OCD, Psychosis, or both?

[Guest guest]

Just heard from 's today and now it will be ANOTHER 4-6 weeks. I'm taking

this somewhat with a grain of salt since it's been " a few more weeks " for the

past few months and I know it's very difficult for them to predict on their end.

Meanwhile back at the farm, my son's behavior is becoming increasingly

concerning. Thankfully nothing about harming himself or anything along those

lines, just bizarre stuff like sitting on the stairs in the dark sometimes for a

few hours doing his tics, not wanting any lights on anywhere in the house, even

at night, still avoiding showers, not brushing teeth, wearing same clothes over

and over, putting shirts on inside out and backwards, eating meals in dark, and

still having bathroom issues. Zero social life, no desire for one, going

anywhere or doing anything is extremely difficult, causes him stress/tics.

He's had a high-ptiched screeching tic for the past 4 month accompanied by a

forceful motor tic. He still has that, but it's far less frequent. Now, for the

past several weeks, he has 2 tics that are nearly constant. One where he kisses

back of hand then looks up, then whispers a " prayer, " the other where he laughs

and then says " you didn't have to do that many, " referring to his previous tics

(he explained the latter to me). Both of the talking/kissing tics are rapid

fire, over, and over, and there's very little time during waking hours where

he's not constantly doing them. To me, although he clearly has Tourette's, these

particular tics seem more like Tourettic OCD to me, then just Tourette's.

He goes to school only 3 days a week and has for the past few months. It's a

HUGE struggle to get him up and off to school, he'll typically take well over 2

hours to get ready and that's with me constantly being on top of him and

literally following him around. If left totally to his own devices, I imagine

he'd take double that time, or more likely never get out of the door.

In the past few weeks, his behavior has become increasingly defiant towards my

husband and I and he basically refuses to do much of anything he's asked to. Now

I'm not talking about anything more than getting up and out of the house in the

morning, getting in and out of the car instead of sitting there, not continually

turning the lights off, and taking showers, brushing teeth.

I emailed his psychiatrist to update him on the above and also to tell him my

concern about it possibly being a few more months (if we're lucky!) for 's.

He called me to say that he had presented my son's case to a group of colleagues

he meets with twice a month and they were all " very adamant " that a lot of these

behaviors are " more than OCD. " The consensus was that some of this is more

psychotic than OCD and therefore he wants to start him on an anti-psychotic like

Risperadal.

Now I did not get a chance to tell him that these behaviors do NOT take place at

school, except of course for his tics which he'll go in the basement to do. So I

have to wonder.......is there such a thing as " selective psychosis " where

someone can turn it on or off depending on their environment or who they are

with? The other thing is that this psychiatrist claims to have a lot of

experience with OCD, but from some of my discussions with him, I'm not super

confident in his abilities in that area.

I'm VERY concerned about putting my son on an anti-psychotic, especially because

of his Tourette's. Now I do know that they use Risperdal for Tourette's kids,

but I have heard some pretty scary stories about side effects, and in some cases

they can be irreversible.

Just wondering what your thoughts are on this and if any of you have ever dealt

with psychosis or psychotic-like behavior with your kids.

Thanks!

D.