Q. My son has social withdrawal and isolation. Yet, he refuses treatment. Please help.
Hello doctor,
The problem started in 2010. Social withdrawal, isolation, inability to continue at a job, negative talk, jealousy, lack of initiative, low self-esteem and fickle minded behavior. What could these point to? The prescriptions are lost in transit. No medicines are being taken.
Hello,
Welcome to icliniq.com.
I can understand your concern. The symptoms of withdrawal from society, loneliness, difficulty in continuing the job, negative thoughts, lack of motivation, indecisiveness, etc. could be due to some severe underlying mood disturbance. Since the symptoms are persistent and are resulting in impairment they should be evaluated properly. It could be either depressive disorder or bipolar depression. Depressive disorders or bipolar depression can be treated properly with medicines. Most of the newer medicines are safe to use and have no serious side effects. These medicines have great efficacy. So, taking proper treatment would solve your issue. Please describe your symptoms in detail, right from the beginning of the illness: How did the symptoms start? What were your initial symptoms? What were the aggravating factors? Did you consult a doctor for initial symptoms? If yes, what were the medications? Did you take treatment or discontinued it? Why do you not want to consult a doctor now? Thanks. Take care.
Hello doctor,
Thanks for replying. I was asking for my son. Let me explain. My son disliked to study, and he loved to play football. But, my wife and I forced him to study. After passing his high school exams, he denied to take up any further education. He became aggressive and threw things around. He used foul language, argued a lot and masturbated excessively. We consulted some psychiatrists from time to time. They prescribed some medicines. But, he never took the pills regularly. He joined work once, five years ago but did not continue it. A psychiatrist we consulted, took images of his brain and said that there was nothing wrong there, and prescribed him two medicines. I do not recall the names. Now the condition has deteriorated. He only keeps to his room. He refuses to go to the doctor. I am a pensioner. I cannot bear such expenses. Please suggest what can be done about this.
Hello,
Welcome back to icliniq.com.
The symptoms you have mentioned, clearly point towards bipolar disorder. Most probably, he developed the first symptoms when he refused to study further and became aggressive. He had hypersexuality, violent behavior was abusive and these are clearly symptoms of bipolar disorder with mania. His symptoms persisted despite the use of medicines. Regarding the psychopathology and course of bipolar disorder, it runs in episodes of mania with or without depression. The treatment should be continued for long periods of time. With proper treatment and good compliance, patients can function normally. Mood stabilizers like Valproic acid in a dose of 750 to 1000 mg should help control these symptoms. Antipsychotics like Olanzapine or Risperidone should also be added to his prescription. Olanzapine in a dose of 10 to 20 mg per day in the evening hours will aid him in sleeping well, and also stabilize his mood. If he takes these medicines regularly, he will definitely recover. Take care.
Thank you doctor,
Just to update you, my wife seems to remember the names of the two medicines our son took. They are Oxetol 300 and Nexito plus. Should he stick to the same? Please advice.
Hello,
Welcome back to icliniq.com.
Oxetol (Oxcarbazepine) is a mood stabilizer. The drug is started at a dose of 300 mg per day and can be increased to 600 to 900 mg per day. This should help in the stabilization of the mood. Since my provisional diagnosis is bipolar disorder, giving Nexito or Escitalopram, might increase the risk of a manic switch and could worsen his symptoms. In place of this drug, a low dose of Olanzapine like 5 to 10 g, can be used for some time. If he fails to respond to these drugs then mood stabilizers like Sodium valproate in a dose of 750 to1000 mg can be used. This will help in controlling his mood swings. So yes, Oxetol can be started again with 150 mg twice a day and after about two weeks the dose can be increased to 300 mg twice a day. This will help in mood stabilization.
Hi doctor,
I propose my son to take medicine as you advised last time Oxitol 150 twice a day for two weeks and then 300 in twice a day and Olanzapine 5 mg to 10 mg. But he disagrees to take twice, and he takes only once at night. Can I give at night alone? Oxitol XR 450 first and than XR 600 and Olanzapine 5 mg and increased to 10 mg unless it is tough to feed medicine in time. Please advise.
Hello,
Welcome back to icliniq.com.
Yes, you can give him Oxetol 300 than 450 and then it can be increased to 450. No need to worry. You can give him Olanzapine 10 mg after dinner. It is common in bipolar disorder patients to show such type of behavior. Do not feel bad about that. Thank you.
Hi doctor,
After talking with you, I visited a psychiatrist because my son agreed to go to a doctor. I showed a print of your advice and doctor talked to my son, prescribed Arpizol 10 mg further in the next month Arpizol 5 mg.
Hello,
Welcome back to icliniq.com.
Arpizole or Aripiprazole also a good drug used for stabilization of mood. The drug is free of metabolic side effects like weight gain, increase in blood sugar levels, etc. So, it is a safe drug. If he is stable on 5 mg dose then that is good otherwise the dose should be increased again to 10 mg. Try to reassure him that the drug is a very safe and even on high doses the drug will not cause any severe side effects. The drug is a good drug for bipolar disorder. Thank you.
Was this answer helpful?
|Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
Related Questions:
My son has social withdrawal and isolation. Yet, he refuses treatment. Please help.
.. understand your concern. The symptoms of withdrawal from society, loneliness, difficulty in continuing the job, negative thoughts, lack of motivation, indecisiveness, etc could be due to some severe underlying mood disturbance. Read full
How to overcome the feeling of hopelessness?Depressive disorder or depression is a neurochemical disorder ... You should be able to distinguish between mental disease and mental disorder ... Read full
Is there a permanent solution for repeated depressive episodes?It means it is a recurrent depressive disorder ... Read full
Also Read Answers From:
Comprehensive Medical Second Opinion.Submit your Case
iCliniq's FREE Newsletters
Expert-backed health and wellness information, delivered to your email.
Thank you for subscribing to our Newsletters!
Also Read
PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions. Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this. Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades. Read more»
Ask your health query to a doctor online?
Ask a Psychiatrist Now* guaranteed answer within 4 hours.