Help diagnose a bright young guy slowly descending into a bizarre state?
October 4, 2015 12:15 AM Subscribe
In the early days, he was very bright, very fun. Not anymore. Now, he’s obsessed with vague, impractical get-rich-quick schemes, flitting around from idea to idea, but getting nowhere. He seems to like the idea of being someone important. This crap is all he talks about, in a weird, insistent, fever-dreamy way, to the exclusion of almost anything else. He has no personality anymore. He refuses to get a job, and gets others around him support him financially, using guilt and anger to get his way. He’s tricked a number of us out of tons of money.
(Long post ahead. Maybe the above is enough for others to get an idea about what’s wrong with him, but for fun and profit, read on.)
HIS HISTORY
As a child, he was a mix of good and bad. He was a smart, funny, energetic. He was also an only child, and very spoiled. Occasionally, he’d threaten to kill himself (yep, as a kid) to his parents if he couldn’t get his way in some matter. Very insistent and manipulative. He was also pretty overweight, a gluttonous eater. Not sure that’s relevant, but maybe it’s worth mentioning.
In adolescence, a set of weird behaviors began to emerge. He would talk at length about ridiculous, impractical business ideas and get-rich-quick schemes, which we’d shoot down. As a teenager, he tricked a credit card company into giving him a card in his dad’s name, and over the span of a few years, he racked up $150,000 in debt. He spent it on motorcycles, luxury car rentals, taking his friends out to expensive dinners, strip clubs, and I can only imagine what else. He managed to keep this a secret for years, until his mom finally caught him, and it all unfurled. He later said the bikes and cars were meant to provide an adrenaline rush he’d developed a craving for.
After high school, he decided he wanted to study neuroscience. He spent a few years at community college, then transferred to a prestigious neuroscience program at a university, and did well enough that he got a job in a lab while studying. Around this time, he says he began to develop severe major depression (constant thoughts of suicide, feeling horrible about everything, wanting to sleep all day). Serendipitously, he’d learned a lot about treatment already. He went to psychiatrists and auditioned random meds. He tried SSRIs (no help), exercise (somewhat helpful), and OTC naturopath stuff (varying helpfulness). Eventually, he found relief in an MAOI called phenelzine. Before he started the MAOI, he called me, in tears, saying this med might change his personality forever. Sad, bizarre convo. I bade him a potential “goodbye forever.”
It’s unclear whether the changes in his personality following this were due to the MAOI, or if they were just part of a cascade of shit that had already been carrying him down the River Crazy for years. His previously stellar performance in school began to erode. He blamed this on the long period of adjustment to the side-effects of the MAOI (namely: narcolepsy, foggy thinking). He started doing so badly that he lost his financial aid, lost his lab job, and eventually got kicked out of the university. At first he was very upset, and wanted to work on getting back on track, but eventually, his get-rich-quick schemes resurfaced, and he focused on those instead. As a teenager, he’d had various jobs, but now he began to despise the idea of working for someone else, especially for anything menial. He claims the nature of his depression makes it so he needs to have a job that’s mentally stimulating, or he’ll lose his mind. It’s unclear whether this is bullshit. (Also, if his med is effective, what’s the difference either way?) He’s always seen himself as special, destined for great things. He couldn’t bear the idea of being an anonymous drone. He became ever more dependent on his mom and dad for money, and spent more and more time planning business ideas, none of which went anywhere. He tried random jobs on and off out of desperation, but absolutely hated them, and would quit within weeks. Eventually, he began to mooch off his live-in girlfriend. Every month, all the money he got from all these sources, he spent. No savings whatsoever. Not sure how he managed to blow it all. He’d been getting his meds from Mexico for years, but even those are pricey. (I’m not sure why he doesn’t just go for low-cost insurance, or claim disability, or take advantage of whatever other gov’t help he can get.)
He began borrowing huge amounts of money from other people, promising to pay them back, and either paying tiny amounts or not paying at all, telling them to wait for his business ideas to succeed, at which point he’d share his riches. I personally lent him a massive amount of money over the course of a few months, because I felt sorry for him and because he created this sense of urgency, saying he was about to get kicked out of his apt, he didn’t want to let down his girlfriend, etc. He’d promised to pay me back immediately, multiple times. Never did, came up with ridiculous excuses about his depression making him do dumb things like spend all my money. After a while, I caught on, was furious, and stopped helping him. His mom sends most of her disability money and rent income to him every month. Sometimes he’ll visit her, ask for his money, and leave immediately. At one point, she didn’t have it, and he grabbed her by the shoulders and shook her, demanding she pay him. As mentioned, his girlfriend has been loaning him money forever, and he’s stolen much more from her than from anyone else. They’ve been kicked out of multiple apartments because he’s neglected to pay their rent. She seems very pliable and manipulable, but she finally got fed up, grew a spine, and kicked him out recently. During that confrontation, he was furious, yelled at her, was incredulous that she’d do this to him, called her a fucking bitch, told her she had no soul, etc. He’s now living with his mom.
Aside from the money garbage, he’s a total weirdass. When talking to people, he rambles on and on about trivial details tangential to his main point, droning on at length about superfluous details. He doesn’t really have a sense of humor anymore. He used to be warm and easygoing and clever and funny. He lit up a room. We’d all go out and have fun. Now, he’s isolated. He lived with his girlfriend for years, lost touch with his friends, didn’t make any new ones aside from business contacts. He’s just this bizarre vanilla robot that talks only about business ideas and advances in tech and medicine. He’ll occasionally tell me or his distant friends that he really needs to talk to us about something important, but when we call, he just talks breathlessly about dumbass advances to social networks or Uber or blood transfusions or whatever, or tries to rope us into doing free work for this or that business idea. Lately, he posts links to random articles on Facebook and Twitter every couple of hours. None of his hundreds of friends on there hit “Like.” We’ve all learned to be weirded out, I guess. I called him on it recently, and he says it’s part of an experiment to raise his visibility to Facebook’s AI. (Er, okay?) When we point out this bizarre behavior and all his other shit, he gets indignant, acts hurt, becomes angry at us, says we’re stomping on his dreams.
That’s where he is now. He’s in his late 20s.
HIS PARENTS
It might help to know that his parents have serious psychological problems.
His mom was diagnosed with schizophrenia decades ago. She’s been on a cocktail of meds to control it (an SSRI, an anti-psychotic, maybe some other stuff). Without the meds, she hallucinates that people around her are mocking her, and she thinks the gov’t is after her. Paranoid delusions, etc. I know the heritability of schizophrenia is pretty high, so that’s worrying.
His dad isn’t diagnosed with anything, but he’s got plenty of problems. He ran a successful small business for decades, but has recently sunk endless time and resources into another small business that hasn’t really taken off. He’s got paranoid delusions too (e.g., he thinks one of his nieces has a chip implanted in her head that controls her mind; he thinks everyone is out to get him, from the gov’t to random business partners, because they’re all jealous of his nonexistent success and potential; he’s very wary of hiring anyone for his business, because he’s highly suspicious of others’ motives; he thinks his computer and email are bugged). He has delusions of grandeur, megalomania, wants desperately to be someone of high status. He denies there’s anything wrong with him, refuses to get help.
SO, WHAT IS THIS, AND WHAT CAN WE DO?
Seriously. A couple of people close to him (well, formerly close to him) have banded together to try to find out what’s wrong, and see how we can help.
Some of this stuff seems like normal, healthy human drives gone haywire (e.g., to feel special; to do something meaningful with one’s life; for self-preservation and the preservation of the species as a whole).
One of us went to a psychologist and described our friend’s behavior. The psych said he’d heard of similar people, and that this kind of con-man personality usually pointed to hidden drug addiction. We looked up cocaine addiction, and while some of the symptoms fit, this dude is so unreliable, we doubt he’s competent enough to hide a drug addiction for years and years. Plus, a few of us have been around him lately, and one of us is familiar with coke-head behavior, and apparently he’s not exhibiting it at all.
It also sounds a tiny bit like the hypomania you see in bipolar II, but I don’t think that’s it. I don’t think he has the strong depressive episodes associated with bipolar.
Is it the Nardil/phenelzine? Its wiki article says in rare cases it can cause hypomania.
I looked up the early warning signs of schizophrenia, but I’m not sure he fits the bill.
Is it a mix of personality disorders? He’s got some features of narcissistic personality disorder, but not sure that’s it. Does he have an inferiority complex? Some deep insecurity that he’s trying to make up for? Obviously, he’s mirroring some of his father’s behavior. What’s tragic is he was the one to point out that his dad was slowly losing it, and now, when we draw parallels between him and his dad, he bristles up and gets angry at us, says he’s not the same at all.
Is the diagnosis simply that he’s a stupid manipulative asshole, but healthy otherwise?
What’s it sound like to others here? And what, if anything, can we do to help him?
(Long post ahead. Maybe the above is enough for others to get an idea about what’s wrong with him, but for fun and profit, read on.)
HIS HISTORY
As a child, he was a mix of good and bad. He was a smart, funny, energetic. He was also an only child, and very spoiled. Occasionally, he’d threaten to kill himself (yep, as a kid) to his parents if he couldn’t get his way in some matter. Very insistent and manipulative. He was also pretty overweight, a gluttonous eater. Not sure that’s relevant, but maybe it’s worth mentioning.
In adolescence, a set of weird behaviors began to emerge. He would talk at length about ridiculous, impractical business ideas and get-rich-quick schemes, which we’d shoot down. As a teenager, he tricked a credit card company into giving him a card in his dad’s name, and over the span of a few years, he racked up $150,000 in debt. He spent it on motorcycles, luxury car rentals, taking his friends out to expensive dinners, strip clubs, and I can only imagine what else. He managed to keep this a secret for years, until his mom finally caught him, and it all unfurled. He later said the bikes and cars were meant to provide an adrenaline rush he’d developed a craving for.
After high school, he decided he wanted to study neuroscience. He spent a few years at community college, then transferred to a prestigious neuroscience program at a university, and did well enough that he got a job in a lab while studying. Around this time, he says he began to develop severe major depression (constant thoughts of suicide, feeling horrible about everything, wanting to sleep all day). Serendipitously, he’d learned a lot about treatment already. He went to psychiatrists and auditioned random meds. He tried SSRIs (no help), exercise (somewhat helpful), and OTC naturopath stuff (varying helpfulness). Eventually, he found relief in an MAOI called phenelzine. Before he started the MAOI, he called me, in tears, saying this med might change his personality forever. Sad, bizarre convo. I bade him a potential “goodbye forever.”
It’s unclear whether the changes in his personality following this were due to the MAOI, or if they were just part of a cascade of shit that had already been carrying him down the River Crazy for years. His previously stellar performance in school began to erode. He blamed this on the long period of adjustment to the side-effects of the MAOI (namely: narcolepsy, foggy thinking). He started doing so badly that he lost his financial aid, lost his lab job, and eventually got kicked out of the university. At first he was very upset, and wanted to work on getting back on track, but eventually, his get-rich-quick schemes resurfaced, and he focused on those instead. As a teenager, he’d had various jobs, but now he began to despise the idea of working for someone else, especially for anything menial. He claims the nature of his depression makes it so he needs to have a job that’s mentally stimulating, or he’ll lose his mind. It’s unclear whether this is bullshit. (Also, if his med is effective, what’s the difference either way?) He’s always seen himself as special, destined for great things. He couldn’t bear the idea of being an anonymous drone. He became ever more dependent on his mom and dad for money, and spent more and more time planning business ideas, none of which went anywhere. He tried random jobs on and off out of desperation, but absolutely hated them, and would quit within weeks. Eventually, he began to mooch off his live-in girlfriend. Every month, all the money he got from all these sources, he spent. No savings whatsoever. Not sure how he managed to blow it all. He’d been getting his meds from Mexico for years, but even those are pricey. (I’m not sure why he doesn’t just go for low-cost insurance, or claim disability, or take advantage of whatever other gov’t help he can get.)
He began borrowing huge amounts of money from other people, promising to pay them back, and either paying tiny amounts or not paying at all, telling them to wait for his business ideas to succeed, at which point he’d share his riches. I personally lent him a massive amount of money over the course of a few months, because I felt sorry for him and because he created this sense of urgency, saying he was about to get kicked out of his apt, he didn’t want to let down his girlfriend, etc. He’d promised to pay me back immediately, multiple times. Never did, came up with ridiculous excuses about his depression making him do dumb things like spend all my money. After a while, I caught on, was furious, and stopped helping him. His mom sends most of her disability money and rent income to him every month. Sometimes he’ll visit her, ask for his money, and leave immediately. At one point, she didn’t have it, and he grabbed her by the shoulders and shook her, demanding she pay him. As mentioned, his girlfriend has been loaning him money forever, and he’s stolen much more from her than from anyone else. They’ve been kicked out of multiple apartments because he’s neglected to pay their rent. She seems very pliable and manipulable, but she finally got fed up, grew a spine, and kicked him out recently. During that confrontation, he was furious, yelled at her, was incredulous that she’d do this to him, called her a fucking bitch, told her she had no soul, etc. He’s now living with his mom.
Aside from the money garbage, he’s a total weirdass. When talking to people, he rambles on and on about trivial details tangential to his main point, droning on at length about superfluous details. He doesn’t really have a sense of humor anymore. He used to be warm and easygoing and clever and funny. He lit up a room. We’d all go out and have fun. Now, he’s isolated. He lived with his girlfriend for years, lost touch with his friends, didn’t make any new ones aside from business contacts. He’s just this bizarre vanilla robot that talks only about business ideas and advances in tech and medicine. He’ll occasionally tell me or his distant friends that he really needs to talk to us about something important, but when we call, he just talks breathlessly about dumbass advances to social networks or Uber or blood transfusions or whatever, or tries to rope us into doing free work for this or that business idea. Lately, he posts links to random articles on Facebook and Twitter every couple of hours. None of his hundreds of friends on there hit “Like.” We’ve all learned to be weirded out, I guess. I called him on it recently, and he says it’s part of an experiment to raise his visibility to Facebook’s AI. (Er, okay?) When we point out this bizarre behavior and all his other shit, he gets indignant, acts hurt, becomes angry at us, says we’re stomping on his dreams.
That’s where he is now. He’s in his late 20s.
HIS PARENTS
It might help to know that his parents have serious psychological problems.
His mom was diagnosed with schizophrenia decades ago. She’s been on a cocktail of meds to control it (an SSRI, an anti-psychotic, maybe some other stuff). Without the meds, she hallucinates that people around her are mocking her, and she thinks the gov’t is after her. Paranoid delusions, etc. I know the heritability of schizophrenia is pretty high, so that’s worrying.
His dad isn’t diagnosed with anything, but he’s got plenty of problems. He ran a successful small business for decades, but has recently sunk endless time and resources into another small business that hasn’t really taken off. He’s got paranoid delusions too (e.g., he thinks one of his nieces has a chip implanted in her head that controls her mind; he thinks everyone is out to get him, from the gov’t to random business partners, because they’re all jealous of his nonexistent success and potential; he’s very wary of hiring anyone for his business, because he’s highly suspicious of others’ motives; he thinks his computer and email are bugged). He has delusions of grandeur, megalomania, wants desperately to be someone of high status. He denies there’s anything wrong with him, refuses to get help.
SO, WHAT IS THIS, AND WHAT CAN WE DO?
Seriously. A couple of people close to him (well, formerly close to him) have banded together to try to find out what’s wrong, and see how we can help.
Some of this stuff seems like normal, healthy human drives gone haywire (e.g., to feel special; to do something meaningful with one’s life; for self-preservation and the preservation of the species as a whole).
One of us went to a psychologist and described our friend’s behavior. The psych said he’d heard of similar people, and that this kind of con-man personality usually pointed to hidden drug addiction. We looked up cocaine addiction, and while some of the symptoms fit, this dude is so unreliable, we doubt he’s competent enough to hide a drug addiction for years and years. Plus, a few of us have been around him lately, and one of us is familiar with coke-head behavior, and apparently he’s not exhibiting it at all.
It also sounds a tiny bit like the hypomania you see in bipolar II, but I don’t think that’s it. I don’t think he has the strong depressive episodes associated with bipolar.
Is it the Nardil/phenelzine? Its wiki article says in rare cases it can cause hypomania.
I looked up the early warning signs of schizophrenia, but I’m not sure he fits the bill.
Is it a mix of personality disorders? He’s got some features of narcissistic personality disorder, but not sure that’s it. Does he have an inferiority complex? Some deep insecurity that he’s trying to make up for? Obviously, he’s mirroring some of his father’s behavior. What’s tragic is he was the one to point out that his dad was slowly losing it, and now, when we draw parallels between him and his dad, he bristles up and gets angry at us, says he’s not the same at all.
Is the diagnosis simply that he’s a stupid manipulative asshole, but healthy otherwise?
What’s it sound like to others here? And what, if anything, can we do to help him?
This post was deleted for the following reason: Sorry, but Ask Metafilter isn't really for crowd-sourcing a psychiatric or other medical diagnosis. Please contact us if you have questions. -- taz
« Older Songs with strong vocals and minimal accompaniment... | Book recommendations for junior fantasy Newer »
This thread is closed to new comments.