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Misdiagnosed And Lied To

Question:

I am a twenty four year old woman. From ages seven to twenty, I was diagnosed with ADHD, and treated for it. However, looking up some of the medications I was put on by one of my last therapists, I am growing both concerned and angry. These medications, which I was put on first singly, then as a cocktail, were Dexadrine, Depakote, and Zyprexa. The medications made me exhausted, irritable, and prone to outbursts when I was awake. They also tended to make me more emotional. The Depakote, after I was pulled off suddenly, even gave me seizures, partially resulting in my being removed from a college dorm. My parents claim I “outgrew” the ADHD, since in the past six years since I have been off medication and NOT in therapy (against their wishes), I have made huge strides in my social skills and am no longer constantly depressed. I know ADHD cannot be “outgrown,” and my mother used to claim I had symptoms of being sexually abused, and would badger me for details. I remember no such incident. She also once mortified me by asking in front of relatives, if I was “hearing voices,” even though I NEVER have. My grip of reality is extremely firm. Since being removed from those medications, I have noticed my memory getting worse, and the occasional involuntary tremor or reflex. These are not small events; friends have commented on them. After hearing about the Zyprexa worries that have recently been in the news, I did some research, confirming that NONE of those medications are used for ADHD. And if I had bipolar disorder or schizophrenia, how does one explain the fact that only that therapist has ever even hinted at either, and how could I have supposedly “outgrown” them? As you can see, part of me is utterly furious at being lied to, and placed on medications that have caused lasting, perhaps permanent, side effects. Please respond with what I should do. Also note that neither of the therapists I saw after him diagnosed me with either, and were in fact puzzled as to why those medications would have ever been prescribed for me. Both said I did not need medication, and minimal therapy.

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Answer:

Not being a psychiatrist or other sort of medical doctor, I cannot say too much regarding the choice of medications that were prescribed for you in the past. I can say that ‘off-label’ use of various medicines is widely practiced within the medical community. By the phrase, “off label” I mean to suggest that some medicines that are approved for one use (say, an “antipsychotic” medication which is approved for the treatment of schizophrenia and psychosis) are sometimes used to treat other conditions such as bipolar disorder or unipolar (regular) depression. Just because a medicine isn’t approved for ADHD doesn’t mean that there may not be some legitimate use for that medicine within the population of patients with ADHD is the point.

Having made the above point, I’ll also say that I’ve never heard of Depakote or Zyprexa being used with ADHD patients either. That doesn’t mean much in of itself because I am not a medical doctor, and do not specialize in treatment of ADHD; I’m not any sort of authority who would know whether these agents have legitimate off-label uses with regard to ADHD.

Dexedrine is another matter, and does seem to fit the diagnosis of ADHD a little better. Dexedrine is a stimulant medication similar to the more commonly prescribed ADHD drug Methamphetamine. Stimulant drugs are thought to create a “paradoxical” effect within the ADHD brain; where another person might get high, an ADHD patient gets focused.

All of this is perhaps besides the primary point of your letter, which really is about your sense of betrayal and outrage at what appears to be a false diagnosis and inappropriate treatment which has had real and negative ramifications for your life. The way you portray your mother, she seems to have an almost ghoulish interest in your being ill to the point where I wonder if we aren’t talking about a Munchhausen’s Syndrome by Proxy sort of situation (where a caregiver induces an illness in a cared-for child through poison or some such method so as to bask in the caregiver role). I hope that is not the case, but you never know.

Here is the thing. Whatever has happened to you in the past is in the past and cannot be changed now. You can only cope with where you are today, which as far as I can tell is angry, outraged and feeling taken advantage of and not protected. You r task is to figure out how to best cope with this anger, and to determine what sort of relationship with your parent(s) will best serve you now and for the future. For example, you need perspective on the situation, but my guess is you also need someone who will take your side intelligently, helping you to feel legitimate in your anger. You need to know what boundaries you want to set with your parent(s). You might most profitably do this work with a good therapist (who can be a good third-party witness and advocate), but there are other ways to do it too; by talking with friends, or even by simply writing about your feelings in a journal.

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