I wish that I could answer all the questions that you, quite rightly, have about your son and his treatment based on an email consultation... But let me offer some thoughts that might be of help.
Clearly your son should not have suddenly stopped his medications, but also that is something that is extremely common for people with depression to do.
I believe the first medication your son was put on was mirtazapine. Mirtazapine is an antidepressant with a pretty high rate of significant weight gain.
I think the other medication is aripiprazole. Aripiprazole is a medication that is sometimes added to an antidepressant to boost the effect. It generally has somewhat less of an effect on weight gain.
The weight gain is probably not related to hormones, it is likely a direct effect of the medications on the brain's hunger centers leading to increased appetite.
For that reason it is often very difficult to change this effect without switching to a different medication (in other words switching from mirtazapine to a different antidepressant), fortunately there are antidepressants that don't seem to have this effect.
I suspect that your son's statement that he doesn't need antidepressants now is not accurate. I would suggest that he talk to his doctor about switching antidepressants rather than stopping them.
Pain is very commonly increased with depression.
I don't have much to offer about his scrotal pain other than the observation that pain may be made worse in depression.
Thanks a lot for your reply and suggestions. I wanted to add to my queries a little bit more by seeing the prescriptions given by the doctors. I have noticed that my son was initially given Mirtaz and sulpitac tabs. Mirtaz 15mg was given alongwith sulpitac 50mg and then after one month mirtaz tab was increased to 30mg alongwith sulpitac 50mg. It continued for almost one year the suddenly he stopped medicines and was on a visit to another country for 8 months. He was called back as he was getting into depression. When he came he was a lean boy. Around eight months he did not take meidcines. Now after coming back he was started with fludac alongwith Mirtaz 15 and thereafter mirtaz was reduced to 7.5 and then it was absolutely stopped but fuldac was continued for some time. He was complaining that he is not getting proper sleep because of fludac. Again he stopped the medeicines .His condition was that he was conversing in a very irritative mannar and was too suspicious about others.He was blaming parents for failiours in life. He burnt oujt books in the house which he thought were being used to cause ill effects on him. He suspected his cousine that he is telling something wrong about him before others and said the he would cut his neck if he see him before him Now again he is started with arpizole 5 mg and then increased to 10 mg. For some time after coming back from other country he was using ayurvedic medicines like Mentat etc for his depression. He also used some medicines which contain ashwagandha, which is a famous ayurvedic medicine for brain improvemnet. However doctor says that this aswhagandha improves suspecion in mond. I have told him to stop it. Now he says that my parents do not allow me to study what he wanted. In the last year of hi engg he went in depression. We were worried a lot about his depression so we were preoccupied with his treatment. we could not arrange finance or we could not concentrate properly what he should do further even he could not do it. I couldnot come to a conclusion about his further studies. He says the going to other country was his third option where as his second option was MBA and the first option was going to UK which was not done. We sent him to Canada for higher studies based on his wish only. He could not stay there as he fell sick and was not even able to go out to study. He says because we did not send him to UK alongwith other freinds he failed in life. Even whiile going to canada I was not satisfied with his health. He appeared right but not fully. He was telling the pains and sickness will continue I cannot stop my progress. I can get treatment where ever I am going. But this does not happen. In Canada he involved in sex activities and was worried that he got HIV. I was to struggle a lot to remove this thought that he do not have HIV as the reports were negative. How to remove this thouight from his mind that no body is responsible for his failiurs. My wife weeps a lot about him. Being one son she expected her son to be very active like other boys of the locality.
I suspect one incidence in college when the lecturere scolded him infront of other students lead to his depresseion , after this incidence he did not go to college for few days. his freinds says that that lecturers tells to every student to encourage their performance but is it advisable to scold students in front of other colleague students. In another incidence he was made fun by other freinds by pasting a poster on his back. After few days when he was going to gym he got swelling on his scrotal siince then he started taling in strange mannar and sat at house calmly. Now he is told that he is clinically ok and there is no problem in his scotal and he did not neet operation. His semen count is also ok but he complains pains and says that he is not able to sit for long and also cannot stand for long. He is not active. he just pass his time in browsing net monstly facebook. some time he goes to one freind who is from his college. His friend has failed fes subjects my son says that he is helping him instudies. Now while he is given aprizol 10 mg heis sleeping in time but some time the tab i missed because it is given without his knowledge, I donot know whether it causes trouble to him. Now today we met another doctor who says that my son can be given T .Arip MT 10mg which is easy to mix with something. He si not willing to try for a placement or job because he says the pain should go first then he can do something. He was showing lot of interest in prayers and became religious for few days even now also he goes for prayers but now regularity is not there. Recently he wanted a two wheeler for him. The two wheeler which he was driving was sold before he left to canada. I told him to take my vehicle as such i can purchase some cheap vehicle but he insisted i should not pujrchase any vehicle if i give him mine. He insisted he wanted a particular 150cc vihicle. I wanted him to purchase a fuel efficient vehicle. He said the vehicle which he wanted gives adequate milage as it was experienced by his freind where as i knew that the vehicle is a failed vehicle. I purchased the vehcle which he wanted. With regard to consulting with psychiatrist when his sister insisted that he should consult a psychiatrist again as it is very much necessary then after a lot of pursing he said that in case if every body consults then I will also consult.However the medicine which is given to him without his knowledge is suggested by the doctor on our consultaition. All this I am narrting to make you aware of his actual condition. Kindly suggest me what should I do now. I will give further details if required.
My personal opinion is that you should not be medicating your son. If your son is sufficently unwell and will not comply with taking medication, etc then perhaps he should be in hospital. Medicating your son is a breach of his rights and could jeopardise his safety.
I think that perhaps you are too invested in protecting your son and you need to let him take responsibility for himself and his actions.
If the doctors have thoroughly investigated his pain and have found no physical cause then there is a possibility it could be psychological.
When I am depressed I find that aches and pains seem worse. Being so vulnerable makes them harder to deal with too. Anxiety tends to make us focus on these things more too.
I think that you should be honest with your son. If he is not accepting of his need for help then it is your right to express your concerns with his doctor. It is then the doctors responsibility to respond (to assess, treat or hospitalise, etc).
Have you tried listening to your son. To me it sounds like you listen but then invalidate him by suggesting something else.
I understand that you are a concerned parent and that this is a difficult situation. I hope that you all can find a healthy way forward.
Than a lot for your concern about my son. I want to add that my son is a shy fellow. Since childhood he is a reserved personality. Now slowly he is opening himself. When he goes to doctor alongwith me I only have to tell to doctor , he donot have that much expression power to explain his total story however he replies in short. I always give him opportunty to talk and more over my son was in such a condition that he was hating parents. He never wanted to sit before me to explain his needs and conditions. I always tried that he should interact with me but he always irritated me. From his behavious what I understood that he wanted me to understand his needs or requirements either regarding his studies or any thing else without his explanation to me. In other words in his veiw explaining things before me was like begging something. He used to get so irritated on asking something or on instructing something that because of his irritation some times I used to get irritated inspite of a lot of paitience. Regarding his study he always blames his mother saying that she did not explain his need before me. But when he is not sitting before and explaining or interacting how could we understand why he wanted to go for a management course immediately after enginnerig. There were different opinions about this moreover my mind was preoccupied with his health conditions. Now when I consulted psychiatrist he says that my son must take arpizol tab without fail and that this tab may reduce his weight and pain also. My son says he is willing to take ayurveda medicine but not aloepethic one. Doctor said there is no such combination available in ayurveda. Hence we require to give this medicine to hime without his knowledge. If we do not give it then he will not get cured and will get further depression. Doctor says he is required to medicine for at least one and half year. How can we continiously give hime the mediince for somuch long time. I was explaining my son to accept doctor's advise but he is not listening. What should be done now. Shall I continue giving medicine to him without his knowledge or shall I leave him to get further depressed. There are examples that youngsters have become mad when there were no body to treat them in time and there is an example in my known people that one young boy died because there was no body to take care of him about his mental illness.
My personal belief is that the medication wont cure him either. It may help with some of his symptoms but I doubt that he would stay depression-free for very long.
I think that the betrayal of trust could do way more damage than the benefit you think you are gaining from medicating him.
You can't possibly be expected to give him his medication. Your son needs educating, etc about such matters. You need to first listen to what he is saying. I think that people tend to be more compliant when they feel heard.
Your post was addressed to the doctor and perhaps he can give you some advice.
If your son is unwell and needs to take medication but is not compliant then hospital could be an option. I'm not sure of treatment laws in India.
There is a mental health international exert forum. Although the doctor charges a fee for posting he is from India and may be better able to advise about what services and options are available to you and your family.
I understand what you're saying. I think that perhaps you're in a no win situation whatever you do. I think that hospital could be a good option for him (for now). ??
I'm just a layperson and are not qualified to make any decisions. Good luck!
Just so you know Jaquta (and myself) are just regular posters and not a psychiatrist like Dr.Forster. You just labelled your response to Jaquta as going to Dr. Forster so I thought I would clarify.
It must be hard seeing your only son struggle. That fact that he blames you must also be very painful. It is really important that you take care of yourself during this time. If your wife is crying a lot it may help her to talk to a psychologist or other talk therapist. It is a lot to deal with.
My parent's say I was a very hard child to raise. That comment hurt me but is probably true. I used to blame them for not understanding, not seeing how much I was struggling, not seeing through my lies. Now I see them as human beings who loved me but made some mistakes along the way. He may come around in time.
I am very surprised that you are allowed by his psychiatrist to medicate him without his consent. In Canada you need a court order to do that.
Treatment is tricky because medication is only about 60% of a successful outcome. The other 40% is therapy, finding out what your triggers are and avoiding them, diet and exercise. The medication can only take you so far. If there is anything he enjoys doing to be physically active it would be a real benefit to him. The endorphines released when you exercise help to regulate moods.
You are in a tough situation and I don't envy you. Make sure you take good care of yourself during this time.