What has helped?

[Poohbear]

I didn't have friends and the only family was my parents all my life until they passed few years ago.
They let me live with them and that was what I wanted. I knew if the day came I would be on my own
without them I would have no idea what would happen.

 

[Poohbear]

SusanLR, it might be that my son will be more productive living with us, or with someone who will help him. But he has definitely decided it’s better to live alone in a dorm room rather than in his parents house. He really wants that opportunity to try to make his life work out for him in his own way. That’s why I keep pushing around the idea of a “life coach” .....someone who would just check in on him, knowing when he will be most likely to be burning out.
However, what he has been going through while on his own is very different from what we saw throughout his childhood. Especially in high school. He had a small group of very good friends, who were of outstanding character imo, very close knit friends through 3 years of drama production, and casual friends thru Boy Scouts , cross country track, band and TKD (2nd degree Black belt). He showed no problems showing up at events either with his friends or on his own. He and his best friend went to the prom together, both “straight” and he good naturedly took any teasing and had a great time.
Then he lived on campus and “fell off the world”.
So I am completely stumped as to what would work best for him. It has been heartbreaking to see him lose all his self-confidence. He might have always had differences and quirks, but it did not devastate him like it has the past several years. I can’t imagine what it would look like for him to be satisfied with moving back in with us.

 

[Autistamatic]

In the accepted sense of the phrase - a "life coach" would likely be one of the worst people to set loose on him.
A support worker who comes in to help him stay in order, make sure his essentials are dealt with for an hour a day or a few times a week might be more appropriate and (I hope) what you are thinking of.

 

[GadAbout]

...However, what he has been going through while on his own is very different from what we saw throughout his childhood. Especially in high school. He had a small group of very good friends, who were of outstanding character imo, very close knit friends through 3 years of drama production, and casual friends thru Boy Scouts , cross country track, band and TKD (2nd degree Black belt). He showed no problems showing up at events either with his friends or on his own. He and his best friend went to the prom together, both “straight” and he good naturedly took any teasing and had a great time.
Then he lived on campus and “fell off the world”.

What I see above that is different is structure. His parents and school provided some structured activities and opportunities, and now he has to provide that on his own. This requires executive functions such as planning, ordering, and executing actions. I suspect this is the biggest problem for your son.

Life coach is one way to look at it, but occupational therapists can also work with an adult to learn some ways of dealing with this. But it will need a client (you, or your son) to express what is needed and oversee it.

Can you talk with your son about this and other ideas you have been offered here? Then you could get buy-in from him, hopefully, without which no change is likely to happen.

 

[Poohbear]

How long has he been on ADD meds? Do they help him in any way? Has his executive function deteriorated since he has been on them?

I had to take some time to think about this.
Why is this a concern?
I believe I have seen a decline in executive function ever since he went to his first college. It was less in the beginning and noticeable when we first found out he was failing classes. He was not on ADD meds at that time, did not drink caffeinated drinks except occasional hot chocolate, and despised alcohol, so no stimulants or any other drug at all to blame. He was diagnosed being on the spectrum after he was dismissed from college for continuing to fail classes and started counseling with someone who firmly believed in cognitive behaviour therapy over meds, but after a couple years, and failing classes at a community college, that counseler suggested Adderall might help. Fast forward to the past year.....my son finally asked his psychiatrist for antidepressants after talking to counselors at his current college about his symptoms of depression. In January he changed to Concerta to see if it’s a better med for him than Adderall. So now he’s on stimulants and Prozac antidepressants, says they maybe help “some” and seems to be suffering more from defects in cognitive function (overwhelmed by deadlines, organization, not remembering tasks, even forgetting hygiene) than ever . So I can’t tell if it’s worse on the meds or if there’s been a steady but continuous decline over the past several years. He does tell me the stimulants help him wake up in the “morning”......in quotes because my idea of morning is before 9 am.
So is add meds a concern for deteriorating executive function?

 

[Autistamatic]

There is mounting apocryphal evidence that Adderall and all it's relatives can impair executive functioning at the cost of increasing concentration at school. People taking it can become better students at the cost of becoming less capable at "life". There's a trade off with every drug. They are also associated with a loss of creativity, reduced motivation and depression.

SSRIs like fluoxetine may reduce depression but also can reduce creativity, motivation and overall emotional response. They can also worsen existing depression.

 

[Poohbear]

What I see above that is different is structure. His parents and school provided some structured activities and opportunities, and now he has to provide that on his own. This requires executive functions such as planning, ordering, and executing actions. I suspect this is the biggest problem for your son.

Life coach is one way to look at it, but occupational therapists can also work with an adult to learn some ways of dealing with this. But it will need a client (you, or your son) to express what is needed and oversee it.

Can you talk with your son about this and other ideas you have been offered here? Then you could get buy-in from him, hopefully, without which no change is likely to happen.

I agree.....EF has always been his problem, not focus. Taking meds has helped him be more aware, especially earlier in the day, but the organizing/planning/executing deficits eventually overwhelm him. Burnout would fit.
And without structured activities he wouldn’t get much chance to socialize, make friends etc. since he doesn’t strike up conversations with a stranger (God bless him, he disapproves of me talking to strangers when he’s around also
An OT would be like a counselor..... Meeting a couple times per week? I will look into it. Thanks.

 

[Poohbear]

There is mounting apocryphal evidence that Adderall and all it's relatives can impair executive functioning at the cost of increasing concentration at school. People taking it can become better students at the cost of becoming less capable at "life". There's a trade off with every drug. They are also associated with a loss of creativity, reduced motivation and depression.

SSRIs like fluoxetine may reduce depression but also can reduce creativity, motivation and overall emotional response. They can also worsen existing depression.

I have not heard this. Do you have any references? He spent all of his childhood without these meds and over the past several years I think he has become more anxious, isolated and less goal motivated than in childhood. He claims the depression is still there.

 

[Autistamatic]

Unfortunately almost all information I have come across at this point is, as I said, apocryphal, as it always is until the perpetrators cannot hide it anymore. It takes either overwhelming scientific evidence, or class-action suits to get the drug companies to take action. The annals of pharmaceutical history are riddled with such stories. It took a great many thalidomide babies, or heart attacks induced by rofecoxib before the problems or side-effects were even acknowledged.

I have never taken any medications of the type under discussion myself, so have only the interest of a concerned outsider.

I'm not saying that there is a connection in your son's case, that would be for you and he to reflect on and decide. The stories I have come across, through social media posts mainly, have described a reduction of overall motivation, absence of creativity (permanent "writer's block" et al), increase in depression/anxiety, and a depletion of interest in or awareness of personal maintenance coinciding with the initiation of such drugs, which ceased after stopping the medication.

That is why I asked the question - I was curious whether you had made the same connection, since your description of events suggested that his deterioration in EF may have occurred around or not long after the time the drugs were first administered.

I do not mean to sow doubt in your mind, I enquired after doubt I perceived as possibly already existing.

 

[GadAbout]

...An OT would be like a counselor..... Meeting a couple times per week? I will look into it. Thanks.

I think in some cases they can actually come to a person's house, for instance to help organize a household. Since your son lives in a dorm, that's probably not so necessary, so he would go to them and go over a weekly planner, etc.

It's not counseling in the "psychotherapy" sense; it would be more task oriented. However, there might be some overlap - for instance, if your son has trouble asking a professor for an accommodation, some role-playing might give him the words to do so.

What are your son's summer plans?