“Marijuana Addiction” or Schizophrenia? The Danger of Misdiagnosis

To the millions of people who turned the original Hunger Games film into a blockbuster, the character Rue played a pivotal role in protagonist Katniss’ evolution from player to champion. To my younger sister, Rue represented much more: The 11-year-old character, from a poor farming community, was actually a personification of my sister herself.

Rue’s Hunger Games death was a metaphor for my sister’s spiritual death, or so she claimed in early 2012, after reading the book for the first time. She was 29 years old, and reading the dystopian novel marked the beginning of her journey into madness.

Okay, that’s a bit dramatic, but the facts don’t lie: In April 2012, my sister worked as a live-in nanny in Portland, Ore., a city that catered to her vegan, SJW (social justice warrior) lifestyle. She shared custody of her 2-year-old son, and by all accounts seemed happy and satisfied on those rare occasions when we spoke on the phone.

Then, one afternoon, she simply disappeared. She was found wandering alone near Multnomah Falls nearly a week later, with little explanation and looking severely malnourished. The story I heard from her employers and housemates was equal parts bizarre and sad — further, it looked and sounded like schizophrenia.

The Root of Delusional Thoughts

Medical professionals disagreed, however. Following her breakdown, my sister was initially committed for a mental health evaluation. At a facility in Portland, she received a diagnosis of “delusions caused by marijuana addiction,” and was sent back out on the streets.

For a number of reasons, I believe that my sister is likely schizophrenic rather than simply addicted to marijuana, with her delusional thinking taking the top spot in my reasoning. For example, her delusions in recent years include her belief that the Santa Cruz Public Library is pumping invisible, lethal gas into its bathrooms in an effort to eradicate her and other homeless “undesirables.”

Her most disturbing delusion involves her son, who she claims was murdered by the government, but who is actually living in Minnesota with his father. She posted announcements of her son’s alleged death far-and-wide on social media, and some of her friends and followers actually believed her, helping to fuel those harmful fantasies.

Since her delusional thoughts remain intact even when my sister isn’t consuming marijuana regularly, I don’t accept the “marijuana dependency” diagnosis. Further, her ideas go beyond the mild paranoia that is a common symptom of THC ingestion.

Treatment Road Bumps

Both addiction and schizophrenia are sometimes lumped into the “invisible illness” category. Aptly named, invisible illnesses are those with little to no onset symptoms. A lack of initial symptoms means that prevention is difficult or impossible.

As far as schizophrenia treatment goes, early intervention and “first-episode” work are critical. About 85 percent of schizophrenics exhibit prodromal symptoms prior to their first psychotic episode. My sister’s prodromal episode was particularly severe, and when compounded with the misdiagnosis of marijuana addiction, almost ensured ineffective treatment.

“Misdiagnosis results in ineffective treatment,” according to the National Center for Biotechnology Information (NCBI), but it can also lead to a complete lack of treatment, as it has in my sister’s case.

Since her distorted thinking incorrectly led her to believe that the government is out to get her, my sister distrusts all authority figures and public facilities. That distrust includes healthcare providers, hospitals, and treatment centers. And pharmaceutical treatment? Forget about it.

According to one study, the majority of opioid prescriptions in the United States go to people living with mental health disorders, but my sister would never take them, even if she were properly diagnosed and medicated. There’s definitely cyanide, a tracking device, or similar foreign object in all types of prescription medication, according to my sister.

Recognizing and Managing Brain Disorder Symptoms

I’m not a mental health professional, but I have seen firsthand how many types of mental health conditions can dramatically affect one’s day-to-day life. For starters, my father has bipolar disorder and self-medicates using cannabis — A resident of Nevada, where recreational marijuana was legalized in July 2017, he claims to have found the perfect blend of THC and CBD to eliminate his manic periods.

Mental illness must run in the family, because I live with generalized anxiety disorder. And finding a treatment that successfully manages my symptoms has been a long-winded battle.

For me, a blend of traditional pharmaceuticals and old-fashioned cognitive therapy did the trick.

I sometimes wonder if alternative therapy might be the solution for my sister. More research into alternative forms of symptom control is needed in order to develop an effective treatment plan for those with schizophrenia who are wary of pharmaceuticals, like my sister.

Conclusion

When diagnosing schizophrenia, one of the tasks of the healthcare professional is to eliminate potential other causes, including substance use. In my sister’s case, it’s where mental health providers dropped the ball. According to the caregivers who treated her following her disappearance, my sister’s delusions, paranoia, and psychotic episodes were nothing more than symptoms of her semi-regular drug use.

I believe that she was severely misdiagnosed, and it is my hope that other families don’t have to deal with a misdiagnosis of their loved one.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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Author Bio: Leah D. Nelson writes about music, sustainability, and traveling, and her work has been featured on Flypaper, Backroad Planet, and Mobility Lab. The parent of a creative and dorky teenager, Leah lives, works, and rides her bike in Boise, Idaho. You can read about her adventures on Twitter: @PrincessLeahD23

Photo by Ramdan Authentic on Unsplash

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