Social Withdrawal

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My son will be 17 soon. He's being home-schooled this year at his request. I've posted previously that my once functioning, quirky kid now warrants an autism spectrum diagnosis (closer to PDD-NOS under old criteria). He's also been diagnosed at one time or another with Tourette's, OCD, ADHD, Depression and cyclothymia (I was told it's like baby bipolar).His behavior and self care skills have deteriorated significantly in the last year. Docs all recommend meds and therapy which he refuses (it doesn't do any good in his opinion). Doesn't want to do therapy because that's "private".

I agreed to home schooling because it had become such a huge issue to get him to school every day and the ride was very unpleasant. He had a routine of compulsions/tics that involved pounding the gearshift and my arm with the tips of his fingers - hard. This was especially painful when he didn't cut his nails. He also wasn't functioning while at school, he would come home at the end of the day having done nothing and we had to play catch up at home. He doesn't want to write, doesn't want to read, study etc. I have a tutor working with him now who is wonderful - but he literally has to walk him through everything to keep him on task. Nothing, and I mean nothing, is done independently.

I envisioned that once the pressure of a public high school was gone he would feel less stressed and resume some of the activities he had dropped out of. He used to play piano and do taekwondo. Instead, he has become more and more isolated. He will go places with the tutor a couple of times a week but if given the choice would never leave the house. He has almost no interaction with others his own age anymore. He won't go anywhere and the few people that were coming here have stopped because he's just not really that pleasant to be around. This semester we tried to get him out and involved with others. Found a great film class (one of his former passions) that he would go to 2 hours a week with other teens that are also "quirky". He went to two classes and is now refusing to go because he "home school should just be home school" and he "wants a break from the world". When I try to suggest he get together with certain friends he'll often put them down or say there's nothing to do at their house or he did go there (yeah a year and a half ago).

Is it common for those on the spectrum to withdraw from the world this way? I am more and more worried that he's displaying the very beginnings of some type of schizo disorder vs. autism. He's not having hallucinations & doesn't have delusions (other than he thinks he's better than everyone else) but he has pretty much every other symptom on the list.

Yes. Possibly not that extremely that young, but it does happen.

Arguably the most complete theory of autism is the Markram's Intense World Theory. They postulate that Aspies and other autistics experience the world more intensely than do allistics. This explains many things from shutdown and meltdown to social withdrawal, with another factor being the social rejection that just about all of us experience. Eventually, overstimulation and anxiety exceed coping strategies and the Aspie withdraws.

I would say it doesn't happen to many Aspies that young, but I wouldn't be surprised by it. It's happening increasingly to me, but I'm much older than he is.

That does not make it healthy in the long run, but overcoming it will be hard work. My suggestion would be to take him to low-stimulation environments (not the cinema).

It might also be a schizotypal disorder, but that would be no more than guesswork on my part, and might be a job for an expert.

What changed between previous functional state and current state? If nothing, then I would look into schizo spectrum disorder, as hallucinations are not required for those, but a big drop in functioning is common, and he is at the right age for onset.

The change seemed to happen last year in spring. We did some med tweaking and his anxiety levels seemed to increase. He was taking Inositol at high doses to help with OCD and I dropped it down slightly because you're not supposed to stay there long term. We were also trying to working with a psych who suggested a different med but he wouldn't try. He then decided he didn't want to take anything at all so he could just get used to the feeling and not have to take meds. Since that point he spends a good portion of his time either pacing around the house or in his room looking at youtube videos. He just always looks like he has a lot of stuff running through his head.

There was some bullying going on at school which he didn't share til the school year ended. He began refusing to get up in morning, locking himself in bathroom to avoid things he didn't want to do and completely dropped out of activities he used to like. Said he was tired and needed a break.

Psychiatrist referred us for evaluation for autism at a well respected diagnostic center. They were hesitant about the autism diagnosis at first because he seemed borderline but ended up deciding he was on the spectrum. It's very difficult to communicate with him. He either can't or won't explain why he won't do some things and he'll deny he has any issues at all if you ask him.

we have almost the same situation...our son is a few month older, but everything you wrote is just like that,almost to the details.i don´t know actually what would i say as an advice because we have the same questions plus kind of regression every now and then(like wetting his bed) and we don´t know wheather one should be angry then or take it as it comes...maybe we can stay in touch and compare things,or you can ask anything you need,and maybe we can do the same...love mamamoo

It could also be a manifestation of depression, or that he had a terrible year last year and just needs some recharging time. I do not know how to determine which of all the possibilities that it could be.

Maybe try encouraging him in special interests that he can share with you or any other household members that do not require him to socialize outside of the family unit. I know that sounds counter intuitive because he probably should acclimate to being out and about sometimes; but if he just needs a recharge that might regenerate him and the stress might drop if he does not feel pressured. If that seems to improve his general well being, you will learn something and you can wait a bit and then see if he will ease back into a slightly more social routine. If it doesn't work then you learned that that is not his main problem. I don't know how to trial and error the rest of it, or even if this is the best course of action.

I´d explain to him, that you respect his wish for his withdrawal "of the world". I have that on my own as well. If I dont have to, I dont do, its not an positive experience to me. When I am at home I am happy, when I am outside I am mostly unhappy.

But explain to him as well, that a complete withdrawal from the world is not possible. Right now he could do so, because of him still living in your place. But when living on his own, there simply is a minimum of contact with the world, that cant be avoided, because of it being necessary. There is absolutely no need to go outside without reason, to "interact with the world", when not necessary, and you as well dont want that for him. But the reason why you want him right now engaging in an acceptable minimum, to engage sometimes with peoples outside, is to give him the ability to do so, when he comes in situations later, when he has to interact with other people.

So there simply will be a minimum of social interaction necessary, later, when he is older. And out of that reason it is necessary, that he right now actually tries to go for that minimum of social interaction, to train that. Nothing more and not in an amount that was exhausting to him, because of you respecting his negative feelings about it.

Thanks for your responses. For now my plan is to step back a bit and not push social activities or classes (more for my own sanity). He gets out at least a couple of times a week with the tutor & I guess that's better than nothing.

If he is still progressing in some areas like school subjects, then I would let him take a break from the world for a few months or a year to recharge, but there is danger of him getting so comfortable with this situation that he loses motivation to do anything, and I have read on wp stories of adults in their 20s or 30s who started taking a break from the world in their teens or were allowed to withdraw as much as they wanted in childhood, and they just stay at home doing the same things all the time.

I think ultimately that's my fear. He will draw further into himself and never leave the house or be a functional person. I want him to get help before it's too late but it's such a battle when he won't discuss and doesn't want to admit anything's wrong.

He's maintaining in his school subjects but only because I have someone working with him one on one. If he has to do one single thing on his own he won't.

I still haven't given up - we'll take the path of least resistance for school right now but still exploring options for getting him help.

It does sound like depression too, not just needing to take a break from world. Is he on antidepressants?

He's not taking anything at this point. He decided he wanted to see if he could get used to the way he feels without meds so he didn't have to worry about taking them. Since he stopped taking Zoloft his compulsions are through the roof but he refuses to go back on them (or even admit they're an issue). Docs are recommending antipsychotics because he has so many symptoms (mood, depression, tics, compulsions). He also had a couple of episodes of odd behavior at higher doses of Zoloft and he bruises on Zoloft.

Maybe it's good to stop all meds and let him take some time to adjust to how he feels in his natural state, then gradually develop ways to work with his traits.