What causes disorganized thinking and behavior?
Patient: I have been dating a 59 year old man for nearly a year and have experienced multiple episodes where he says one thing one time, another thing another time--usually the opposite thing. An example is that one time, in an attempt to get me to remain in the relationship, he said he would propose to me in six months. A couple of weeks latter, he denied ever saying that to me, and any time I ve mentioned, hoping for an explanation, he remains silent. There were other times he said things like I ve been single for 14 years and tired of it, want to get married . A short time later, he said I ve been single for 14 years and do not want to get married . He also seems often unable to make decisions, unless either I or one of his family (usually his sister) urge him to decide. He recently spent over 6 months trying to get some very simple repairs done to his house. He insisted he couldn t get anyone to do them. I finally intervened and got a contractor I know to do the work. I do know that he has, in the past, one time 15 years ago, and another 1 year ago, had what the family refers to a mental breakdowns, the last time spending a month in a psychiatric unit, with no recovery, until seen by a psychiatrist, after he left the hospital. Not being a family member, I am not privy to his diagnosis. I just know that he takes a large number of medications. Another thing he does is sometimes come out with totally inappropriate, and what I consider bizarre, comments. A couple of examples: At the end of a regular checkup by his family Dr., after discovering they d both graduated H.S. in the same year, he said to her, Too bad we didn t know each other in high school, we might have got together . He couldn t understand why she just turned and left the room, not answering. He also said recently to a grocery store check out person (a girl): You re pretty good. You re pretty and you re good. Now, maybe that o.k., but it seemed strange to me, the way he later went around, boasting of what he d said, as if it was a really brilliant remark. The latest version of his lack of planning or whatever this suggests, is that he s been off-on re. marrying me for many months, in a very confusing way. So, I gave him the date of May 31 as a time for him to make a decision. The above described self-contradictory remarks re. marriage caused me to try to break-up with him several times, but I truly love the guy--the part that is sweet, kind, very lovable/affectionate. Anyway, with May 31 still a couple of months away, and without ever proposing to me or telling me of his decision, last night, at dinner, his sister said he remarked that She (meaning me) will sell her house here and move to ____ (where he has a house). I will rent out my house. We will buy a house there . There s nothing wrong with all he said, except we ve never made the decision to marry. I sure could use some professional help now. He really is nearly driving me nuts, and I myself am hovering close to depression (which I ve had in the past) due to his disorganized thinking and behavior. What would be the possible cause(s) of his disorganized thinking? Doctor: Thanks for being concerned about your partners health. I would directly answer your question by stating that your partner has a thinking problem. You mention that he was hospitalized a long time back, for a mental breakdown. There is only one possibility. I will politely inform you that, given the graphic descriptions of your partners behaviour, he may be suffering from Schizophrenia, Paranoid sub type. He might also be suffering from OCD (Obsessive Compulsive Disorder), in tandem with schizophrenia or as a distinct illness. I have answered your query by making a diagnosis based on your detailed description of your partners behavioural patterns, thoughts, speech, memory and actions as a schizophrenic with OCD, or as a person who suffers from Obsessions alone. Please take care of your partner. He's dilly dallying the marriage, but he's not doing these things to you on purpose. He just cannot help it. He needs professional help and medication. You must regularly give him the medication and make sure that he takes it in front of you.If you can accomplish this, he'll become "normal" and take the right decision to marry you. I really hope this helps you.Please feel free to re-post and take care of your health too.