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Forum Name: Psychiatric Topics

Question: Is compulsive lying a symptom or the cause?


 stichomancy - Fri Aug 06, 2010 10:11 pm

I am 16 years old, have ADHD and take Adderall XR 20mg x2 daily. My former therapist noted me for also having manic-depression and social anxiety disorder, but I'm not treated for either at the time. The one issue I always managed to leave out in our sessions, though, is my compulsive lying. My psychiatrist knows now, but not the extent. I never realized how serious my issue was until 9 months ago when my lies ruined everything I had (scholarships, respect of family/friends, etc).
Therapy isn't an option anymore (conflicting laws that apply because I'm a minor erase the positive aspects of therapy), medication is fine but it isn't a CURE, and my family isn't one to work with me. I don't know where to go from here, because since I realized how intense my lies are, I don't trust myself. I'm at the point where I don't believe I am depressed or have ADHD or anything and only believe I have them in order to gain attention, and I only believe I don't want attention so I can comfortably use illness as an excuse to be lazy and inept and awful. I am so completely against believing anything I have ever thought to be real because I don't want to live like this anymore. I don't want to live a life based on lies or fantasy- I want a real life with real memories and real relations and real pain and real happiness...But how can I trust myself to be truthful with a doctor or anyone if I can't even be truthful with myself? I don't know what's real anymore. Is compulsive lying a symptom of my ADHD like my psychiatrist said, or is it the cause of all my trouble? Is there any way I can know for sure?

And for the record, I do not mean to sound self-defeating or paranoid. I know I come off as a bit of a conspiracy theorist, but I hope you can understand that I'm not paranoid to the point where I am delusional or a potential danger to myself. I'm not implying that I don't believe I exist or that I don't believe I don't have any serious problems, but I mean that I'm not very convinced as to what my problems really are. I hope that anything I just said makes sense. Thank you in advance! Have a good one [:
 Faye Lang, RN, MSW - Mon Aug 09, 2010 8:49 pm

Hello stichomancy,

I don't understand how being a minor and conflicting laws erase the positive aspects of therapy. Therapy is generally individualized, and since you have already been receiving therapy, I don't know what laws would change the applicability. I encourage you to continue in whatever therapy is offered.

To be diagnosed ADHD the person has to have 6 or more of the symptoms of inattention for at least 6 months, and with an intensity that disrupts the person's environment, and which is not consistent with the developmental level of his or her age group. The symtpoms include failing to give close attention to details or gives only careless attention, has difficulty maintaining attention in tasks or play, does not seem to listen when being spoken to directly, does not follow through on instructions or duties, has difficulty organizing tasks and activities, loses items needed for tasks or activities, is easily distracted by external stimuli, and is often forgetful in usual daily activities. There also must be at least 6 or more symtpoms of hyperactivity-impulsivity for at least 6 months, and which is not consistent with the age group's developmental level. The symptoms of hyperactivity include fidgeting with hands and/or feet and squirming, leaving an assigned location, moves about or climbs inappropriately, has difficulty playing or doing leisure activities quietly, seems driven, and talks excessively. The symptoms of impulsivity include blurting out answers or comments, has difficulty awaiting one's turn, or interrupts or intrudes on others. Some of the overall symptoms had to have been present before age 7, some impairment must be evident in at least 2 settings (as home and school), and there must be clear evidence of clinically significant impairment in social, academic or occupational functioning. The symptoms do not occur during the course of another disorder. Symptoms often become more controllable in adolescence. For those who have many of the symptoms but do not meet the criteria for ADHD may be categorized as ADHD NOS (not otherwise specified).

A diagnosis with some similar symptoms is called Conduct Disorder. The key feature is a repetitive and persistent pattern of behavior that disregards the rights of others, or age-appropriate societal norms or rules. The behavior is evident in a variety of settings, as home, school and in the community. The person with a conduct disorder tends to minimize their conduct problems. There are subtypes of Conduct Disorder, which are Childhood-Onset Type and Adolescent-Onset Type. There are also severity modifiers, which are Mild, Moderate and Severe. A Mild disorder has symptoms that cause relatively minor harm to others, as lying, truancy, staying out without permission, or disregarding household rules. In a Moderate disorder, there are also effects on others, as stealing or vandalism. In a Severe disorder, the problems cause considerable harm to others.

Certain personality disorders may also include some symptoms of ADHD and conduct disorder, including lying. Personality Disorders may not be diagnosed prior to the age of 18, and are often preceded by conduct disorder symptoms.

If any one person within a family system has an emotional disorder, the entire family is affected and would benefit from treatment. You appear to recognize the impact of your actions and accept responsibility for the consequences. This will sound oversimplified, but lying becomes a habit. If lying and manipulation through acting out other symptoms are not the result of a mental disorder, then there is choice involved. If there is the ability for choice and you choose to lie, perhaps because it's the most familiar to you, there would be little anyone could do to stop you, other than process your actions in therapy. Medications can be helpful. Being "real" as you appear to be infering involves accepting responsibility for one's actions, respecting others, respecting rules and laws, and cooperating with others. Or, as some would put it, growing up and behaving in a mature way.

If you do have any feelings of self harm, tell your parents or call your physician or crisis line immediately, or go to the local emergency room. Don't take chances. I enourage you to continue with therapy and to be honest and forthcoming with your psychiatrist and/or therapist.

Good luck to you.

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