The pervasive stigma about mental illness can still discourage families from seeking psychiatric treatment for children suspected of having bipolar disorder. However, psychiatric treatment should feel no different than going to see an allergist or any other specialist. Here’s what parents and caregivers need to know:
#1 What to expect the first visit
The goal of the first visit is a thorough psychiatric evaluation to assess the functioning status of your child at home, at school and with her friends. The doctor will look at each of these areas to determine if there are problems to be identified. The psychiatrist will then look closer at any troubling behaviors to ascertain whether these are reasonable reactions to life events—bullying at school, an ill relative, family conflict—or whether the emotion does not fit the problem.
#2 A bipolar disorder diagnosis
A psychiatrist will take a thorough look at the child’s symptoms, the length, severity, and frequency and will assess using specific criteria from the American Psychiatric Association’s DSM-V. He or she will look closely at whether your child has periods of extreme or unusual irritability or elevation in moods that are coupled with sleeplessness, or increases in energy and fast-paced thinking and speech.
#3 A look at other illnesses
Impulsive behavior and exaggerated mood swings can sometimes mean psychiatric disorders other than bipolar. The doctor will look at other illnesses that mimic the symptoms of bipolar disorder, such as ADHD, borderline personality disorder, impulse control disorders, anxiety disorders, schizoaffective disorder and developmental disorders. It may also be determined that your child could have a comorbid condition to a diagnosis of pediatric bipolar disorder.
If your child’s psychiatrist determines that medication is a consideration, then the family will meet with him or her. Medication can be effective, and sometimes it is absolutely necessary; however, the decision to use prescription drugs will be made after a discussion with you, your child and the doctor. Many psychiatrists try and start out with the lowest possible dosage and then adjust accordingly. Keep in mind that medication will be only one part of the total wellness program, which will include counseling, sleep, and a healthy lifestyle.
#5 What you can do
Encourage your child to write down the symptoms he notices that reflect either/both hypomania or depression or the emotional reasons for your visit to the health professional initially. It is wise as parents for you to also do this as it will provide a different, and perhaps more accurate, perspective. Keeping a log or chart of symptoms will also be extremely helpful if your child’s psychiatrist, in consultation with you and your son or daughter, considers medication to be warranted. In order to find the correct dosage, a careful monitoring of any side effects and behaviors, in general, is essential feedback.
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