<p>“Rate a doctor” sites will be of limited value, I would think. For something like this, I would dig into sites for specific medical centers, look at their find-a-doctor tools, see what kind of emphasis they put on mental health in general and whether they have specific programs for autism and autistic spectrum disorders, etc. Some will have better information and offerings than others. Once you find some people you want to check out, then you might want to see what the “reviews” are, to the extent they’re out there.</p>
<p>Missy- Do you have a major medical center anywhere near you? Check their site. Look for anything related: eating disorders, young adult support, psychologists, social workers, etc. You need to find one good lead to talk to and ask for more leads, through a professional network.
You can go the route of talking to a near-by center for emotionally disturbed kids or something extreme like that, and ask for a list of their therapists.
Usually, the professionals in current use are also a source of leads (the PCP, the EFD therapist): This is part of their job.
Last, sometimes at the back of books about these types of issues there is a list of practitioners.</p>
<p>You are right- it is very hidden and murky. To a lay person it is. And your son is an adult, legally, anyway.
Take care of yourself. We are all here for you. You can do this!
Keep us in the loop for support.</p>
<p>Missypie, here is another good referral resource:
[ABCT</a> Association for Behavioral and Cognitive Therapies (Cognitive Behavioral Therapy)](<a href=“Membership - ABCT - Association for Behavioral and Cognitive Therapies”>Membership - ABCT - Association for Behavioral and Cognitive Therapies)<br>
If for some reason the link doesn’t work, go to <a href=“http://www.abct.org%5B/url%5D”>www.abct.org</a> hit the find a therapist button. This is an organization populated by academicians, researchers and therapists who identify themselves with mainline cognitive and behavioral therapy.</p>
<p>Missypie- I send my best as you navigate this complexity, worry and sadness. You may need to optimize the team you have to connect these dots, but if that doesn’t take you far enough, here are some tips I’ve learned while navigating rare medical diagnoses and working in a research hospital. A way to dig for local experts is to search for conferences/lectures/seminars on the topic you are interested in and see what comes up. Also. search google scholar for mood disorders/eating issues/autism spectrum and see what authors might come up. You can then see where the experts’ medical affiliations are located, researching the medical center itself for possible relevant programs. Don’t be discouraged if the experts aren’t local, call and ask if you could speak with someone. They may well have colleagues they have trained or trained with whom they can refer you to. Lots of mental health issues co-exist with some frequency and these connections are of interest to researchers and clinicians. I hope this is so for your son’s constellation of symptoms. Affective disorders often are present in patients with eating disorders/issues-don’t know how the autism spectrum component may relate to all this. There can also be overlap with treatment options and clinical sophistication on the paychopharmacology front is a big plus. Also, if you find a good person or center, it can be time and money well spent to get a thorough consult so his treatment is grounded. A consult can help get all the local players on the same page. You have done so well by him and he is fortunate to have your support. He is young, with a lot of strengths - now may not be the time for full time college, but eventually, there may be ways to keep that part of his life active and it could help with all you have discussed. Hang in there.</p>
<p>One of you with an amazing memory recalled that I had worried that Son was diabetic. It turned out that he was incredibly anemic. Not “take iron pills” anemic, but “come in right now for an iron infusion” anemic. Since January, he has had 4 or 5 iron infusions, an endoscopy, a colonoscopy, has swallowed the camera and now the gastroenterologist wants him to do the barium x-ray thing. He’s seen the pcp many many times and the gastroenterologist at least five times.</p>
<p>They see this kid whose belly looks like it is about to burst, who has a hiatal hernia and reflux and esophagitis and possible other GI problems and neither of them ask what he eats, how much he eats, how he eats. It takes Internet Doctor Missypie to find that Binge Eating Disorder is closely tied to GI problems of the exact type Son is having.</p>
<p>We have this big wellness push going on at work, we hear so much about how diet and exercise can save so much in medical bills. Son is living proof. If either doctor had focussed on Son’s binge eating, we could have probably avoided thousands of dollars in medical bills and perhaps Son would already be meeting with other professionals. I guess the gastroenterologist makes a living by doing all these procedures.</p>
<p>So now I’m a mommy on a mission, to find the right team to address the binge eating. Thank you all!</p>
<p>It’s a tough situation, Missy. Finding a good psychiatrist is very difficult. He needs to find a good one who will work with his other doctors including someone who works with eating disorders.</p>
<p>But overeating is something that is ever so difficult to address. I know so many grossly overweight folks. Yes, they know they are, but they cannot stop eating. Some of these folks have no other outstanding mental health disorder. They are addicted to eating. </p>
<p>I have one son who really has to watch his weight as he loves to eat, especially all of the wrong things. And he gains easier than the other kids. It’s a tough go for him, and I worry when he stops playing sports, as to what will happen. My MIL is obese and it’s been an ordeal trying to keep her weight down.</p>
<p>I’m not sure about getting too specialized. In the end, this is about a person, not a diagnosis.</p>
<p>Well, Missy, are you sure he is not Type 2 ? Anemia caused by… poor nutrition? Something else- if so, how serious is that?
Not trying to get into private details, just trying you to own the logic here.</p>
<p>Hope you can get some traction in your research- some great ideas from here.</p>
<p>best of luck, and keep in touch whenever you need support.
I am blown away by how helpful and knowledgable many are on this site.</p>
<p>He’s definitely not diabetic - I had him checked. The pcp thinks he has a genetic blood condition that was exacrbated by his gastric issues (the gastric issues made him so anemic, but now his red blood cells are still pale and small.)</p>
<p>Missy I didnt read all the posts but they say lexapro does not make you gain weight but it does. I know many people on it who have gained weight.</p>
<p>Good luch getting the right team together to sort this out & get your S the help he needs & deserves. I am sure you have the persistence to assemble the team. I agree that it can be challenging to find the right folks who match with your S & can establish a good connection.</p>
<p>The suggestion to work with teaching hospitals is a good one–they often are able to help or can refer to local resources & professionals who can help. I have found them invaluable for my health and we have flown H & the kids to be evaluated as well. Unfortunately, they were not able to refer us for follow up locally but at least work with the local docs I have found.</p>
<p>Know that you & your S & family are in many thoughts & prayers as you search for good treatment for him.</p>
<p>Is there any way you can talk to other medical professionals? They usually hear who is good. Nurses? Doctors? Who would they go to for eating issues? I know that works with surgeons & dentists. You ask the orthodontist nurse who they see as a dentist and since they see the work of so many dentists they have a pretty good idea who is quality.</p>
<p>You are so right, it is all about the relationship with the therapist, you have to have someone who thinks like you do, who is willing to understand you & your family for them to make helpful suggestions. I don’t know how you find that…local academic medical center? Somehow you need word of mouth referrals, but where would you find the best source of referree?</p>
<p>I googled this for you, and you may want to check this forum for parents in your situation: [Around</a> the Dinner TableSupport forum for parents and caregivers of anorexia, bulimia and other eating disorder patients](<a href=“http://www.aroundthedinnertable.org%5DAround”>http://www.aroundthedinnertable.org) </p>
<p>Also, the website: [F.E.A.S.T</a>. Eating Disorder Treatment Support for Anorexia and Bulimia - Nourishing Words](<a href=“http://www.feast-ed.org%5DF.E.A.S.T”>http://www.feast-ed.org) also has some information. </p>
<p>I am so sorry that you are dealing with this.</p>
<p>Missypie- Sending you some hugs. It seems like you are carrying the majority of the workload in your family. Working full time in a professional job, handling most of the EC and HS activities of your girls plus the educational and health issues of your son.
I don’t know why but in my community there is no shame in admitting you see a mental health professional. It is almost expected. All my children think it is “normal” to have a therapist. I personally know several psychiatrists plus numerous MFT’s and psychologists. When I needed to find specialized care I asked friends for recommendations.
I would try googling treatment centers for eating disorders in Texas or even specifically Dallas. Call and speak to someone. All residential treatment centers send patients home with an aftercare plan. Ask who they refer to. I think one roadblock you will find is that most eating disorder specialists mainly work with females.
[Behavioral</a> Health – Eating Disorder Services at Texas Health Presbyterian Hospital Dallas](<a href=“http://www.texashealth.org/body_subsite.cfm?id=1888]Behavioral”>http://www.texashealth.org/body_subsite.cfm?id=1888) I know nothing about this place but you might get some information from their site.</p>
<p>Missypie- Sending warm thoughts and support to you as you wrestle with this challenge. </p>
<p>Great suggestions from the CCers as always; hope the professionals identify a path for your son’s recovery soon.</p>
<p>Antidepressants and anti-anxiety meds can often trigger weight gain. Is he binge eating after the Concerta wears off? I find that my kiddo on Concerta eats an astonishing amount if he doesn’t take it for a day or two. A psychiatrist may be able to help untangle whether any of the meds are aggravating some of your S’s issues, esp. if any of these meds were added around the time he started some of these behaviors.</p>
<p>The best recommendations we’ve gotten were from others in the field (or allied fields). Someone at our preschool recommended our pediatrician (who, it turns out, went to HS with my DH!). He recommended our optometrist, who specializes in developmental vision issues and has a great rep in the local LD community. This guy recommended us to an occupational therapist for assessment. She recommended a counselor who would “get” my kid’s unusual set of abilities and issues. He was a godsend. He, in turn, recommended me to someone who has been amazing for my journey, and who in turn, gave our family another good resource for another family member. </p>
<p>Is the GF still in the picture?</p>
<p>Sending many hugs.</p>
<p>Yes, the GF is stil in the picture. Y’all have such good memories. He was damn handsome when they got together…she’s a loyal woman!</p>
<p>I really don’t think the binging is drug related. He’s been on Concerta for many years (6? 8?) and the binge eating started this fall. (He’s been on Lexipro for about three years.) He was already eating like this before he added the Wellbrutin.</p>
<p>I really think it is tied to poor impulse control, which comes with EFD.</p>
<p>Missypie, but his impulse control has always been poor, so it’s worthwhile figuring out why the binge eating only started this fall. What changed? Obviously, many things, but maybe the relevant one can be changed back.</p>
<p>I think that in HS, it didn’t occur to him that he could spend money (he had a credit card for emergencies and never used it.) It didn’t occur to him that he could buy food.</p>
<p>Then he went away to college. After maybe three months, he started spending. We put money on his school card, and he had a job, but he spent way more than he earned. On fast food.</p>
<p>I think the dose of freedom gave him the ability to act on impulses.</p>
<p>It can happen to anyone. It’s worse though when it happens to someone with issues in these areas.</p>