Dale Archer, M.D. Thursday, February 2, 2017 Comments Off on Fearful/Anxious

Dear Dr. Archer,

My 43-year-old son has a difficult time socializing, and has a tough time retaining any instruction, unless it’s a routine. He has difficulty in gathering his thoughts together, and sometimes has anxiety attacks. He can express himself, but his vocabulary is limited. 

He experiences ringing in his ears, but is able to sleep. He lacks self-confidence, and from time to time needs someone with him to tackle a project. Presently he lives with his mother and me. 

He just lost his job as a truck driver after almost six years, and has plenty of fear. He is taking Risperdone, 5mg, but it doesn’t seem to be helping him at all. He is still under a doctor’s care.

What do you think? I’m sure it’s a chemical imbalance; I’d just like someone to give it a specific name.



Dear Chris,

It sounds like anxiety to me, but it could be on the autism spectrum, or possibly depression. Of course, I can’t make an accurate diagnosis simply from a letter.

I must say I’m surprised that the treating doc hasn’t given you a diagnosis. You might ask your son to sign a release of information, so you can discuss his situation with the doctor.

I find it interesting that he has been prescribed Risperdone, which is an antipsychotic medication. You don’t mention that the symptoms include hallucinations or delusions. If not, then I’m not sure why he is on this medication.

There is no way I can give this a name, or a diagnosis, via a letter. I strongly recommend a second opinion from a psychiatrist. I also think psychological testing would be appropriate to evaluate his socialization issues.

Getting the right diagnosis is the first step on the road to recovery, so do that, and make sure you stay involved.


Dear Dr. Archer,

In the past few months, I’ve become increasingly uncomfortable in social situations. I’m not depressed, and I’m perfectly content, as long as my routine of daydreaming isn’t disturbed.

It seems like I’m always daydreaming, or in deep thought, or having hypothetical conversations — brilliant, life-changing conversations that would dumbfound people if I could communicate the same way in person. 

It’s like I’ve forgotten how to socialize! 

I’ve always been shy, but still socially adept, and somewhat extroverted after warming up to people. Now I feel resentment toward my own mother when she interrupts my solitude. I even suspect she may do things on purpose because she likes to see me uncomfortable. This is the only situation that makes me cry, otherwise, people say I look blank.

I don’t feel strong emotions other than satisfaction or paranoia. I talk to my reflection, saying “she’s evil” about my mother after she sabotages my peace. Sudden noises and movement make me jump and get anxious. When I’m alone in the house, the slightest noise will have me looking throughout and calling out “Who’s there?” Even though mom is at work, I’m nervous that she snuck in. 

I don’t trust my mom, and I don’t trust my friends. I’m anticipating abuse, but I’m not abused. I feel like they’re all ganging up to deceive me. It’s not like this all the time, but often. I’ve since quit caring about my friendships. I’m at my happiest, most peaceful, most creative and least bored when I’m alone.

I feel rushed when someone wants to talk to me, and it’s a waste. I zone out, and either don’t hear what they say, or I forget. 

What’s happening to me? I’ve been paranoid since high school, but this fear of people, noise and absent-mindedness is recent. I don’t know what to do, and Mom is getting sick of my behavior.

She thinks I’m doing this on purpose, but why would I choose to be like this? Most of this started after I had to withdraw from college and move in with mom. I’m not depressed. Once in a while I have 30 minutes of giddiness, where I’m very happy. Most of the time, however, my mood is quiet. What’s going on?



Dear Chess,

Although anxiety and paranoia are distinct conditions, both can cause fear, confusion and uncertainty. What I’m most concerned with is the paranoia.

Paranoia is a feeling of being targeted by others, without any logical proof to back it up. Common symptoms include:

• Poor self-image

• Social isolation

• Belief that others always want to take advantage

• Inability to relax

• Inability to work with others

• Lack of trust.

Treatment for paranoia includes cognitive-behavioral therapy, which is popular among patients, and has a low relapse rate. Medication is often administered if there are more severe symptoms.

Predicting the prognosis of paranoia is difficult. The sooner you receive treatment, however, the better the prognosis. Learn all you can about paranoia and anxiety to understand more about what you are dealing with.

My advice is to get an assessment from a mental health professional. In a worst-case scenario, this could be an early-onset psychosis. Best case, merely adjustments disorder. But, you need to get formerly diagnosed, and go from there. Good luck.

Dr. Dale Archer is a board-certified psychiatrist who founded the Institute for Neuropsychiatry in Southwest Louisiana.  He is a frequent guest on Fox News, CNN Headline News and other national TV programs, and is the author of The ADHD Advantage and the New York Times’ best-selling book “Better than Normal.” Visit him at DrDaleArcher.com.

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