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Mental Health (Expert Forum)
admission to medicine addiction program
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
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admission to medicine addiction program
by graceh10, Jun 26, 2004 12:00AM
My daughter who is 27 yrs old lost her job as a speech pathologist a year ago. She was fired because she was not going to work because she could not wake up to go or she had panic attacks. The therapy company took her back, but she had the same problems and stopped work again on medical leave. She never felt ready to go back to work, so she resigned. Now she sleeps from 3 am to 4 pm many if not most days. She is taking wellbutrin, luvox, and xanax daily. Also occasionally Ambien. I recently found out that she is drinking several times a week as well.
She also has been shopping compulsively on e-bay.
She says that she does not have a drug problem, that her problem is depression. The fact that she is unemployed has made it worse. I am trying to arrange for her to get assessed for entering a medicine addiction program, which will be very expensive. Do you think that her problem of not being able to wake up and participate in life is due to depression or does it sound like she is taking some combination of medicines that is at the root of the problem. Also is there any point in twisting her arm into entering treatment if she doesn't think she has a problem?
She has a psychiatrist but she sees him for only 30 minutes once a month to get her prescriptions refilled. I have no communication with the psychiatrist because of her privacy rights. The medicine addiction program is at a very reputable hospital in another city and her current doctor is not connected to the program. Should I wait until someone else decides she should be admitted for help or untll she hits bottom and wants help or should I try to do something. I am afraid she won't wake up one day.
She also has been shopping compulsively on e-bay.
She says that she does not have a drug problem, that her problem is depression. The fact that she is unemployed has made it worse. I am trying to arrange for her to get assessed for entering a medicine addiction program, which will be very expensive. Do you think that her problem of not being able to wake up and participate in life is due to depression or does it sound like she is taking some combination of medicines that is at the root of the problem. Also is there any point in twisting her arm into entering treatment if she doesn't think she has a problem?
She has a psychiatrist but she sees him for only 30 minutes once a month to get her prescriptions refilled. I have no communication with the psychiatrist because of her privacy rights. The medicine addiction program is at a very reputable hospital in another city and her current doctor is not connected to the program. Should I wait until someone else decides she should be admitted for help or untll she hits bottom and wants help or should I try to do something. I am afraid she won't wake up one day.
Doctor's Answer
by Roger Gould, M.D., Jun 30, 2004 12:00AM
, Jun 30, 2004 12:00AM
I don't see the connection with a problem in what you described, but I too would worry about her depression. She needs help, and just using medications is not enough. Try to convince her to see a real psychotherapist...it is a better way to spend money on her behalf if she does not have a problem.
As you describe it her "drinking" followed her initial set of depressive and anxious symptoms, not the other way round. It is not unusual for people with inadequately treated mood disorders to then self medicate with Alcohol etc. This problem from what you have written is first and foremost a mood/anxiety problem and not a drug problem. She needs not only her medication but even more importantly at this stage a supportive sychoteraputic environment - which could be provide by a trained psycotherapist.
The greatest help family can give at this stage is to give support and in particular to show she is valued for who she is and not only for what she does. Probably the most damaging family intervention are demands that the person "pull themselves together".
Anyone who has suffered depression can tell you how little energy they may have, and how even getting dressed can be a long and ardeous ordeal. So everytime your daughter does something for you or your family make sure she knows you appreciate it. Overtime this will help her sense of self esteem which will be a prerequisite for getting back involved in life.
All the best
Shaun
I can tell you how I felt... I literally could NOT get up, could not hear my alarms. I had 5 alarms and apparently I turned them off in my sleep. I could not get dressed...it took HOURS. I had no self-esteem at all, and eventually was fired for not going to work because I was always feeling so bad and couldn't "pull it together. I would finally get ready, and get back into bed, unable to make myself drive to work or face anyone. I stayed in bed constantly, never cleaned anything, and life went into a hole that was so deep. I had no friends because I was so ashamed of myself.
I, too, had a internet shopping problem like your daughter. It made me feel empowered to buy things, the only moment I felt "good", like I accomplished something. Shame temporarily lifted and I could sleep. Sleep forever. Shopping can easily be an addiction. It was for me, and may be for her. I thought nothing of where the money would come from to pay for it all. I had no job, but still thought nothing of it. Drinking a little like your daughter was common, too. I don't even know why I did it...trying for a small escape from the world, maybe.
I finally asked my parents for help, and voluntarily went into treatment because I felt I had to get off a the meds this "psychiatrist" put me on. He eventualy was thrown out of doctoring because he apparently over-medicated everyone. Your daughter doesn't seem "over-medicated", though she may not be on the right meds for her problem.
My experience with inpatient treatment was horrible. I would NOT recommend it, nor AA, NA, or any of those types of groups. She needs one-on-one treatment. Attention for her only.
I want to tell you what happened to me at the treatment center so you can be sure to check the placed out thoroughly before you allow her into any facility. Better to get ONE psychotherapist to help her.
Let me say that none of this is to frighten you or discourage treatment because she clearly needs it, it is only my experience with one center.
I was forced to take meds to tranquilize me, forced to participate in activities that were against my beliefs. If I did not, I was punished by having to do chores or more exercise than others, even make other peoples beds.
Everything was in a group setting and I was treated like a common criminal, as if I were stealing to buy crack or something. I was only taking what my doctor told me to! Most of those in the facility were forced by court, others were in situations similar to mine. It was humiliating, and none of it was relevant to my problems. This was supposedly a very reputable place for treatment. My parents went there, talked to everyone, really checked it out...they thought.
I was not allowed to speak to my family at all. I could not make any phone calls. I NEEDED my family then, more than ever, and they wanted to help. They called, left messages, sent flowers and cards that I never got. I was never told. My parents asked how I was, they were told I was doing very well, which was a lie. I was not supported, I was controlled and forced. I don't think I stopped crying for 8 or 9 days, then finally just went into "zombie" mode and did everything I was told, regardless of what I really thought, just to avoid conflict.
I never saw a therapist while I was there, but saw a
"psychiatrist" once for about 15 minutes. I went in for a 7 day detox to be sure I didn't have convulsions or other problems while getting off al the meds. They kept me 28 days.
They decided somehow that I needed further treatment, due to "dual disorders", depression and anxiety, and wanted to send me to a 30 day facility. How this decison was made... I have no idea. I knew the moment I stepped in I did not belong there.
They told me if I left, my insurance would not pay and they said the fees were in the range of 75 THOUSAND DOLLARS. I personally would have to pay if I left, they said. That was a lie, but I couldn't call anyone to find out the truth, and was so drugged I didn't know what to do. I still could not contact my family. Since I was in vountarily, I could have walked out at any time, but did not know that. And my insurance would have paid.
Due to the fact that I was drugged beyond rational thought, I went to their 30 day facility, still unable to contact my family. In this place, I was in with serious criminals...
murderers, paranoid schizoprenics, thiefs, people who injured their own bodies and even their children, to get drugs. Broke their own bones to get drugs. I was in shock. I said nothing in group because nothing related to me. I could not believe what these people did and where I was. They drugged me further. Seriously FORCED to take meds. I was NORMAL compared to these folks. They stole from me, they scared and threatend me. The staff did nothing about it. They stole as well.
Again I saw one "psychiatrist" and she deemed more meds. I simply "zombied" through it. She was demeaning and there for no reason but to make the insurance company think I needed to be there longer. She literaly invented things in my chart that I never said, things that were totally untrue, that I was abused, my parents were addicts...unbelievable lies.
I was also injured by a paranoid schizophrenic who had an episode and threw me onto a conrete floor, injuring my back and gving me a concussion. I was taken to the emergency room and told there was nothing wrong. I still have problems. I was attacked in the shower by my roomate when she had some episode. No reason. I did nothing to bring this on.
There is more. I stayed the thirty days, finally got to my parents, and got a little better wit a therapist. But that stay effected me forever. The emotional and physical pain will never go away.
I only went in for one week to be monitored to be sure I had no convulsions while getting my medications. I still ended up with piles of bills from them.
So please, please, get her in therapy, find her an excellent psychotherapist, make her go somehow, perhaps with the help of your seeing a therapist to help yourself help her. But check it out very intensively, because it can be a wreck or a lifesaver.
Best of luck to you and your daughter...I will think of you and wish all is well for you both.
Miena