QUESTION:
Dear Dr. Heller,
I could write my own book about my family and mental health issues. This is a very short version. I could ask 100 questions. My son has had a severe panic and anxiety disorder since grammar school. Each time I took him to a Doctor I was told he was hyperactive and finally in the 8th grade I was told to leave him alone because he was going through puberty. He started self medicating (became a heroin addict) and is now on Methadone. He is the only one in the Methadone clinic that is allowed to take Klonopin. He is constantly depressed and has been put on every medication in the mental health field and nothing seems to work. He was diagnosed as bipolar at one time but his current Doctor has told him she thinks his severe depression is related to his panic disorder and has just put him on Effexor.
My son is now 25 and says the only reason he has not tried to take his life is because he knows what it would do to me. I am concerned that the day will come where it will not matter. He is also gay and hates that fact. I am a sales executive and manage women all over the United States. I am happy, positive and have gone to Al-anon. My son is constantly negative. He doesn't seem happy unless everything around him is negative. He has tried to get off the methadone so he can have his life back but he can't. He has phobias of using public rest rooms and he can't give a supervised urine sample at the clinic which is causing him a great deal of grief. He has tried to explain to the nurse at the clinic that not being able to give a supervised urine is another phobia he has.
Almost every statement that was made on your Website "...my mind never stops...."etc. sounded exactly like my son. I am almost to a point where I don't know where to go. I am a very concerned mom and I am afraid I am going to lose my son. I would love my son to read your book but he has never been able to concentrate and read anything I give him. Could he also have ADD?
My questions are: 1. Will this horrible situation ever end? 2. Will the Effexor be another drug that he will not be able to get off? 3. Are there actually some people that no drugs will work for? 4. How can you distinguish between panic, anxiety, bipolar, borderline personality or severe clinical depression? Can he actually have all of these problems? 5. Can all the drugs he has been taking for the last five years make his brain worse?
ANSWER:
There is no reason he can't have multiple diagnoses, including attention deficit
disorder along with panic and the generalized anxiety disorder.
1) Unless the underlying diagnoses are made and comprehensively treated,
it is unlikely that his situation will change much for the better.
2) Effexor can have lots of side effects, and a withdrawal syndrome can
be a problem. If he wishes to get off it he'll need a slow taper.
3) I haven't met anyone that medications didn't help, although
many individuals never really want to get better and sabotage the recovery process.
4) All these diagnoses have a different set of symptoms and criteria. My
screening test may be a helpful first step.
5) It's highly unlikely that the medications you've brought up
would cause brain damage.
