Does this sound like schizophrenia?

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I have a teenage son who has had a lot of anxiety and OCD symptoms since he becamea teenager, and he also has an Asperger's diagnosis. But he has some behaviors which are worrying me a lot and which sound like he may be schizophrenic. First, he iwon't do any homework anymore. Just because I did his homework a couple of times he now expects me to do it all the time. Instead of engaging in a converation or even an argument about this, he just screams loudly and hits the wall. He also usually insists on following ritual routines every day and night. Once he does something a certain way, it becomes a routine. For example, he has a hand-washing routine that involves cupping his hands in a certain way that the water sprays all over the floor. This happens every single time. He also has elaborate bathroom (pooping and wiping) "rituals" involving making me wipe him over and over again until it feels a certain way. Any attempt to change or modify these behaviors is met with tantrums and fist through the wall. Nobody else can wipe him. He also does very little besides the computer games, and never wants to go anywhere anymore.

Second he has what seems like very dependent behaviors, which he never used to have. Like he will ask me, his mom, to get him some tissue when its only a few feet away' he will insist that I stay around the house when he is home. He seems to be becoming more dependent. Finally, he uses paper napkins and rolls of toilet paper a lot to stim. I think its stimming. He pulls off a long piece of toilet paper, rulls it up, and then wipes his arm. He does this absent-mindedly while playing video games. When he talks to his friends on the multiplayer games he likes (especially WoW) he seems like a much older, more mature, more intelligent person. When he talks to me he acts like someone much younger and almost mentally ret*d. (he is 15).

When he goes to his classes, he just sits there and stares at some random spot in the room,even if the teacher is talking directly to him. There is only one teacher who can engage him. He walks around like a zombie. When I question him, he gets angry really fast, and says things like "why are you bothering me?" or "leave me alone!!" Then he gets online and plays video games and seems to transform into a different person almost.

He is taking Celexa for anxiety and OCD (40 mg) but it hasn't helped at all; we have a psychiatrist that he saw a couple of months ago, but we focused on the OCD stuff before, as I had hoped that the meds would help him. But they aren't Could these symptoms be schizoprenia?

It doesn't sound like schizophrenia to me and he's a bit young for the onset, tbh.

It does sound very distressing, though.

schizophrenia has delusions or hallucinations. i don't see any desciption of those here, so i'd say, "no." would speak to doc about it, though.

No, that is definitely not schizophrenia. It sounds like emotionally and developmentally regressive behaviors. I'd talk to a doctor, particularly about how to handle the unusual sounding bathroom rituals.

I'd roll with the positives and try and matter-of-factly make forays and add other positives.

Maybe also roll with that one teacher that can reach him and if they can recommend tutors (?).

I had precursors of OCD at different times throughout my childhood. When I was 16 and a half, it hit me hard. Our house had just gotten flooded, my parents was arguing, my Dad was becoming more of a bully including being physically threatening and physically abusive to my Mom. My Mom wasn't protecting herself. My Mom was investing so much into my applying for AFS, doing well on a trig test, etc. I rebelled. I kind of started a school protest I didn't know how to stop.

I became very worried about herpes which the other young people at my high school didn't seem to know about at all (this was back in 1979). I hadn't been successful in developing beginning friendship to dating behavior, and now I had this obstacle to worry about.

I became very concerned about the things like chemical cleaners and strong chemical smells. Yes, this stuff is unhealthy to breath on a regular basis, but short term, probably not an issue. And, the previous school year, there had been a carbon monoxide poisoning incident at my high school which the school had handled in an inauthentic manner. So, there is some rational basis like there usually is. And the feeling that people don't take things sufficiently seriously enough, that's a big one.

Yes, I had a ritualist way of washing my hands. Very big on making sure all soap was rinsed off. Had to specifically let water flow over each crease between my fingers (feel silly saying this now).

Avoided touching things because I didn't want to have to go through the whole production of washing my hands yet again.

Some things felt safe and felt that I could touch them without having to wash my hands again.

And very much is a sense of the ritual feeling complete.

Banged my head playing a stunt at the scout house. That one I probably should have gone to the doctor right away. Instead I worried about it three on four days and then went to the doctor.

Got rubbing alcohol on my eye when putting alcohol on a pimple. This one, in retrospect, was nickels and dimes but I worried about it intensively. I rinsed my eye, but then the back of the bottle said, rinse for 15 minutes, which I hadn't done (and realistically is way overboard). So I rinsed my eye some more. Worried that I wasn't being careful enough not to bump or brush my eye against the faucet.

So, you see how a sense of responsibility is a big, big part of it.

The sense that other people aren't being responsible enough. That I need to be.

That other people aren't following the rules that they themselves made. And that I need to.

Eventually, I would take hour-long showers having to use a freshly-bought new bar of soap and a freshly bought new comb.

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Okay, so what helped. Studying a little zen. Accepting that imperfections actually add texture to life. Trying to be a low-key leader. Learning useful health things that I can tell others without overdoing.

Accepting that different is just different. That it's about engagement, not conformity.

I would sometimes feel so socially disconnected (and poorly groomed and excluded), that I would just zombie out and stare out.

You might be interested in this post. Konner arguing (from 1987!) that schizophrenia more heavily diagnosed in U.S. and bipolar more in UK.
schizophrenia or bipolar? (Melvin Konner, 1987)
http://www.wrongplanet.net/postt177714.html

Sounds very familiar. The bathroom rituals seemed to start at the same time that my son became interested in sex, and back wehn he was still in middle school, he would constantly talk about the "gross" behavior of some kids at lunchtime--e.g., making sexual advancesto each other, showing off buttocks, etc. He watches Youtube and is probably masturbating when I don't notice. He spends a lot of time changing his clothes too, if he thinks they are "dirty". When I ask him why he took off a shirt, he'll sometimes get angry and say something like "it brushed up against my balls". He seems to have associated his body with "dirty" and sex with "dirty." We are not religious and don't say things like that. So where did it come from?

@Pekkla

It sounds like his autistic behaviors have regressed somewhat, but his OCD is completely out of control. His serotonin is probably almost nonexistent, and he's now learned dysfunctional behaviors. You probably won't be able to take care of all that at a doctor or therapist's office visit. I suggest that you look into a 1 or 2 month inpatient treatment program to get his meds straight and get intensive therapy. Unlike an office visit he would have to address the bathroom rituals that way. If this drags on into adulthood you will probably lose all say in his treatment.

there is a good study about a study regarding citalopram/celexa for people with autism spectrum disorders, funded by the National Institute of Health:

Citalopram No Better Than Placebo Treatment for Children with Autism Spectrum Disorders
http://www.nih.gov/news/health/jun2009/nimh-01.htm

don't know if it applies, but it is definitely a worthwhile read.

Let me respectfully disagree with John who I often agree with. I do not think his OCD is completely out of control. Plenty of people accomplish all kinds of things with OCD. It is more the absence of positives.

Okay, when he talks with people about WoW, it sounds like he's treated as a valued person and is a member of a community. That's a positive thing. If he could have two other positive things going on for a total of three, he'd feel a lot better about himself, the world, his place in the world, some of these problems might solve themselves or he could address them from a position of confidence.

A medical student once explained phobias with big dog, little dog, medium dog. Two mistakes you want to avoid. One is putting your face right in front of big dog as some kind of demonstration of "will power" and to solve it once and for all. That usually doesn't work and in a way, the person's just making it a bigger deal. Nor does a person want to obsesively avoid all small dogs in order to avoid the fear (that second order thing), that usually doesn't work either. Instead, more the attitude, okay, here's this medium size dog, maybe I'll try and pet him, maybe I won't it, and either way is perfectly okay. That kind of loosey-goosey approach is a better way of coming down the hill of these fears.

When I was a teenager I had boy scouts and to a lesser extent judo. Looking back on it, I was very lucky in that I lived right next to a school boundary and most of the other boys in my boy scout troop went to the other school. And thus, all my eggs were not in the same social basket. And so, if things weren't going well in school, things might be going good in boy scouts, and vice versa.

I like the idea a lot of three positives in my life at the same time. And if that's not always possible, maybe two.

With sex . . . okay, the idea that sex is dirty is very widespread even in families that aren't raised that way. Plus, I remember that guys talked about girls in disrespectful ways, almost borderline date rape much of the time. And movies, regular Hollywood movies often try and push an edge, or it's a certain frission, or it's just poor screenwriting and the sex showed is borderline consent nonconsent. And a teenager may have a feeling, this just ain't likely to work out. And maybe just the fact that you're likely to be blamed, and nothing wrong with worrying about that. And plus, this is not the way people should be treated. But, this is the way the other guys sure seem to be talking.

I've even asked myself, okay, so what books might I recommend. Well, I enjoyed Irwin Shaw's Bread Upon the Waters in my mid 20s, but that's probably too mature for your son. And it's really more a book about life and only occasionally about sex. But asking myself, what book depicts both pro-sex and pro-respect. And that's pretty hard to find. As his mother, it makes it doubly difficult, in that you can't really preach at him. Maybe the most you can do is leave a book around the house and hope that he picks it up. Or, maybe an uncle who could talk to him in a respectful way?

I think with other positives he can figure out a lot of this on his own.

Last edited by AardvarkGoodSwimmer on 15 Nov 2011, 11:12 pm, edited 1 time in total.

Okay, I hear you saying he's been having anxiety and OCD symptoms since he became a teenager. So, at least two years. But maybe outside chance of frequent strep infections, or a relatively recent one making it worse? (and all the following is controversial.)

You may want to look at PANDAS, which stands for Pediatric etc etc Associated Strep.

It's rapid-onset OCD, possibly from the body's own antibodies to strep attacking part of the brain. Or, not. It is controversial.

Even one the early studies, 50% of rapid onset cases were suspected PANDAS and 50% were something else.

The doctors on the skeptical side are basically saying, look, strep is common enough in childhood that you are going to get all kinds of false correlations anyway.

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Another topic, plain old OCD . . .

Okay, as I understand it, an SSRI like Prozac for treating depression might work great for some people and not for others. It's just that the biochem of the human brain is complex and tends to be different for different individuals.
Treating depression can be hit or miss (2009 article)
http://www.wrongplanet.net/postt163505.html

and OCD, too ? ? ?

As I take it, the game plan is to be willing to try, say, seven medications for a month each (less if the side effects are unacceptable). And hopefully, one will hit. If not, try another seven (and there are a bunch!). This is for depression. I have no idea whether this is also for OCD. And sometimes it's also important to come down from the medication in stages even if it doesn't seem to be working.

Also, I have not had good luck with so-called mental health professionals, not at all. Other people have. An equally valid option is to see a family practitioner or internist who can just as well prescribe an SSRI (or a newer SNRI or one that boosts dopamine, etc.)

I hate Citalopram I'm glad I don't take it anymore

Doesn't sound like schizophrenia. Other than your son's strange bathroom related OCD my brother acts exactly the same especially towards video games.

Maybe the meds are having a negative affect on him. It's emotionally harder for boys when they go into puberty too. Personally though I'd be more worried about the meds.