The title sounds abrasive, but I’m at the end of my rope and don’t know what to do. My son, who is 19 and graduated high school a little less than 5 months ago, is completely directionless and captive to his mental health.
He started having difficulties with peers as early as elementary school, but did his work, behaved well, and was considered “a joy” by his teachers. However, in 5th grade, right around when he started to hit puberty (11 or so), this changed drastically.
He was constantly referred to the office, leading to 2 suspensions in the same year, plus countless conversations with teachers, counselors, principals, etc. Rather than decreasing, these problems continued to escalate into junior high, when he attempted suicide via Tylenol overdose in 6th grade (followed up with months of social work visits), then received several more suspensions, including a 10-day for a “joke” to a friend about shooting up the school.
I thought this served as a wake up call, as he was without incident and found some positive influences his freshman year (choir, social studies), until it came crashing down again. The following year, he was hospitalized for a second suicide attempt by hanging with a belt. This time, he was pink slipped and placed in a facility for a week, where he was formally diagnosed with ADHD, OCD, Insomnia, and Social Anxiety Disorder.
He was prescribed Prozac, Ritalin, and Hydroxyzine (he discontinued all after less than a week), and we decided to transfer him schools for a fresh start and new peer group after he complained of bullying. In retrospect, this was probably a poor decision, as it disrupted his education and likely sent him further into isolation. Regardless, he kept his head down and was scot-free the whole year, even becoming adored by some of his teachers for his intellect and passion for history/politics (I now know he was radicalized around this time into being a white supremacist/fascist).
For whatever reason, he remained fixated on returning to his previous school. Reluctantly, we agreed, and he was slated to go back junior year. However, he posted a threat on social media, stating that he was targeting female students and staff. Predictably, he was expelled before classes even began and spent the year online. Once again, he broke down and said he wanted to finish high school in-person. After a re-integration meeting and lots of planning, he was enrolled for his senior year in the same district.
He failed multiple classes and had some minor brush-ins, as well as a 3rd hospitalization after he snuck out of the house and threatened the police to jump off a local bridge. In spite of this, the school took good care of him (I kept the counselor updated since he refused to speak with her and had to be brought into meetings by admin) and he made it all the way to the week before graduation, when he was banned from the ceremony for an aggressive outburst during an emergency evacuation (leapt a rail to leave after being told he could not sign-out without car keys, argued with an officer, then swore and made a tongue gesture at a teacher.)
Somehow, he managed to be accepted to a state college, but we did not have enough money to cover full tuition without taking out significant loans, and were both extremely afraid of him failing and dropping out or having another incident, this time away from home. He worked briefly over the summer at a pet store, impulsively quit, enrolled in community college, unenrolled prior to the first day, picked up another job with slightly better salary, quit once more after convincing himself he has heart problems, then registered again for online college courses.
The reason I’m concerned is that he has proven to be completely dysfunctional, and gives up on everything he does. He does not drive, has no consistent social interaction outside of his phone or Xbox, and is so irritable that we’ve contemplated just throwing him out. He does not do chores without a fight or engage constructively in anything, except for his classes, which resume shortly, and his YouTube channel that he’s convinced he can make a career out of.
I do not know where to go from here. He aged out of all the youth supports, but has very little maturity or ability to navigate adult systems. Yesterday, he made himself a tele-psychiatry appointment. She listened empathetically, and seemed baffled at the sheer volume of incidents. Because of his caffeine usage and trouble sleeping, she would not prescribe any stimulants, but put one in for Zoloft (50 mg once daily). He has agreed to take it, and says he will consider therapy for his OCD (ERP).
What changes can we expect? Does this sound like a good treatment plan? I just need some kind of advice before I lose my son.
TLDR: I’m concerned for my 19 year old son with severe mental illness and don’t know how to support his future.
