Posted by ace on June 25, 2003, at 1:02:54
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
> My son(age 21)is lost in a maze of diagnosis, comorbidity and medications. His survival out in the world is seriously in doubt because of zero motivation to do ANYTHING. He was approved for SSI this year while he was working part time. Now he is unemployed, living in clutter, smoking pot, dropping out of his one college class and not even trying.
I'm sorry to hear about this. It can be a hard age.
> In looking for answers, I've come across the drugs Adrafinil, and Provigil. Light bulbs went off when I started reading about the effects these drugs may have on the brain. The description of what the ventral striatum area contols is almost an exact definition of what my son lacks - cognitive flexibility, coherence, vigor, goal oriented behavior and associative learning. Has anyone seen an increase of motivation, drive or setting and attaining goals or sustaining effort on Adrafinil, Provigil or some other meds? My son has been on Cylert, Ritalin, Concerta and Wellbutrin over the years. Most were stopped because of irritability or lack or lessening of response. Most were taken along with other drugs so I am unsure how they really worked. We saw improved neatness, especially in handwriting.
For motivation I would urge an MAOI. Either that or Ritalin, but you mention you've tried this?
> He definitely has a history of some sort of PDD. He matches so many symptoms in the DSM but does not match any diagnosis definitively. The psychologist who treated him for years referred to his symptoms as a bowl of spaghetti. Diagnosis history includes Asperger's, severe NVLD, ADD, bipolar, ODD and depression. Meds seem to lead to only temporary improvement or change. He has been on so many different meds I honestly don't know the difference between symptoms and side efffects.
I wouldn't worry too much about these 'labels'. I would concentrate on his behaviour and symptoms. Labels serve to get one into big trouble.
> He has many Asperger's characteristics so how can he be a pathological liar too? How can his early language skills be classic hyperlexic but didn't read until age 7 and has very good comprehension? How can he have ODD but has never been in any real trouble at school or with the police? How can he be bipolar but never really manic? The huge spread between high verbal IQ 125 and low performance IQ 72 result in expectations being too high or too low. The resulting frustration has led to some of his seething anger but does not really explain his temper outbursts. Positve reinforcement doesn't work anymore, he rebuffs and dismisses positive comments.
>
> He got through high school with lots of prodding and case management. Since then he has been unable to successfully complete classes or keep a job, or stay in agency programs. Late in high school Risperdal was added to his mix of meds. Since then he has gained a lot of weight, overeats, sleeps a lot and complains of lack of feelings. I think Risperdal is making things worse - has anyone experienced this also? Currently he has Rxs for Risperdal and Zoloft but I am fairly sure he has stopped taking them. And he skipped his last pschologists appt.
>
> Almost everyone that deals with him finds him very engaging, vunerable and a"good kid." The world has expectations for him to be a MAN and he is far from that goal.
>
> I am looking for some way to reach him before I lose him to depression, drugs and defeat.
Sure, I understand. First of all, I would urge him to talk about want he wants in life. Prod him for his goals/ambitions- he would have them I'm sure. Take one step at a time to achieve them. Once started motivation might flow. Secondly, a young man with mental illness smoking a lot of pot is not good. This must stop i think. It is probably what is making him so apathetic- I lived with guys in the past who smoked it all day- they lost all motivation. Thirdly, I would urge new medication- such as an MAOI, Remeron, or Zyprexa- these meds work well for a wide range of disorders.He sounds very talented, and I'm sure there is that spark in him. He just needs to get all the
thwarting influences away- pot, giving in to urges to stay in bed etc etc.Good luck to you.
Ace.
poster:ace
thread:236674
URL: http://www.dr-bob.org/babble/20030624/msgs/236862.html