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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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My 20 year old nephew has ocd bad he does ritual several times

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My 20 year old nephew has ocd bad he does ritual several times during the day, has trouble concretrating if hears people talking when he is doing this he gets mad he says he feels tingling in arms or legs he has to start over. he has a very bad temper, he is really over weight. He not a germaphobic his rituals get very loud he disrupts our house. He blames me for his ocd, because me and my boyfriend broke up and my behavior started this, I was dealing with my own depression. Could I have brought this ocd out on him, he says I stressed him out. He is very smart in history and politics he can tell you anything you want to know especially about religion. We are at a loss, we don't know what to do he won't go to the hospital, he drinks every night. He keeps talking about if he could only concentrate.He sometimes stays up all night and sleeps all day, and this happens the otherway. He is very lazy and demanding. Please help, he believes that no medication can't help him.

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your concern

Dr. Z :

Please give me a few minutes to read over your question thoroughly so that I can assist you better

Dr. Z :

I am so sorry to hear about your nephew, I can imagine how distressing this is for him and for you to watch

Dr. Z :

I would like to ask a couple questions to better help your nephew, if that is okay with you

Dr. Z :

How long has he been diagnosed with OCD for? And are there any other diagnoses that he was given?

Dr. Z :

Also you mentioned that your nephew was in therapy, is he in Cognitive Behavioral Therapy (CBT) by chance?

Dr. Z :

So I can also answer your earlier question about if you caused this OCD for your nephew. OCD is not entirely understood, but we do know that the OCD is genetic and those that are susceptible, then it can be triggered by stress. So I do not think that you caused his OCD as it was already there and any significant stress could have caused it.

Customer:

about 3 yrs he believes he has Pallilalea

Customer:

He is just seeing liscw, when was younger 10 or so he would get fixated on things for awhile like the Tintanic he know all about it, then is was King Henry know all about him, and religion and politics. He has friends on facebook from all over the world and they are adults he has discusstions with them. excuse my spelling I had a minor stroke and it effected my memory, I am on depression meds, anxiety which he is making worse

Dr. Z :

Its okay, I understand. Please take your time with your typing, there is not time limit here and I will be online for as long as you need help. It is interesting that you mentioned Pallilalea because I think your nephew may have Tourette's Syndrome as his anger and just tingling feelings in his arms and legs may be caused by motor tics, which are symptoms of Tourette's Syndrome.

Dr. Z :

May I ask, does he have trouble reading people's emotions? Does he have trouble understanding how other people feel?

Customer:

I really don't believe its touretts, he is very selfish he thinks only of himself he dropped out of high school then went to take GED scored high in everything except math he is completely tuned out to math, doesn't know times table. He doesn't ask he demands or he will keep bugging me or my brother. His mouth is dirty saying bad things to my mom (87) and me and his mother he talks very loud he breaks things like the door to his room I think he kicked it in. I do feel sorry for him its disturbing, he wishes he could die the rituals have become more frequent

Customer:

some times he get physical he punched me one time I am afraid!! My sister his mother doesn't know what to do, he won't go to the hospital she called the police one day and he took off to the woods. He says he is stressed out anxiety he keeps mentioning focus and concensention. the tics I mentioned I do not see but he feels something

Dr. Z :

And he has only been diagnosed with OCD? Because OCD does not usually account for the physical violence he is expressing

Customer:

I believe he hides it when he is with is friends no ocd (but he says he does it under his breath I think the physical violence is the frustration from his ocd, he hasa room down stairs if we walk or move or talk during rituals he gets very angry and loud, shouting why are you doing this to me, he keeps blaming me constantly over and over he used to call me auntie now it Joann, we all enable him to try to keep the peace my poor mom is frustrated he wants everybody to wait on him, to get his clothes ready and stuff for his shower. He eats a lot and has gained a lot of weight.

Dr. Z :

Well I think your nephew may have OCD, that was diagnosed by professionals who have seen him and treat him, so I am not questioning that at all. But I think he also qualifies for a diagnosis of Intermittent Explosive Disorder based on his anger outbursts or Asperger's Disorder based on his fixation of things, like you said King Henry and Titanic, and individuals with Asperger's Disorder can have violent outbursts as well.

Dr. Z :

But either way you are looking for a treatment. For his OCD, you may want to try Lexapro 10-20mg as this is very effective and usually has less side effects. If that does not work, I would recommend Anafranil, as this is a very effective medication for OCD. It is usually used after the SSRI and SNRI medications are proven ineffective because Anafranil doe have more side effects because it is an older generation medication.

Customer:

Ingrammer school he was put in a behavrioal hospital the school made him stay for a week he did something but I don't knowexcatly what is was. He was scared and everyone was crying. It was always difficult to get him to school.

Dr. Z :

Violent behavior as a child can be due to Intermittent Explosive Disorder, Asperger's Disorder, or other Pervasive Developmental Disorders (PDD). For his anger outbursts increasing the Risperidone may help. Or switching to Olanzapine, Quetiapinem, Ziprasidone, or Aripiprazole may be helpful too

Dr. Z :

Also these treatment books can help treat OCD effectively if he is willing to try them

Customer:

What about the ocd that he thinks has pallolalea? Hebelieves he will be like this for the rest of his life, says no meds work. The trouble is finding a psychiatrist? vey hard I believed he had ashburg syndrome myself but no one every said that when he as younger. He has always been a troubled child. Dou you know somebody in the Springfield ma area that could help him, they are not taking new patients its tough he has ma health which makes it worse some do not take it. where am I calling what city?

Dr. Z :

Give me a few minutes to see if I can find some good psychiatrists in your area that can take your nephew, but you are right that many psychiatrists have long waiting lists. I am personally in California, but the experts on this website come from all of over the world

Customer:

His father was abusive to my sister pulled out a chuck of hair gave her a black eye, Dylan was an infant then he has no contact with him he's not around here my mother kicked him out.

Dr. Z :

I am so sorry to hear that, he definitely has an anger issue that he needs to control with medication and behavioral therapy, this is truly not just OCD although the anxiety from OCD may contribute to it

Dr. Z :

What is the official name for the Massachusetts healthcare plan? Is it called BCBS Massachusetts?

Customer:

Should he see a certain psychiatrist but my concern is that he drinks every night he is a big boy he looks older than he is. I that was an issue too

Dr. Z :

Well I would look for a psychiatrist that specializes in OCD, Anger issues, and PDD

Customer:

the insurance is welfare, Medicaid.

Dr. Z :

Okay, give me a few more minutes to find some psychiatrists in your area that take that insurance

Customer:

Okay then thanks for the help. I think you should change your picture is looks like your in a lineup with the blue shirt!! Thanksagain Dr Z

Dr. Z :

Here are a list of psychiatrists that take Medicaid in your area

Dr. Z :

Haha, well actually it was taken when I used to work at a state hospital a couple years ago.

Customer:

Funny!!

Dr. Z :

Well good eyes for you though, you are very perceptive :)

Customer:

Thanks I could use a complement I keeping getting told I am to blame.

Dr. Z :

You are not to blame for his behavior at all, this is purely biological in him

Customer:

I will show this to him, but I hope he doesn't brake my computer.

Dr. Z :

I hope he does not as well, but there are a lot more medications out there to try that can help him

Customer:

Thanks and guess we are done! I am very satisfied I'll give you high # XXXXX gave good suggestions, and I hope we all get through this!!

Dr. Z :

I hope so too and I hope that your nephew responds well to the treatment. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer:

Good night Dr Z

Dr. Z :

Good night :)

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