Introduction: Why Age Matters in Psychiatric Care
Research has shown that life-span developmental changes can have a significant impact on sleep, mood, anxiety, energy, behaviors, motivation, hormones, neurotransmitters, memory, and attention, and hence overall adaptive functioning. In working with a Child/Adolescent vs. an Adult Psychiatrist, you are ensuring that the physician has training and expertise in specific developmental stages of your life and its impact on your mental health care across the lifespan. When you seek out child psychiatric, adolescent psychiatric, or adult psychiatric services, you should ensure that your psychiatrist specializes in the age group you are seeking services. Some psychiatrists specialize in both Child/Adolescent and Adult Psychiatry, as does Dr. Kapur, Double Board Certified Psychiatrist at Aspiring Families, so that she is able to meet the medical and psychiatric needs of clients across the life-span.
Developmental Factors in Children Adolescents
Children and Adolescents have multiple ongoing and rapid changes in their bio-chemistry, cognitive function, and psychological needs.
Early Childhood: Infancy to Kindergarten (0-5 years)
Young children are expected to meet certain developmental milestones within an expected age range. Speech and language, fine and gross motor skills, toilet training, and cognitive, intellectual, and social development are key areas to be assessed. If delays in any of these areas occur, a developmental evaluation is typically necessary. In moderate to severe challenges, a child psychiatrist is likely to order developmental therapy, lab work, medical works ups, supplements, and if absolutely needed medications. The young child’s brain has tremendous neuroplasticity, so the earlier the evaluation and targeted interventions, the higher the probability of success in the brain and body returning to developmental norms.
Elementary School Age: 6 yrs-12 years
In this stage of development, children are growing their abilities and skills in multiple complex ways. Children are expected to be more independent in self-help adaptive life skills such as hygiene, eating, changing, and sleeping. Children are expected to make friends and be more social. Children are expected to pay attention in school, sit for longer periods, stay on task, work independently, learn across academic subjects, and participate in activities that demonstrate solid gross and fine motor skills. Additionally, children are expected to be motivated, engaged, happy, cooperative, and confident. If you see blips in these areas and your child does not seem to be thriving, and therapy and school support has not helped, you may consider an evaluation with a child psychiatrist. They have expertise across these developmental domains and are likely to recommend medications that can appropriately target the vulnerabilities or challenges disrupting typical development. These barriers could include depression, anxiety, OCD, sleep, attention, focus, motivation, cognitive delays, learning disabilities, and behavioral challenges. Once again, young children have a tremendous capacity for neuroplasticity, and often medications in conjunction with therapy and school support can have a powerful positive impact in all areas of development, adaptive functioning, and performance.
Adolescents: 13 years – 19 years
Adolescence is typically described as chaotic development; hormones are raging, the body is rapidly changing, and the frontal cortex of the brain is developing. However, teenagers do not yet have the capacity for impulse control, risk assessment, and sound judgement. Adolescents are also struggling with identity development, sexuality, separation-individuation, and launching into college or vocational journeys. With so many complex life changes, teenagers are often debilitated with confusion, anxiety, depression, OCD, substance use, poor sleep, poor nutrition, poor exercise, and impulsive behavioral choices. Parents and teachers need to watch for red flags and have the adolescent assessed and supported quickly before they move into the danger zone, as the risk for self-harm and suicide is very high in teens and college students. In meeting with an adolescent psychiatrist, you will receive an in depth evaluation for your child, you will have access to all the necessary lab orders and medical work ups, and the choices of prescription medications that will quickly stabilize your child. You will also be able to request support in school from the psychiatrist and their therapeutic team. It is imperative that we don’t wait until the child engages in self-harm to proceed with this evaluation. Early psychiatric and psychological intervention is prevention when it comes to adolescents and reducing the risk of crisis interventions.
Adult Psychiatric Care: Different Needs, Different Focus
Adults have unique changes in their environment, life situation, and biochemistry across the life span. Entering the work environment adds significant stressors as young adults learn to navigate living independently, managing finances and daily life tasks, and engaging in relationships. For women, pregnancy and birth can trigger multiple hormonal changes which could be related to depression and anxiety. Having children exponentially increases all the above stressors as parents are now responsible for young ones. The heavy demands of work, children, bills, and relationships often takes a toll on adults, including their own selfcare of nutrition, exercise, sleep, and adult time. It is not surprising that the rates of depression, anxiety, ADHD, OCD, and other symptoms now flare up from past chronic conditions or can resurface from recurring conditions. Utilizing the services of an adult psychiatrist to assess and determine the best medical support for you is sometimes necessary to re-stabilize your functioning and abilities. We have seen clients recover from deep depression, self-harm, and crippling anxiety within a few weeks with effective medications and management with an expert adult psychiatrist. Additionally, as you move through the later stages of life with hormone changes, changes in sexual drive and performance, menopause, sleep and energy fluctuations, an adult psychiatrist will be able to order labs, make referrals, prescribe treatment regimens, and manage your physical and mental health from an integrated bio-psycho-social approach.
Key Differences in Psychiatric Evaluations
For children under the age of 18 years, a child and adolescent psychiatric evaluation typically takes 1.5-2 hours with different segments. The psychiatrist will typically meet with the parents alone for 45 minutes to learn the history, presenting concerns, medical interventions, and previous evaluations conducted. The psychiatrist is then likely to meet alone with the child or adolescent (if they are old enough and comfortable) for about 45 minutes, to learn directly from them their strengths, challenges, goals, needs, and to assess their developmental functioning. Towards the end of the evaluation the psychiatrist will either meet with the parents alone or all together as a family to provide a possible diagnosis, and/or recommendations for an assessment, therapy, labs, and medications.
For adult evaluations, the psychiatrist is likely to meet with you alone for 1.5-2 hours to do a thorough evaluation of your history, past and present challenges and strengths, previous medical and therapeutic interventions, and goals. The psychiatrist may also want to speak to your ongoing therapeutic team and review any previous assessment reports. Based on all the information, the psychiatrist will likely provide a diagnosis, and recommendations for labs, medications, referrals to specialists, and medication options. The psychiatrist will rely on self- reports for adults, so the more accurate you can be in providing correct information, the better the psychiatrist will know what might be most effective for you.
Integrated Care Across the Lifespan
Aspiring Families offers a unique integrated bio-psycho-social approach to mental health and wellness for clients across the lifespan. Working collaboratively as a team, we offer medical and psychiatric services with physicians and psychiatrists, individual and family psychological services with licensed clinical psychologists, assessments and school support with school and educational psychologists, in-home and in-office support with behavioral interventionists, expressive arts therapy with expressive arts therapists, and neurofeedback using an FDA approved bio-feedback system. We approach the client from a whole systems perspective, addressing biological, social, emotional, developmental, school, and family needs across the life-span.
Conclusion: Supporting Mental Health at Every Age
We offer individualized evaluations with our double board-certified psychiatrist, Dr. Kapur, who has expertise in child, adolescent, and adult populations. Her fellowship at Stanford University, her leadership roles as Director of mental health clinics, and in working closely with the Aspiring Families team, Dr. Kapur is able to provide competent and compassionate care for you for Developmental, ADHD, OCD, Spectrum, Depression, Anxiety, Behavioral, and Mood challenges. Reach out to Aspiring Families to schedule your intake call and evaluation with Dr. Kapur with no waiting times and follow ups as needed. Early interventions are the best platform for improving your symptoms and wellbeing.