Howard Hughes was born in 1905 to parents, Allene and Howard Hughes Sr. Allene was a descendant of English royalty and Howard Sr. developed a patent for an oil drill bit which led to great financial success, with a multi million dollar company. Howard Hughes took an interest in his father’s mechanical inclination and developed skill as a self taught designer and engineer. His relationship with his mother was close, and likely conflicted. Allene was extremely protective of her son. She had a fear of germs and obsessed about protecting her son from the possibility of disease.
Allene died at the age of 39 as the result of a pregnancy complication. Howard was 17 at the time. His father, Howard Sr. died two years later of a heart attack. At the young age of 19, Howard Hughes was suddenly the beneficiary of a multi million dollar business. Hughes had been attending Rice University but left college, married and moved to Hollywood to pursue a career in the movie industry. He was extremely successful in Hollywood as an actor and director, making films such as The Outlaw and Hell’s Angels. He gained a reputation as a “ladies man” as a result of his many relationship and friendships with various actresses.
He shied away from publicity yet worked in a field that put him in the center of media attention. His enormous success in Hollywood made it difficult for him to avoid the media. In 1929, his wife divorced him. He had left her isolated at home alone for weeks at a time. Hughes had a love for aviation and developed a company to build aircraft. He was the designer, builder and pilot and successfully broke several word records of aircraft speed. He suffered serious injury as the result of an aircraft accident in1946. He was flying an e experimental Army spy plane at the time, when an oil leak resulted in difficulty.
Hughes was a skilled pilot and tried to save the plane but ended up crashing in a Beverly Hills neighborhood. While recovering in the hospital from his injuries, Hughes had the engineers from his personal plant build him a custom bed as he was not happy with the standard hospital bed. It was at about this time that Hughes began a long term dependence on painkillers. The obvious symptoms of an obsessive compulsive disorder became increasingly evident to the public and media in the 1950’s. He became a recluse and earned a reputation a being odd and possible unstable.
The sign of this behavior are evident in several scenes from the movie, Aviator. In the scene where he meets Errol Flynn, the peas on his plate are placed precisely and it is clear that he would not be comfortable with any other presentation. Peas were said to be his favorite food and he was incredibly particular about his eating patterns and habits. Another sign of the mental disorder was that he tended to repeat the same thoughts or sentences multiple times. This is shown in the scene where he repeatedly requests a set of blueprints for the Hercules, saying the same sentence over many times.
Hughes became obsessive and paranoid regarding a communist threat. He authored several articles which he sent to newspapers for publication. A scene from Aviator showed Hughes burning his entire wardrobe, presumably as the result of a break up with Katherine Hepburn. The perception at this time was that he was becoming increasingly paranoid. The public opinion was that this ever increasing odd and paranoid behavior was the result of a mental illness or from brain damage inflicted as a result of numerous accidents, or perhaps from the syphilis.
Howard Hughes was one of the best know individuals in America and perhaps the world. His interests spanned from movies, aerospace, engineering and medicine and he had gained much respect for his accomplishments during his lifetime. Yet, he practically disappeared from public view all together during the 1950’s. Hughes dies in 1976 and was in severely decompensated condition at the time. Analytical Axis I. Diagnosis: Anxiety Disorder (303. 23) and Polysubstance Dependance (304. 80) Howard Hughes exhibits all of the traits necessary to meet the diagnosis criteria for this disorder.
His battle with social phobia can be dated back to his childhood as a shy, withdrawn child. His mother’s obsession with the potential for illness and excessive fear of germs, likely exacerbated Hughes’ anxiety and led to the development of some avoidant behaviors. As a child, Hughes used illness as an excuse to avoid social situations. This resulted in his missing much school as a young boy. While he had remarkable success in his chosen fields, his interest in these pursuits appears to be as a result of genuine interest as opposed to ht need for public acceptance and acknowledgment.
For his history, it appears that he did not want to be famous, he simply was. Anxiety disorders can be associated with obsessive-compulsive disorders, substance abuse, and agoraphobia. All of these categories were issues for Howard Hughes. Hughes has a documented history of polysubstance dependence. Axis II. Diagnosis : Obsessive-Compulsive Disorder (300. 3) Howard Hughes exhibited the classic history and symtomology of an individual with Obsessive Compulsive Disorder. He had recurring and persistent thoughts that were not based in actual problems.
The obsession is evident in the extreme attention to detail including rewriting letters, repeating sentences and reshooting scenes. The difference between a health attention to detail and a disorder is one of degree. A disorder is noted when the attention and repletion is not based on actual or factual evidence. The repeating and redoing are simply repetitious without the positive outcome. Hughes mother, from the historical information, also appeared to suffer from obsessive compulsive disorder as evidence in her fear of germs and disease.
Hughes was a shy, introverted child, who suffered social anxiety as did his mother. The progression form a shy, anxious child to a reclusive and obsessive, compulsive adult is well documents in this mans history. Axis III. Diagnosis: Syphilis Howard Hughes contracted syphilis as a young man. This disease could be the basis for at least some of his behavior. The exacerbation of his symptoms and development of added disordered behavior could be the result of syphilis. The anxiety and obsessive compulsive behaviors were in place prior to the contraction of the syphilis so can not be discounted.
Axis IV Diagnosis: Problem with primary support group Howard Hughes lost both parents with the two year period of 17 and 19. He was particularly close with his mother who appeared to have many of the same issues and problem behaviors that he experienced. Her death, when he was only 17 left him with a father who was often absent form Howard life, though he appeared to be a more stable functioning person. Two years later, Howard Sr. died unexpectedly and left Hughes with a multi million dollar inheritance, no will and no support system. Axis V. Global Assessment of Functioning
The GAF for Howard Hughes likely changed many time over the years. At his best, Hughes probably functioned at a GAF of no more than a 70, and it is likely that it was closer to a 60. . He was so successful in his work, that the social issues may have been masked or even accepted as simple personality nuances for many years. As he aged, the symptoms became increasingly problematic and noticeable. Even though he continued to be extremely successful in his work, his obsessive behaviors, anxiety, avoidance and paranoia began to affect his day to day life. Treatment Recommendations
Treatment for this individual should have begun with his family when he was a young child exposed to his mother’s obsessive behaviors. Treatment of his mother would likely have had a major preventative influence of Howard Hughes own disorders. As an adult, the treatment for Howard Hughes would need to include cognitive behavior therapy to address the problematic behaviors. Medication to reduce the level of anxiety could have reduced the anxiety to a level that he would be able to gain insight and work to change, or learn to control the behaviors as well as the level of stress and possibly social phobia he experienced.
It is possible that he medicated himself through he use of pain killers to reduce the anxiety. This substance abuse, while understandable in that context, served to cause further problem and in the long term, worsen his symptoms. Substance abuse treatment would also be recommended. It is unclear if the diagnosis of syphilis was correctly diagnosed and treated. Early and appropriate treatment would make this medial issue less of a factor in the developing symptoms.