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Suggest Remedies For Personality Disorder And Substance Abuse
Question: Dear Doctor,
As asked a few days ago about my son who the first Psychatrist wrongly diagnosed as OCD. I visited another Psychiatrist and he diagnosed like you that it is not OCD and possibly not ADHD and asked us to see a clinical psychologist.
Today the clinical psychologist spent a long time with him and then us and said she sees a case of Personality disorder - specifically disassociation disorder. She said the symptoms has some similarities with ADHD symptoms. In any case she interviewed him alone for 45 minutes and then spoke to me and my wife and broke the news. She said that he has also developed a habit of substance abuse, smoking and drinking. He lies and steals. She said this probably developed some time in his much younger years and now feels no medication can help but proper talk therapy can help.
She says we can only hope for a 30 to 40% improvement and we cannot change his inbuilt personality completely. She is suggesting the track of having regular family sessions with her where she will try to start a conversation that involves all of us helping him to be back on track.
Do you think she's right and is there any way to improve him dramatically?
As asked a few days ago about my son who the first Psychatrist wrongly diagnosed as OCD. I visited another Psychiatrist and he diagnosed like you that it is not OCD and possibly not ADHD and asked us to see a clinical psychologist.
Today the clinical psychologist spent a long time with him and then us and said she sees a case of Personality disorder - specifically disassociation disorder. She said the symptoms has some similarities with ADHD symptoms. In any case she interviewed him alone for 45 minutes and then spoke to me and my wife and broke the news. She said that he has also developed a habit of substance abuse, smoking and drinking. He lies and steals. She said this probably developed some time in his much younger years and now feels no medication can help but proper talk therapy can help.
She says we can only hope for a 30 to 40% improvement and we cannot change his inbuilt personality completely. She is suggesting the track of having regular family sessions with her where she will try to start a conversation that involves all of us helping him to be back on track.
Do you think she's right and is there any way to improve him dramatically?
Brief Answer:
Private Consultation
Detailed Answer:
Thank you so much for reaching out to me. I'm very glad to have this update. Here are my thoughts.
I find this psychologist's assessment much more likely. A 45 minute session is usually enough time to establish a proper provisional diagnosis. An unspecified personality disorder alongside substance abuse seems like a more likely diagnosis than OCD or ADHD. These diagnoses are always subject to change over time with more information, but I think the psychologist is doing an excellent job.
I would disagree somewhat with the 30-40% number. I think with intensive psychotherapy your son could improve dramatically. It is true temperament and some things about personality cannot be changed, but a great deal can be changed and improved with treatment. I would encourage you to encourage your son to attend regular weekly psychotherapy for at least a year and ideally longer.
Dr. Sheppe
Private Consultation
Detailed Answer:
Thank you so much for reaching out to me. I'm very glad to have this update. Here are my thoughts.
I find this psychologist's assessment much more likely. A 45 minute session is usually enough time to establish a proper provisional diagnosis. An unspecified personality disorder alongside substance abuse seems like a more likely diagnosis than OCD or ADHD. These diagnoses are always subject to change over time with more information, but I think the psychologist is doing an excellent job.
I would disagree somewhat with the 30-40% number. I think with intensive psychotherapy your son could improve dramatically. It is true temperament and some things about personality cannot be changed, but a great deal can be changed and improved with treatment. I would encourage you to encourage your son to attend regular weekly psychotherapy for at least a year and ideally longer.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Many thanks for your response which has given me even more hope. My wife has been distraught since hearing this diagnosis yesterday, especially the 30-40% part.
In any case, we will work with him. Do you think a clinical psychologist is the right person to have regular talk sessions with for a person like him?
Please let me know your thoughts. Is it wise for him to ALSO get him to engage with an online therapist? He is comfortable with online text chatting.
In any case, we will work with him. Do you think a clinical psychologist is the right person to have regular talk sessions with for a person like him?
Please let me know your thoughts. Is it wise for him to ALSO get him to engage with an online therapist? He is comfortable with online text chatting.
Brief Answer:
Private Followup
Detailed Answer:
I think his primary treatment should absolutely be conducted in-person by a trained clinical psychologist or psychiatrist. However, I would also be happy to speak with him online at this website to supplement his work with a psychologist in your area. Perhaps if he is more comfortable in the online setting, I could be of help in some way.
Dr. Sheppe
Private Followup
Detailed Answer:
I think his primary treatment should absolutely be conducted in-person by a trained clinical psychologist or psychiatrist. However, I would also be happy to speak with him online at this website to supplement his work with a psychologist in your area. Perhaps if he is more comfortable in the online setting, I could be of help in some way.
Dr. Sheppe
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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