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What are the reasons for excessive day dreaming,aggressive behaviour and OCD?

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my son suffers from excessive day dreaming; he always dreams of becoming a billionnaire, takes names of 1 or 2 famous persons who are billionnaires and goes into depth to find out their history, where they educated and their business empire etc etc.... He tries to run away from studies by taking shelter of these personalities who have not done better in education but still have become billionnaires. He finds that one of the industrialist has gone for under graduate studies to a US university (stanford) and moving on to Harward. He feels that one need not study in these places and one can get through if you pay money. He starts day dreaming as if he is on way to US for studies, he being at college and completing his studies etc... He also dreams and acts as if he is giving his interview to the media on his success in business and how he became a billionnaire. He also starts showing actions like the person he has in mind ( this after seeing vedios). There is a excessive urge for seeing the business TV channels and trying to know more about top ranking companies owned by billionnaires. Favourite channel being Bllomberg. He starts comparing himself to be a chairman of a company and having a no of secretaries and living in a cosy atmosphere. He strats dreaming about this quite often. he also feels that Chairmans need not work and get the work from the assistants. ( we always try to tell him the reality as I myself is an engineer and working from a big company in India) when we try to convince him and make him understand what the reality is, he starts becoming aggressive and starts listening to loud music and dancing to the tunes, clapping etc.. Due to above symptoms he is not focussed on studies and is continuously falling in his academics. Now he being in 12th standard and due for getting into a professional carrier, such mindset is really putting him into a danger zone. He is on treatment from a professional doctor since 2 years. Presently he is taking following medicines. morning---------afternoon-------night Tab ADDWISE OD 18 mg: 1------0------0 Tab ATOKEM 10 MG : 1-----0--------0 Tab DIVAA OD 500mg : 0-------1-------0 Tab ETILAAM MD 0.5 mg : 1/2----1/2----1/2----1/2 ( morning----afternoon----even--night) we have been seeing a change of pattern in his dreaming and we feel he gets swayed away through some friends. He has limited friends (1-2) with whom he shares the dreams. He is intovert and shy person and does not speak outside in college. Does not have any other habits and is a straight forward guy. He is found to be lazy, does not worry about health, does not control at times food intakes (wt- 85 Kg, height 5ft 10"). sleeps well. My son has a habit of frequently washing his hands and gargle. This happens may be on an average about 20-30 times a day sometimes 2-3 times in succession. Thkis happens mechanically. At such moment he will not be knowing what he is doing. Even after we tell him not to do, he goes on and does it forcibly.
Posted Mon, 30 Dec 2013 in Mental Health
Answered by Dr. Srikanth Reddy 1 hour later
Brief Answer: Clarifications Detailed Answer: Hello, Thanks for using health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. However I would require a couple of more details to help you in answering your query in a better justified way. 1) How long has he been in the same state? 2) were there similar episodes before 3) Has he had any depressive episodes before? 4) Any family history of mental illness? 5) Does he indulge in magical thinking as well like believing in supernatural powers etc.? Hope to hear from you at your earliest convenience. Regards and wish you good health, Dr. Srikanth Reddy MD Neuro-Psychiatrist and Sexologist
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Follow-up: What are the reasons for excessive day dreaming,aggressive behaviour and OCD? 12 hours later
Pointwise replies as below; 1: this is for over two trs now. His pattern of behaviour is however varying. Earlier he was a bit aggressive also. Now this is reduced may be due to medications. His dreaming topics have changed frequently. He started with dreaming to become a NASA engineer, then a pilot, then neuro surgeon etc... He wants to now become a businessman and a chairman of a company so that he can earn in billions. His role models are XXXXXXX Tata and XXXXXXX Ambani. He gets into the issues of interest to him depth thru net. Starts dreaming and acting keeping himself in the role he fantasises. He thinks studying is not required for becoming a chairman. 2.history ; as above 3. Dippressive episodes: no I do not think so. 4. No family history. My wife's brother has some psychic problems 5. Magical thinking : I do not think so. As mentioned, he tries to fantasise by keeping himself in the role of someone he has in mind (presently it is XXXXXXX Tata). It is observed that such fantasising is seen due to some triggers like watching some business chanels (bloomberg being favourite), watching videos of XXXXXXX Tata, or other vidoes of similar billionnaore personalities. Does not believe supernatural powers. We are a family of four. Daughter is a twin with son and my wife being housewife. We both lose patience at times due to his behaviour. Sometimes it becomes streamy at home due to his misbehaviour. Note : he gargles / washes hands frequently. At times it could be 20-30 times. Sometime 2-3 times in succession. It I observed that this happens when we scold hom or when he feels, may be to release tension perhaps.. Earlier he used to take clonii 18 and Trikoprex which is stopped since last 10 days acfter we referred his case to a new doctor. Regards Nandakumar
Answered by Dr. Srikanth Reddy 14 hours later
Brief Answer: Onset of schizophrenia/schizoaffective disorder Detailed Answer: Hello Thanks for the details. I would like to appreciate that you have taken veryy good efforts in explaining your sons condition. From all the information that you have given it appears that currently your son is having a schizotypal personality disorder and there is a high chance that this may get converted to either schizophrenia or schizoaffective disorder in future. The repetitive hand washing pehnomenon could be a feature of both schizophrenia or schizoaffective disorder and need not be an independent feature of OCD. He cerainly needs to be on an antipsychotic and a mood stabilizer. If he is on clonil and tikoprex, the antipsychotic is missing from his prescription and he has to be on either olanzapine/risperidone/ clozapine/aripiprazole . You can discuss with your new psychiatrist these details and he can start you on these medications. Tikoprex will certainly help in reducing the aggression.These medications will try to reduce the problem. The illnesses which start this way do not have a good prognosis and there is no point in falsely consoling you. Along with your sons treatment you have to take care of yourself as well otherwise there will be caregiver burnout for you as handling yur son will be very demanding.
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Follow-up: What are the reasons for excessive day dreaming,aggressive behaviour and OCD? 21 hours later
Apart from clonil and Tikoprex he used to take Addwise 18 mg and atokem previously. I forgot to mention about this in my last message. I have following questions; A. Whether the medication now being taken (as given in my first narration) is OK? Was there a need to add clonit to this. Is Atilaam given now is a good substitute for clonil? B. I strongly feel that presently his main issue is day dreaming. He does not behave like this (hand wash etc) when he is outside or when in classes, in my relative's house etc. Day dreaming behaviour also goes down substantially when outside. But he creates fast opinions about others and starts disliking or becomes restless at times if what others tell him does not comfort him or oppose his ideas. Can we think of some other therepies apart from medication like putting him in some camps etc which tone his mind or exposing him more to the outside world etc.. Are there are any such camps specially designed for such cases which we can think of after he finishes his XII exams. Any other advise to parents? I was looking forward to comfortable time for him till he finishes his exams. Hr is not able to focus in his studies now and not performing well in exams. Regards
Answered by Dr. Srikanth Reddy 2 hours later
Brief Answer: Answers as per the questions asked Detailed Answer: Hello Thanks for the follow-up query. Iunderstand that he had ADHD as well. 1) His medications are fine although I feel that the sode of tikoprex may have to be increased. Secondly there is no comparison of clonil and etilaam and both are different medications. He was on clonil for OCD but it seems the OCD part is more of a aprt of psychosis and he should be n a good antipsychotic which he is currently not. There are no special camps to my knowledge which treat psychiatric patients. If someone insists for such camps please check the credibility and there should be a psychiatrist in the panel. Otherwise please refrain from being a part of such camps. He will have difficulty in studies cause of his ADHD and schizo symptoms and he will have to put in extra efforts for the same. His day dreaming behaviour will improve only when his illness will reduce. Do not change any medicines without the knowledge of your treating doctor. Regards Dr. Srikanth Reddy MD
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