Expert: Libby Bonner - 3/28/2009

Question
QUESTION: My 20 yr. old son cannot get it together in life.  Anger issues (absent father) very bright, H.S. grad. 2006 had several jobs since longest for 6 months. Fired for smoking pot has wrecked 2 cars. friend was driving one. lies about everything will not take responsibility for anything. has punched several holes in walls and doors. I think he is stealing from family members. and me will not admit to anything. gets very angry when approached will not let famlily get close. paternal aunt dx. with chemical imbalance yrs. ago takes lithium daily. never bonded with step-father causing lot of strain on my marriage. Became very angry 4 days ago with me asking him about finding a job and getting a haircut to look presentable. punched hole in room door and left home with some clothes.  today someone broke into his room window, he says it was not him we cannot find anything missing but my husbands electric razor. I tried to make a long story short as possible.  PLEASE HELP I AM ABOUT TO GIVE UP AND I AM THE ONLY ONE THAT HAS NOT.

ANSWER: It is certain that your son is not well, though whether w/ bipolar and/or other illnesses it is hard to say.  The aunt is a good clue that he is probably ill....and my assumption is that he currently cannot behave differently because of untreated illness, or illnesses.
[Therefor, pls give up on all requests to him to be and do other than what is there now.  You all already know that he can't get or keep a job, and that asking him to get one, or telling him he must, is just sheer wasted energy....and an open invitation to more anger, more misbehavior.]

You need help from several sources.  Go to nami.org and find contact info for your state NAMI office and from affiliate/s near you.  At the NAMI site, or the state office, try to get names of any attys who deal w/ mental health issues - not just getting them on disability, but other issues as well.  Ask the state office specifically if there is a usual way that this sort of problem is handled in your state.

I would also go to treatmentadvocacycenter.org to to get some legal info, perhaps atty names, and to find out what your state does w/ regard to "assisted outpatient treatment."

[As an aside, I congratulate you and your husband for hanging in, even though now it is only you....barely.]

Here are the critical issues.  Without treatment or hospitalization," the concerns are that he could end up in jail, or injured/dead, or simply lost and gone....though it sounds as though he is not leaving soon.

It will take longer, probably, to get him treatment than to build in some things to keep him safe.  For instance, is there anywhere at all that he could bed down at night - could even be someone's garage, depending on weather.  If he had shelter, could you [and other family] pre-pay either a small sum to a grocery or to a very inexpensive cafe?  Not sure where he gets walking-around money, or gas money.....maybe, assuming he has any control of his own behavior at all, he gets those by doing small chores, doing them well, and not mouthing off about them.  Or, do you have city buses?  Get him a bus pass.

[Anyway, in the short term, put him in a cheap motel w/ prepaid meals nearby for a week while you figure out what to do.  Tape a letter to him to the outside of one of your house doors explaining that he can't be home for at least a week, and tell him that you are hopeful that everyone will make good use of a cooling-off period.]

In addition, I would change the external locks on the house, or add dead-bolts.  Don't know about first floor windows.

The issue to take up w/ atty, and NAMI state or local offices, is whether you can have him committed to a hospital.  But you need to make sure how long they would keep him and have some idea where he could go next - like a small residential living center while he continues to get better, gets meds adjusted.

Other issue/s.  Is there a hospital near that has a psych ward at all?  Is he covered by health insurance - I suspect not.

Do start going to a local NAMI. If there is not meeting very soon, ask if there are members whom you could call to ask some questions.  As soon as you can, take their 12 week free class Family to Family.  Perhaps later, your husband will agree to take it.

Here is some more help.  Don't try further dialogue w/ him until you buy the book by Woolis called When someone you love has a mental illness.  The book will help you feel less helpless, and you will start communicating w/ him in a more effective way, will trigger less anger, etc.

This second book would be a help to at least read:  author is Amador, title is I am not sick, I don't need help.  Get the later edition.  The process he suggests is not quick, but this is the one fast thing that I get from the book:  what does the person WANT?  Almost no matter what it is, you can assure them that seeing a doc and taking some meds will move them toward that goal.

Here also is a very good site for communicating:  helpguide.org.  The material may assume that the person already agrees w/ a diagnosis, but I think the dialogue examples are still very very useful.

It doesn't feel good, being him, doesn't feel good being angry about everything, having people always angry w/ you.  Take your good maternal instincts and hang onto those truths.  Also believe that things can be better and that solutions will be found.

Now - spend a lot of time at the nami.org site, call the state office, maybe contact an attorney, call a locksmith, find a roof for your son to be under -- for a week or for a while.

Write again whenever.





---------- FOLLOW-UP ----------

QUESTION: Thanks Dr. Bonner for your quick response.  Is there anyway possible I could have done something as a mother to deter this behavior.  Sometimes now in hindsight I have so many question about my own mothering skills.  It was so hard being a single parent with two children I have a daughter 4 yrs. older.  SO many questions did I work too much? spoil him, not spank him enough, should I have noticed something wrong when he was a child. I did suspect he might have ADHD. I forgot to mention that he picks the worse people to surround himself with,  Just found out that he possible has relationship with gang members.  Even most of the girls he choose. some or even worse off than he is. I will look into the books and web sites you suggested.  It is so hard to want so badly to help your child when he want even admit there is a problem.  I feel the same way about what you said and I pray everyday he does not end up in jail or dead.  He already got in trouble with pot in our sm. town but because of his fathers good family name the chief of police gave him a break.  I don't have much family left both parents deceased no brothers or sisters. My son once had a very close relationship with paternal grandmother but now she will not even allow him to her house. Thanks again for your answer.  God Bless! Gloria/Georgia.

Answer
Don't blame yourself.  Mental illness pretty much just happens.  Also, when he was just a school child, practically nothing was known about childhood mental illness [assuming that he was ill that early; we don't know] and nothing was written in magazines to alert parents.

Remember that we have all been imperfect parents, and we all had imperfect parents as well!

If you are going to be the person NOW who tries, w/ better information, to help him - or at least to keep him safe, if possible - I surely do mean for you to BUY the Woolis book.  It is your single best resource for improving communication and contact w/ him, for setting limits on his behavior, and for feeling like you have done all you could.  It will make you less discouraged.

Since you are in a small enough town that names mean something, and the police have given him a break, pls consider getting a committment order.  See an atty about it and then s/he or you, or both of you, can ask the police for help in rounding him up.  You will need to know beforehand whether you have any choice of hospitals....perhaps the police would honor your wishes in that regard...where he is to go.

Pls do also consider your safety in your home.  The Woolis book might help you decide IF he can safely continue at home, and under what agreement among all parties.  Remember, too, that you will be communicating better w/ him, with Woolis, so the odds go up that maybe he can be at home for awhile, with way less stress on everyone.

I hope your husband will even use some of the very simple techniques that Woolis spells out OR will let you be the one communicator w/ your son.  Your husband shouldn't give him the silent treatment - he should just not offer many suggestions on behavior to your son, nor express disappointment or anger.....

I hope things improve.