What to do with 19 year old son? Help!

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I am the proud parent of an (as yet undiagnosed) Aspie son, but I am baffled as to what to do now.

He has severe anxiety and paranoia and is unwilling/unable to leave the house. He will not even venture into the back yard as we have a two story house behind us and he imagines the people who live there can see him. He cannot go to school, cannot get a job, and refuses to see a doctor for a diagnosis and treatment. At this point I imagine depression is getting the best of him.

How do I get this young man to at least see someone for a diagnosis?

bring the people to him, atleast thats what happened with me. Just invite them to your home, even if he says he doesnt want to. Its clear help is needed. It really depends on who the person is though. If its someone specialized in autism that has a lot of experience its great. BUT if you send in a person whom is inexperienced its likely going to backfire. You dont want someone asking the wrong type of questions that only cause more stress and annoyance for him.

Its weird but i was able to tell my family to F off, but still had some respectful attitude towards strangers even though i wanted to tell them the same. I listened to what they had to say even though i didnt want to at first.

I hadn't thought of bringing someone in!

That "might" work. I say might in quotes because my fear is that he will go off the deep end if we go behind his back like that. If we tell him he needs help, he says no ... he really believes he's OK just sitting in his room all day without outside interaction. Then again, he's also mentioned that he is just waiting to die ...

Crap! This is so hard on us, I can't imagine how hard it is on him!

maybe you can ease him in, search the internet for some tests for him to do, so he can find out for himself that he is different from others (there are some tests linked here at WP; in the 'general autism discussion' page under the sticky 'set of scientific tests').
also; you might want to introduce him to wrong planet, so he can find out for himself that he is not weird in any way, and how his life could be.

Bringing the people into your home sounds like a great suggestion.

He has already self-diagnosed and knows he has AS, he just hasn't been 'professionally' evaluated yet. He also knows he's paranoid and has some OCD issues.

And he knows about Wrong Planet ... probably even knows about this post and is now in his room, festering .
Yup, it's me, kid! Say hi to yer Momma!

I will look into having someone come in.

Thanks for the advice!

If you can manage it, I'd recommend finding a psychologist that you can see to give you some insight and advice on how to proceed. I know all too well, from having a boy who experienced severe social anxiety (that we've since learned is secondary to Asperger's), how important it is for parents to get professional support.

I read your message yesterday, and really don't have a lot of personal advice. Just want you to know that my heart goes out to you -- a lot of us have been where you are now!

You have to walk a fine line at the moment between pushing your adult child to the edge of his comfort zone and totally overwhelming him.

Please let us know how you and your son continues to do!

Paranoia is not a symptom of AS and having a schizophrenia spectrum disorder (a common cause of paranoia) excludes a diagnosis of AS in the US...that's not to say one couldn't have AS and schizophrenia for any biological reasons, it's just that some forms of schizophrenia spectrum disorders can mimic AS.

Anyway, your son needs professional help. Anyone presenting with paranoia needs a complete evaluation by a psychiatrist and a medical workup as well, as there are medical conditions that can cause psychosis.

If he does have schizophrenia, it's important to treat the disorder early.

Have you asked him what he wants?

Have you asked him how he feels? And what would make him happy?

Seems to me, that there might be something on his mind.

WHATEVER YOU DO DO NOT BRING SOMEONE INTO YOUR HOME WITHOUT HIS CONSENT. I cannot emphasize that enough. I would think it would be extremely likely that he would go off the deep end, lose all trust and confidence in you, and become considerably worse in terms of anxiety and depression. By the sounds of it he might even kill himself.

I think the best thing would be to encourage him to make contact with other people on forums such as this, so that he can see other people who are like him wanting other things for themselves. I don't know what qualifications he has, but maybe some Open University qualifications might give him the confidence and spark some interest in going to a campus university. If he gets to the point where he really wants to go because he is interested in the subject, he might be willing to look at strategies to help him achieve that.

If he has some confidence from achieving academically, it may also mean he is able to engage with/accept help without it damaging his limited self esteem further, because it can be framed positively in terms of helping him to build on his (real) achievements, and the help would only be with the more minor parts of going to uni.

I agree that bringing someone in the home at this stage would be a phenominal disaster because he would become paranoid of you and scared sh@tless of who is going to walk through that door.
He needs professional help with a facility that is very gentle. He needs crisis intervention and maybie hospitalization cause he IS suicidal and most boys dont give a warning or much of one if they are really going to kill themselves...so that little statement, "I am just waiting to die" should be a red flag for you. He needs help beyond what you can give...he needs professional help. I cant tell you if he has autism or a schizoid disorder...but I can tell you this, You cant fix this yourself...you are going to need to see the pros.

I think it might be a good idea to take a step back here before we all recommend drastic things like hospitalization and medication.

To sciencegirl:

When you say he is paranoid, what do you mean by this? Is he delusional and irrational in his fears? For example, does he think that his neighbors and waiting in their houses with sniper rifles, and are waiting to pick him off if he goes outside? If this is the case, then you do indeed have 'paranoia' as defined by medical terms, and that is something that needs to be addressed.

However, people often times used the term paranoia to describe somebody who is merely overly self conscious, shy, and dealing with social phobia. For example, he might be afraid that his neighbors will stare at him, thus making him self conscious, and triggering problems with anxiety. He might be afraid that his neighbors will try to interact with him, and he is afraid of social interaction.

It might just be that he doesn't like dealing with other people, and prefers to stay inside. I live in a 60 person apartment complex, and I don't know any of my neighbors at all. At most, I nod at them in the parking lot, but I don't know their names, or anything about them. Our apartment complex has a nice outdoors picnic area, but I never go out there because I have no reason to, and I don't feel comfortable being clearly visible from everybody's balcony. So I would be very similar to your son. I don't go out much, and I don't see much of a reason to. If I didn't have to leave for school and shopping, I would gladly stay in my apartment for months at a time. In fact, I have done that. Once when I had a long break, I just did a bunch of shopping, and then stayed inside for 3 weeks strait, only leaving for 1 minute a day to get the mail.

But I wouldn't say that I am in need of therapy, nor would I say that I should be committed to a hospital. I don't think I am in need of drugs either. I just prefer my solitude, and don't see the reason to go outside, or interact with people unless I have need to do so. If this person's son is in the same position, then I don't think advice about hospitalizing or drugging him as being warranted.

As far as dealing with depression, and anxiety, I do have some advice:

1. Don't try to force the problem with anxiety. You can encourage your son to deal with the problems, give him some help, and encourage him to take it in slow, reasonable sized challenges, but adopting an attitude of 'O, just get over it and go get a job' isn't going to help. Getting out of a deep rut takes time, patience, and effort. You and your son will need all three. But trying to skip the time and patience portion and just force it under the idea of 'he just needs to try harder' is likely going to backfire. I recommend working slowly. It may take a while, but it is better then working backwards.

2. If your son is 'just waiting to die' then it is clear that he sees no purpose or goals to his life. He has given up on achieving anything of importance, and doesn't see much to look forward to. You need to help him realize how much life has to offer, and talk with him about what he can do to make his life better. Again, this isn't just a simple matter of saying, 'get a job'. For example, how about getting your child his own place? Is he ready to live independently? How likely is he to get a job? What skills does he need to get a job, i.e. what is holding him back? Is there a career he would have skills in? Is his problem simply social phobia, or is he dealing with executive dysfunction as well? Basically, the idea is to determine what the problem is, and then put a plan into place to make progress. It may take some time to make progress, but if you can lay out a road map to a meaningful, fulfilling, life then you'll get much better results.

3. Encourage your son to take small steps. Similar to point #1, but be proactive about making progress a bit at a time. For example, take time to make a quick 10 minute trip to the store to buy something he needs. Perhaps encourage him to join in small social outings, such as attending a local LAN party, or going out to play D+D, or some other small group, friendly, social events.

4. Don't be afraid of medication, but do use it wisely. If your child is indeed struggling with depression, then some medication may help him to break out of a rut. But don't just grab some pills and consider it done. Medication should always be used as PART of a comprehensive approach to dealing with the situation. And it should always be used carefully with full knowledge of the dangers and awareness of what to be careful for.

5. I would encourage you and your son to read some of the works written by people on this forum. Many of us have dealt with hard times in our life and learned useful lessons that are worth reading about. Callista has a wonderful blog over at http://chaoticidealism.livejournal.com/
It talks about all sorts of problems with things like college, living independently, organizing, etc. There are many useful lessons to learn there and if your son is sitting at home then he has plenty of time to read.

I would also recommend reading my own book, available at: ASDstuff.com
It is written primarily for parents with newly diagnosed children (usually ages 5-15ish), so it isn't targeted towards your situation specifically. But it does contain a fair bit of my hard earned knowledge and experience that I believe anybody would benefit from, regardless of age.

And of course there are many posts on this forum that let your son know that he isn't alone in his difficulty. Even if there isn't useful advice offered, having somebody who understands your situation can go a long way towards helping. So, I encourage you, and your son, to read about the forum, ask for help where you need it, and participate in some of the posts.

Beyond that, best of luck to you, and please come by and post again.

Hi ScienceGirl - stepping in a bit late. I have a 19 year old who is diagnosed with autism who behaves very similarly to your son. He quit school just a few weeks before the end of his final year and will not leave the house, rarely showers or gets dressed and doesn't see any problem with that. He has the same sort of social anxiety, and when your son says that the people over the fence might see him, that doesn't mean he's psychotic or paranoid. For him, it's a real issue, he doesn't want people looking at him for some reason of his own which we may never understand. All these things lead me to consider that your son is feeling acutely out of control of things in his life, and one thing i found very useful with my son was to ask his permission for everything i did on his behalf or for him. He wouldn't eat with us for a while, so i made light of this, and asked did he want me to put food aside for him or if he'd get what he felt like later. It sounds so simple, but it means a lot when your world is spinning out of control. I did have successes in getting him to change clothes on occasion by asking him if he wanted anything washed because i was putting in a load. Occasionally things like that worked. Most often, they didn't. Even giving him small jobs to do on occasion helped too. He fixed all the holders for our fan remote controls on the door frames using a portable electric screwdriver and felt pleased with himself for doing a job that needed doing, but was also something that he liked to do. At his father's house, he declared one day that he was no longer going to help around the house (washing up, getting the washing off the clothes line, etc) because he was different from other people and he shouldn't have to do things other family members do. It's incredibly difficult when they are adults to get help for them. My GP and I spent many weeks finding resources for young adults on the autism spectrum, and they're mostly nonexistent, especially when it comes to high functioning verbal young people who fall between the cracks in the system all over the place. My son makes some bad decisions and choices from time to time, like deciding not to register to vote when he turned 18, because he doesn't believe in our political system. In my country, voting is compulsory. I explained this to him, and I told him that the possible consequences were that he could be fined, and ineviteably, if he was fined and didn't pay the fine, he could go to gaol for unpaid fines. He decided that it was worth the risk, and I had to accept his decision, even though I did try very hard to explain to him what the consequences of his actions would be. While he's very depressed, he has the most interesting views I've ever come across about how the world works and we as people fit into that world, and what would make this a better world. I've encouraged him to finish highschool and go to university, so that one day he could publish his ideas, and perhaps other people would agree with him, or debate with him, and give him the opportunity to more finely tune his thoughts and theories about society. The only thing I can encourage you to do is to make sure you're really listening to him. This isn't an easy thing, but you'll lose nothing if he really believes that you "get" him, and accept him as an adult. I would always repeat back the things my son said to me in my own words, giving him the opportunity to correct me if I got it wrong, and we'd keep at this until I really understood what he was telling me. Sometimes this gets scary, especially when he would convey very negative thoughts about life in general. Sometimes I questioned myself - if I really don't want the answer, then I'd better not ask the question. My own fear was less important than really trying to understand my young adult son, though, so I did the work on myself to be able to deal with whatever he threw at me.

One thing that I learned in working with disabled people is it sometimes helps to offer options only in the acceptable category and to be really target based in what you're offering as choices. "John, would you like to come shopping tomorrow for some new jeans for you, or would you like me to take you out to practice archery?" My goal was to get him out of the house for the afternoon, so both of these options was acceptable to me. He still gets choices, but I have more bargaining power - I can say "Oh, you don't want to go tomorrow, well how about Tuesday at 10 then?" which kind of locks him in to agreeing to something which will get him out of the house. If I said "John, what do you want to do tomorrow, you spend far too much time indoors" that's threatening to him and will lock him down. I don't know if this will help you with your son, but it worked to a limited degree with my son. You might also look up the positive aspects of the spectrum and focus on the good things about it. Our boys are creative and think outside the square, and that's a wonderful unique thing in a world filled with far too many clones! That's just a start. My son has marvellous pedantic language, and a great sense of humour, and when he makes us laugh and he laughs too, my heart sings. Try to stay positive and focus on the good things.. it's easy to get bogged down in all the hard tough stuff we have to deal with.

I am in the same situation, except it is my nephew, he moved in with me a year ago, and just wants to hide in his room, play computer games and pretend nothing is wrong.

You know, I'm getting comfort just from other people having the same experience as I am. It's sort of normalising for me, and I feel less like I need to push and more that I need to give him some space and time and hope he finds his own way out. A lot of my friends say things to me like "he needs a good kick up the butt!" and "I wouldn't put up with that, I'd show him the door", and neither of these 2 approaches are at all helpfull. The outside world seems to think that we should boss our kids out of their idleness, but how exactly are we supposed to do this? I can't think of anything I can use as a stick or a carrot at this point. I won't give ultimatums to him, because that very well might backfire on me, and then what? At least while he's still at home, we can keep an eye on him. If he leaves, where would he go and who would put up with his behaviour? I guess this is how young people with a disability end up as 'street kids'. Parents and carers who don't get the support they need reaching the end of their tether and showing them the door. I can't do that. Even my partner doesn't understand, no matter how much I've tried to explain, he sees my son as a lazy user with his hand out all the time who's not willing to participate in anything. "He needs a bomb under him". It's a very difficult situation we're in! Don't give up on them, okay?