Help! 18 yo son suddenly paralyzed w/ocd

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Hi - I'm new. My son was diag w/aspergers and non-verbal learning disorder at 9 y.o. He's been given extra time to do his homework and tests as his IEP for years. He wasn't particularly interested in people, esp. kids his own age, but conversed well when spoken to. He did homework for 7 hours every night - but pulled really good grades. And his teachers love(d) him. That was it - he was fine. Quirky, but fine.
Four months ago the s**t hit the fan - hard. He shut down. At first, we'd just catch him staring into space, or sitting with his eyes closed. He mentioned thinking about 'doing marijuana'. I later found out this was his original "bad thought".... he's an incredibly sheltered kid - wouldn't know where to find pot if someone put a gun to his head. His other bad thought was cheating at school. Couldn't figure this out to save my life. But the paralysis got worse daily. When it was time to go back to school after christmas break, he finally told me what was going on. He was OCD - in the extreme. Voices telling him to do bad things - hurting himself, hurting others. Compulsions that now include weird vocalizing, rocking, counting, counting, counting. He's talking to himself - out loud. Stands in the middle of wherever he's trying to get to and just covers his eyes. My daughter saw him at school - crouched down - staring at a piece of gum on the ground - who knows how long? He rubs his eyes so much they're bruised, his eyebrows are nearly worn off, his fingernails are non-existent - painful to look at. In fact, just watching him struggle is killing me. Can someone tell me what the hell happened? He's supposed to graduate high school in June - I have his grades transferred to his resource teacher and he's technically on independent study. I can find NO ONE to treat him. County Mental Health md put him on lexapro - which seemed to help for about 2 weeks - but now we're back to square one - if not worse. His Bio-mom ( egg-donor, p.o.s. husband's 1st wife ) was/is bi-polar and who knows what else. I can get no diagnosis, the MD is kind of backing out of this bec. he's unfamiliar with AS. I'm in Northern California - between Sacramento and SF - is there ANYONE anybody can recommend? Neurologist? Psychiatrist? BTW - Pediatricians won't see him now, bec he's 18. Any thoughts, suggestions, personal experience, miracles would be most appreciated!

-has he suffered any phyiscal trauma? I mean a head injury. In addition to having Aspergers I've had several concussions of various degrees of severity. In such cases I reverted to a very bizzare state, laughing at nothing, and really freaking out. At them same time I didn't really notice it. other people DID.
-Remember with many non-verbal people you're looking at a very high pain tolerance so he may have hit his head and never mentioned it at all. Check the skull under the hair for any brusies or bumbs.
-Also the bit about voices is odd, isn't 18 very young for auditory hallucinations? ie on the (I can't sepll the word you know.) Are you're sure they are 'vocies' or simply his way of expressing scary ideas.
-Sadly that is the only thing I can think of that could explain sudden odd behavior.

This doesn't sound like OCD, it sounds more like schizophrenia.

There are medications he can take to suppress the voices - he needs them taken away to give himself mental breaks.

If necessary, see a different doctor.

BEFORE he starts believing in the voices.

Schizophrenia is nothing like what is described in the movies - and it's really quite common and treatable.

No head trauma, I'm quite sure - just asked him. It's funny you mention a high tolerance for pain - NOT this kid - he is by far and away the worlds BIGGEST hypochondriac!
And, he's pretty convinced that the voices aren't his own, although his explanation of this is that the voices must belong to someone else because he's not a bad person and doesn't want to do any of the things the voice suggest.

And gbollard - wow - schizophrenia - very scary. I thought the whole OCD thing was "obsessive thoughts" tollerated by performing "compulsive behaviors".

I read somewhere in the posts here that AS people tend to react differently to prescription meds. Any thoughts on this? It would certainly explain the lack of help from the Lexapro. He's up to 20 mg/day - no help.

I'm not very familiar with Lexapro but with most meds, there's a dose and a period.

You take the dose and if you don't notice any change within a certain timeframe you either increase the dose or change the medication. You might increase the medication once, probably not twice without ANY noticeable effect

If it doesn't have the desired effect at a higher dose - discontinue.


---> Update : Just looked up Lexapro - It's actually Escitalopram - an antidepressant approved for the treatment of major depressive disorder and generalized anxiety disorder. Does this really seem like the right drug for his condition? It doesn't sound like it to me.



Schizophrenia - I was conscious of scaring you and was a little reluctant to suggest it. I have two friends with Schizophrenia, both are a little confined indoors because they condition hit hard as adults before anyone recognized it for what it was.

One of these friends was my best friend at school - and I lived with his symptoms on a daily basis. They were very subtle, but I'm frustrated for not having picked them up earlier.

His medication has the Schizophrenia mostly under control but he also has chronic fatigue.

Your son sounds very similar so I'd really suggest looking for a different diagnosis.

It could also be epilepsy. Seizures can cause people to hear/see/smell things that aren't there, make weird noises, and to stare blankly out into space. Not all seizures are the screaming/shaking kind

Your best bet is to speak to a neurologist and run all the tests/cats casn/MRI/EKG etc

I agree with everyone else, it sounds like he has schizophrenia to me. I just wanted to add, that I take Lexapro. I take 40mg(max rec. dose) a day, and it is used for my depression and anxiety disorder. I would recommend finding a different Dr. that will prescribe something different. I think he needs something stronger than Lexapro. In my opinion, it is a quite mild drug. It sounds like he needs something a little stronger, and something that's commonly prescribed for schizophrenia. I wish you the best of luck.

defintiely not ocd.....i' get him to a doc asap...could also be bad reaction to meds....

I have to agree here - my daughter has absence seizures - and when she has them she is "day dreaming" but sometimes she has visions of death, dying, evil things being said to her. It took two EKG's and an MRI to find out what was going on.

A county M.D. prescribed the Lexapro? I think you might do better with a psychiatrist. Can you get a referral for a psychiatrist? They often do sliding fee scales for people with no insurance. I know its hard to find one with experience with AS. Good luck.

I agree with the other poster who suggested schizophrenia. OCD is not a psychotic mental illness. Bi-polar can also include psychosis.

Wow - thanks to all of you. Your responses remind me of all the good things I love about my son. Very thoughtfull, very generous.

I'll try to hit on some of your responses.
It WAS a county Psychiatrist who prescribed the Lexapro - Upon my announcement that Al has not only not improved, but worsened, he's pulled himself off the case. He started his practice in the 60s and feels this is just way over his head. And has no recommendations for us. Sucks. There are virtually no psychiatrists in our very rural area - and Al seems to just not fit into any other doctors criteria. Either no longer accepting patients, can't treat him 'cause he's over 18, no experience with AS, etc.

This bi polar thing rings home. Partly bec the schizophrenia is scarey. And also bec his "real" mother ( ouch, that hurts ) is bi polar. My husband says he's re-living with Alex what he went through with her. My husb tends to oversimplify things - and has relatively no other experience with any type of mental issues - but maybe he's right. Ultimately - I'll probably have to talk to her ( the ex ) and try to get some more info on her diag & treatment, if she'll co-operate. Yuck, this sucks, too.

What defines psychosis? The med nurse at the county mental health suggested anti-psychotics -but it didn't ring true to me, either.

He's now in his room, struggling to put a sock on his foot for the last 1/2 hour. "I'm fine! Really, I'm fine." is all I can get out of him. I'm at my wits end. Utterly and completely failed at helping him. We're on the verge of heading out to the emergency room.

Yes, we will certainly pull the Lexapro - it may be doing more harm than good. But, isn't it rather un-wise to simply stop? He's only been on it a little more than a month. It's supposed to reach it's effectiveness in 1-2 weeks.

Any way - sorry for the whining. Yes, I know "would you like cheese with that......"!
Thanks again.

Auditory psychosis includes hearing voices or sounds that are not there. If he's hearing voices (like entities separate from himself) that are telling him to do stuff, then that's psychosis. With OCD, a person might dwell on certain thoughts, but it's not a separate audible voice telling them to do stuff.

Since your son has been dx with AS, is there any way to get him evaluated at the MIND Institute? It's the center for autism and Californians can get referred for care and evaluation. I don't know if they can help with the mental illness end of it but perhaps they can screen for autistic issues.

You really need to be careful with pysch meds and autism. The County mental health care system in California sucks. I'm from Butte County where it's really bad.

The talk about Lexapro made me curious. I looked up the possible side effects and found this (auditory hallucination is a possible side effect)........

Psychiatric Disorders
Frequent: appetite increased, lethargy, irritability, concentration impaired. Infrequent: jitteriness, panic reaction, agitation, apathy, forgetfulness, depression aggravated, nervousness, restlessness aggravated, suicide attempt, amnesia, anxiety attack, bruxism, carbohydrate craving, confusion, depersonalization, disorientation, emotional lability, feeling unreal, tremulousness nervous, crying abnormal, depression, excitability, auditory hallucination, suicidal tendency.

You should find another doctor ASAP to sort all of this out for him.

RE: schizophrenia being scary.

Forget the Movies

"schizophrenia is not synonymous with dissociative identity disorder, previously known as multiple personality disorder or split personality; in popular culture the two are often confused."

"Schizophrenia is a psychiatric diagnosis that describes a mental illness characterized by impairments in the perception or expression of reality, most commonly manifesting as auditory hallucinations, paranoid or bizarre delusions or disorganized speech and thinking in the context of significant social or occupational dysfunction. Onset of symptoms typically occurs in young adulthood, with approximately 0.4–0.6% of the population affected. Diagnosis is based on the patient's self-reported experiences and observed behavior. No laboratory test for schizophrenia exists."

That sounds really really close to me.