Advice on finding a child psychologist privately - can a 6 year old be depressed?

[RedTurtle]

Please can someone advise me on the best way to find a child psychologist or counsellor privately. We live in the South West and when I've looked on the Internet I can't seem to find what I'm looking for. I'd like someone really experienced with children - my DS is 6.

He has angry outbursts at times (sometimes up to 3 weeks without any, sometimes having them every day for up to two weeks, it really varies) which have been getting worse for the last 6 months, during which he shouts that he wants to kill himself, that he hates us, doesn't want to be in this family, wants to throw himself off a cliff, that he doesn't want to be in this world any longer. He also hits and kicks me and DH and smashes things. He told me last night that he had been trying to strangle himself in his bedroom but it didn't work because he didn't die.

When he has calmed down, he is so tearful and upset. This is worse to watch because he keeps saying he is sorry, that he is a bad boy, that he shouldn't have hit me and that he doesn't deserve to be in the family. We really try to calm him and reassure him that we love him (whilst stressing that hitting and smashing is not okay and that we need to find other ways for him to keep calm).

The angry tantrums only happen in front of me, my husband and grandparents. My DS behaves brilliantly at school. He is high achieving academically, has never been in trouble (he takes the school rules extremely seriously) and has lots of friends. His teachers comment on how well behaved he is. I've thought about trying to access help through the school but because his behaviour is so good at school, I'm not sure if I can ask them for help?

My DS has always been advanced verbally and has been able to have quite adult conversations about complex subjects from an early age. I'm not sure if I've explained that well but it's something other people used to comment on, especially the type of words he used. He asks a lot of questions about death. For example: when he was about 4 he commented that it would be helpful if we knew the dates when were all going to die (within the family) then we could sit with a calculator and work out how many days and nights we have left together. My DH finds these type of conversations unsettling but I think it's just the way DS is. He has a phenomenal memory and loves facts and information especially about nature. He gets obsessed with certain subjects.

There have been several times when it's crossed my mind that he may have aspergers syndrome - but then he copes so well socially that it seems unlikely. He also plays team sports which he loves and he is able to work as part of a team.

As well as the anger, he has been having trouble going to bed at night as he has been having nightmares and he worries about murderers, wars, fires, and many other things. We now make sure he doesn't watch the news because he picks up on so many things. When they learned about the 2nd World War at school he became terrified we were going to be bombed at night.

There have been days recently when he comes home telling me that he has been really sad and doesn't know why. He says he has a sad tummy and has a feeling a bit like a headache (which doesn't hurt) that comes and goes and makes him sad.

This morning he woke up in one of his vile moods. He attacked my DH because my DH told him we have taken his computer away to have a break from it (his behaviour is noticeably worse after playing computer games) and was then crying and hitting himself on the head and shouting "what's wrong with me?".

It breaks my heart to see him like this and I need to get him the right help as soon as possible so any advice would be appreciated. If anyone is still reading, thank you so much, I didn't mean this to be so long.

[overmydeadbody]

OG goodness. I couldn't read and not comment.

I would go to your GP first. And don't rule out him being on the spectrum, a lot of what you describe sounds like my DS, who is on the spectrum, but also popular and sociable and can work as part of a team etc. ASDs are very complex and varied.

There is also no harm in talking to the SENCO at school to get some advice form her. Just becuse he is good at school doesn't mean they won't want to help.

Sounds like he doesn't cope well to changes to routine? Also, with DS, he comes across as very verbally able, uses big words, talks about complex things etc., but there is definately a discrepancy between what he says and what he seems to know nd what he actually understands.

I hope you get some help and reassurance soon.

In the meantime, I would recommend lots of praise, lots of unconditional love, if you are going to take away his computer you need to let him know in advance, come to some sort of agreement that he has control over, instead of just removing it completely. DS is vile if he spends too long on it, so we limit it, but he knows exactly how long he has on it every day, and we give him warnings (ten minutes left...five minutes left) so it's not a shock when he has to come off it.

[PosieParker]

Talk to a GP and get him referred to a paediatrician.

[RedTurtle]

Thank you so much for your replies. I had ruled out going to a GP because for some reason I don't like the idea of it - maybe it's because it then seems like there really is a problem, whereas at the moment I keep telling myself that maybe there isn't and he'll just grow out of it. That sounds pathetic, I know.

One thing I may not have made clear in my post is that when he is not angry or sad, he seems so happy and lively. I think that other people outside our family would be so surprised if they had any idea of how he can be at home as he's a popular boy. He has actually had meltdowns with his friends on a very small number of occasions, now that I think about it but I think boys of his age do argue and get angry at times so it hasn't stood out as really unusual behaviour.

He can go from an awful outburst to bring absolutely fine, within seconds. That's terrifying in itself. Once, on holiday, he asked me (while I was still reeling from a tantrum when he'd attcked me):"

"What's wrong Mum? You look sad" and when I explained I was upset about what had happened he said "Oh mum, that's done now. Let's just move on". This is common for him, it's like Jekyll and Hyde.

Overmydeadbody, you are really right about the routine. I think that might be why he copes well at school - and with sports actually as there are very clear rules to follow. We have tried a reward system recently (focusing on good behaviour and minimising the bad) and we have had about 10 really good days. However, last night's episode (when he said he'd tried to strangle himself) was the worst so far and I know Ican't ignore it.

I think I'll make an apt to talk to the school liaison this week.

[PosieParker]

I think you need to get over prejudice and go to your GP. A school liaison will not have the knowledge or credibility to do anything about your son. Unless he's disruptive schools don't usually want to know.

[tasmaniandevilchaser]

I agree with Posie, school are unlikely to be interested if he's no problem at school. Go to your GP asap, get referred on. And definitely get a proper assessment for Asperger Syndrome, if only to get it excluded as a possibility.

Keep going with the reward chart, as that seemed to help. Keep regular routines, warn of changes if that helps too. Be consistent with the strategies you use. Don't bury your head in the sand, sorry to be harsh, but it won't necessarily get better on its own and these things can take months of waiting on waiting lists to see someone.

Sorry just rechecked and seen that you can go private, I don't have any details, but you might want to find someone that has experience with Aspergers. Hope that he gets some help soon.

[tasmaniandevilchaser]

Ps I am definitely NOT diagnosing your son over the internet as having Asperger Syndrome, but children with Aspergers can be very different in different settings, e.g. fine at school but not at home, or the other way round. And people on the autistic spectrum are as varied as people who aren't on the spectrum!

[RedTurtle]

Hi, I just wanted to give a quick update. I spoke to the school liaison today and he's being referred to the school counsellor, in confidence. My DH and I are also going into the school to have a chat about what's been happening and to get advice on ways of dealing with his anger and hitting. I appreciate that my DS is lucky to go to a school that has such a helpful approach - they often run parenting courses there and are big on communication between parents and school. I think that as the first point of action this is a good place to start and I feel reassured already that I am not alone in helping my DS with the problems he is having at the moment.

Thank you again for your quick responses and advice.

[PosiePumblechook]

Brilliant OP.

[tasmaniandevilchaser]

That's great, you have a very good school there.

[Selks]

Please, your DS tried to strangle himself. That is very serious - he needs to see more than the school counsellor. You need to go to your GP and request a referral to CAMHS - this is about safety and safeguarding. Plus what you say about him hitting himself on his head and saying 'what is wrong with me' and being very anxious about the news etc. A school counsellor cannot adequately deal with that; he needs a proper assessment by CAMHS.

When you see your GP you need to say that your DS tried to strangle himself and talks about wanting to kill himself.

[spendthrift]

Look up dabrowski syndrome. It's not uncommon with high performing children. Yes he can be depressed.

Pm me if you want for not identical but similar issues and what we did.

[RedTurtle]

Selks, I think you are right, I am going to see the GP tomorrow as the situation seems to be getting worse.

Spendthrift, thank you, I will have a look.

I am going to make sure he is assessed for Aspergers syndrome. I have been looking into this more and I was really surprised to find discussions of echolia (I think that's the correct spelling!). My DS has always quoted lines from films verbatim. He often uses them in the correct context and it can be very amusing - it's one of the things that made him seem very intelligent when he was young and we've only recently realised that he's lifted them from films. I always thought this was unique to DS but I see now that it isn't. When he tells me about a talk that was given at school he gives me the whole talk, word for word! The same with conversations he's had or heard. He also quotes adverts (for bizarre products like dishwasher cleaner and anti-bacterial hand wash) when we are in the supermarket (every line) and gets annoyed if I don't buy the product.

There are several other things that have really stood out to me as I've looked into aspergers a little more - we've always just thought he was just 'intense' ' and maybe this is the case - or maybe there is something more to it?

Anyway, I think it's time to involve someone with specific experience of child mental health and I hope that we see the right people so that the situation starts to get better rather than worse.

[noteventhebestdrummer]

Without wanting to dissuade you from the course you are taking (which seems sensible), can you simply treat your DS's bad behaviour (that's what it is) as bad behaviour which has a consequence? Try not to respond to it emotionally, just factually - 'Because you did/said this after we warned you to stop, now we remove your computer for a day'. Because in a way you are letting him have a lot of control and that may not be a good thing?
(I agree that talking to the GP re the strangling is wise but also know that clever kids know even better which buttons to press, unfortunately)

[Selks]

RedTurtle.......thank heavens you are going to the GP and are now taking this seriously. I'm really glad to hear that. Get a referral to CAMHS.

Noteven.....ridiculous and unhelpful to dismiss this as 'bad behaviour'. Agreed basic parenting principles still need to apply but this child's emotional distress needs help.

[noteventhebestdrummer]

He's not emotionally distressed though because he behaves well at school and in playing sport where the rules matter. He only behaves badly where he has a vested interest in manipulating his parents. I have 5 grown up sons and I have taught hundreds of kids but probably I know nothing. CAMHS are often quoted on MN as a good idea but in reality they don't seem to help much. Private psych will earn their fee and hopefully say all is well.

[Selks]

Some children often DO cope well in school but lose it at home - that does not mean that they are not struggling emotionally. There is plenty in the opening post to suggest that to me.
My real concern however is to do with the self harm and I would hate for any well-meaning posting on here to put the OP off from getting the right help, which is CAMHS.

[Selks]

It may be that there are elements of manipulation as you say, but that does not preclude the possible need for CAMHS intervention. You cannot say that CAMHS is not necessary from the other side of your computer screen when you do not know the child.

[minceorotherwise]

Red, sorry to hear you are having such problems and your DS is so unhappy much of the time. Sounds like you are really heading in the right direction thought and hopefully you will see some progress. Just wanted to add that you might want to look at the whole dietary aspect as well, this in itself can bring about positive changes when managed correctly

[noteventhebestdrummer]

I think the GP and CAMHS are both necessary as a precaution but may not be helpful. It may not be helpful to overreact to a 6 year old who is aware of his ability to disconcert his parents and to please his teachers and coaches. I am glad the OP is also seeking a professional opinion from a skilled child psychologist - good luck OP.

[StarlightDicKenzie]

I would try to get a referral to a developmental paediatrician first off, and if that is not possible THEN go to CAHMS.

The reason is that paediatrician take developmental history of the CHILD, whilst CAHMS tend to prefer to investigate and then rule out environmental factors such as bullying, parenting etc.

They should both come to the same conclusion eventually (hopefully) but the paediatrician will be faster if it IS ASD.

[StarlightDicKenzie]

Nothebest, I'm afraid I don't agree with you. The signs are there or severe anxiety. It needs to be investigated before a course of action is decided upon and taken.

Harsh behavioural treatment from parents can be very destructive if home is the only form of outlet for the anxiety.

[ouryve]

noteventhebestdrummer - self harm is not a typical 6 year old method of acting out. 6 year olds find much more direct ways of pissing adults off when they want to make an impact. Echolalia and obsessions with death are also not typical. Your inference that all this child needs is some discipline and that any medical intervention should be avoided is potentially harmful to anyone reading this thread with concerns about their child and lacking the courage of their convictions.

Yes children with ASD do still need discipline, but it needs to be so much more focussed and sensitive than for NT children, including the NT child the OP, up until recently, had no inkling that her DC might not be. You might have taught hundreds of kids, but it's highly likely that none of them had ASD with challenging behaviour. My DS1 (ASD/ADHD - highly demand avoidant) had a teacher who was convinced she could cure all his behavioural difficulties, last year. He hates school, now. He used to find it a bit overwhelming at times, but no, this teacher who thought he needed firm discipline has put him off school and dulled the spark and eagerness to learn that he used to have.

[RedTurtle]

Thank you for your comments. I saw the GP yesterday -she listened well, made notes and referred DS to a developmental paediatrician. Unfortunately the wait will be at least two months. There is no option to pay privately in our area. I am trying to find a private assessment for him in London (as we can stay with relatives). I made a call today but the private lady I wanted to see isn't available until the end of April. I am going to look for alternatives tomorrow.

Not the drummer - I understand your theory completely and I'm not offended by it. My mother's opinion is very similar and I've had similar advice from the school liaison. However, my gut instinct keeps telling me there is something more here.

The more I look back now, the more I think about things that I didn't question at the time. I am writing it all down and keeping a diary of incidents at home. Yesterday my DS started hitting my mother in the street - this is very unusual as it only normally happens at home - this makes me think the problems are getting worse. He hit her because she laughed at something he said. My DS is hypersensitive to being laughed at, even when it's not being done in a nasty way.

Yesterday he had such an awful, violent tantrum that I can't even write about it. Today he was supposed to attend a football day that he was looking forward to (he has been before). Before he was due to get ready he started asking who would be there and could I guarantee if there would be anyone he knew. He then said he didn't want to go. This always happens and we are normally able to 'ride it out' as he enjoys it as he soon as he actually gets there. I left him to get dressed, with the promise of a reward.

I then heard loud screaming and crashing. I found him in a fury because he was having trouble getting his trousers and shin pads on (he often loses his temper when getting dressed). I explained, again, that all he needs to do is ask and I will help and that screaming does not help. Once he was dressed he said that the shin pads were on 'wrong' and started kicking out at me and saying he wasn't going. To cut a long story short, I ended up saying he didn't have to go. Normally I would have pushed it as I know how could it would be for him. But he is bigger now and angrier than he has ever been. I didn't know how I could physically dress him/get him to the car whilst being attacked. I was also trying to look after his younger sibling at the same time.

Then I found him crying in his room. He said "sorry mum" and I gave him a hug. He then said "part of me wants to go" but when I asked him to get ready he screamed at me again. It's exhausting.

We has a quiet, relatively calm day at home. I did not let him play the computer and he kept moaning that he was bored and wished he was at football!

The highlight of the day was when I took him to an apt. at the bank to set up Internet banking. He was enthralled by the whole thing (especially as I had a demonstration of how it works). When we left, he said "that was SO MUCH FUN. It was so interesting, I loved all of it, i wish we could have stayed there all day". He wasn't being sarcastic. This put him in fantastic mood and he was muttering to himself "Natwest. Helpful Banking" (or something similar that he'd read on the board) all the way home.

I did then think to myself - there's got to be something here that isn't normal for a boy of his age?

This was compounded at dinner-time when I heard him saying to his sister: "Beware, it's a dangerous world out there. There are people out to get you. They are after your life" (luckily DS is 1 and doesn't take much notice!).

He then called her a "rotten scoundrel" and started talking about the "footsteps of death". When I asked him where this was coming from he informed me it was from Horrible Histories and quoted about 10 lines of script from the tv programme. He treated DH to the same quotes when he arrived home.

This post is much longer than I intended, I think I've gone off on a tangent there as I needed to get some of it off my chest. If anyone is still reading, thank you

[Selks]

Well done for getting the referral but did you tell the GP about your son trying to strangle himself?