How do doctor's diagnose possible mental illness in a teenager?

[Mango]

She's 12. She can't tell the truth to save her life. She takes (steals) anything that she likes, wants, from whomever. Family mostly but we've also had situations with non-relative too.

 

Today it was her baby sister's wallet, with a few coins & library card. Everyone wanted to go to the library. But baby sister's wallet was missing.

 

I said, no wallet, no library.

The card showed up 15 minutes later

I said, no wallet, no library. Oh the weeping and wailing and denials....... it's Looooossssstttt! I start to make supper and continue waiting. No wallet, no library.

 

The wallet showed up 30 minutes later. We all jump in the car and a mile down the road the baby's wailing that her money that'd been in the wallet was missing! 12 year old daughter says she gave the coins to Daddy and it was 2 quarter, 1 dime and 10 pennies. I said great, lets call him. Oh she changed her story and told me they were in her desk but that it was only a couple pennies.

 

i turn around and go home and discover everything but the quarters in her drawer.

 

The process of hunting for the wallet was that everyone found missing belongings in her room. That's not unusual. The reality is that we're all changing the way we do things to protect our stuff. And it's not because she's lacking anything, wants or perceived needs. We ask. We are very careful to say YES often.

 

When it's not possessions it's food. Trying to help her make better choices but I don't think its possible for her to exercise self-control in any area of her life. She used to say that she stole money so she could buy stuff in the vending machines. We gave her more $$$ to buy stuff, she still would take from the other kids and from my purse.

 

If I call the mental health doctor that our pediatrician recommended, what can I expect? Will they hospitalize her? I know she can clean up her act briefly, enough to give a good impression and act the like persecuted one.

 

I am tired of living hiding important things and the stoopid things just to be sure it stays available when I need it. I know everyone else is too. She's deathly afraid of doctor's too. Last ped. visit was horrible. She put her head under her gown and wouldn't make eye contact or nothing. She leaned into me and sobbed the whole time. I was really glad for the 4 normal healthy kiddos that followed her. Oye.

[amo_mea_filiis.]

I doubt they'll hospitalize without serious harm to herself or others going on.

 

They'll probably evaluate, discuss meds and therapy (depending on the type of provider).

[Butter]

Pretty much what she said ^. I used to work for a therapist office. They saw lots of adolescents. They would only hospitalize for threat of self-harm or harm to others and generally there needed to be an active plan for that. Most likely what you are describing will be treated with therapy and possibly meds.

[albeto]

A visit with a psychologist or psychiatrist won't hurt. She won't have to wear a gown. She'll answer questions, you'll answer questions, you'll both fill out standard questionnaires and talk, talk, talk with the therapist. The questions will reveal to the therapist if they are working with something like OCD (which is not your dd's fault any more than Tourette's or Celiac would be her fault). When you find out what is explaining this behavior, you should be directed to some resources to help you get started on how to respond to best help her overcome this compulsion, the anxiety that feeds it, and learn how to manage a brain that is impulsive in a frustratingly inappropriate way.

 

Good luck. You can do this.

 

:)

[MomatHWTK]

Based on our experience, I don't think they will hospitalize unless there is a danger to self or others, unless the parent requests an inpatient evaluation. There are initial meetings with parents and child, followed by questionaires and then follow-ups. It takes awhile to get a dx.

 

You might start by researching adolescent mental illness to see if you can get some idea of the areas that might apply. Take a look at these:

http://www.nationwidechildrens.org/mental-health-assessment-and-scoring-instruments

[Mango]

She rides horses and so we use horse terminology al ot to help her understand why we're doing what we do.

 

She's been told that we're putting her in an emergency stop. She's going to have to keep her nose to her tail until she can be honest and stop stealing. We're doing it not because she's in danger, but because she's hurting everyone else around her. We've asked, We've told, We've demanded, and now we're going to make her do it. For that we'll need help.

 

If they give her meds, she won't take them. She took ADHD meds when she was younger and it was awful. It helped for focus during school time but the rest of the behaviors we saw only got worse. AND she wasn't sleeping so it was much easier for her to raid and pillage while we all slept.

 

What would they do with that situation? I can't make her.

[Catherine]

She is not sick enough to be admitted, most likely. They will do an interview with her and with you to assess the situation and then begin to make recommendations.

 

IMO you should ask around for a psychiatrist or psychologist who is accepting of homeschoolers. Otherwise you might find yourself pathologized and questioned. Of course in any situation the provider will want to meet with her family to help you all to cope and find adaptive ways to handle her behavior. That's not the same at all as making your choice to home school into the problem.

[amo_mea_filiis.]

Your original post sounded a bit like bipolar disorder. Bipolar will (usually) respond very poorly to ADHD meds.

 

ETA: OCD is not something I deal with, so I don't know how is can present. I've researched autism, bipolar, ADHD, anxiety, etc.

[Tita Gidge]

Seconding albeto - pathological lying can be an offshoot of OCD, and might explain her lying profile and impulsive stealing.

 

A private hospital would accept her in-patient if you requested it, if only for an overnight evaluation. Since she's not posing any harm to herself or to others, you might be best off avoiding in-patient care; chances are, from my experience, she'll pick up more there than she came in with. Not good. She may begin to identify with the population and either exaggerate her condition or otherwise play it up. Private facilities can be like playgrounds, unfortunately.

 

Have you asked her why she lies? I mean, just a matter-of-fact conversation far removed from any specific incident. I'm curious if she recognizes it or if she's unaware that she's even doing it until the lie is discovered. That alone would give you indication to where you are with her mental and emotional health, and pave the way for selecting the right professional for your situation.

 

It's tough, but again I'll second albeto - you can do this!

[amo_mea_filiis.]

I agree with Catherine big time!

 

I've had so many problems with my son's therapists over homeschooling. None of them are willing to comprehend that the behaviors were there years BEFORE hs'ing started! It is one of my biggest problems with mental health stuff right now.

[gardenmom5]

she definitely needs a mental health professional. a pediatric psychiatrist might be a good start. MHPs are well versed in patients lying and denying. there will (probably) be an intake from you, and probably several sessions to try to get an evaluation of her.

 

she's not an immediate threat of physical harm to herself or others, so it probably won't go the hospital route unless you ask, and your insurance may not cover it.

[albeto]

She rides horses and so we use horse terminology al ot to help her understand why we're doing what we do.

 

Good thinking.

 

She's been told that we're putting her in an emergency stop. She's going to have to keep her nose to her tail until she can be honest and stop stealing. We're doing it not because she's in danger, but because she's hurting everyone else around her. We've asked, We've told, We've demanded, and now we're going to make her do it. For that we'll need help.

 

The thing is, it's likely she can't stop. That's what I meant about it being no different than Tourette's. If I recall correctly, these are related in that the parts of the brain that regulates motion and decision making are not in the individual's complete, conscious control, so asking an OCD to "just stop" is no more helpful than asking a person with Tourette's to "just stop." She would if she could, don't you think?

 

If they give her meds, she won't take them. She took ADHD meds when she was younger and it was awful. It helped for focus during school time but the rest of the behaviors we saw only got worse. AND she wasn't sleeping so it was much easier for her to raid and pillage while we all slept.

 

What would they do with that situation? I can't make her.

 

There comes a time in a child's life when you can no longer persuade them to do what you think is best, and so having developed a strong personal relationship will be key for you, I think. Knowing she can trust you will go a long way (which is one reason I would encourage you to try and avoid a language of guilt, such as "keep her nose to her tail until she can be honest and stop stealing," because she probably isn't choosing to steal). In any case, one of the reasons I like working with psychiatrists as the lead therapist is that they can see the direct effect of medications. Also, they're aware of the different classes of meds and how effective different ones are likely to be (like was mentioned upthread about ADHD meds and biopolar incompatibility). Letting her know this might help her feel better to try something, especially if the therapist understands her trepidation and starts her of very slowly.

 

For the time being, maybe you can give her a "safe place" to put things she's taken, no questions asked. Put a box in your bedroom, or laundry room or something so she can deposit things without getting any attention from anyone. Don't ask her why she took these things, shy may not know, and if she feels she has to be on the defensive she'll likely not bother. After all, if you don't know, you can't ask her and make her feel guilty, right? Maybe start things like keeping a "worry-thermometer" to help her identify the kinds of things that make her feel anxious. You can work on having various plans in mind to help calm her down and make her feel more in control when she realizes her anxiety is on the upswing. In other words, empower her by giving her the power to identify, and then control the anxiety. Your therapist should have more (and better) ideas, but perhaps this kind of thing might get you started.

[Joanne]

A licensed, trained professional would do a complete evalutation; and I would not expect this kind of assessment from a regular medical doctor. A Psychiatrist, Psychologist, LCSW or LPC are better choices.

 

The assessment should be comprehensive, including both a complete history involving family if possible and some testing such as an MMPI.

 

A full medical exam would be of benefit, also, although it seems more likely you are dealing with something mental.

[Ottakee]

A top notch pediatric psychiatrist sounds like it would be in order.

 

I would also want that doctor or your primary care doctor to run some basic blood work and check for thyroid, anemia, blood sugars, and the basic panels. This is to help rule out any physical issues that could be at play here as well as give you a baseline if they decide to start meds.

 

If you think it might be bipolar (mood swings, etc as well) then check out www.bpkids.org and www.bipolarchild.com and the book The Bipolar Child for some good information.

[Melissa in Australia]

:grouphug:

[Harriet Vane]

:grouphug:

[Liz CA]

I am thinking along Joanne's post. Before you wonder about mental illness, have her speak to a counselor (more than once) and see if she is acting out for other reasons that are not readily apparent.

[TechWife]

If they give her meds, she won't take them. She took ADHD meds when she was younger and it was awful. It helped for focus during school time but the rest of the behaviors we saw only got worse. AND she wasn't sleeping so it was much easier for her to raid and pillage while we all slept.

 

What would they do with that situation? I can't make her.

 

 

A good therapist will help you develop a behavior plan and family boundaries that will work on this.

[ondreeuh]

Your original post sounded a bit like bipolar disorder. Bipolar will (usually) respond very poorly to ADHD meds.

 

ETA: OCD is not something I deal with, so I don't know how is can present. I've researched autism, bipolar, ADHD, anxiety, etc.

 

No, not bipolar. Bipolar Disorder is alternating episodes of mania (or hypomania) and depression, or mixed states. Mania can cause people to do things they wouldn't normally do (they may feel invincible) but compulsive lying and stealing is a separate thing (AFAIK - I am not a doc, just have experience with this).

 

Stimulants can make mania worse - but they can make other things worse too. This is something the OP needs a specialist for - and the reaction to the stimulants is an important piece of information that points to a biochemical cause.

 

OP, the doctor will have seen this before, and will hopefully suss out the behaviors and possible triggers, to help figure out the root cause. Good luck!

[swellmomma]

BTDT they won't hospitalize for that. Ds14 is great at cleaning up his act short term. He steals(mostly food, but also money from everyone in the family, from strangers etc), lies (worse yet he believes his lies often),massive melt downs/tantrums, is destructive and can be violent. I have been trying to get him mental health help for years, but he has them snowed. He has even done 2 inpatient assessments, but they are only 3 weeks long with him coming home on weekends. During assessment they try to keep it fun for the kids so no school if they don't want to, pizza night, movie and chips night, bingo night for prizes etc. Weekends he would come home and terrorize the family. Go back monday and complain about how mean I was etc. Even when during bag search during drop off we found belongings of every person in our family they didn't put that in his report because he put on a show that he wanted something from each of us because he would miss us etc. No that's not what it was, he simply wanted that stuff. Anyway, I am still trying to get him proper help as he gets into more and more trouble. He was diagnosed Adhd and conduct disorder and I was told to put him in ps but that there was no help for that since it was not a disorder per se but a choice of behaviour. I can agree to a point that there is choice at play since he can turn it off temporarily, BUT I see a whole other side to this too. I started video taping the outbursts today to start getting real help. I am tired of being fobbed off as an exaggerating mom, or being told ps will fix the problem right up(of course the fact he was previously in ps and planned his suicide as a result doesn't stay in their minds)

 

Anyway sorry to threadjack, just saying having btdt your best bet is video tape her in the act, because if she can charm she can make herself look like the victim and there is no help in that.