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Depression and/or Anxiety in a preschooler?
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Depression and/or Anxiety in a preschooler?

My 3.9 year old daughter was diagnosed with an anxiety disorder in 10/2012 but could it be more?  We started in-home behaviorist, family therapy, therapeutic mentor and social skills program (with public preschool).  Everything was going great for about 4 months and we're back to square one.  She had complete behavioral study with Children's Hospital in Boston, MA as well as Public School System (with the addition of Occupational therapy eval for possible SPD) Regression does not begin to describe this because now she's stronger, angrier and more fearful.  We see behavioral medicine fellow monthly in addition to nutritionist and gastro at BCH.  Her symptoms are:
Original and returned again:
-kicking, biting, hitting
-fear of simple situations (such as a rainbow outside, trucks passing by, emergency vehicle sirens, family arguments, her favorite ice cream truck)
-heightened disturbance with smells, tastes, textures, sounds
-rapid mood changes
-tearfullness
-anxiety in crowds
-desire to be with adults and not children
-teeth grinding while sleeping
-excessive thirst (even while asleep and glucose test was negative)


NEW:
-stomach pain (all thyroid and gastro testing performed and negative)
-SEVERE headaches followed by complaints of being cold
-punching
-swearing/yelling
-difficulty falling asleep and restless sleeping
-obsession with making contact with other people including strangers (touching someone's arm, leg, back or head)
-much quicker turn from "good" to "evil"
-"potty" accidents (has been fully day trained since 18months but is not yet night trained)
-difficulty paying attention and understanding
-OVERLY jumpy (I just coughed and I swear she flew off the bed!)
-excessive and RAPID weight gain (is 41" and weighs 53.6lbs)
-Hurtful and abusive to animals and family members
-complains of being hungry all the time (even with 30mins of meals)
-inability to handle any type of discipline without hysterically crying

242606_tn?1243786248
I'm assuming your daughter is prescribed some medication. What is it?

She clearly displays multiple conditions, both psychiatric and non-psychiatric. At the psychiatric end of the spectrum, the likely diagnosis is juvenile onset bipolar disorder, though this would not exclude the other diagnoses that have been made. It would lead in a certain direction re: medication.
4 Comments
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Avatar_m_tn
Dr. Kennedy,
My daughter is NOT on any medications....  They haven't given her anything except for our in home services and a recommendation for integrated preschool which my town will not add into her IEP regardless of doctor recommendations!  My fight is not over.  I sometimes fear my 3 year old because she is so strong but I am skeptical on medications since I'm convinced that these issues are situational... We live with my mother who's twin sister is bipolar and there is clearly some disturbance in my mother but she is in denial... She tends to fly off the deep end and spends a lot of time yelling to the point of putting my 3 year old into screaming fits and fear!  She has thrown things and hit me in front of my 3 year old and when DCF was called, she sugar coated everything and agreed to participate in family therapy.... When they closed their case, she started skipping family therapy!  Is it possible my 3 year old's symptoms can be corrected by leaving this house? (which is not an option financially as i am not working due to my child's constant therapy sessions).  
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242606_tn?1243786248
Your description indicates that the home environment is unstable and yes, that will definitely contribute to unsettled, disorganized behavior in a child. Having said that, there are sufficient indications that your child also displays biologically-based mental illness and even at her young age a pharmacological regimen should be considered.
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Avatar_m_tn
Thank you so much for the input.  I'll be seeing her mental health physician on 7/11 and will certainly request something for medication.  I'm not a professional but I seem to think that with medication AND the in-home services hand in hand, my little one's quality of life would change for the best.  Im hopeful medication would be able to help her deal with other non-home related issues as well. I'm in the best area for medical care being outside of Boston by 20 minutes.  I've also requested an entire evaluation with Tufts Floating Hospital for children.  Something somehwere has to point to the real problem. Most respectfull y  
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