Expert: Joyce A. Anthony - 5/22/2008

Question
I am a mother of a 10 year old boy. He has had some anger issues throughout his life, but until recently has been able to control it pretty well. Recently he has been experiencing episodes of uncontrollable anger and rage so severe that he has started physically attacking myself as well as his 2 younger sisters, 8 and 4, sometimes unprovoked, when he is angry. Sometimes even just telling him no to something will cause him to throw something or hit us. I have taken him into his pediatrician and have an appt scheduled for him to see a mental health specialist. I have been doing some research on my own on mental illness as to try and figured out what could be causing this and what I can do to help him. I noticed he has numerous signs of depression, like withdrawing from favorite activities, inability to sleep, overeating, lack of interest in friends and activities and has even mentioned hurting others and himself recently. Whats most difficult for me is that he is extremely irritable and hostile and now using violence. He has been brought up in a home where hitting was not allowed and now he is even maKING up false allegations of being abused when he is the one abusing us. The last incident was 2 days ago when he got so angry because he was asked to go to bed and didnt want.He proceeded to get a butcher knife out of the kitchen and thtreaten to kill someone. I called the police and they took him into the er for a mental health evaluation. while there my son told them the reason he did it was because I hit him first, which Ive NEVER done once. (I dont use physical violence as punishment. )They checked him out and saw he had no marks or injuries and called me after 3 hours to come and pick him up. The only thing they could come up with was possible depression, but did nothing about it. So, needless to say, I am at my wits end. The last thing I want is for him to have to be put on medication or taken away but Im running out of options because no one can seem to find out what is wrong with him. He has never been physically or sexually abused and I cxant get him to tell me or find out what triggered the recent violent outbursts. Any ideas what is wrong with him and what can be done?

Answer
Hi Brandy:

There is something definitely going on with your son, although there will need to be some more evaluating--by a child psychiatrist--to determine what exactly it is.  

You described some typical childhood bipolar symptoms, especially a depressive episode.  Look in your phone book for child psychiatrists and set up an appointment as soon as possible. The violence makes this an emergency situation.  Do you have a mental health crisis service where you are?  If so, please write down the number and do not hesitate to call them at any signs of violence.  They may also be able to help direct you to appropriate mental health aid.

The sudden onset of symptoms such as this can be very confusing, and scary--for parents, siblings and the child involved.  Medication is a hard decision to make, but it may be necessary.  First, set up a psychological evaluation for your son--and then take it from there.

One last thing.  Let your son know that, no matter how he feels, violence is not an appropriate action.  Have some kind of safety plan in place--a place for your other children to go during an episode, etc and do not hesitate to call the police again if necessary.  

Please feel free to ask any other questions you may have.

                          Joyce A. Anthony