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Q. How to come out of my ego problem at office?

Answered by
Dr. Seikhoo Bishnoi
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 01, 2016 and last reviewed on: Apr 03, 2020

Hi doctor,

I am 30 years old. After completion of school and I did not join college for eight years. Then I joined a diploma course. My father consulted many psychiatrists to find out my problem. Unfortunately, I was admitted by one doctor in nursing home for around three months for treatment. I hate both the doctor and my father for punishing me by placing in this nasty place. My only fault is I do not like printed education and not sociable with people. I like loneliness and withdrawal from society. I love my desktop computer and spent time there. Now, I am giving good interviews on different company and getting jobs in many places, but cannot serve longer period. I am working there only for a short period. I cannot stay in the service. At present, another psychiatrist prescribed Oxetol XR 300 and Nexito plus one per day. I cannot understand my problem. Kindly help me to continue my job.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
#

Hi,

Welcome to icliniq.com.

After reading the history I can say that your main current issue is difficulty in continuing a job for long.

  • You perform well in interviews and get selected for jobs but not able to continue the job. I want to know what kind of difficulties you face during the job? What is the main reason that compels you to leave the job?
  • First of all find the main reason which results in change of job. Try to find the possible solutions for the problem. Once the solution is found then try to apply this for a job and you will be able to continue the job.
  • You were not able to complete the degree during college time, because of differences in opinion with your father. There is liking for loneliness and withdrawal from society. This occurred probably because of the problems during college time.
  • The medicines you are taking include mood stabilizer and antidepressant drugs. Oxetol (Oxcarbazepine) helps to stabilize mood and result in reducing anger, irritability, etc.
  • Nexito (Escitalopram) helps with depressive symptoms. In my opinion as loneliness, restlessness, difficulty to stay in job, withdrawal from society, etc., are present, so you should continue to take these medicines regularly.
  • With time the symptoms will start reducing and you will be able to lead a normal life. Avoid confrontations with anyone and this will help you a lot.

For further doubts consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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Thank you doctor,

As per your advice I shall continue the medicine, In job, I have some ego problem as if I know better than my fellows. How to come out of these situations? I cannot contribute to the family. I feel inferiority with other family members. Please help.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
#

Hello,

Welcome back to icliniq.com.

  • You have mentioned that you have problems related to ego. A lot of individuals have such issues during a job, but try to accept that doing a job in an organization is part of the system.
  • The organization can bear the loss of individual, but an individual might lose big in losing a job.
  • So, even if you are not satisfied with the opinion of others still keep one thing in mind, that your main aim should be to continue the job and to do the work. Pointing others mistake or feeling that you have high knowledge should be limited to your mind only.
  • Try to channelize the energy towards positive things. Confrontations in job result in your loss only.
  • Accept this thing and you will be able to continue the job for long. Just keep one thing in mind that you have to work for your well being.
  • Continue to take medicines and remain relaxed, everything will improve.

For further information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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Dear Doctor, after getting your last advice, my son who disagree to take any medicine took lonazape 5mg for one month . my wife tried to persuaded my son to visit a psychiatrist in a clinic in our area. Son agreed and visited in the clinic. Dr. Debashis Roy first talk with us and then listen to my son, My wife said that doctor in nimans in banglore prescribed tegritol 300 once a day and nexito plus twice a day. and Dr.said that nothing is found as per image taken of the brain . He advised to discontinue the medicine after 9 months. My son was comparatively better but frequently leaving job. after 9 months,to discontinue the medicine as per advice of nimans, we visited Dr ghose, a local psychiatrist to take advice. Dr. Ghose said after talking with my son that only 25% problem exist and advised to take oxitol 300 mg once a day. My son was better except frequently leaving his jobs after appointment in different IT firms. which our headache. Because his age is 31 years, As Dr.ghose was not in station, I online talked to you, I showed your advice in print to Dr. Roy with problem of becoming faty and increasing weight. He advise for test of lipid profile and seeing report high in lipid profile prescribed orpizol 2.5 for 7 days then 5 mg once a day for another month and then orpizol 10 mg once a day for one month, we visit to the Dr. in the last month and said that my son has lost all the interest in job searching and most of the time lying in bed lonely,gained weight. Hearing my wife and my son Dr, Roy reduced the dose to 5 mg. he is taking now orpizol 5mg once in month, we are sorry to note that day by day my son is loosing his interest in job searching, lying bed in most of time lonely, no improvement, my son is saying that he has forgotten that he learnt from institution and practice in jobs, lost partially his memory, unhappy with us for giving medicine. we are in dilemma what we should do in this situation, please advise.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

Aripiprazole is a good medicine and this can help to control the bipolar disorder symptoms and also will not cause weight gain. He is on 5 mg dose which is a very low dose.

Even if he is not showing any positive symptoms but lying down, not searching for job, lack of motivation, lack of interest in anything etc can't be ignored.

The medicines as we discussed are safe and if we do risk benefit analysis for bipolar patients then giving medicines is beneficial rather than skipping the medicines. So please talk with his doctor and ask for increase of doses. If he is not on any other medicines then dose of 10-20 mg should be given in order to control the symptoms.

Just have faith in your doctor and avoid changing the doctors. This will help in early recovery.

Thanks and Take care

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Dear Doctor, I place record of increasing weight of my son vis-a-vis medicine taken
14.9.2017 weight-75 kg medicine orpizol 10mg
10.10.2017 weight-80kg medicine orpizol 5mg
10.11.2017 weight 82kg medicine orpizol 5mg
15.12.2017 weight 85kg medicine orpizol 5mg
It appears that weight of my son is increasing with continuing taking medicine orpizal 5mg besides in lipid profile test, LDL-119, HDL-34, LDL/HLD Ratio-3.5,and triglycerides-605 which is too high. Is it a side effect of medicine orpiz0l? beta cap-40mg is prescribed one tab daily for 20 days.
At present he has no motivation, interest in job searching, solitary living in his room, always lying in bed, no self will to do any thing is found unless we take interest,
but he is telling that I (my son) cannot understand why are you bound me to take medicine. Doctor, we are confused, age of my son is 31 yrs, very crucial time, after word no service will be available. please advise what we should do stop medicine or continue medicine.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

If we consider Aripiprazole then the drug is safe and doesn't cause metabolic side effects. The drug doesn't cause increase in weight. I even prescribe the drug to those patients who have weight gain as main issue.

If his weight is increasing then that might be due to his depression or altered dietary habits. Addition of drugs like Topiramate can be kept as option.

The drug is a mood stabiliser drug causes loss of weight. So is very safe. You can talk with his doctor for that.

Thanks

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Dear Dr, I am talking about my son Arup Mitra, In my last report I reported you that my son is suffering from increasing weight step by step from 75 kg in Sept to 85 kg in Dec,2017., In January 13,2018 weight has increased to 90 kg. In the meantime, my son joined a IT company in the month of January 1st day and was doing job. Today he leaves the job, I tell him to go to office he replies I have lost memories and cannot remember the steps to complete the IT work .
I am sorry to say that after taking anti psychotic medicine, 4. things come to my notice .
1) sometimes talks like a full, 2. increasing weight,3. too much sleepy.4. cannot remember many things. As parent, we are upset, a boy of 31yrs age have join more than 20 jobs but cannot continue job, He is sober, no anger or any odd behavior but cannot continue job, In Nimans, Bangalore, Dr. advised after seeing all the prescriptions and checking the image of the brain that the boy has no problem , prescribed tegretol 300 and nexito plus for 9 months only. He was fine at that time, but to stop the medicine after nine month, we visited to a local Psychiatrist Dr. ghose, who said that my son has still 25% problem which will be removed in time , he further prescribed oxitol 300 ,In absence of Dr ghose, we visited Dr Roy to know whether medicine will be stopped or not, He further prescribed anti psychiatric medicine orpizol- 5,
I mention a expert veiw " Do not use aripiprazole if you feel you have gained weight, develop unusual movements, feel excessively sleepy so much that it interferes with your daily activities, or develop difficulty in swallowing," (quote from 1 mg website , orpizol 5) I asked Dr Roy, do you think that my son is suffering from bipolar?. He said no bipolar but have some psychotic problem, Very soon he (my son) will be cured.
we are puzzle.

At present my son is taking 1) orpizal 5mg, Rexipra 10mg and rozavel(F) 10,
Please advise.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello thanks for asking again

He is on Arpizole 5 mg and I don't think the drug is a cause of weight gain in his case. The drug is a safe drug and we even prefer to use this drug in patients who are apprehensive about weight gain. Also he is on 5 mg dose which is a low dose. At this dose such rapid weight gain is not seen.

If he has gained significant weight then that is probably due to persisting mood disturbance or some associated metabolic disturbance. If he has not been evaluated for diabetes then please get his blood sugar levels done. Also get his thyroid function tests done. Both these are known to result weight gain in mood disorder patients.

He is also on Escitalopram which is also not a cause of significant weight gain. But still you can think of reducing the dose to 5 mg again if needed.

For his significant weight gain you can think of starting Topiramate. As discussed earlier too, Topiramate is a mood stabilised too and will also result in weight loss. The drug is safe to use and has no serious side effects.

He suddenly stopped going to job and that is most likely part of his mood disturbance. Though proper evaluation is needed but he might be suffering from bipolar depression at present time. Try to motivate him again and ask him to not resign. Bargain with him for this, suggest him that he can take a break for a couple of days and if he thinks that he should not leave the job then he can join back. Try to remain balanced and gentle. He should be agree with you.

Thanks and take care

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--file attached--

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

All three attachments are same only.

This prescription also shows some drugs which are mood stabilisers. If he got response from these drugs then these can be restarted. No need to worry.

If you need more clarifications on these prescriptions please elaborate in detail?

Thanks

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Dear Doctor, I sent wrongly three prescriptions last time, I am a senior citizen of 69 years,not habituated in uploading files. I am sorry for my mistake,
I have got a prescription of 2010 of a psychiatrist which i sent for your observation.
At present our observation for my son is i) Too lazy, always lying in bed, do not go outside of room days after days. ii) talk very less with anybody iii) have no enthusiasm for work or any thing,iv) do not take bath longtime otherwise he has no anger,very sober in behavior. Now he is taking orpizal 5 .how can we bring his enthusiasm, will we give him re vital with arpizol-5 ?
yours father of arup mitra

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

I am sorry for your inconvenience. Please don’t be sorry for this. The symptoms he is showing are of bipolar depression most probably. This should be treated with addition of at least a mood stabiliser.

I can understand your concern but if he gets proper treatment in good doses then he should come out of his depression. Aripiprazole can help but 5 mg dose is very low dose. This will not help in controlling all symptoms.

You can give Revital and this should help him. No need to get worried. Lamotrigine can be added to his prescription. The drug will help to control his depressed mood and will help in stabilisation of mood. Please don’t get worried for that.

Thanks

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Dear doctor, I was silent about my son, arup mitra as because our existing local doctor Dr. Royon13/1/2018 prescribed to continue arpizol-5mg and rexipra-10mg, one tab after dinner. we continued the medicines and further visited on 13/5/2018 to Dr ROy to inform him that position of my son remain same, he always is lying on bed in his room, no interest in job or any thing.we do not find any better change. Dr said that my son is suffering from depression because he is getting no job, so,Dr Roy further prescribed Dvenniz 50 and lipicard 50 and said that my son will get energy and come out of depression.
To day morning my son came out his room and start to talk with me with anger.he said that he will not doany job and many others negative things. I remember the initial conditions of my son telling the same for which i visited to Doctor. I am a heart patient ,cannot take this pressure, what can I do for sons, I am puzzled, today I think proper diagnosis is not being done. As a result there is no improvement, If it is bipolar why arpizole has been dropped? pl advise.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello thanks for asking again

We discussed about him in past too and his symptoms are not due to unipolar depression alone. He is not having job because of depression symptoms and his mood swings and the reverse is not true. His depression is persisting and the illness itself is more responsible for that rather than having no job.

Since he got angry again and his symptoms are persisting he should be started with some mood stabiliser again. Arpizole should be started again and the dose should be in good range. 5 mg Arpizole for an adult are very very low. The dose should be in range to 10-20 mg per day. The dose of antidepressant should be increased too.

Please try to understand that his illness is the cause that his behaviour is bad with you. This can't be overlooked or justified by any means. You should accept this. If he is not ready to take medicines then medicines can be given by mixing with food.

Thanks

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Dear Doctor, My Son has got an appointment in a IT firm in Gurugram, Training class is going on from 3/10/2018. Now he is telling us that In the class, trainer is not properly behaving only with him so he proposes to leave the job, He always DOUBTS every fact and confidence level is low.
He is taking medicine from 1st July,18 as follows
1. Arpizol 10 1 tab daily
2.Dvenniz 50 and lipicard 50 1 tab daily.

AT present, there is no aggressiveness , anger etc. but doubting every work,overreacts against female, confidence level is low. An idiocy attitude is developed.
please advise so that he does not come back from job.
apurba mitra
father of arup mitra (patient).

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

This is happening because of his illness only. Suspiciousness or ideas that someone is against me are part of bipolar disorder and also in psychosis.

He is more or less stable on his medicines so there is no acute need to change medicines or alter the doses.

First of all you should try to increase his motivation level. Try to make him understand that the training period will be over in sometime and once he is regular in job then there shall be no issues. These things will be there for sometime only and are no permanent. He should focus on his job and the thing what are beneficial to him. Try to tell him these points. Ask him that he should not quit job by taking any abrupt decision.

If he doesn't agree then the dose of Arpizole can be increased to 20 mg. This will help to reduce his suspicious behaviour.

Thanks

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Dear Dr. I am very much frustrated to inform you that my son has left the job last Friday, 12/10/2018, inspite of all efforts from our end to continue the job, rather he has decided to come back home, at Kolkata. When I advised to stay in the job, he said that I can't stay Long time in job, Nothing will be done by me. He talks less and every time silent now.Though his nature is less talkative. Now idiotic behavior is developing. Is it for the medicine?. Unless all bad effects aren't removed, his life will suffer seriously. Dear Doctor, please help me with your advice.
Apurba Mitra
Father of Arup Mitra.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

I can understand your problem, but you have to accept that his illness is not mild. He has history of repetitive shifts of jobs, loss of jobs, social and occupational disfunction.

But the medicines he is taking are not in proper dose. We discussed about this in past too. The dose of Aripiprazole should be increased since his mood is again unstable. For his bipolar depression symptoms drugs like Lamotrigine can be added.

Rest prescription should be same. Talk with him about his depression symptoms and explain him that he should seek re-evaluation by a psychiatrist. Once he is ready visit his psychiatrist. Talk about the dose adjustments and any need of Lamotrigine which is very helpful in bipolar depression.

Thanks

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Dear Doctor.
present position of my son Arup mitra:
1) My daughter with whom he is living in gurugram,says ,her brother ( my son, arup) has no mental problem. He talks less in nature but talks longtime with persons he likes. Arup does not disturb anybody. Necessities of material goods for life is minimum. Arup has already joined three jobs but do not continue, as per arup's version he becomes tensed and lacking confidence.he cannot continue his job for spot tension.His responsibility is low for,how he will survive after expiry of father who is pensioner and his financial source.
2) My wife(mother of arup) used to talk with him through video call from Calcutta every day, find no other problems except telling, I cannot continue jobs, I have memory loss
let I come back to kolkata to you.
PRESENT MEDICINES : 1. Arpizol 10 1 tab daily
2.Dvenniz 50 and lipicard 50 1 tab daily.
I being father become confused what shall I do.At least earning is necessary for future. As per your opinion, he should seek re-evaluation by a psychiatrist, I have shown lots of them but cannot properly diagnose for recovery.
by Apurba mitra( father)

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

I can understand your concern. He is socially doing good but you have to accept that he has bipolar disorder and he is not performing well in job. He is shifting the jobs and not finishing tasks. These too are psychiatric symptoms. Please don’t think of stopping his treatment.

I know you have consulted many doctors but the doses of medicines he was given were not adequate. The doses should be increased to get best results. Once he become stable he will perform well in job.

He should take opinion of a psychiatrist again for best results. The dose of Aripiprazole should be increased to 20 mg. This will provide better control of symptoms.

Thanks

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Dear Doctor, My son, Arup Mitra returned last month from gurugram,delhi to Kolkata at home. He joins an IT company here as technician.
He is expressing to his mother that he has too much tension and doubting his ability to do the job. He has no other problem at this moment except his natural behavior of loneliness. His mother is counselling him to get back mental strength to continue the job. He has gone today office at night shift .
PRESENT MEDICINES TAKING : 1. Arpizol 20 - 1 tab daily at night from the date of your last advice.
2. Dvenniz 50 and 3. lipicard 50 1 tab daily at night.
Please advise, how his tension and doubt to complete works can be removed.
we are entirely depending on you.not have gone to any other psychiatrist.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

If he is taking medicines regularly then that is very good. Aripiprazole 20 mg will help to reduce his symptoms definitely.

His loneliness, fear of not finishing or completing work are most likely due to mild depression symptoms. Bipolar depression can be the reason. In that case one option is to increase the dose of Desvenlafaxine to 100 mg. This will help to reduce the depression symptoms and he will regain the lost confidence.

Also if his weight in normal then get his lipid profile done. If lipids comes in normal range then Lipicard can be stopped.

Please visit a doctor for proper prescription and give him the medicines in prescribed doses only. Always motivate him to continue to take medicines.

Thanks

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My name is Arup Mitra. I am 32 years old. I am very lazy. I cannot stick to any job. If I join any job after few days I start to dislike it as I hate to go to the same place again and again. I know this is not correct. But I can't stop it. I am undergraduate. I have faced many situations like received many good job offers from good companies but due to undergraduate I got rejected. This happened to me so many times so now I am aimless in life. I am getting some jobs in BPO's but I am not satisfied. I feel I am somehow devastated. I need to overcome this. I was sent to so called rehab once with the consultation of my parents and an asshole doctor. Those 3 months became the darkest spot in my life till date. It creates negativity, anger, hate in my mind for others. I tried to suicide once but failed. I do not feel I need medicine anymore because I have no feelings after taking medicines.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello thanks for asking

First of all you have to accept that there is something wrong which is resulting in repetitive loss of jobs and shift of jobs. Pressure at jobs could result in reduced interest but if this is resulting in loss of jobs or resigning from jobs then this is due to poor interest in work. This might be because of depression.

Depression results in progressive loss of motivation, lack of desire, poor focus in work, poor concentration, lack of interest in anything etc symptoms. This is the probable reason you are seeing such setbacks in life.

Considering your past history you have bipolar depression and you should take medicines regularly. You were advised Aripiprazole which is a good drug and has no serious side effects. In past you have been advised medicines but these were not in sufficient doses and this could be the reason you suffered symptoms like loss of any emotional feelings etc.

So please take your medicines regularly and avoid missing the doses. For your depression symptoms any good antidepressant like Fluoxetine can be added. This will make you a better person psychologically.

I hope you will follow my advise. Please don'y hesitate if you have more doubts.

Thanks and Take care

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Dear Doctor, I am father of patient Arup mitra,
we are confused to understand your medicine advice.
on 26/12/2018 you advised
1. Arpizol 20 - 1 tab daily at night from the date of your last advice
2. Dvenniz 100(increased from 50 mg) and 3. lipicard 50 1 tab daily at night.

on 1st january 2019 you advised that Fluoxetine can be added.

from60/01/19 my son is taking following medicines
1. Arpizol 20 - 1 tab daily at night
2. Dvenniz 100 1 tab daily at night(anti depressant)
3.Prodep 20mg 1 tab daily (anti depressant) and 4. lipicard 50 1 tab daily at night
WE ARE CONFUSED THAT D VENNIZ 100 AND PRODEP 20 (BOTH ANTI DEPRESSANT) ARE PRECRIBED BY YOU OR NOT, BECAUSE HE IS TAKING BOTH THE ANTI DEPRESANT MEDICINE. PLEASE ADVISE CLEARLY.
present position of my son
1. he is enthusiast, wanted further study and stared for graduation
2. Now he is interested for service but not getting.
3. He is going for marketing as per our advice. Afterall he is sober, no anger,but lazy.
4. HE SOMETIMES SHOWS IDIOTIC MANNER.
As per pathology report
RBC COUNT-4.45, CHOLESTEROL- 254, TRIGLYCERIDES-343, HDL-32, CREATINE, SERUM 1.30, ECG-WITHIN NORMAL LIMIT.
PLEASE CLEARLY ADVICE THE MEDICINE.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello again

Fluoxetine was advised in replacement of Deveniz. He is on right medicines. One thing that should be done is to reduce Deveniz to 50 for one more week and then stopping it completely. Dose of Fluoxetine can be increased to 40 after a week.

So he should be on

Aripiprazole 20 mg (preferably in 10 mg dose twice daily)

Deveniz 50 for one more week and then stopping it completely.

Fluoxetine 20 to be increased to 40 mg after a week. To be taken in morning after breakfast.

He should continue to take Lipicard.

This should help him. He should be given medicines after proper prescription only.

Thanks

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I am Arup Mitra. I am 33 years old. I have passed diploma in hardware and networking in 2015.
My problems:- 1. I am lazy
2. I feel sleepy all the time.

3. I do not like to exercise.
4. I do not have any motivation.
5. I feel I do not need any medicine anymore.
I wake up in the morning at 11 am. Then I have some breakfast. Then I sit on my computer. As I feel very sleepy throughout the day I again go to sleep on 12:30 pm. Then at 2 pm I have my lunch. Then again at 3 pm I go to sleep. Wake up at 6:30 pm-7 pm. Then I search for jobs on my computer, play games. Then at night at 10.30 pm I have my dinner and go to sleep by 1 AM.
AS father I present my observation
1. You have advised me every-time to contact with local Doctor.Accordingly I am visiting time to time chamber of local doctor and show the printed copy of your opinion/ observation to the local doctor. .He says every time that my son has no bipolar disorder and simply psychological depression.and motivation is down. I become confused. We have no other alternative except to take advice of Doctor. when doctors become money machine, give importance for their fees and experiment with patient it is ill luck of us that we have to bear the same.

I told every time that my son talks less and unsociable in nature. He escaped from education and comeback from service,cannot stay in job, I visit Doctor to get diagnoses but Local doctor never write in prescription particularly the diagnosed result.mention the name of mental problem my son he bears. Now a days Doctors are getting image of all parts of the body.Medical representatives convincing doctors composition ,use,side effect of medicine. Doctor's main function is to diagnose the disease ,record it to the prescription and do the management. Patient has every right to know the diagnosed deceased to be recorded in the prescription.
you both are different opinion and putting medicine accordingly. what shall I do

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
# Hello thanks for asking

First of all I'd like to tell you that no doctor makes a wrong diagnosis deliberately. The diagnosis in psychiatry is made on the basis of clinical symptoms, history, effect of clinical symptoms on social, personal and occupational life. Family history too plays a role.

Now coming to the symptoms of your son. You have mentioned that there was frequent job changes, sense of superiority, frequent anger outbursts during start of illness. He used to be argumentative and these are symptoms of bipolar disorder. Currently he is drowsy, has tiredness, fatigue and he also have other depressive symptoms. He might be in bipolar depression. But the clinical diagnosis might vary between two clinicians.

Since beginning I am stressing you that he should be given drugs in proper doses and regular psychiatrist consultations are needed. I can provide a second opinion and I can't prescribe medicines online. For prescription you've to visit a psychiatrist in person with patient. This will definitely help your son.

Thanks

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