Sir, My elder daughter, age 24 years is a patient of schizophrenia and is under treatment at PGI Chandigarh for the last 10 years. Presently she takes clozapine 200 mg single dose daily. Her problem is somewhat controlled but not totally cured. My younger son aged 17 years ,who is presently studying in class 12th (Non Medical stream) is quite intelligent and is presently taking coaching for Joint Entrance Exam of Engineering stream. His problem is that while he is quite at ease with Maths and Physics, he does not fare well in Chemistry. In weekly coaching/school test he does not fare well in Chemistry. Whenever, his results are out he is quite upset and gives up studying other subjects also. He does not want to go school/coaching institution and quarrels with his mother. When scolded for this, he becomes abusive and makes illogical arguments. However, after some time all is normal and he agrees to go to school/coaching institution . He does perform well in studies but again he is not consistent with his studies for the reasons mentioned above. Sometimes he is so optimistic that he he boasts of cracking IIT exam. But gives up easily when confronted with non performance. His lifestyle is somewhat similar. Sometimes, he cares well for his outlook, dress etc. But on another occasion, he does not care about his personal hygiene also. This issue was also discussed by me with Consular of my daughter at PGI Chandigarh, who asked me to bring my son for check up as soon as it is possible, but the problem is that my wife differs with me and says that our son has no psychiatry problem and it is just a behavioral problem and that would subside with the passage of time. She also fears that taking our son to PGI Chandigarh would make him dependent on medicines (with side effects) life long , as is the case with our elder daughter. Here in this context, I would request you to kindly advise me the right course. Thanking you.

Dr. Saul PereiraPsychologist46yrs exp

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The counselor could be right for some reasons and your wife could be right for other reasons. The timing of the problem your son manifests is very significant and something has to be done. The reason I say this is that he is in his late teens and this is the last time his issues will come up looking for a resolution goaded by hormonal imbalances, particularly testosterone. If you do not take care of it now, he will have permanent negative features and those will grow over time and will become serious if he is under any stress. He seems to be stress-prone already. The other problem is that he carries the same genes as his sister, and may be prone to schizophrenia if he lives under duress. His weakness in chemistry may be because of the impending inherited problem pushing to come out or he may have a mental block against chemistry that keeps him under stress. His mental swings from high confidence to low and anger outbursts can be quite indicative of impending problems. The best thing to do under these circumstances is to talk to him and warn him and see if he is amenable to meeting with the counselor and under his consent a lot of possibilities will open up. Perhaps you can take your wife to the counselor to let that person do some convincing for her too. The problem is that once your son has a breakdown, he would have activated the chemical, electrical and neurological pathways for a pathological condition. Then it will become curative work. Whereas what I am suggesting is that, if we are lucky, we could intervene now and bring about a preventive approach to the situation. Your son's entire history has to be taken into consideration along with the big age-gap between his sister and himself too, being a factor. So you must somehow take him to the counselor who can also advise as to when s/he wants to see him. You could also take him (in confidence with the counselor), in the guise of seeking career guidance because of his difficulty with chemistry, to explore other avenues for his professional choice in life. The counselor can take this opportunity to discuss his personality issues!!! 

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