MH in 18 year old

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My youngest son will be 19 this year. Currently, I am very worried about his mental health and the trajectory of his life.

He has always been an anxious person and his difficulties resulted in: attending a nurture group in his early school years; having dental appointments with a specialist dentist due to his anxiety; having extra support for literacy and numeracy at school; having speech and language therapy in a group at school because he would not speak in class and finally, having an EHCP with (SEMH) as the primary need when he refused school completely from the age of 14.

Just after he refused school, he was diagnosed with GAD and received some CBT, which was stopped after three sessions because he would not engage. Since formally leaving school, he attended college for three days, then refused to go; acquired two jobs, each of which he gave up after a day and secured an apprenticeship which he walked out of on the first day.

When I talk to him he says he does not care about making friends and he likes his routine. However, his routine is crippling: he has to eat the same thing just about every day; he spends hours at the gym or walking to get his 'steps' in; he is terrified of germs and cleans and sanitises all surfaces multiple times a day and he questions family members to see if they have a cold or have been exposed to germs.

Added to that, he has to go through various checks to make sure there are no intruders in the house and that everything is secure.

I suppose, this message has been triggered because the manager of the gym has offered my son a very part time role, just half a day a week. However, my son is panicking and says he will turn it down because it disrupts his routine too much and frightens him.

We talked a lot about his mental health last night and my son says he feels like he is not really part of the world and that his mind is 'separated' from his body. He states he does not think he will live very long and that he has no plans or dreams for the future.

I talked about seeking help, but he dismissed the idea.

I do not know what to do or how to help him. Should I just continue encouraging him to try things and/or to seek help, but not condemn him when he does/can not do so, or should I get 'tough' with him? We live alone together (father/husband visits) and my husband and eldest son are both on the autism spectrum (eldest son also has MH issues and is in residential care).

I realise I have written an essay, but I just feel a bit lost.

Really feel for you. All you can really do is provide basic human need (food, place to sleep etc) and accept that this is how he lives /wants to live at the moment. Like my situation, professionals will tell you he is an adult who can manage his own feelings on how he wants to live

Sorry you and he are going through this, op. I have lots of sympathy, having an 18 yo dd with GAD. However, your son's sounds a lot more serious and I'm surprised he is not also considered to have autism and OCD. Has he ever been put on meds for it? My dd has suffered since around age 14 and has just recently started meds after not coping with uni. It's early days but I am hopeful they are helping a bit.

Hello,

When he was 15, he was under CAMHS and I consulted with his psychologist who referred him for assessment for autism. However, my son did not want to pursue assessment and he had the right and capacity to refuse. I still have the letter of referral, should he chance his mind.

OCD is something my son acknowledges himself. He is locked into routines that do not give him pleasure. He uses them to control his anxiety. I just feel impotent as I stand on the landing and searches for intruders in my wardrobe and in the large chest in my room and how he has to gaze out of the window for exactly three minutes to make sure it is safe; make sure the curtain covers every chink of light (possibly a sensory thing) and stare at the switch on the cooker, feeling it for minutes to make sure it is off.

He has been like this for nearly five years, and still refuses external help.

That sounds so hard. I'm really surprised about the fact that at 15 he was able to refuse the assessment. I don't know what to say. I know how hard it is to watch your child/young adult struggle to live a normal life, but to be unable to get them to engage in any help must be heartbreaking .

Thank you ZaZa. You mention that your daughter has GAD. Do you think that rather than GAD. she may have a cluster of anxiety disorders? I feel that it the case with my son. I am sure he has health anxiety and OCD co-occurring with something like ASD.

Does your daughter receive any therapies for her anxiety as well as the medication?

I guess GAD is a broad description. She doesn't have autistic or OCD tendencies, bit does have social anxiety, health anxiety and a few phobias. She had counselling around age 15/16, and functioned ok for a while but the start of uni was too much and she decided to try meds. There should be some counselling too but as she's been away from uni she hasn't yet started it.