Family and Caregiver Schizophrenia Discussion Forum

Son Requires Direction and Lacks Good Memory

My 32 year son with sz lives my wife and I. He is doing pretty good but there are times that he requires so much direction and things to do. He hangs around in the kitchen waiting for us to give him something to do. My wife gives with chores in the kitchen and I have him working around the yard and in addition we ride bikes and play tennis. However, that is still not enough…lol. What can we do to give him something to occupy his time? He waits to watch movies with me at night which is the only time I see him relaxed. He is so lost without some direction or guidance. Is this normal for sz? He will not go out for any purpose unless it is with me shopping or going to work (part time) - which is really promising.

Also, he really seems to have issues with remembering things. His short term and long term memory seems really poor. He has no real awareness of things around him at times. Is this common?

I know that sz has many faces and this might be one them. Overall, he seems to be doing not bad but I am 62 and my wife is 58 and we can only keep him busy for so long.

The Doctor has prescribed 20 mg propranoloL to help him with his agitation (he is always bouncing his legs). That does not seem to help much.

Any ideas? Thanks

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adding supplements that help the brain are excellent. I have had great results in this area, especially with N Acetyl Cysteine and Sarcosine, which are amino acids and sold by Profrontal dot com. B complex and flax seed oil are also great for SZ and my daughter had amazing results adding that every day for the brain. You can also find these recommendations on the regular SZ dot com website. They also have on their website two other supplements, D-Alanine and D-Serine. My daughter did not try those two, but they must also be good to have them on the website as helpful for those with SZ.

I spoke with the doctor that is in charge of mental health for veterans in Southern California and he stated that it is the parents job to be sure that our loved ones are not over medicated and that was one of the biggest issues of taking the anti psychotics. The leg shaking can be a result of too much medication. I have read many testimonials that adding supplements can help with reduction of needing higher levels of meds.

That’s my son on most days as well. He doesn’t self direct or motivate consistently. Usually he waits on me to lead or suggest things on a daily basis. We live together and do pretty much everything together. On occasion he will decide that some household chores need to be done and he will do those without any prompting. He has jobs that he kind of “claimed” as his own like sweeping floors and taking out the trash. He’s also forgetful and doesn’t catch or notice details around him. I am 60 and my son is 36. Otherwise he is a really sweet guy and nice to be around. I think all of this falls under the “negative symptom” category, also known as lesser symptoms. One thing that helps my son look like he is self directing is helping him make a list of things he wants to do the next day, he does well with lists and he crosses things off as he gets to them. My son mostly likes TV and would watch it 24/7 if I didn’t intervene.

Checklists and mnemonics are helpful with memory, sequencing and organization when you have SZ. I use “mindmap” software that helps me organize my often non-linear thinking into lists, hierarchies and sequences. An occupational therapist should be able to evaluate his deficits and offer ways to compensate for them. They aren’t just for physical problems and they don’t necessarily need to related to vocational issues. CBT (cognitive behavioral therapy) can help with cognitive strategies to help with organizing and planning. SZ is said to affect “the executive function” which has to do with forming and executing plans. This is thought to reside in the frontal lobes of the brain. So his deficits aren’t surprising, but can be compensated for, and neuroplasicities can in some cases help rewire around them.

I’d encourage active rather than passive pursuits, and where possible activities that require social interaction. Anything that engages brain stimulus without overstimulating him, or creative pursuits that on the face appear more meditative, but still stimulate.

I took up singing, guitar and eventually acting. I also took a pottery class, but didn’t stick with it. These were both one-on-one and group activities. Card and board games are good. Solo pen and paper games like crosswords, sudoku, word find, jigsaw puzzles and paint by numbers are good if you don’t have time for interaction. Gardening, sewing, crotchet or other handwork could help too. Pet care is often very therapeutic. Pretty much any activity you might give to a kid or an elder to keep them occupied is what you’re looking for. Don’t dismiss any ideas that might seem babyish or dull, you never know what he might like. His taste in things will likely have changed, or he may feel emboldened to do something he’d always wanted to do.

Per the akathesia (jumpy legs), what AP medication is he on? Sometimes adjusting dosages or switching to a new medication can help.

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He is on 4 mg of risperiDONE, 1 mg COGENTIN and 20 mg of propranoloL. The issue is not bad but it seems more apparent when he does not have anything to do.

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Not my favorite one, but everyone is different. Propranolol is a common treatment for akathisia, cogentin is more to counteract Parkinsonism effects like rigidity. Both risperdone and aripiprazole (Abilify) are more prone to akathisia, Vralar is similar to Abilify so I would expect it to be similar as far as akathisia is concerned. Switching to a different AP other than these may help, but could lead to weight gain. The fidgeting burns off calories. In some cases the akathisia remains even after AP medication is ceased.

I guess I shouldn’t over react. I wanted to ask you an off topic question. My son before SZ smoked marijuana and drank alcohol in the past. I believe he smoked and used CBD to smother the voices. To this day we do not know if the drinking and smoking caused the SZ or did he smoke and drink to mask his problem. Since he has been living with us for almost 5 months he has had no alcohol. However, in the last month or so, we have allowed him to have a beer once and awhile. Is that a mistake? He is 32 and at some point he might be on his own and I know he will drink. I figure better here with me under my care and supervision. I really hate to strip everything away from him. I keep reminding him that the combination of his meds and his condition could set him back and trigger his psychosis. He is respecting that and is very concerned not return to his prior self. Thoughts?

My opinion is an occasional beer is okay, although I would strongly discourage any cannabis use. There are studies that indicate it can be a factor in onset and exacerbate existing psychosis. I don’t know much about CBT oil, although I’ve seen it used in animals to calm them.

Sometimes alcohol will mix with medication and increase any sedative effect, but it’s manageable in moderation and self limiting. I agree a certain degree of feeling ‘normal’ can help with recovery, what you want to watch for is dependence. I’m not much of a drinker or smoker (cigarettes or otherwise), but I do have a caffeine problem at times and have to take care I don’t overdo it.

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Thank you Maggotbrane. I appreciate your feedback. I agree completely about cannabis.

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I would argue your son does not suffer as much from negative symptoms. This is clear when he actually has the motivation to do chores, play tennis and ride bikes. The average schizophrenic with negative symptoms likely won’t do any of those things. They cannot feel enjoyment from anything, similar to depression but without the depressed part.

The problems you describe are similar to ADHD. I also have memory problems and my psychiatrist is evaluating me for ADHD. I also get fidgety a lot but it’s different from your son’s akisthisia from medications. You say he also has no awareness of things around him, which sounds like he is hyperfocused at times at the detriment of other things occuring around him. The schizohrenia definitely can affect focus and memory also. I personally play a lot of video games and read a lot of books in my spare time. I think reading will help with his ability to focus and improve his cognitive faculties back to a pre-schizophrenia level. First person shooter video games or chess for example have also improved my focus and concentration, partially because they are interesting activities.

I go on www.twitch.tv a lot. It is a website with video game streamers. It might not be the best use of time, but I guess it is similar to watching movies. One benefit is that you can interact with the streamers and the rest of the community. There is also a psychiatrist that streams on there helping people.

I would say also to stay away from heavy drinking. Occasional beer once in a while is ok but my friend who smokes weed and drinks alcohol got his psychosis back. He is always repeating this cycle.

Lirik - that is very interesting. You might be on to something. He has started playing video games again, which I encourage and have taken some jobs on line (graphic designer). ADHD sounds very interesting. I might bring that up with his Doctor.

I agree completely with smoking and heavy drinking. I have repeatedly told him that smoking will trigger his psychosis - which is scary for him. Thank you.

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Thanks for mentioning video game play, I specifically recommended active and social activities to discourage it by omission. Certain video games aren’t particularly healthy in these and other regards. Some video games have decidedly linear narratives which may explain him continually asking “what happens next” outside gameplay. They can also lead to dopamine overstimulation and exhaustion, as they are setup in operant conditioning models that meet out doses of payouts like slot machines hook compulsive gamblers.

“Dopamine fasting” by staying away from video games and gamified social media is a fad in various high tech settings to optimize clear mental function. While this practice may be a bit dubious or less supported by science, most AP medications act on dopamine receptors, so I could see gameplay contributing to the lack of focus and clear thinking you describe.

I played a lot of video games and pinball in my prodrome, but I recognized solo gameplay was detrimental to my recovery, so I took a break from them. I am prone to VR sickness, so as 3D first person shooter narratives became popular, I found them difficult to play without becoming nauseous, so I was relegated to spectator status in social multiplayer games. Faster frame rates of newer game systems don’t make me quite as nauseous, but I play only sporadically in moderation, and usually focus on more open ended games.

The impact of negative symptoms vary per the individual, in my case I found social interaction especially on shared goals helped me overcome many of my tendencies to withdraw. Being part of activities and being given opportunities for socially recognized achievement can help. Has you considered involving your son in the mental health clubhouse systems for psychosocial development? I have no experience with these, but I’ve known a few “consumers” and mental health “professionals” who worked within the system and spoke highly of them.

What does dopamine overstimulation and exhaustion mean? I am quite tired every day and I sometimes wonder if it is because of me playing video games or my anti-psychotics. Granted, I don’t game as much anymore because I have played every single variation of game there is. I also have sometimes unrealistic expectations of my sleep schedule, as I want to sleep only 7 hours a day but end up sleeping 10 on most.

I do think www.twitch.tv could be a good way to socialize because it seems his son doesn’t have any friends he can hang out with. Surely you have heard of Ninja, he used to stream on there. I think socializing through internet has become the norm, especially with the people under the age of 20. You are right about video game addiction though. However, I think his son is doing ok given he is already working part time.

@Lirik here’s a link to an article about dopamine fasting.

I’m not sold on the science behind this, but the basic idea is overstimulation via dopamine rewards for food, gaming wins and sex leads to ahedonia which is one of the negative symptoms of SZ. I’m not sure of the full theory behind it, but I think the idea is dopamine receptors begin to anticipate they will get boosts of dopamine and it stops having an effect. Fasting is supposed to reset this dynamic. Back in the days of typical APs psychiatrists would sometimes give patients “drug holidays” with similar intent.

There are certainly ways that gaming can be social with mechanisms like twitch and discord servers etc. Considering the COVID-19 crisis more and more people will interact online. I just think when someone is first starting out on their recovery, having in person social interaction can be beneficial. I game from time to time and have had online relationships from the 1980’s on, but they are almost always enhanced by meetings IRL, so for someone just starting out I’d try to eliminate the middle-man to enhance their social skills. I’m a late boomer, so I may be a bit prejudiced toward online only relationships.

I was worried about my son returning to playing video games a couple of year ago, but at this point I see it as a benefit. They do occupy his thoughts, and provides him some motivation, and I haven’t seen any of the negative things be a bad influence for him. He also shares interesting screenshots on social media and its nice to see him participating in social media appropriately like that.
Yes, I would rather see him able to participate more in the social world, but, since that doesn’t appear to be possible, this has been an okay option.

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Our son is 26 yrs old with schizoaffective disorder. He also lacks good memory, but was able to get a very part time job thru the DVR program. He only works 3 hr shifts 3 days a week with an Old Navy Outlet. He puts clothes away from fitting rooms and now sanitizes after use.

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I would love to see my son progress to this point. For some time he was sure it wouldn’t be possible, but lately I sense he is beginning to see it as something he might be able to do. He has talked about volunteering and might try that once restrictions are further reduced.

Volunteering is a great place to start. My son liked working with the cats at the animal shelter. When he then started working thru DVR they trained him for the job and also limited his hrs to only work 3 hr shifts 3 days a week.

Hi, I have schizophrenia (28F) and my parents are in their mid 50s. Have you tried attending support groups or other meeting places like group therapy, day programs, or clubhouse to meet others who also have mental illness? Not all of it is about “doing the program”. I’m still social despite my illness for some reason so I’ve made close friends who also have schizophrenia through support group. (But some people do become less social post psychosis). I get invited out to birthday parties at least 3-4 times a year and I call them when I’m bored. :slight_smile: I like women’s group the most. I see people at clubhouse form large groups of friends that go out all the time. I get invited out by them sometimes, too, though I’m not part of clubhouse. Also, we recently got puppies so I cook for them and take them on walks. I like posting photos of them on Instagram and my old high school friends will even sometimes like my posts. Mine is a papillon chihuahua and it cheers me up having a dog. Back when I was a member of forum.Schizophrenia.com, many people liked having their pets too! I also help out with chores but it gets boring/can’t concentrate after an hour or so. I also like going out to the gardening shops to pick out flowers which I post to Instagram, going to the grocery store by myself to pick out snacks, I like having relatives visit, watching a scary movie, and in the past I held a few short term jobs as well, though I don’t like to volunteer because I don’t like most of the non paying jobs I found. My friend with sz volunteered for a religious organization, though, and being involved with your religion can be fun. :slight_smile: My parents are really worried about me too, though we’re getting by financially and they want to leave something for me when they die… but unfortunately they’ve turned their attention to why I’m not seriously dating. They bother me about my weight and my housework skills, lol. I am fairly attractive for an Asian girl and there are people who are willing to date me but I already like somebody and I don’t mind spending time with friends. If your son prefers staying home a lot, there will definitely be some times of boredom. When I meet guys with schizophrenia online who don’t want to live decently because they’ll never be successful anyway, I threaten them that they will regret it when they’re all alone, old, parents gone, never mustering a shower, etc. so better to get a good support system and practice while you’re still young.

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My son is 33, been back living with us since 2012.
He is SZ, and anytime he would go off his meds., He would end up in hospital. Now he gets a shot once a month and antidepressant. He does help his father and drives, but will not get a job. But gets SSD, and lives with us, so doesn’t have many expenses. Sleeps a lot, due to meds., But able to take care of himself, so it could be worse.

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