Bloopers
When people make mistakes in psychology it impacts peoples lives. I hear about mistakes all the time. I get to read charts and notes from other clinicians as part of my work. It’s not that I don’t make my own mistakes, I’m human.
Case 1. I treated a guy for depression for 6 months. He wasn’t getting bettter. He was on medication. He was taking it religiously. He wasn’t getting better. Something was wrong. It turned out, he had a knee infection. The infection was causing his depression. Once he was treated with 10 days of antibiotics his depression disappeared. Sometimes depression isn’t depression.
Case 2. A man saw his doctor because he wasn’t sleeping well and started hallucinating. He was hearing his name called. Sometimes he would see things and sometimes he couldn’t move just as he was falling asleep or waking up. His doctor referred him to a psychiatrist. He was misdiagnosed as schizophrenic and put on antipsychotic medications. These worsened his sleep problems and made him so he couldn’t stay awake during the day. He lost his job. It was several years before he was diagnosed and taken off his medications.
Case 3. A woman was having very bad mood swings. Sometimes she was starting to faint. She was diagnosed with a personality disorder and anxiety. She got so desperate she attempted suicide. Although the nodules on her thyroid were noted on her medical chart at the hospital, no one did a complete thyroid work up. She continued to be treated for a personality disorder and anxiety and they added depression to the increasing list of diagnoses. Eventually she was diagnosed with Hasimoto’s thyroiditis, treated for the thyroid disorder and taken off the psychiatric medication.
Case 4. I was treated for depression with Paxil. Paxil should take at least 4 to 8 weeks to work. It worked in 3 days. Clearly Paxil was treating something other than depression. It took awhile to find the gastrointestinal disorder of Hartnup which the Paxil was masking temporarily. It can be controlled by diet.
Case 5. A man brought in his 11 year old son who was being treated for hyperactivity (ADHD). He was also being treated for asthma. The child was on several stimulating medications for asthma. The side effects of the asthma medications were explained to the man. The child didn’t start getting symptoms of hyperactivity (ADHD) until after starting medications for asthma. The diagnosis of hyperactivity must start prior to age 7. He was advised to discuss the asthma medications and their side effects with his prescribing MD.
Case 6. Steroids like prednisone are great medications for serious allergic reactions. An unusual reaction to them is steroid psychosis. It doesn’t happen every time the medications are given, so people doesn’t associate the onset of irritability, delusions, or hallucinations with a medication they have taken in the past. When the medication is stopped the symptoms go away. Usually a family member brings in the person complaining they are irritable and are screaming at everyone. A review of medication finds the steroid which has been started recently.
