Had I known that one day my sweet innocent daughter would turn into a psychiatric patient, I would have taken Haldol instead of prenatal vitamins during my pregnancy. I had been forewarned by fellow parents, but assumed there was no way MY child would succumb to such behavior. Then at 15 months, my little monster reared her curly haired, bi-polar little head.

Conduct that would guarantee psychiatric commitment in the ED is apparently ‘normal’ for a toddler. Emotionally labile? Check. Flight of ideas? You bet. Decreased sleep? Of course. Violence? Unfortunately, yes. Welcome to your very own in-home mental health facility, open 24 hours a day, 7 days a week!

Suddenly the wrong color of sippy cup would lead to TM-rupturing screams and flailing on the floor. If she requested grapes, by the time they were given to her she wanted strawberries and would cry until her face was the color of aforementioned grapes. My husband was not allowed to touch the stroller, remote control, or baby wipes unless he was looking for an attempted bite wound. In between these outbursts, however, she was as delightful as ever. We relished the happy moments and tried to take cover when the predictably unpredictable tornadoes struck.

Our initial thoughts as first-time parents were ‘What just happened?’ and ‘What did we do wrong?’ Naturally everyone was full of advice. Friends without children enlightened us that it was simply a matter of standing your ground, which has apparently worked wonders for their non-existent children. Our parents hinted that the problem was with us, since our daughter was amazingly perfect when she was with them, and her every demand was fulfilled immediately. Standing our ground was sometimes tantamount to the definition of insanity – doing the same thing over and over and expecting different results – and giving in to her was pure masochism.

I turned to books, which gave equally confusing guidance. Some recommended distraction and comforting while others stated this would lead to escalated tantrums from children who felt like their feelings weren’t being heard. In addition, many friends warned us that three-year-olds made the terrible twos look like a relaxing vacation. For the time being, it seemed, our miniature manic was here to stay.

There were at least a few points I could apply from my adult psychiatric patients to my little one. Like adult patients, even toddlers want someone to listen to them. They need to be fed and they need to sleep. Most importantly they need to know that someone they trust cares about them and will be there for them. So my husband and I take it one day at a time and try to meet these basic but challenging needs. As with ED patients, it certainly makes for interesting stories.

Just the other day I sat through a 15 minute psychotic eruption at the zoo, instigated by a dent in my daughter’s banana. I endured the judgmental stares from other parents and the pull on my heartstrings to soothe her with whatever bribe I could think of. She finally stood up and in between tears and hiccups confessed, ‘w-w-want to be happy’. At least we have that in common.



# The Little Joys of Parenthood are without number...NOT! (always)Louise Andrew 2011-09-02 10:27
Engaging story beautifully written. Your attitude and approach to the challenges of parenting a "difficult one" are refreshing and healthy. One caution, though: don't label her too early. Some of the MOST crazed seeming toddlers turn out to be the most normal people (and of course, vice versa). I suspect you know this, but it wasn't completely obvious from the article that you don't really think she needs "psychiatric" care. BTW, have you tried fish oil?
# The Little Joys of Parenthood are Without Number (NOT always!)Louise Andrew 2011-09-02 10:34
Engaging story beautifully written. It certainly seems that your attitudes and approaches to parenting a "difficult one" (including choosing to ignore well meaning advice) are refreshing and healthy. One caution about labeling, though. As I'm sure you know some of the most challenging toddlers turn out to be the most normal people (and vice versa). It wasn't completely obvious from the article that you don't think "psychiatric" care may be warranted. Wise mothercare (with a good dose of humor) may be just the ticket. Keep writing. And oh, and have you tried fish oil?
# Dare to DisciplineIatros55 2011-09-05 06:15
Don't give up. This is normal behavior. Teaching discipline and self control will result in a much better behaved teenager. Lose this battle and the teens and young adulthood will be terrible too. I recommend older books, not newer ones full of the psychobabble. James Dobson's revised book, 'New Dare to Discipline', is a good start, as are the older books on raising children. Don't go back to Spock, he started the practices that resulted in the hippy generation.

Be patient, strong, don't give in to bad behavior, and read the books.
# Psycho-Tod? NoPamela Curran 2011-09-13 10:30
Thank for sharing. Absolutely agree with revised 'Dare to Discipline'. Your toddlers attributes I know all too well as was also experienced with my now 8 year old daughter. Whom is a typical well-rounded, attentive and intelligent child. She has her days as we all do. Take the advise of the former comments, especially with the labeling. My first born did have many of the attributes as yours and I too could see the Pysch patient as well as Alzheimer's characteristics he had. One of the main differences with my son, he did not show feelings, didn't look us in the eyes and appeared in and out of his own world. So, much of the same but more atypical and you guessed it of course, autistic disorder. Your child has feelings and told you what she wants. Beautiful.
# Oped 2011-09-25 05:50
This discipline needs to be applied to docs and admins. Bureaucrats on power trips display your child's characteristics far more often children.
# Great writing, great story on many levels...Susan T. Haney, MD, FACEP, FAAEM 2011-11-21 00:57
Great writing, great story on many levels. I appreciate your compassion, warmth, and honest dismay at your daughter's perfectly normal behaviors. I also appreciate the (intended?) way that you brought up discussion of treating persons with mental illnesses with the same dignity and respect as you undoubtedly do all of your patients. I suspect you're a fine physician and a great mother (two of the hardest jobs ever created, IMHO).

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