03
May 24

Hiring the Right Psychiatrist for Your Teen

Psychiatrist With Teen“There is no substitute for the highly experienced psychiatrist who seems to work magic by making tiny, just-right adjustments to the medicine.”

If you’re anything like my husband and I, you may be scared to let your child take “that kind of medicine.” It was when our son was hospitalized for depression that we realized we needed to do everything we could to help him get well. At the time, we did not know that he had bipolar disorder. Letting him start medicine was scary, especially when he seemed to worsen on the antidepressant he was prescribed. I later learned that patients with bipolar disorder often worsen on antidepressants. I also learned that medicine is the key form of treatment for bipolar disorder, so I’m glad we didn’t wait.

But you may still feel in the dark about what is happening with your teen, wondering if hiring a psychiatrist is too major a step. Fortunately, the psychiatrist himself can often give you the clearest answer. Taking your child for an assessment does not mean that the doctor will prescribe medicine. In many cases, he will not make an immediate diagnosis, though he may suspect a particular condition. Because there are no blood tests for diagnosing mental illness–at least not yet–the doctor may need time to observe the symptoms as they unfold. Mental illness often emerges slowly in teens so it can take time and even some medicine trials before the doctor can narrow down what the symptoms mean.

If you find yourself balking at the idea of hiring a psychiatrist too soon, keep in mind that the initial assessment takes about an hour and these appointments are often booked out by one or two months. Once the initial visit is over, shorter follow-up visits can be scheduled more easily. Even if you want to hold off on medicine, having that initial visit completed gives peace of mind that the doctor will be there if you need him.

If you’re fortunate to live in an area with a psychiatrist who is board certified in child and adolescent psychiatry, I suggest you start there. These individuals have a total of roughly fourteen years of education behind them. Treating children and adolescents is different from treating adults. Adolescents are often growing and their hormone levels fluctuate. They sometimes exhibit symptoms differently than adults do.

Locating a good psychiatrist can be more challenging than finding a therapist, partly because there are fewer of them. Listen out for the names of highly regarded individuals and make an appointment, even if it’s two or three months away, then get on the cancellation list. You can always cancel an appointment, but remember to cancel it in time so that another person can use it. Also, many therapists and psychiatrists charge a fee for missed appointments.

Some psychiatrists do not accept insurance. If you are having trouble finding a psychiatrist you like, and a cash-only psychiatrist has been highly recommended to you, consider hiring them. I know it may seem exorbitantly expensive to go outside of insurance, but if the psychiatrists you’ve tried can’t get your teen’s symptoms under control, it may be money well spent. There is no substitute for the highly experienced psychiatrist who seems to work magic by making tiny, just-right adjustments to the medicine. The initial evaluation fee may be as high as $400, but follow-up visits are likely to be only $100 or so. Your insurance may cover a percentage if you file a claim for an out-of-network provider. Also, once the illness is under control, your teen may need to see the doctor only every three months or so.

Best wishes with this sometimes formidable task. The right person is out there.


01
May 24

Grieving a Teen’s Mental Diagnosis

Relapse.jpg“If you find you cannot stop grieving, try to choose a time of day to release your feelings.”

Many parents grieve after the shock of hearing that their teen has a mental diagnosis. It’s hard to accept that our dreams and expectations for our child may have changed. In our modern society, we are used to planning everything from our vacations to our retirement. It lowers our anxiety level to know what to expect. But the prognosis for our son or daughter may be impossible to guess.

When we grieve, we experience denial and isolation, bargaining, depression, and anger before we reach acceptance. These stages occur out of order and may recur, even after we have achieved acceptance.

Denial

For many parents, denial is the first reaction. We cannot believe that our bright, outgoing, creative, or otherwise wonderful child will never be the same again. When my daughter was diagnosed with schizophrenia at age fourteen, my husband and I briefly convinced ourselves that she was faking it. The fantasy lasted only a day, but I’ll never forget the desperate lengths our minds went to in order to cope with the news at that moment. If you find yourself struggling with denial, have compassion for yourself and let it run its course. In time, your mind will find it easier to accept.

Isolation

Complicating the grief process is the fact that many of our peers do not understand what we are going through. Friends will not walk up to us and say, “I’m sorry for your loss,” the way they would under normal mourning circumstances. They may be afraid of saying the wrong thing, making it difficult for us to find someone to talk to and leaving us feeling isolated. At such times, our spouse can be a great comfort. All we have to hear, or say, during tough moments is, “I know, honey.” We all need to feel understood. A support group can be helpful, especially if you get to know someone in a similar situation. The NAMI Family to Family class will not only give you information about mental illness, but it will introduce you to other families who understand. Look for one in your area.

Bargaining

When my son was diagnosed with bipolar disorder, also at age fourteen, I deeply regretted all of the opportunities I had missed to help him sooner. I mentally negotiated, picturing all the things I would do if I could go back in time. Eventually, I came to understand that these desires were myths that I had more control over the illness than I did. It still comes up now and then, but I ignore it and focus on the far more productive task of looking to the future and enjoying the good parts of the present. As your teen’s symptoms begin to stabilize, look for positive moments, even if its just watching a favorite family movie one night. Good things lie ahead even when there is an illness to be dealt with.

Frustration and Anger

No matter how hard we try to be positive, most of us wish our child could be at a better level of recovery. We do our best, but we may become frustrated and angry. Anger is a primitive emotion that can soothe us because it refocuses our attention. Unfortunately, we may lash out at the wrong person, whether it be our spouse or the grocery store clerk. Without a target, anger cannot thrive, so we may look for one, even if our logic is far-reaching. The real source of our anger is, of course, the disease. There is an old cliche that goes, “Living well is the best revenge.” Sometimes, when I feel depression or anger rise, I make a list of all the positive things my son or daughter still has, including a loving family.

If you find you cannot stop grieving, try to choose a time of day to release your feelings. You may cry, write in a journal, talk to your spouse, or just sit and shake your head in disbelief. It is okay to let your feelings surface and to acknowledge them. After that, try to set them aside for the next part of your day. If it resurfaces, set it aside again. You will get better at it with practice. This method is not for everyone, but for some people it allows them to grieve while getting on with those parts of the day that can still be positive for them and their families.

Most of us eventually realize that all is not lost. In time, we learn to alter our expectations in order to cope with the new reality. We feel grateful that our child is still alive. In the stunning moment in which I learned that my son had tried to commit suicide, I experienced three thoughts in the flash of a second. First was disbelief, followed by the sense that it explained his recent withdrawal. Finally, I realized that I had been granted an amazing privilege: the opportunity to save my son. Whenever I feel angry or depressed about my children’s illnesses, I remember this gift I was given, and I never take it for granted.