Posted by Emme_V2 on June 30, 2013, at 12:26:49
In reply to Re: 14yo daughter - bi-polar, not MDD - new info HELP » SLS, posted by laurah952 on June 29, 2013, at 12:54:21
> > As I mentioned in a previous post, there is certainly some concern as to what effects antidepressants can have on a maturing brain. This remains largely unknown. If I had a child with bipolar disorder, I would opt to try psychotherapy first, followed by lithium and anticonvulsant mood stabilizers. I would then consider the need for neuroleptic antipsychotics and antidepressants. It often comes down to evaluating risk/cost versus benefit. Ideally, one would want to be treated by a pediatric psychiatrist.
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> From what I've seen, Taylor's therapist uses a combined strategy of both psychotherapy and CBT. Taylor sees her once a week, and responds most positively. It's difficult to sit out, and not be privy to all that is said, but I know that in order for therapy to work for her, she needs to be able to open up completely. As you may know, I have a new adolescent psychiatrist for Taylor, but we must go through the intake process first. I thought a medical work-up was done while she was an inpatient in the adolescent psychiatric hospital. Since I have not gotten any results, I will ask what tests should be done, and go from there. I will also be asking about a bi-polar diagnosis, as opposed to the original MDD diagnosis. I have pages of notes on my observations of Taylor that I formed into letters addressing both her therapist, and her previous pdoc. I will bring them with me to her intake on Monday.
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> I will research and take the lists of medications you have so graciously provided me to her new pdoc. Thank you for that!
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> > Personally, I would not deny a child an > > antidepressant or antipsychotic if it would keep them alive and thriving. Close monitoring during the first 4 - 6 weeks should effectively screen for a negative reaction to the drugs being trialed.
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> Although I am questioning long term effects, I will not deny her medications that will keep her alive and well. I will be researching, and asking the pdoc about all possible negative side effects of any med she takes. I will also monitor closely her moods, especially her suicidal ideations and cutting.
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> > If ADHD is present, perhaps using a mood stabilizer and stimulant would be considered.
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> She may have ADD, but I haven't seen the hyperactivity index since she was much younger. (unless constant leg/knee shaking when sitting is a factor)
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> Taylor has always been a sweet, caring, and loving child. She's never been in any trouble, and other parents always comment on what a polite girl she is. She's also very sensitive, and "stuffs" resentments/anger instead of letting them out. She has incredible low self esteem despite her beauty, loving demeanor, talents, and the hard work she employs in school. (final grade average for the year is an 89, despite all she's been through) She believes that she is a burden, and this scares me as her perception is way off.
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> I'm sorry for the long post; I'm just going to continue to fight for her as diligently as I'm able...
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> Thank you so much, Scott, and everyone who's helped by answering my questions and providing information and support.
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> - Laura
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Hi Laura,I've been following a few of the posts on this thread, and although I don't have any specific thoughts to offer med-wise, I do think your approach towards helping your daughter is really great. You're asking good questions, staying on top of the right information, taking an intelligent and pragmatic approach. You're doing an amazing job with a difficult illness.
I hope her new pdoc has some great ideas. I know for myself that a knowledgeable pdoc and appropriate meds have made all the difference in the world. It can take a lot of patience to find the right treatment, but it is so worth it to have relief from horrible symptoms.
Good luck to you and Taylor.
Emme
poster:Emme_V2
thread:1045977
URL: http://www.dr-bob.org/babble/20130617/msgs/1046105.html