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Forum Name: Psychiatric Topics

Question: Autism, aggression and possible hallucinations


 autismmom - Tue Jul 20, 2010 10:39 am

My profoundly autistic son has been diagnosed with bipolar disorder. I think he is also having hallucinations. He sometimes "zones out", with wide, staring eyes. We get the feeling at these times that he is seeing or listening to something in his head instead of to reality. He then gets very insistent about saying something that may or may not be appropriate for the situation. He then becomes dangerously aggressive and chokes us. He is now seventeen and becoming too strong to handle. Is it possible he has schizoaffective disorder instead of bipolar? If so, what can we do to address this behavior? I put his meds in. Would higher doses of any of these meds help stop the hallucinations, if that's what they are, and the aggression? This is becoming a very serious problem, with law enforcement and the courts involved. Thank you for any help.
 Faye Lang, RN, MSW - Tue Jul 20, 2010 8:37 pm

Hello, autismmom,

You have been doing your homework! You raise some valid points regarding your son's diagnosis, and despite evaluation and treatment by professionals, you have to live with your son's issues on a daily basis, and thus you know him better than anyone else.

Autism is probably a neurodevelopmental disorder, involving difficulty relating to others with delays in speech, behavioral milestones, and problem behaviors. Younger persons may show more manic symptoms than depressive symptoms. Autism may improve as the person matures. Residual problems include language issues, impaired social skills, and continued difficulty in adjusting to new situations. In adolescence, behavior problems may increase.

Schizoaffective disorder also may have similar early symptoms, identified in retrospect. As the child becomes older, symptoms become more pronounced. Symptoms may include combinations of strange thoughts and/or perceptions, delusions, mood disturbance, paranoia, disorganized thought processes, depression, mania/extreme energy or unusual behavior for that person, suicidal or homicidal ideation, incoherent speech and/or irrelevant speech, catatonia (which may be associated with pronounced agitation), memory and attention deficits, poor hygiene along with little interest in hygiene and activities of daily living, sleep disturbances and psychosis. There may be other related signs, but these are the majority.

When we consider the issues that your son is currently and progressively experiencing, you have a good case for requesting re-evaluation of his diagnosis, with subsequent alterations in treatment in accordance with any altered diagnosis. Regardless of the diagnosis given, medications should address the severity of the symptoms. Your son is still a minor, and in most states would receive mental health services related to developmental issues until he is 22. During that time, you have the right and responsibility to be involved in advocating for the most appropriate and effective treatment, which could include re-evaluation of his diagnosis as a basis for ongoing treatment.

I hope this information is helpful to you, I wish you all the very best of luck.
 autismmom - Wed Jul 21, 2010 10:58 am

Thank you so much for your help. We'll get him re-evaluated asap.
 Faye Lang, RN, MSW - Wed Aug 04, 2010 5:51 pm

Hi autismmom,

You're very welcome! I hope it's helpful. Good luck on the re-evaluation.

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