Weird psychiatrist?

[peppersnap]

DD16 is currently under a care of a psychiatrist and a therapist and on Prozac.

The Psychiatrist has said some things I find really strange and inappropriate and I'm wondering whether there is some reasoning behind this or if I should try to change (don't know how easy this will be - we are in UK and here you have to go through Child and Adolescent Mental Health Services (CAMHS) and he may be the only P we have access to).

Some examples: When, in her first session, she disclosed that she self harmed at school, his response was 'it's a good job your school jumper is red then.'

He has refused to believe that she is as affected as I say, even though I've given him numerous examples and told her that she's now off school as they feel she is too mentally ill to attend. He's told the school I'm 'an over anxious mother'.

I told him that she had disclosed that she's been self medicating with vodka for two years. Then when the school told him the same thing he went back to my daughter and said 'you haven't been honest.'

Now apparently he's told her that her 'number one mission' for this week is to find out how I'm doing. Why? What does that have to do with her? She's not responsible for me - yes, her behaviour affects me but my priority is to get her well. It's like he thinks she's just being self-indulgent.

He won't assess her for BPD as she's under 18 and says she must have multiple hospitalisations before he can refer her for DBT.

Her actual therapist seems very good. I just don't understand this psychiatrist. Can anyone shed any light on why he might be saying these things?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Googie]

Wow Peppersnap,

Sounds like a bit of research is called for.  Does the UK have boards or committee's who oversee and handle consumer complaints made against doctors?

I would search for disciplinary committees and medical review boards just to see if there have been similar complaints.  I'm sure you will be able to find information on other adolescent psychiatrists allow your search.  Call your local hospital's social worker and see if she might be able to advise you how to proceed in finding another doctor as well as finding out if this doctor has a history of unprofessional behavior.

I had one experience with a doctor that made me think there was something very wrong with the way he conducted himself when communicating with my daughter.  I looked him up and sure enough there were multiple complaints and he was currently on probation and required to have supervision for every prescription he wrote.

Go with your gut.  Sounds weird.

Googie

[lever.]

This isn't right Peppersnap. Yes there is a reluctance to diagnose BPD in under 18s in the UK but there are services for adolescents with emerging BPD. You can write to the service manager at CAMHS requesting an opinion from a different psychiatrist, even if they have to bring someone in from a different area. Look up Dr Michaela Swales at University of Bangor North Wales. She is one of the UK experts in DBT and other DBT services may come up in her publications. In my experience CAMHS services can be hit and miss depending which psychiatrist and therapist you are allocated to, but you are entitled to ask for second opinions. Hope that helps.

[peppersnap]

Thank you both

We are having a private assessment done next week with a psychologist who specialises in adolescent mental health and emerging personality disorders.

After that is done we will take any findings back to our local CAMHS. If necessary I will take your suggestion lever and ask for a second opinion.

Thanks again for your input.

[raytamtay3]

I'd say so. Those comments are highly offensive, unprofessional and uncalled for. I'd definetly switch if you can.

[MammaMia]

I agree with everyone else.  This psychiatrist could do more harm than good.  Be sure to tell the psychologist about it.  I think there is reason for concern here.

The LAST thing you need is someone making things worse.

[Being Mindful]

While I'd be concerned, I'd also question the validity to your d's reports. With my d. we called it plate spinning. She'd get one or several of us on tangents that distracted from the real work that she needed to do. My d. did this multiple times in making reports about a therapist that were not true, but some version of a made up reality for my d. Sometimes it was very intentional to distract and stirring the pot, sometimes not.

[MammaMia]

peppersnap

Were you present during any of these comments?   Did the psychiatrist speak directly to you or are you getting second-hand information from dd and the school?

[lever.]

I was assuming you had heard some of this directly, peppersnap. If its related by your DD be a bit more cautious and wait to see how things develop. Hope the private assessment goes well.

[peppersnap]

I was present when he told her it was a good job her school jumper was red to hide the blood.

He told me to my face that she was 'fine' when I told him that she'd been drinking vodka, collapsed at school, and was now at home as school felt she was too mentally ill to attend.

The school told me that he'd described me to them as an over anxious mother.

Her therapist confirmed that he'd come into their last session and told DD she hadn't been honest.

He told me directly that he would not assess her for BPD and she would have to have multiple hospitalisations before she could have DBT.

The only one I have not had confirmed (yet) was him telling her that her number one mission was to find out how I was doing. However, based on the above, I think it likely to be true.

[maxen]

hi peppersnap. i don't have a child but i do now have a psychiatrist thanks to my stbxBPDw. he's about the most sensible person you could meet. i agree with all above that those comments of your daughter's P are certainly unsettling. remember, this is the person who's prescribing medications for your D. please do try to interview another.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[peppersnap]

I've just realised that, whereas other message boards I've been on use 'd' to mean dear/darling - DS, DH, DD etc - here the first D means diagnosed.

So in the first post I should have written uD16, not DD16. The only  thing she's currently been diagnosed with is major depressive disorder. She hasn't yet been dx or even assessed for BPD. We'll see what the result of the private assessment is.

Sorry for any confusion.

Peppersnap

[redroom]

Pepper,

I'm so sorry to hear about your daughter's experiences. 

The D in DD is darling (or Dear).  You used it correctly!  The lowercase d or u that mean diagnosed or undiagnosed generally go before BPD (or another disorder) only.  So you would have a uBPDd (undiagnosed BPD daughter), or a DD (dear daughter).  dBPDd would be a diagnosed daughter.  It's a lot of d's... .  

[peppersnap]

Ah right. Thanks! I'm just getting my head around all the abbreviations.

Anyway, Friday is private assessment day. Thanks for all your input everyone - since in all but one case I either heard the P's comments first hand or had them confirmed by a third party, I'm going to trust my gut. After her private assessment I'll gp back to CAMHS and ask for another psychiatrist.

Peppersnap

[twojaybirds]

Here are my lame thoughts. 

I told him that she had disclosed that she's been self medicating with vodka for two years. Then when the school told him the same thing he went back to my daughter and said 'you haven't been honest.'

Now it is not you vs her but the school as witness to her behaviors and that is true  she had not been honest with him about her drinking

Now apparently he's told her that her 'number one mission' for this week is to find out how I'm doing. Why? What does that have to do with her?

Perhaps to see if she has understanding or empathy towards others

when she admitted to self harm how would you want him to react?   

He is a P for medication purposes mostly and diagnosis which cannot be done before age 18 for BPD.

What is her diagnosis?



He's told the school I'm 'an over anxious mother'.

I would have been offended by this 'then' but now with reading/time/this board/ etc realize I was over anxious

[peppersnap]

It was a meeting between her and her psychiatrist when I told him she'd been drinking as he asked me to start by telling him how the week had gone from my perspective. He then asked her about the drinking and she told him. I also told him that I felt she was getting worse and her life was being badly affected. He refused to accept the drinking was a problem and then described me to the school as 'over anxious'. When they backed up what I'd said he then had to cover his a@@ by blaming her for 'not being honest'.

It's all very well to say she should have been more insistent about how bad she was feeling, but she's an adolescent and he's a grown man in a position of authority. It's really hard, if you open up and someone dismisses it, to stand up for yourself in that position. As far as I'm concerned, he knew she was drinking, she was there when it was discussed, and if he insisted on downplaying it, that's his fault, not hers.

'Over' anxious suggests the anxiety is disproportionate to the situation. What level of anxiety is proportionate to your daughter wanting to die, having episodes where she goes catatonic, being asked to stay off school, gouges her arms and legs, has to down vodka every morning before she feels she can face the world?

How would I like him to respond to a disclosure of self harm? Professionally. 'Okay' or 'I see' would have done. Snarky comments about her school jumper are neither necessary nor helpful.

She has lots of empathy. Part of the problem is that she's so aware of not worrying me that she's been hiding things. Making her more conscious of how I'm dealing with it all is probably going to make that worse.

She has only been diagnosed with MDD so far. However, anti depressants are not doing much at all, and although they run DBT at the centre, she has to have a diagnosis of BPD to get it.

[MammaMia]

Peppersnap

So MDD is what they call it before they turn 18 and can be formally diagnosed as BPD?  That is sad.

My dBPDs was put on antidepressants and anti-psychotics and they made him worse.  He was totally out of control until he stopped them and stabilized.  Watch your dd carefully.  If she has BPD, she may not see any improvement on meds but they seem to think they must try them first.

DD is obviously self-medicating with alcohol.  Bpd and alcohol are NOT a good combination.  One fuels the other.

I hope you are able to find someone who sees your dd's illness for what it really is.  Please do not give up.  You want what is best for her and the system has its criteria to follow. Things never move quickly with diagnosis and treatment.  I also think you are correct in saying everyone is covering their butts ... . when the main priority should be getting you and dd help.

Keep a watchful eye and if things get scary... . the Emergency room where she can get immediate care is always an option.

[peppersnap]

Well... . bit of an update.

She saw him today, after being suicidal again this week. He has not changed her medication and seemed hell bent on 'catching her out', which has been his attitude all along. He asked her what her treatment goals were with her therapist and when she told him, said 'that sounds rehearsed.' He also claimed that the appointment was for an hour earlier than it was (I know what time it was as I specifically arranged it so I could be there if she wanted me to be and I had to co-ordinate it with picking up my youngest son). So he told her she was 45 minutes late when in fact she was 15 mins early.

Now for the really weird part - she said he did some 'tests' on her. I asked what kind of tests, thinking she meant a questionnaire. She said 'to test my reflexes'. I asked her what she meant. She said 'to check I don't have liver damage because of the drinking.' ? How on earth would a psychiatrist administer physical checks regarding liver damage? Wouldn't he have to refer her to a specialist or at least a hospital for that? She said something about him holding her hands and saying her hands were sweaty.

I wasn't there for this BUT I have been present when he's said a lot of very strange things, so I believe her. She said she's not comfortable seeing him again (no kidding). So I'm going to speak to the CAMHS manager and find out who else we can see (and also mention this latest weirdness with the hands).

[MammaMia]

Peppersnap

I think you are correct.  It is time for a change in T, especially since your dd is getting bad vibes from this guy.

[maxen]

Well... . bit of an update.

She saw him today, after being suicidal again this week. He has not changed her medication and seemed hell bent on 'catching her out', which has been his attitude all along. He asked her what her treatment goals were with her therapist and when she told him, said 'that sounds rehearsed.' He also claimed that the appointment was for an hour earlier than it was (I know what time it was as I specifically arranged it so I could be there if she wanted me to be and I had to co-ordinate it with picking up my youngest son). So he told her she was 45 minutes late when in fact she was 15 mins early.

Now for the really weird part - she said he did some 'tests' on her. I asked what kind of tests, thinking she meant a questionnaire. She said 'to test my reflexes'. I asked her what she meant. She said 'to check I don't have liver damage because of the drinking.' ? How on earth would a psychiatrist administer physical checks regarding liver damage? Wouldn't he have to refer her to a specialist or at least a hospital for that? She said something about him holding her hands and saying her hands were sweaty.

I wasn't there for this BUT I have been present when he's said a lot of very strange things, so I believe her. She said she's not comfortable seeing him again (no kidding). So I'm going to speak to the CAMHS manager and find out who else we can see (and also mention this latest weirdness with the hands).

that's atrocious. not just about the sweaty hands, but about the time. that would grind my gears. you're doing exactly right to seek out another.

[peaceplease]

peppersnap,

Yes, run from that guy!  That sounds weird!  She was not there complaining of physical pain, was she?  It does not even make sense, that he would be physically assessing for liver damage!   I can see if she was going to a doctor for complaints of  pain.  And, then they would follow up with blood work.  

Listen to your dd.  If she feels uncomfortable, then make him history! 

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders