Question:
Dear Dr.
I have a 15-year-old daughter who creates fantasy lives for herself via the internet. She creates posts giving completely false info along with false pictures of herself. This has been going on for at least a year and everytime I think she has stopped I find it again. Tonight I found a letter to a male and she has clearly told him she has a child, which she doesn’t. An example of another lie was that she was raped twice and her brother was now in prison for killing one of the rapists. All of this is completely ficticious. We are middle class living in a residential neighborhood and she attended parochial grade school. She has always been an attention seeker but this seems very far over the edge & what is the point. You could never hope to meet these people because of the lies you’ve told. She has been seeing a psychiatrist for over a year now. The 1st one she had we stopped seeing after 9 months because there was no progress & I believe my daughter had the therapist snowed. She now has a new one who tested her for ADD, which she has severely. She is now on medicine for this and I guess I thought it was the magic bullet-clearly not. She is also on prozac for depression by the family doctor. I guess my question is, is there a disorder where people lie for attention (to create drama that doesn’t exist) and if so what is it called. I would like to point her psychiatrist in the right direction, and yes he is aware of all of this. I truly feel like she is headed for an institution as an adult, please help.
Mom
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Answer:
Part of the problem that many people have in seeking help for themselves or their loved ones is knowing who to go to for a consultation. There are psychiatrists, psychologists and clinical social workers, all of whom do similar, though not the same, types of work. To make matters more complex is the fact that each of these professionals have sub specialties. While psychiatrists are medical doctors and do specialize in using psychotropic medications to help patients, only some of them specialize in pediatrics, ADHD and teenagers. Psychologists do psychotherapy, as do psychiatrists and social workers, but only they specialize in psychological testing. Furthermore, there are those psychologists who specialize in testing and treating only children and teenagers, including those with ADHD. Lastly, there are clinical social workers who do psychotherapy and some of whom specialize in working with teenagers and children.
Thus far, you have sought the help of two psychiatrists for your daughter. While these might be excellent professionals, they may not have working with adolescents and ADHD as their specialties. The reason I mention this is that one would expect that, in addition to medication, one or both would have referred her to a clinical psychologist for testing and, based on the results,to the necessary treatment. That has been the way psychiatrists who specialize in these areas have worked with me in the past.
At least in my opinion and given I know very little about this case, I believe your daughter should undergo a full battery of psychological tests. These are conducted by a clinical psychologist who specializes in working with children and teenagers. This is important to learn the nature of her ADHD and what other problems may be interfering in her life. For example, why does your daughter sit at the computer and make up fantasies about her life. What else might be wrong that is contributing to this behavior? She may have other neurological deficits that complicate her ADHD diagnosis. I have had the experience of working with youngsters who appeared to have ADD but, in actuality, are bothered by additional problems. It is also concerning to me that two different doctors are medicating her. If she is seeing a psychiatrist then that is who should be providing the anti depressant and any other psychotropic medications she needs to take.
Once the testing is complete then the clinical psychologist and psychiatrist need to meet and plan the appropriate treatment plan to best help your daughter. One or both should then meet with you and your daughter in order to provide information and move ahead. It is possible that you and your husband need to meet with the psychiatrist or psychologist or each of them in order to move ahead with treatment.
Please remember that in dealing with a youngster who has any disability it is important that the entire family be involved in the treatment process. Why? The answer is that you and your husband need to learn what to do and not do at home in order to help her make progress.
It appears that none of this teamwork is happening at the present time.
Also, ADHD refers to the fact that your daughter has a learning disability. At present, she has difficulty focusing her attention. Along with ADD or ADHD comes the need for her to learn the skills necessary to cope with and be successful at school and at work. While medication is helpful it is not the entire answer to what she is dealing with. This is also where the psychologist comes in: helping her to learn what she needs to do to help herself concentrate better.
In other words, in addition to medication for depression and ADD, she needs psychotherapy where she can learn how to concentrate and where she can resolve the other problems causing her to fantasize at the computer.
By the way, I am sure I do not need to remind you of the dangers of young people using E. Mail or Instant Messaging. There are predators out there just waiting to swoop down on naive and unsuspecting children and adolescents just like your daughter. Perhaps you need to speak to her about those dangers.
