Ideas as to what this mental disorder is?

[J-rap]

I have a sweet nephew whose parents are trying so hard to help him in life.  I thought these boards with all of the varying experiences might have some ideas.

 

He is in his upper 20's now and kind of resistant to being evaluated, but if his parents had any ideas as to what it could be, they would really encourage him in that direction.

 

As a child, he was quite difficult, because he was always getting into mischief and trouble.  They had two other boys, and this one was always so different and relentless.  He also seemed to have no understanding of boundaries or safety issues.  One example, when at the lake:  when he was three years old, he would walk into the water and just keep walking until it was over his head.  It would never even occur to him that he should stop at some point.  And he would keep trying, any way he could. 

 

Growing up, he couldn't sleep.  They finally put a mattress on the floor in their own room, and sometimes they could soothe him with their voices so that he could finally sleep.  This went on almost through high school!

 

In high school, he got into a lot of trouble, drinking, etc.  Very impulsive, and always so very sorry about it afterward and wanted so much to change.  It was almost like he had no control over his impulsiveness.

 

He has been in the hospital ER more times than they can count.  Honestly though, probably over 25 times.  He has always been so impulsive, and acts before he thinks.  He has been in multiple car accidents.

 

Academics have always been very difficult, though he did make it through college by the skin of his teeth.  (With a lot of help.)

 

He has a lot of friends because he is fun and does crazy things.  But he also burns them out.  They can't keep up with his antics.

 

He can't keep a job, because he can't sleep.  His sleep is so terrible, that he resorts to over the counter meds, but then needs other meds to wake up. 

 

He can't plan ahead.  He'll suddenly have a great idea, but does not take the time to really think about, to decide if it's realistic.  So, he sets himself up for failure a lot.

 

He has a soft heart.  He'll drive an hour to visit his grandparents quite often just to say hi, but then will only stay for 10 minutes.

 

He was just in another car accident last week.  Completely totaled the car. 

 

The only thing I'm not sure of his emotional state, although I was told that he is usually quite down these days.

 

He did have a job on an adventure team that went all over the world, and did enjoy that because it was irregular hours and outside and moving all the time.  But once that ended, he has been completely lost.

 

He has had other jobs, but they never work out.  He admits that it's hard for him to focus.

 

Anyway, he's at a point where he is kind of spiraling but will not seek an evaluation.  However, he has a really good relationship with his parents and they want to help him any way they can.  He is extremely close to his dad.  He is probably his best friend.

 

Thanks in advance!

 

[jelbe5]

My first inclination is to say Bipolar, but I'm not sure if that is correct if he has never had a major depressive episode. But the impulsivity, recklessness, and lack of sleep made me think of that.

 

Perhaps severe ADHD?

 

When my son was born up to almost age 3 he would. not. sleep. I told my husband either he needed to be medicated or I was going to need to be. We began giving my son melatonin and he also began some prescription medication after he was diagnosed. I wonder how these poor parents have survived so many years with their son's sleep issues. I hope they can help him.

[maize]

My ADHD kids have trouble sleeping.

 

Impulsiveness goes with ADHD.

 

(ETA actually, thinking a bit more, the ADHD kids with serious behavior issues are the ones who also have sleep trouble; I have one who is very hyperactive but sleeps fine and generally does not have many behavioral challenges.)

[maize]

Lack of sleep though impairs brain function for anyone; if he would be open to doing a sleep study that might be the best place to start.

[J-rap]

My first inclination is to say Bipolar, but I'm not sure if that is correct if he has never had a major depressive episode. But the impulsivity, recklessness, and lack of sleep made me think of that.

 

Perhaps severe ADHD?

 

When my son was born up to almost age 3 he would. not. sleep. I told my husband either he needed to be medicated or I was going to need to be. We began giving my son melatonin and he also began some prescription medication after he was diagnosed. I wonder how these poor parents have survived so many years with their son's sleep issues. I hope they can help him.

 

I hope they can too.  For the longest time, I think they just thought it was his own unique personality, but not an actual disorder.  Seeing how things are playing out, they are quite certain now it must be some disorder, and I was wondering about bipolar myself.

[wapiti]

I'll throw out my two cents.  Obviously an evaluation with a psychiatrist would be important.  I don't know the DSM well enough to speculate on possible labels (I'd start by looking at criteria for ADHD but there may be something more applicable).

 

Personally, I take a big-picture, way outside-the-box view.  I would want to look at the entirety of his health.  I'd start with the insomnia first.  I'd ask about gut symptoms.  I'd want extensive bloodwork looking at a variety of things, including but not limited to immune parameters and markers of inflammation, if possible.  Insomnia can involve a vicious cycle impacting the immune system which in turn impacts the brain (e.g. the vast majority of serotonin is produced in the gut) and an impacted immune system can contribute further to insomnia.

 

Perhaps if he isn't willing to see a psychiatrist, he might be willing to see another doc for a complete physical checkup.  Who to see - and what to test for - are not easy questions to answer as many docs are not in a position to go this big-picture, though most should be able to at least run some basic bloodwork.  Eta, I would approach him with the idea that his issues (focusing on insomnia and anything physical) may have a biological basis that may be discoverable/treatable.  Whether the biological basis can actually be discovered and treated within the current state of mainstream medicine is another question, but IMO it makes sense to try, at least.

 

ETA, note that a combination of a faulty immune system and particular infections can cause insomnia (essentially, a faulty immune response to infection).  This is a controversial view.  Nonetheless, in *some* cases, simply treating the underlying infection can resolve the insomnia, at least until other types of infection come along.  (Fixing the fault in the immune system is a whole 'nother ball of wax, unfortunately.)

[Anne in CA]

Obviously any evaluation that does not figure out how to get the kid to sleep is in trouble. Sleep deprivation makes people nuts. My high school sweet heart had the nuttiest mom, but I found out that she had a brain disorder that prevented her from sleeping and that is part of why she was so nutty. Sadly, there was really no treatment for her, most sleep medications did not work for her. Hopefully modern medicine will be able to help the boy, but he is going to have to be evaluated, probably multiple times. Possibly, since he is impulsive, an emotional appeal with tears and pleading will work better than logical ones. I have seen that to be more effective with getting people to help themselves than logic.

[J-rap]

I'll throw out my two cents.  Obviously an evaluation with a psychiatrist would be important.  I don't know the DSM well enough to speculate on possible labels (I'd start by looking at criteria for ADHD but there may be something more applicable).

 

Personally, I take a big-picture, way outside-the-box view.  I would want to look at the entirety of his health.  I'd start with the insomnia first.  I'd ask about gut symptoms.  I'd want extensive bloodwork looking at a variety of things, including but not limited to immune parameters and markers of inflammation, if possible.  Insomnia can involve a vicious cycle impacting the immune system which in turn impacts the brain (e.g. the vast majority of serotonin is produced in the gut) and an impacted immune system can contribute further to insomnia.

 

Perhaps if he isn't willing to see a psychiatrist, he might be willing to see another doc for a complete physical checkup.  Who to see - and what to test for - are not easy questions to answer as many docs are not in a position to go this big-picture, though most should be able to at least run some basic bloodwork.  Eta, I would approach him with the idea that his issues (focusing on insomnia and anything physical) may have a biological basis that may be discoverable/treatable.  Whether the biological basis can actually be discovered and treated within the current state of mainstream medicine is another question, but IMO it makes sense to try, at least.

I love the big picture approach.  A physical check-up is probably a very good place to start, and might be something he is more comfortable with.  Will suggest that to my brother. 

[J-rap]

Obviously any evaluation that does not figure out how to get the kid to sleep is in trouble. Sleep deprivation makes people nuts. My high school sweet heart had the nuttiest mom, but I found out that she had a brain disorder that prevented her from sleeping and that is part of why she was so nutty. Sadly, there was really no treatment for her, most sleep medications did not work for her. Hopefully modern medicine will be able to help the boy, but he is going to have to be evaluated, probably multiple times. Possibly, since he is impulsive, an emotional appeal with tears and pleading will work better than logical ones. I have seen that to be more effective with getting people to help themselves than logic.

 

Wow, that's super interesting about the brain disorder that prevented her from sleeping.  I wonder if they could put a name to that disorder now.

[J-rap]

Was there prenatal exposure to alcohol?

 

No, there would not have been. 

[MercyA]

Oh, poor guy! It sounds a lot like severe ADHD. Maybe if he read a book by someone with similar issues it would help him be more open to treatment? The right meds could potentially be a huge help to him.  

 

I agree with the poster who recommended getting a complete physical workup and dealing with the insomnia first.

 

ETA: Also agreeing that there may be some Aspie tendencies there as well.  :grouphug: to him and his parents.

[Anne in CA]

Wow, that's super interesting about the brain disorder that prevented her from sleeping.  I wonder if they could put a name to that disorder now.

I think there was a name for the disorder when they discovered it, there was just very little that could be done, sadly. I don't remember the name of the disorder, though. Sorry.

[DawnM]

Maybe:

 

ADHD 

Obsessive-Compulsive Disorder

 

As far as the sleep disorder, I would wonder about:

 

Circadian Rhythm Sleep Disorder

 

 

At first I would rule out Asperger's because of the social aspect, but we have a boy in our Asperger's group who is VERY social and very impulsive and sounds very much like your nephew, but he was indeed diagnosed with Asperger's (ASD) because he met some other criteria, which included not fully understanding the social (like burning out friends.)  The criteria included social SKILLS, which, even though he was social, he clearly didn't fully understand.  So,  I wouldn't rule out ASD either.  

 

Another boy in our Asperger group keeps getting into car accidents.  

 

My Aspie barely sleeps.  It affects everything he does.

 

 

 

 

[Alessandra]

I'll throw out my two cents. Obviously an evaluation with a psychiatrist would be important. I don't know the DSM well enough to speculate on possible labels (I'd start by looking at criteria for ADHD but there may be something more applicable).

 

Personally, I take a big-picture, way outside-the-box view. I would want to look at the entirety of his health. I'd start with the insomnia first. I'd ask about gut symptoms. I'd want extensive bloodwork looking at a variety of things, including but not limited to immune parameters and markers of inflammation, if possible. Insomnia can involve a vicious cycle impacting the immune system which in turn impacts the brain (e.g. the vast majority of serotonin is produced in the gut) and an impacted immune system can contribute further to insomnia.

 

Perhaps if he isn't willing to see a psychiatrist, he might be willing to see another doc for a complete physical checkup. Who to see - and what to test for - are not easy questions to answer as many docs are not in a position to go this big-picture, though most should be able to at least run some basic bloodwork. Eta, I would approach him with the idea that his issues (focusing on insomnia and anything physical) may have a biological basis that may be discoverable/treatable. Whether the biological basis can actually be discovered and treated within the current state of mainstream medicine is another question, but IMO it makes sense to try, at least.

 

ETA, note that a combination of a faulty immune system and particular infections can cause insomnia (essentially, a faulty immune response to infection). This is a controversial view. Nonetheless, in *some* cases, simply treating the underlying infection can resolve the insomnia, at least until other types of infection come along. (Fixing the fault in the immune system is a whole 'nother ball of wax, unfortunately.)

What a thoughtful post!

 

I second the idea of getting as complete a evaluation as possible. You don't want to be treating ADHD if there is a brain tumor.....

 

Recently, I have heard of two types of ADHD misdiagnoses. One was so-called acquired ADHD, from over exposure to media, often diagnosed in mid teens. The second was from lack of sleep, sometimes diagnosed in mid elementary. So, yes, the big picture is critical. Someone could have the symptoms, but not the actual syndrome.

 

ETA. Should have said injury, not tumor.

[melbotoast]

There are a lot of things that can cause the ADHD symptoms. For more ideas on underlying causes, you could look at the book ADHD Does Not Exist.* For my DD it was food allergies. We've also used melatonin to get her back on a good sleep schedule. I would probably focus on getting good sleep first. 

 

*Rather an inflammatory title, but does have some good information.

 

ETA: Dr. Hallowell's website and books have good info on ADHD.

[J-rap]

Lots of excellent suggestions.  Thank you so much everyone!  I really appreciate all of your thoughtful answers. 

[NorthwestMom]

I have a sweet nephew whose parents are trying so hard to help him in life.  I thought these boards with all of the varying experiences might have some ideas.

 

He is in his upper 20's now and kind of resistant to being evaluated, but if his parents had any ideas as to what it could be, they would really encourage him in that direction.

 

As a child, he was quite difficult, because he was always getting into mischief and trouble.  They had two other boys, and this one was always so different and relentless.  He also seemed to have no understanding of boundaries or safety issues.  One example, when at the lake:  when he was three years old, he would walk into the water and just keep walking until it was over his head.  It would never even occur to him that he should stop at some point.  And he would keep trying, any way he could. 

 

Growing up, he couldn't sleep.  They finally put a mattress on the floor in their own room, and sometimes they could soothe him with their voices so that he could finally sleep.  This went on almost through high school!

 

In high school, he got into a lot of trouble, drinking, etc.  Very impulsive, and always so very sorry about it afterward and wanted so much to change.  It was almost like he had no control over his impulsiveness.

 

He has been in the hospital ER more times than they can count.  Honestly though, probably over 25 times.  He has always been so impulsive, and acts before he thinks.  He has been in multiple car accidents.

 

Academics have always been very difficult, though he did make it through college by the skin of his teeth.  (With a lot of help.)

 

He has a lot of friends because he is fun and does crazy things.  But he also burns them out.  They can't keep up with his antics.

 

He can't keep a job, because he can't sleep.  His sleep is so terrible, that he resorts to over the counter meds, but then needs other meds to wake up. 

 

He can't plan ahead.  He'll suddenly have a great idea, but does not take the time to really think about, to decide if it's realistic.  So, he sets himself up for failure a lot.

 

He has a soft heart.  He'll drive an hour to visit his grandparents quite often just to say hi, but then will only stay for 10 minutes.

 

He was just in another car accident last week.  Completely totaled the car. 

 

The only thing I'm not sure of his emotional state, although I was told that he is usually quite down these days.

 

He did have a job on an adventure team that went all over the world, and did enjoy that because it was irregular hours and outside and moving all the time.  But once that ended, he has been completely lost.

 

He has had other jobs, but they never work out.  He admits that it's hard for him to focus.

 

Anyway, he's at a point where he is kind of spiraling but will not seek an evaluation.  However, he has a really good relationship with his parents and they want to help him any way they can.  He is extremely close to his dad.  He is probably his best friend.

 

Thanks in advance!

This constellation of issues makes me think brain injury. Perhaps he had more plain ADHD when he was tiny, but all of the accidents have caused more injury?.......  :sad:  I definitely recommend an evaluation! I hope his dad can talk him into it.

[MooCow]

Ocd is what first popped into my head......it reminds me of oldest child

[wapiti]

nm

[ktgrok]

Manic episodes is what it sounds like. But frontal lobe damage, maybe from an early accident, is another thought. 

[Chris in VA]

Executive function issues? That's located in the frontal lobe. I've heard EF described as having 3 parts--working memory, cognitive flexibility, and inhibitory control. Sounds like his inhibitory control is way off. EF doesn't fully develop til around 26 (average) but he sounds like he may have some extreme immaturity in that area. So I would think "brain."

 

Also, I would think there may have been a root cause, but different symptoms are feeding off of one another--you know, like not sleeping makes it extremely hard to focus.

[texasmama]

Without more information on his moods, the simplest explanation is severe ADHD.

[J-rap]

 

 

Also, I would think there may have been a root cause, but different symptoms are feeding off of one another--you know, like not sleeping makes it extremely hard to focus.

 

Yes, this definitely makes sense.  I can see it will be very important to get to the very root.

[Catherine]

ADD.  It sounds like almost everything he has is fairly typical: the impulsiveness, being accident-prone, "time blindness" and inability to plan ahead, insomnia.  It all pretty much fits.  Adults can benefit from treatment for ADD if they are really having problems functioning, which it sounds like he is.  And if he is well-intentioned, that makes it much easier.  I hope they are able to find help for him.

[sbgrace]

I would be thinking along the lines of severe combined type ADHD.

Sleep difficulty can, usually does, go along with that.

My ADHD (and other stuff) child also has a sleep phase disorder. That's something else to check.

[MBM]

Poor guy! Thorough physical evaluations would help to rule out anything physical that might be causing these problems. A sleep study done by a sleep specialist who studies neurology could be helpful, too.

 

Walking until he's under water and not pulling out suggests something may not be quite right in his brain. Most people will instinctively pull out of water if they can't breathe. The impulsivity and not being able to plan well are common in the teen years but are also pointing to his brain. The sleeping problems, too.

 

His accidents are most likely caused by his chronic sleep deprivation. Driving while being overly tired is very similar to drunk driving. His sleep deprivation is also probably affecting his mood and ability to learn because what we learn gets *stored* during sleep.

 

My youngest son's friend, who was not capable of feeling much fear and, thus, found himself in dangerous situations throughout his childhood, was evaluated his senior year in high school and, lo and behold, they discovered a benign brain tumor (I think it was near his pineal gland). It was successfully removed at UChicago. This kid also had a terrible time learning and was very impulsive but was also very sweet-natured. He was also physically immature and short -- about 5'2" despite having parents who were both around 6' -- because the tumor was affecting his hormones. Symptoms of a tumor depend on what parts of the brain it's affecting.

 

At this point, your nephew's parents could begin to search for a specialist and begin to compile a history of unusual symptoms, events and problems that they could leave with the doctors who examine him.

 

I hope you and his parents find something that helps him.

[jelbe5]

Something to suggest - Since he is resistant to taking meds I wonder if he would look at more natural/alternative treatments such as diet and even acupuncture. Years ago I received treatments for sinus problems from a medical doctor who specialized in nutrition and acupuncture and other eastern methods. I felt more comfortable giving this a try because the doctor was also an MD. There are alternatives out there. Just a thought.

[gardenmom5]

it sounds like it could be severe adhd. 

 

those with adhd/spectrum/etc often have difficulty sleeping.  their brains don't produce enough melatonin, and that can make a huge difference.  dudeling refused to EVER take a supplement. if he knew I'd sprinkled something on his food - he'd rather starve than eat it.  I forced him to take a melatonin, and the next day he asked for it.  he started sleeping at least two hours more than previously and he noticed he felt better for it.

 

the walking even when he's underwater also sounds like it could be fetal alcohol affect.  (less severe than fetal alcohol syndrome - which also has facial features.)  it also affects ability to learn.

 

 

if they are in a state with naturopaths - I would strongly urge the parents to take him to see one who deals with adhd etc. a naturopath will look at blood chemistry and see where it falls and make suggestions to help (supplements, diet, etc.)  it into the normal range - and it can make a big difference.  I take my asd son to a ND, and the differences have been phenomenal.

[J-rap]

I would be thinking along the lines of severe combined type ADHD.

Sleep difficulty can, usually does, go along with that.

My ADHD (and other stuff) child also has a sleep phase disorder. That's something else to check.

 

Have you found anything that helps her sleep phase disorder?

[J-rap]

it sounds like it could be severe adhd. 

 

those with adhd/spectrum/etc often have difficulty sleeping.  their brains don't produce enough melatonin, and that can make a huge difference.  dudeling refused to EVER take a supplement. if he knew I'd sprinkled something on his food - he'd rather starve than eat it.  I forced him to take a melatonin, and the next day he asked for it.  he started sleeping at least two hours more than previously and he noticed he felt better for it.

 

the walking even when he's underwater also sounds like it could be fetal alcohol affect.  (less severe than fetal alcohol syndrome - which also has facial features.)  it also affects ability to learn.

 

 

if they are in a state with naturopaths - I would strongly urge the parents to take him to see one who deals with adhd etc. a naturopath will look at blood chemistry and see where it falls and make suggestions to help (supplements, diet, etc.)  it into the normal range - and it can make a big difference.  I take my asd son to a ND, and the differences have been phenomenal.

 

That's interesting about ADHD brains not producing enough melatonin.  I'll have to ask my brother if he has tried this.  I know they've tried a lot of natural type things over the years to try and help him sleep.  I'm quite certain there would not be fetal alcohol syndrome involved.  They were a very dry household over the years.

 

[gardenmom5]

What a thoughtful post!

 

I second the idea of getting as complete a evaluation as possible. You don't want to be treating ADHD if there is a brain tumor.....

 

Recently, I have heard of two types of ADHD misdiagnoses. One was so-called acquired ADHD, from over exposure to media, often diagnosed in mid teens. The second was from lack of sleep, sometimes diagnosed in mid elementary. So, yes, the big picture is critical. Someone could have the symptoms, but not the actual syndrome.

 

I attended a homeschool workshop presented by a MD with adhd. (he'd take naps in the middle of the road. the road was warm. .. . )

 

 he said he adhd kids made repeated visits to his ER.  he finally founded an adhd clinic.  he said more than half the kids referred to his clinic for adhd did NOT have adhd - it was something else.

[gardenmom5]

That's interesting about ADHD brains not producing enough melatonin.  I'll have to ask my brother if he has tried this.  I know they've tried a lot of natural type things over the years to try and help him sleep.  I'm quite certain there would not be fetal alcohol syndrome involved.  They were a very dry household over the years.

 

 

 

FAS and FAE are two different things.  FAE can be caused by as little as glasses of wine/etc. at the wrong time. 

 

or mom with a temp over 101 (illness or hot tub) at the wrong time can cause issues.

 

 

eta because those on the spectrum/adhd/similar disorders often don't produce enough melatonin, supplementing with it can be helpful.  those whose sleep issues are caused by something else - often do not respond to melatonin.

I now know why I didn't sleep as a child.  i'd lay awake in bed.  i'd wake up in the middle of the night, I rarely had enough sleep, and even less quality sleep.  there are a cascade of consequences to that.  insomnia can also breed insomnia.

[J-rap]

FAS and FAE are two different things.  FAE can be caused by as little as glasses of wine/etc. at the wrong time. 

 

or mom with a temp over 101 (illness or hot tub) at the wrong time can cause issues.

 

 

eta because those on the spectrum/adhd/similar disorders often don't produce enough melatonin, supplementing with it can be helpful.  those whose sleep issues are caused by something else - often do not respond to melatonin.

I now know why I didn't sleep as a child.  i'd lay awake in bed.  i'd wake up in the middle of the night, I rarely had enough sleep, and even less quality sleep.  there are a cascade of consequences to that.  insomnia can also breed insomnia.

 

I see. I didn't realize FAS and FAE were different.  Thanks for clarifying.

 

Are you sleeping better now, as an adult?  If so, what do you think changed it for you?

[gardenmom5]

I see. I didn't realize FAS and FAE were different.  Thanks for clarifying.

 

Are you sleeping better now, as an adult?  If so, what do you think changed it for you?

 

 

I was also pretty stressed as a child/teen. and pretty sure with todays standards and awareness, I'd have been diagnosed asd/apd.

 

 I've had times when I've been able to sleep better than others.  and times I've flat out needed more sleep than normal.

 

I have a homozygous (two copies) of a mthf mutation. (50% of the population is thought to have at least one copy)  it seriously affects my ability to use b-vitamins and folates. I supplement with very high quality b-complex and mthf.  that's made a big difference, and my sleep it also better.

 

diphenhydramine for years - only at night.  I also have allergies, so the sleep was a byproduct of my reason for taking it.  but I'd only sleep six hours, then wake-up.

MTHF does help me sleep better - and more vivid dreams. (which have calmed down).  I'm still ramping up my dose.  I do take melatonin and it helps me go to sleep. normally, I'd lay there for 45 - 60 minutes before going to sleep

[sbgrace]

Have you found anything that helps her sleep phase disorder?

 

I should have added that he really needs a sleep study. They are expensive, but poor sleep can cause much of what you describe.

My son's sleep phase disorder was diagnosed via sleep study, but he also had sleep apnea. We could fix the second part!

 

The sleep phase issue, and it really does sound like this is a possibility, is hard to address.

 

This link has all the treatments I have ever heard of. http://www.circadiansleepdisorders.org/treatments.php

 

For my son, other than very careful sleep hygiene, we use blue light blocking glasses and supplemental melatonin. Both of those are mentioned on that site. Even with that, it's a struggle--sometimes more than others. Several nights last week he couldn't fall asleep until 5 am for example.

[Tsuga]

Without reading the others:

 

Frontal lobe injury. Doesn't matter how he got it--prenatal (not necessarily FAS but in any manner of ways which would not be related to the mother's behavior--heck, I think it's a miracle any baby gets out alive at all, personally), perinatal, as a baby, congenital, whatever.

 

If you Google it, all the symptoms are there. Basically... a lack of control, and they also don't sleep or have disregulated sleep, but the symptoms vary depending on the type of the injury.

 

It's not the same as ADHD at all. What you are describing doesn't sound like ADHD to me. It sounds different. It sounds like brain damage, to be honest. I'm sorry.

 

ETA: I'm not saying it's not ADHD. I'm not a psychiatrist. What I'm saying is what it sounds like to me, personally.

[J-rap]

Without reading the others:

 

Frontal lobe injury. Doesn't matter how he got it--prenatal (not necessarily FAS but in any manner of ways which would not be related to the mother's behavior--heck, I think it's a miracle any baby gets out alive at all, personally), perinatal, as a baby, congenital, whatever.

 

If you Google it, all the symptoms are there. Basically... a lack of control, and they also don't sleep or have disregulated sleep, but the symptoms vary depending on the type of the injury.

 

It's not the same as ADHD at all. What you are describing doesn't sound like ADHD to me. It sounds different. It sounds like brain damage, to be honest. I'm sorry.

 

ETA: I'm not saying it's not ADHD. I'm not a psychiatrist. What I'm saying is what it sounds like to me, personally.

 

Interesting.  I wonder, if this were true, if it would show up on an MRI...

 

[gardenmom5]

Without reading the others:

 

Frontal lobe injury.

 

ETA: I'm not saying it's not ADHD. I'm not a psychiatrist. What I'm saying is what it sounds like to me, personally.

 

I agree some off it doesn't sound like adhd.

 

do want to add that you can find clinical psychologists who specialize in brain injuries - which can be advantageous over a general psychiatrist if it is a brain injury.  dd's bff (since they were 11) is one.

 

might want to consider a neurologist.

[ktgrok]

Agreed it shouts frontal lobe injury of some kind. 

[Classical Katharine]

Books by Dr. Daniel Amen might be worth consulting. He uses PET scans to image which brain areas are affected, and integrative methods to treat. He's controversial in some ways so FWIW.

[Classical Katharine]

There's also a clinic devoted to concussion--I think in Texas--they treat vets among others--the techniques are interesting vestibular techniques--they look at things like how your eyes track and so on, and design customized tilt-table type therapies designed to open up the compressed area--this is all vague layman's language and take my summary with a grain of salt. If I find the website I'll post it.

 

[J-rap]

There's also a clinic devoted to concussion--I think in Texas--they treat vets among others--the techniques are interesting vestibular techniques--they look at things like how your eyes track and so on, and design customized tilt-table type therapies designed to open up the compressed area--this is all vague layman's language and take my summary with a grain of salt. If I find the website I'll post it.

 

If you can find the website, I'd be interested in looking at it.  Thanks!

[Katy]

Frontal lobe damage, autoimmune issue, bipolar, adhd, possibly even schizophrenia...  he really needs a decent physical by a general practitioner and then a referral to either a neurologist or a psychiatrist, depending on what the PCP finds.

[trulycrabby]

I would say referral to a neurologist and a psychiatrist; and also a sleep study. Poor kid. :grouphug:

[MBM]

If you can find the website, I'd be interested in looking at it.  Thanks!

 

I'm not Classical Katharine, but if you're interested in something similar to what she posted, the following book chronicles the life of a professor at DePaul University after his concussion and again after his eventual successful treatment using some kind of eye tracking treatment. I haven't read the book but I saw him in an interview. The treatment that worked for him is very interesting.

 

http://www.amazon.com/The-Ghost-Brain-Concussion-Plasticity-ebook/dp/B00OZ0TOLC

 

ETA: You might also want to read Richard Davidson's book The Emotional Life of Your Brain: How Its Unique Patterns Affect the Way You Think, Feel, and Live -- and How You Can Change Them. Davidson is a neuroscientist and professor of psychology and psychiatry at UWisconsin who oversees two labs. His book is about the six circuits -- continuums -- that he found in all of his brain imaging studies and how those circuits (continuums) affect our minds and behaviors. He explains what impulsivity shows up as in brain imaging studies, for example, and that might help you understand what is going on physically in your nephew. He also explains how these circuits can be physically changed simply by changing our habitual ways of thinking.

[Liz CA]

Agree with severe ADHD. If available, a brain spect or fMRI may give a big clue to what is going on. I realize they are not offered at every medical clinic but given all the issues this young man is facing, it may be worth exploring.

As far as the big picture approach goes (with which I agree) you could also check for MTHFR, bipolar disorder, evaluate his sugar intake or all carbs that convert to sugar. A multi-pronged approach may yield faster results.

 

 

[Liz CA]

Interesting.  I wonder, if this were true, if it would show up on an MRI...

 

 

http://psychcentral.com/lib/types-of-brain-imaging-techniques/

A fMRI would be better. The regular MRI shows the structure of the brain but what they may want to see is actual brain activity. I have looked at some of Dr. Amen's work and as can be expected it is controversial but he has also helped people. Definitely worth considering IMHO. - His approach is Brain SPCT = single photon emission computerized tomography.