What’s wrong with my brother?

By Dr. Marie Hartwell-Walker

My brother is 38 years old and he has never lived on his own. He has always lived with our parents. He talks to himself all the time and he makes weird noises. He has no control over this behavior at all. Everyone in the family has talked to him about it and until very recently, he would not admit that something is wrong. If you ask him why he does it, he just says he is thinking out loud. He has a part time job, he drives, he seems to be able to function,but he has never had friends, a girlfriend, and he is very emotionless. He is very selfish, and does not really form attachments to anyone. He can be very verbally abusive and aggressive, and he is just weird. I really want someone to tell me what is causing his behavior, sometimes he sounds like he is talking to another person, and we are wondering if he hears voices. What is wrong with him? what is the medical term that would apply? he has been talking to himself since he was about 12 years old, but over time he has gotten much worse. He also makes strange movements with his hands, fluttering and shaking them, sort of the way I have seen autistic children’s hands flutter. Will my brother end up in a mental hospital if he doesn’t get help? can he be cured of this behavior? what is causing it? thank you for any answers you may be able to provide.

A: Without talking to your brother, I can’t make a definitive answer, of course. The same symptoms can be present for a number of diagnoses. However, given what you were able to tell me in a letter, a starting point might be high functioning autism or Aspergers Syndrome. Neither is fatal. Neither in themselves results in hospitalization. Most people with these diagnoses think their way of being in the world is just fine. Why don’t you do some research on the web and see what you think?

What is striking about your letter is that it seems that you and other family members are troubled by his behavior, lack of friends, etc. but he isn’t. That being the case, it’s unlikely that he will consent to an evaluation. But if he’s interested to know why he is different, you might suggest he see a psychologist or psychiatrist for an assessment. If I’m right – and if he’s interested – he could get some coaching in social skills and in managing the movements. He would have to be motivated to do this, though. If he’s not interested and he’s not distressed, chances are he’ll go through life being a bit odd but not as concerned about it as you are. In any case, if he’s not ill, just different, love him for who he is and let it go.

You might find it helpful to read the book, “Look me in the Eye” by John Elder Robison which is a first person account of life with Aspergers.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 4 Feb 2009

APA Reference
Hartwell-Walker, D. (2009). What’s wrong with my brother?. Psych Central. Retrieved on October 24, 2014, from http://psychcentral.com/ask-the-therapist/2009/02/04/whats-wrong-with-my-brother/