoms to a manageable level. In the meantime, we were on the waiting list for several places that take insurance - Inova Keller and Children's Hospital (Fairfax clinic), We got a spot at Inova Keller before Children's Hospital and then switched from the out-of-network psychiatrist to Inova Keller. We were sad to leave the psychiatrist because she had helped us tremendously. However, it was a financial hardship to be out-of-network and Inova Keller had other services (psychoeducational testing, partial day hospitalization, etc.). Sending you a virtual hug. I feel like I have PTSD for that period with DC. It was very, very difficult. Sending you a virtual hug.

Anonymous wrote:Go online to Quince Orchard Psychotherapy (it's in Rockville). Look on the bottom right, there is a yellow "book online"sign. They have a Family Psychiatric & Mental Health Nurse Practitioner named Sarah Gibson who has a first available June 13th via video. It looks like she provides consults and can also prescribe meds as needed. I can 't speak for this provider but I have a friend who used Dr. Kanal at that practice for a neuropsych and she had a very good experience.

OP here. I’m on the website for Quince Orchard Psychotherapy and don’t see this yellow button to book an appointment online. Are you already a patient there? Perhaps that’s only a functionality for those already in the practice?

The explosive outbursts described my son at that age. He was asked to leave his preschool at exactly that age because he was attacking other children. I witnessed this myself one time. He wasn't provoked that I saw. It was frightening behavior and I wondered for many years If he was schizophrenic or had bipolar disorder, etc.
He was violent and unpredictable at home. He would be amazingly sweet and empathetic one moment and then throwing furniture through the wall the next.

He was eventually diagnosed with Autism, ADHD and extreme anxiety. Physically, he had alot of ear infections, was pale and overtired often, eventually went from fullt potty trained to having constant accidents. He had lower body hypermobility, very loose and bendy lower limbs and hips.he sleeps in strange positions including on his back with one leg crossed over the other leg which is bent upright. He is sensitive to sounds, tastes, textures, smells and lights.

He was put on methylphenidate 54 mg and zoloft 200 mg.

Fast forward 10 years- I just started a thread called dialing back zoloft. He has had a complete turn around, does well in school, has many friends, is involved with sports, etc.

Looking back here is what we did and what we should have done. (We also were with Potomac Pediatrics and neuropsych through childrens)

1. He was taken out of preschool and put in a smaller, mixed age group preschool. This put a stop to the physical outbursts immediately- at least at school. The all 4 year olds, 20 + kids was overwhelming to him.
2. We learned to identify what set him off at home and tried our best to avoid them but also learned to understand that he absolutely did not understand that when someone did something that bothered him (something unexpected) they were not doing it on purpose. This was a huge piece of the puzzle. So, for example , if he was given toast cut in squares when he was expecting triangles- the second we saw his disappointment we would say "oh no! I'm so silly. You said you wanted triangles but I cut squares!! I really made a mistake! I am so sorry. Indidnt meant to do that!" And then remove the toast and redo. At that age, he probably had a language deficit that went undiagnosed and he had little methods to express his feelings other than throwing the toast at the wall and screaming. We tried to voice his thoughts for him "this was not what I was expecting " and gave him alot of control to ease his anxiety.
It was my sole goal to make him feel he had more control when things went wrong.

This took years, OP. I'm not going to sugar coat it.

By 3rd grade he started experiencing alor of anxiety at school. This is the age other kids start being mean to each other and jockeying for social position.

By lucky, he was put into a class with quieter more studious kids which cut down on the anxiety tremendously. Somewhere in here we also started the adhd medicine and zoloft.

Things were pretty smooth sailing after that. At least for us the parents and teachers. But we also have noticed that he is overly placid and non reactive. No highs or lows.

At the same time, someone pointed out that his hypermobility was having a huge negative effect on his athleticism. I had looked into hypermobility years before but it didn't look like much could be done about it. I went back again recently and discovered an article with a new hypothesis about a relationship between hypermobility and an inability to metabolize folic acid. I took him for testing and during the lab work noticed his iron saturation levels was extremely low. He doesn't exactly have anemia according to his cbc. But looking back- his last cbc 5 years ago showed his bloodwork was a tenth of a point away from flagging for anemia.

I now wonder if he has suffered from low iron and borderline anemia for most of his life. I highly, strongly recommend that you find a pediatrician who is not a large practice and who will actually look at his bloodwork results not just skim for flags from the lab.
Ask for every test imaginable. Have them repeated every year or more often if any show his is constantly high or constantly low. Go to a genetic testing counselor.

We did not find a therapist who was able to work with him. Talk type therapy doesn't work very well with boys. However, there was a program he was patt of that was offered by the elementary school that was hugely helpful. I wish I could remember the name of it. It taught them how to identify their feelings and come up with strategies to manage.

Don't be afraid to use medication but keep looking for other physical causes.

I believe you that you’re struggling OP, and that your child needs help. Inpatient isn’t the best place for most children, though, especially 4 year olds, unless they are suicidal. It will be traumatic, and then you will have that trauma to deal with on top of whatever he’s currently dealing with. A psychiatrist, ChildFind, and a developmental ped or neuropsych are the path you need to be on right now. You can get some very good strategies to not set off his rages from The Explosive Child. They call it Plan C. Good luck! I know it feels incredibly lonely but many of us have been there and our kids are doing so much better. My daughter started getting better after three days on Zoloft.

A few things.

1. I am so sorry that you are struggling. What you’re experiencing is scary. I have a long-time friend who has been in your shoes. It’s hard to feel so much love and concern for your child while also being afraid of them. Whatever happens, it’s important to find a support system for yourself. Find a friend or family member who can listen without judgment and/or a therapist. You have a long road ahead.

2. We use Potomac Pediatrics. My 3 kids have all struggled with MH stuff at some point. One sees a therapist within their practice and while it wasn’t my first choice (was on waitlist elsewhere), I’ve been very impressed. I find most of the pediatricians to be empathic and understand the complex mental health needs of children. Personally, I don’t like the idea of pediatricians prescribing psychotropic drugs because they require training and knowledge most pediatricians don’t have. However, I know some will prescribe and I know you’re desperate for some relief.

3. There is a major shortage of psychiatric hospital beds in our area and nationally. Pediatric beds are definitely scarce. Also, they may be very reluctant to admit such a young child as hospitalization of young kids is rare and can be scary. Still, the litmus test is “is he a danger to himself or others?” If so, use those words to make it clear this isn’t just a behavior issue or a tired parent.

I’m sending you a huge hug and hope you find the help you are seeking.