Possible mental disorder?

[IntruigedYoungFellow]

     I have a friend who I am certain is suffering serious health problems. I hace no dount a mental issue is among them, the sad irony being his dad is an excellent therapist. Anyways, his physical problems are easy to doagnose but I have searched and searched and his odd behaviors and things are compounded and complex and I've little knowledge of psychology. Here are the symptoms. I'll list his physical situation afterwards and some examples to help anyone who wants to try their hand.

-Self harm (cutting)
-Clinical and analytical reactions to serious situations.
-Lacking in empathy.
-Occasional yet uncommon episodes of a nigh catatonic state in which he cannot speak, is extremely confused and hallucinates. Suffers temporary cognitive loss and amnesia. Lasts 30-120 minutes.
-Reacts negatively to touch.
-Has a fear of creatures he knows are only in his head.
-Responds negatively to sound. (This is probably related to his physical condition)
-Sometimes reacts with uncalled for aggression but rarely.
-Usually he is able to explain complex theories easily, but sometimes he unexplanably fails to describe simple procedures, let alone relative time-variable theory which he is very fond of.
-Seems to prefer technology to most people.
-Obsesses over obscure topics no one seems to understand.

     I have not uncovered any delusions although he doesn't talk much about himself. Despite his problems he seems more scientific about things like cutting than depressed. In fact, analysing experiences and understanding them seems to be all he does. Learn from scenarios and simulate new ones in his mind. He expresses constant distaste for modern culture, and is very sarcastic towards it. This is why he doesn't know the names of songs and singers or actors most people do. In terms of emotions he still laughs and smiles but his empathy is nonexistant. We watched someone break both their arms and he stood back watching people swear and scream, freak out and try to comfort the kid. He started listing off medical problems and didn't seem shaken in the slightest. Afterwards he told me he stifled a laugh when someone shouted "Oh my god!" upon seeing the wrists pushed far out of place. I think it may be worth mentioning he speaks of torture often and almost as though it is normal


     His physical condition is unfortunate. He has been severely migraine prone since he had a memory and expects it to stay this way for the rest of his life.He has miopia to the point of vision loss beyond a foot, inability to make out shapes at two meters. He has severe pains in the neck that have caused him to faint. His knee joints can never fully straighten, but this is not s severe problem. However, throughout gradeschool his migraines have caused such damage that it may well be related to his condition. They seem to make him shut down. He seems to immediately suffer hypersensitivity upon headaches, making all sounds seem louder, lights brighter and smells sharper. That may have added to his distaste for cleaners, LEDs and subwoofers greatly.

     I am uncertain of what to do because he made me promise not to refer him before telling me any of this, so I feel that at least getting a general idea of what we're dealing with is vital. He has no psychiatrist, not even a counsilor which is suprising considering the high amounts of pain he must suffer.

[jemma116]

Do not assume what a doctor may or may not expect.
Doctors are not mind readers and they do have lots of patients to see and do not always have the time to give the patient time to go through all problems.  If you friend does not tell the doctor of his joint problems and symptoms that he has, the doctor can only treat the problem that is presented to him.  If the doctor does have time, he may ask what other symptoms your friend is experiencing, but if your friend does not tell the doctor, then the doctor can only treat what is presented to him.  This is why writing a list of all the symptoms and problems is a good idea.

Speech problems and confusion can arise from other medical conditions.  As your friend is an insomniac his lack of sleep can affect his cognitive behaviour.  Having a urinary infection can also cause memory problems and confusion.

He clearly has lots of issues and medical problems that need medical help.  Schizophrenia is a very complex mental disorder and your friend would have to have the appropriate specialist to examine him to confirm this disorder.  

At this moment in time try and get your friend to write all his symptoms and problems down so he can make the doctor aware of the problems he has and have a chat with his parents about your concerns and like Democratic_Anarchist points out, keep your friend's medical condition to yourself and do not discuss his condition with other school mates.  Discussing your concerns with his parents is fine.

Your friend's mental issues may be because his parents are away from home and not giving him the love and attention that he needs.

[Democratic_Anarchist]

I understand what he's going through all too well. You see, I'm also migraine prone. I cut, I hide my emotions and I'm not particularly fond of people. However you should know a bit more about migraines before leaping to conclusions. States of extreme confusion and cognitive failure relate directly to a type of migraine. If he's anything like me then I doubt it's due to a mental disorder. Now cutting, depression and hallucinations, specifically auditory ones, as well as uncalled for aggression and confused speech point to the development of many mental disorders so I understand your confusion. I would say look into disorders related to auditory hallucinations and depression.

     If your friend's a minor please try to sort this out without spreading the word.Think what would happen if you were in his position and suddenly everyone at school knew you cut and had auditory hallucinations. They probably wouldn't be too kind about it.

[IntruigedYoungFellow]

Thanks yet again.

     If I'm not mistaken, the doctor he's going to see only expects headaches, but considering they often check for other pains he may get help elsewhere. As for his mental condition I'll try to get a hold of his parents but their family is strangely enough more away than at home. They only spend about a maximum of five hours in the house outside of bed per day. I will keep my promise not to refer him but I'll try to comfort him and maybe convince him a councilor may be able to help. But mostly I'll remain accepting. His own father said schizophrenics have recovered from their condition simply because they had people who treated them like normal humans.

[jemma116]

You are quite right that people that suffer from chronic pain can have insomnia.

Tell your friend to write down all his symptoms on a piece of paper so that he can give it to the doctor to read.

You do not say how old your friend is, but I did not get a picture of him being a minor.  If he is a minor then you should not interfere, but do talk with his parents about your concerns.  

If he is not a minor, you can still talk with his parents about your concerns.  A lot of times close family do not see what happens under their nose, because the "ill" person conceals what they feel inside very well.  Take care so that it does not mar your friendship.

The doctor will be able to find out by further investigation the problem with his knees and his neck and if surgery is an option if his joints are severely damaged.  There are different types of medications that can help with pain relief and certain antidepressants are also used to reduce pain  and these can be taken alongside with other antidepressants for his depression.  These will also help his insomnia.

I am not surprised that he is missing school if he is feeling so low and in pain and tired from lack of sleep.

He can also try some self help for insomnia by not watching late TV or doing any computer work or playing any computer games and also not drinking caffeine drinks, that includes tea, coffee and cola and fizzy drinks.
Having a warm milk drink and having a relaxing bath may help with relaxation and getting ready for sleep.

[IntruigedYoungFellow]

     I guess you're right. I'm just worried about him. He's extremely intelligent and clever but he never tries to be that way. His grades have begun to drop and he's becoming less and less attached to reality. I'd hate to see his talents go to waste. And he's also perhaps my only close friend. To be perfectly honest with you he acts like a totally different person around his family. He laughs and smiles and makes jokes he actually finds annoying till they turn away. Then he frowns bitterly and finishes his business. I mean,  he despises the idea of seeing a councilor and his father is a professional himself so I inferred no one knew of his problems, which I know is a dangerous thing.

[caregiver222]

I he is a minor, it is not your business to be discussing his alleged medical problems or analyzing them. Or interfering with his life. You should not make promises to another person that you are not prepared to keep.  Unless he is in danger of injuring others or suicidal you should mind your own business. It would be appropriate to have a meeting with his parents, in person, and discuss this issue with them. I suspect they are well aware of them, and they have been long-standing. It appears he is having an appointment with a medical professional. Do not be surprised if what he tells the physician is not what he tells you.

[IntruigedYoungFellow]

UPDATE:

     Having almost immediately followed advice, I phoned his house. However both his parents had left for somw reason and he was taking care of his brothers. I asked him how he was and he told me to guess. He then talked about a doctor's apointment on Nov. 27th for his headaches. He predicted he predicted three outcomes. Either the doctor gives him medicine that has terrible sideeffects, decides nothing is wrong with him and sends him home, or takes a head scan, which would be the third scan so far and somewhat redundant. He seems to have a distrust of medication.

     I could hear the sound of fabric constantly rustling, which I am guessing was his rapidly tapping his heel on the floor. He does this all the time, not sure if it means anything. I asked him if he was okay and he sighed, and he told me of recent happenings. He had gotten into a fight with his family a week ago and he didn't understand it. It seemed so pointless to him that he even had the capacity to be that angry. Over the past month and a half he would occasionally here words no one spoke. Short random words like and, then or it. Sometimes his name too. He had also noticed flickers of movement where nothing moved. He at first dismissed it as part of his headaches but got worried later. He was also starting to feel paranoid that his family had started to notice his peculiar behavior. He was worried of them finding out because he had lied to hide it. When I told him he should talk to the school counsilor he told me his fear of being given anti-depressants or other medication which tends to do the opposite of its intention.

     I am concerned at this point because indeed he has recently missed a lot of school and gone through a lot of tylenol. I feel I need to find out what's going on before this turns into a schizophrenia spectrum disorder or something.

[IntruigedYoungFellow]

     Thank you. His migraines seem to be triggered by high pitched metalic noises, bright lights, neon lights in a dim area, the mell of cleaner, listening to a crowd of people talking and listening to music above a very small volume. He describes it as always being there. Like a very small headache but when a trigger happens it rapidly groes massive. That's probably why he has costant hypersensitivity. It's odd too because I would be listening to music on my phone and he can often hear it when other people can't.

I suppose it's also worthy of mention that he's a chronic insomniac, which I hear is also common in sufferers of chronic pain.

I shall attempt to contact his parents as soon as possible.

[jemma116]

It is not uncommon for people who suffer from chronic pain to have depression and act aggressively.

With you saying that he cannot straighten his knee joints and also has severe neck pains seems that he has some form of arthritis, probably osteo.  

Not being able to straighten the knees may be from moderate or severe degeneration of his knee joints and he may also have osteophytes that have grown on the bones and in the neck vertebrae that are aggravating the nerves and soft tissues.

He really needs a thorough examination of his cervical area and his knee joints.  The neck problems may be what is causing his migraines, but migraines can also be triggered off by foods like chocolate, red wine, cheese, oranges, coffee.  He may have different food triggers.  Migraines can also be triggered off by stress and anxiety, glaring at a computer screen for too long or by flashing lights.  He needs to get a brain scan done to find out if there is a problem with his brain or whether the migraines are caused by other reasons.

People who suffer from migraines do experience sensitivities to sound, touch and smell.

People with depression are not always aware that they are suffering from depression and will get engrossed with "their own" thing.

Chronic pain can have an influence on his behaviour and stress, anxiety and depression can also make any symptoms worse.

He clearly does have physical problems that need to be dealt with and help  with his psychological issues.

Have you spoken with his parents about his condition or are they already aware of what is going on?

Your friend does need to recognise that the he has a problem that he can get help for.  This is the first step.  Without him accepting that he has a problem, he will just say he is fine and can manage.  A lot of people with depression do not accept that there is anything wrong with them.

Best of luck.