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Physically Abusive Mentally Ill Son

Question:

Help! Our son is physically abusive to his sister and us. He has been diagnosed with bipolar and ADHD. He is 16 years old. We live with our bedroom doors locked at night for fear he will hurt us. I don’t want to live life like this anymore, but feel if we send him away we are giving up. He is drug and alcohol free, but for how long will that be, he has had drug tested. He has been to many psychologists, physchiatrists, mental health therapy, inpatient setting, etc. He is on lamictal, abilify, aderall, lithium. I am at my wits end. I am afraid to talk to him, wake him up or just disagree with him because of his retaliation. Any suggestions on medication changes? Maybe something we haven’t tried. We have had tegretol, depakote, ritalin, respirdal, stratera, concerta, remeron, etc.

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Answer:

This is one of those ultimately crappy situations life throws your way from time to time where you don’t get to have any outcome you want, but maybe you can have an outcome that is necessary, and which minimizes damage. On the one hand, you are (as a parent) responsible for this child and need to do everything you can to help him out in life. On the other hand, he has become a danger to you and your other child. You’ve clearly done good work in getting him to see the doctors and to receive the treatments that he needs to have his best shot at health. The list of medications that have been tried is staggering, actually. I am not a psychiatrist and thus cannot comment on the medications involved. However, it would appear that they are not enough if you are still fearing for your safety with him in the house. Something more appears to be needed under the circumstances.

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p> I can only guess at how difficult it would be to contemplate institutionalizing a child, but it might be something you have to not only consider, but actively seek out if you are to preserve sanity in your home and protect both yourselves and your daughter. I do not have a good idea of what sort of programs might be available for someone in your situation, so would suggest you speak with your local doctors who will hopefully be better informed than myself. Let me be clear that you’d be contemplating live-in therapeutic programs, not rubber rooms. It is a terrible thing that your family is having to endure, and it will not be made better by your failure to take protective action necessary to preserve your mutual safety.

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