Armchair psychologists, have at it!

In My Humble Opinion
1

As somewhat documented throughout the years I’ve been posting, my son (now 24) was a bit scary to raise. He was loving and gentle at home with his parents, and had amazing affection for animals - but he also exhibited many signs of Asperger’s, was almost pathologically upset about spending time with his peers as a toddler, and got LOTS of complaints from the school through about 5th grade (didn’t play well with others, had extremely poor fine motor skills, would occasionally “melt down” although never violent - just crying and a lot of self-talking), after which things calmed down.

Still, between the trauma of his issues when he was young and the history of mental illness in my biological family, I’ve always felt like I’ll breathe a sigh of relief when he hits 30 or so without any signs of schizophrenia. I know that a classic situation is when a sensitive young man in his early to mid-twenties has a psychotic break.

He’s 24 now and seems pretty well balanced, if quirky. But we’re not out of the woods yet. He’s in a bit of a funk now as his girlfriend of 4 years broke up with him, he’s gained a disturbing amount of weight, and he’s not getting along with his research partner.

Anyway, I am transcribing a Skype chat I had with him earlier today, with a few identifying details such as names changed (Will is a friend from college he spends a lot of time communicating with on line; Debbie is his former girlfriend). He’s in his second year of a PhD program in physics, having passed all coursework with flying colors and exempting out of the need to take qualifying exams for the next stage of his studies.

I’m inclined to find this exchange charming, if a bit unusual. Not many of his peers write/talk like he does. But does anyone see signs of possible trouble? I’m a mom, I’ll always be a little worried…

CAIROSON: Probably nothing to be worried about without a pattern, but I think I just had a very minor visual hallucination and wanted to mention it in case it happens again. Nothing major, I looked up from my computer and thought I saw a rather large insect flying in my room. When I went over to see where it landed, there was nothing. I looked around a bit: no insect (it would have been big enough to spot). Since the door/windows are closed, it’s very unlikely there was an insect of that size.

probably just my eyes adjusting from looking up from a screen or something, but the sort of thing to put a pin in, so to speak

ME: Could have been a floater although you probably would have been aware of that earlier.

CAIROSON: yeah, could be that too

ME: Pay attention if there are more as it could be an early sign of a retinal detachment. Which I don’t think you have risk factors for, other than being my son. You’ve dodged a lot of bad eye genes on that score, it seems.

CAIROSON: yeah, just putting it out there. I think I’ve made it to the other side of the peak schizophrenia onset in early adulthood, but I am always cautious. Lately my sleep’s been a bit off, too, which doesn’t help. When I am having trouble sleeping I also often have some trouble distinguishing dreams and reality in the 1-2 minutes after I wake up. It clears up very quickly, but there’s a brief window where I need to remind myself “that event didn’t occur, even though it’s in your short term memory.”

ME: I know the feeling (confusion on waking up). Sorry you aren’t sleeping well. That’s no fun.

Do you know the origins of your watchfulness on the symptoms of schizophrenia? Does that perhaps come from something I said? My apologies if so, it is not something I’d want you to worry about.

On the other hand, I guess no one knows what’s going on in your head as well as you do, so no harm in being vigilant as long as you don’t worry about it too much.

I assume this comes from you being aware that I have some mental illness in my genetic family (schizophrenic uncle, mother with depression severe enough to cause suicide attempts).

CAIROSON: Sorry for the delay, was walking into the office. It’s that, and Will has schizophrenia, has talked a bit about it’s symptoms, and Debbie had hallucinations due to medication issues before she met me. Combine that with my slight tendency to fuck up capitalization, which is a minor symptom of the disorder, and my general interest in the subject of delusional disorders, which stems from my interest in the philosophy of cognition as a material process and epistemology, and it’s just something I keep an eye on, as you say, as I’m the person bet equipped to do so. Not worried, just cautious.

besides, putting even my direct sense-data under scrutiny is good practice for the informed skepticism I try to maintain.

ME: How did I get so lucky to have a son who could produce the text above? You have some amazing insights and thought processes.

…at that point we both went back to our work.

If you had this exchange with your child, would you worry (more than any parent worries about their kids, just on principle but especially if they’re coping with some frustrations, as he is with the girlfriend breakup)?

2

If this can truly be done from an armchair, presumably without a relevant degree, I’ll go. I have no serious mental health issues, and I see phantom insects all the time, sometimes large enough to get up and look for. I’m convinced they are floaters in my case. And I absolutely wake up momentarily confused sometimes, more so when I was his age.

Your son sounds well put-together, and really quite charming.

3

Your son sounds mentally healthy and self-aware, and I’ve known people with various issues. No sign of trouble! (No room to write more, I’m on my phone. )

4

Concur. A person aware of their own potential for schizophrenia is not acting schizophrenic. His cautiousness is a healthy sign. Its only if he becomes insistent about delusional thinking that you need to become concerned.

5

I occasionally get bright flashes in my field of vision - I once told an ophthalmologist, who said that it sounded like minor migraine symptoms. Or it might be related to blood sugar or posture issues, or other non-scary causes. The discussion happened 12 years ago, and I’m not dead yet, so I’m voting for another harmless visual manifestation in your son’s case.

It would be a good idea for him to visit an ophthalmologist anyway - not a bad idea in general, but given this symptom, I’d definitely encourage it.

The other thing that comes to mind is: seizures. Many people on the autistic spectrum have seizures of one sort of another. My older nephew, who is fairly severely autistic, has them. My younger nephew, who is likely an Aspie though never formally diagnosed (the two are brothers) had a few seizures while they were sorting out his antidepressants. The meds apparently lowered his seizure threshold. It was just a couple of times, and he’s fine now.

Note that seizures can manifest in loads of different ways (I suspect you all knew this already). The one seizure I ever witnessed was a kid at my son’s school - he was just wandering aimlessly, shaking his hands. My older nephew mostly had absence (“petit mal”) seizures throughout his life, though at one point in his early 20s, he threw a couple of tonic-clonic (“grand mal”) seizures.

My daughter, when she was about 20, came to us one day and said she thought she might be having seizures. She’d get these strong, weird feelings of deja vu, and then be very tired. I admit, I assumed she was malingering (loads of baggage there, I won’t bore you all with the details, but it wasn’t an unreasonable first guess on my part). But… there were her two cousins, so I couldn’t rule it out. I told her to call her primary care doc, and get a referral to a neurologist.

Initial EEG, nada. 72 hour EEG… caught seizure activity.

This was when she was just turning 21. She’d been a challenge all her life, but her behavior and emotional lability had been worsening to the point that we were close to throwing her out of the house. Example: asking her to do the dishes would provoke a meltdown, and (we didn’t realize it at the time) SIGNIFICANT suicidal ideations.

The doctor had said that given the emotional issues, she’d start Moon Unit on Lamictal since that also has a mood stabilizing effect. And the change in her behavior was shocking. Within a few days, she became less explosive. We were able to consider sending her to a therapeutic program - which would NOT have taken her in the state she was before she started on the Lamictal.

She still struggles with self-care activities - but she’s living independently, and working part time, mostly remembering to take her medications, and often remembering to eat.

I am not being facetious when I state that those seizures quite literally saved her life. . More specifically, the treatment for them - but she would not have been put on Lamictal otherwise, and the psychiatrists around here were simply not bothering to tweak her medications.

6

Thanks all for the insights and reassurances. @Briny_Deep - absolutely, no degrees needed, any and all impressions welcome.

@Mama_Zappa: he does get thoroughly checked by an ophthalmologist periodically, because traits like severe myopia seem to be very much passed through the maternal line, and … well, let’s just say that at my last appointment with the retinal specialist, the doc said, “I can’t believe how well you can see, given everything you’ve got going on with your eyes!” (I think that’s good?) But CairoSon seems to have inherited none of my crappy eye genes, thank goodness.

Also @Mama_Zappa, the seizure thing is an intriguing idea. Once in less-than-a-blue-moon (like maybe 10-15 times in my whole life, and I’m 63), I get this weird thing that seems to be a type of seizure that comes on while you are sleeping - but since it’s so rare and has no ill effects other than causing nightmares and sore muscles on a really rare basis, it’s not worth exploring. I only ever mentioned it to one physician, and she thought it sounded like a seizure disorder, but obviously one so mild that it was nothing but a minor curiosity. It does suggest that my son could potentially inherit some propensity toward seizures, though.

I’m happy that your daughter has had such good outcomes with the Lamictal medication. Hooray for the progress she’s made!

7

The one and only visual hallucination I’ve ever noticed was in my late teens, when I was going through a major depressive episode, and my ability to sleep was incredibly messed up.

ETA: and strangely enough, mine also involved something flying across the room!

ETA ETA: You had expressed an interest in hearing from me about my family situation, and I had always intended to start a thread for you, but then… Didn’t. I’ll try to put something coherent together!

8

I know you’re looking for a psychologist, but given his weight gain, difficulty in sleeping, and the confusion upon awakening he may want to be assessed for sleep apnea. When I had it I was prone to hypnagogic hallucinations. After I lost the weight and the apnea resolved I kind of missed them.

9

If I pass the 72-hour mark for not sleeping, I am very prone to hallucinations. They are as vivid as real life. Nothing vague or questionable. If it were not for the absurdity, I would certainly confuse them with reality.

10

Also not a psychiatrist but I’ve always understood that the early signs of schizophrenia are not the positive signs like hallucinations (more commonly auditory than visual) or delusions, but the so-called negative ones like increased social withdrawal, paucity of speech and content …

His ability to articulate intellectually coherent complex ideas well argues strongly against having those “negative signs”. IMHO.

Obviously individuals vary from textbooks, so FWIW.

11

Cool! There’s never any rush, of course. But I look forward to it.