Friday Five: 5 Reasons to Find a New Psychiatrist

Note: These are all real things that have happened to us, and not all with the same doctor.

  1. The psychiatrist invites you into the office for an appointment and does not even close the door, because the appointment will be that short and there will be that little discussion. Perhaps excusable in a private office, last patient of the day. Not so much when the waiting room is filled with families who can now be witness to your entire appointment.
  2. The psychiatrist tells you that if you cannot get your child to calm down, then you will have to leave the office. Wait, what?! Aren’t you supposed to be the medical professional helping make that happen?
  3. The psychiatrist says that perhaps you need to be firmer in your “no” and take a stronger stance, despite knowing that your child has a history of trauma and is diagnosed with mental illness.
  4. When you approach your psychiatrist for assistance, because you feel that your child is on the verge of hospitalization, the psychiatrist takes a “wait and see” approach. For two months in a row.
  5. You leave the office crying. And not because someone gave you tough news, which happens, but because you feel that unheard. Don’t let that happen. You know yourself best. You know your child best.

I’m hoping this is the worst of what has happened, but I’m pretty sure I might just be blocking other things out of my memory. What are some of the reasons that you’ve sought out a new therapist or psychiatrist?


Diagnosis 2.0

Ruled out: oppositional defiant disorder, hearing impairment, conduct disorder, vitamin deficiencies, FASD, intellectual disability, specific learning disability, dyslexia, hypothyroidism

Misdiagnosis, or old diagnoses that could have been right but were not: ADHD, bipolar disorder, mood disorder – NOS, mental disorder (what does that even mean?), disruptive mood dysregulation disorder

Diagnosis that he has almost left behind: disinhibited social engagement disorder (formerly known as RAD)

Current list: PTSD, autism spectrum disorder, anxiety disorder, speech-language impairment, sensory integration disorder (I think the last 3 are sort of “duh!” with the first two), and probable dysgraphia

WHAT A MESS, and wow, so far from science it sometimes seems. When we first got the autism diagnosis, just a couple weeks ago, it felt weird. It felt awkward, after so many misdiagnoses, to now say, “my son has autism.” I think any new diagnosis will feel weird. There have been so many errors, and it’s hard to believe that this won’t also turn into an error. It might.

Still, it’s what we have for now, and it is slowly turning into a relief. There is space in our relationship as things begin to make sense, things that didn’t quite click as long as we solely viewed his strengths and difficulties through the lenses of child, trauma, mental illness. For example, when we call his name, he does not respond over 90% of the time. Those with no understanding originally saw him as oppositional and defiant. When viewed through a trauma lens, we saw it as part of the anxiety and fight-flight-freeze response. This is still true. PTSD and trauma are still intensely parts of how his brain works. We have learned, though, that it is more complicated than that. He has difficulty with attention shifting, with multi-tasking & attending to more than one sensory information source simultaneously, with delayed processing, with the pragmatics of how and when to respond. Knowing that, learning that is a relief. It creates space and relaxation in our relationship as I see him and his abilities more clearly.

There are lots of things like that we have noticed over the past few months, as the possibility of the diagnosis became more and more clear — his eye for detail, associational thinking, difficulty generalizing concepts, literal understanding of language, difficulty with multiple step directions, difficulty with conversation, with social rules, and oh the sensory things!

The sad thing to me is that these aren’t new traits. Some of them I noticed a year ago. He was almost diagnosed with autism three years ago. However, once a child has been in foster care, that’s ALL anyone can see. He was labeled bad, then ADHD, then a whole host of other things. People assumed he was doing it on purpose. Then we came along, and we focused on the trauma, before looking at anything else. I don’t know that there was any other way to do it by then.

Now we know, though, that he is a complex child. His labels may change, but we are learning to seek out his individual profile of strengths and challenges in a way that even we missed before. I can only see good things coming from that.