Living with a mentally ill adult

My husband and I have an 18 year old son who started his first day of college at a small college in Nebraska today.

For a long list of reasons, we moved him to Nebraska when he turned 18, 2 months ago today.  He moved into an apartment that we paid for, all bills paid for, fully furnished by us, fridge and pantry stocked by us, so he had no bills.  This was until he could get into the dorms earlier this month.

Part of understanding what is to follow is that he has a host of mental illness.  His birth mother drank and used through the entire pregnancy so he has Fetal Alcohol Effects/Syndrome and pre-natal drug exposure.  He also has ADHD, Oppositional Defiant Disorder, Obsessive Compulsive Disorder, Tourette's Syndrome, Reactive Attachment Disorder, Bi-Polar Disorder, Post Traumatic Stress Disorder and he was diagnosed with Borderline Personality Disorder before he was 18.  Technically a person can't be listed as Borderline Personality (a nice term for sociopath) until he/she is 18, but as the psychiatrist pointed out, no one wakes up on their 18th birthday and suddenly is affected.  But, this is what the medical community considers the criteria.

We have a fabulous psychiatrist here in Wisconsin that we have worked with for years.  He saw our son the month before he turned 18 and son talked about going off his medication.  Many of his disorder cannot be medicated but the ADHD and Bi-Polar can.  He's been on  medication since he was 4 years old, and it is very apparent when he is off his medication.

The psychiatrist told our son in no uncertain terms that going off his medication while he was making such major changes in his life was a VERY bad idea and that he should monitored if he decided to change the doses or try to go off his medication.  Most psychiatric medications need to decreased slowly rather than just stopped.

Before he moved, we made it abundantly clear to our son that our continued financial support of things like the cell phone bill would be dependent upon two things.  1) that he remain in school AND 2) that he remain on his medication.

About a month ago I had suspicions that he had gone off his medications.  There were little signs that I could detect even 10 hours away.  I called his doctor in Nebraska and confirmed that he had not had his medication refilled.  The doctor did not violate any HIPPA regulations.  Our son is considered a minor, for health reasons in Nebraska, until he is 19 and he signed a consent form when we got him set up with the doctor in Nebraska that allowed them to release any medical information to me.

My husband and I confronted him about the medication issue and at first he lied, then he finally confessed and became very hostile about it.  We have no right to keep him "drugged up" and so on.  These rantings are typical when he's off his medication.  We again reminded him that our financial support would cease if he chose to continue this.  We had already agreed that we would pay the doctor bills and the co-pays on the medications so there was no financial burden on him to continue the meds.  He was openly hostile to my husband, but much more polite to me.

Today, I received a text from son asking me to pay his cell phone bill. I reminded him that we were not paying the bill since he chose to go off his medication and he blew the, literally, thousands of dollars that he made at a job he had for the summer.  Actions have consequences I reminded him.  He became hostile and cursed me.

Now.... Why don't I argue with him and point out the errors of his ways and give him the logical reasons why we are doing this?  The simple answer is, you can't argue with a crazy person.  Off his medication he is crazy.  Many Bi-Polar people have cycles of mania and depression that cycle throughout the month or a certain time period.  Our son can cycle a dozen times in one day.  He's like a roller coaster and you never when the next high or low is coming.  The other issue is that his "manic" states are not happy. He becomes angry and violent.  This is one of the many reasons he was moved to Nebraska right away.  He has hurt me and we have a 9 year old daughter to consider as well.

Besides the Bi-Polar issue is Fetal Alcohol.  People who have FAE/FAS generally do not have cause and effect thinking.  That portion of their brain is destroyed by the alcohol and there is no fixing it.  There is no medication to handle this.  It also causes incredible impulsiveness.  This combination is dangerous.

While some people may think we are being cruel or abusive to our son, we cannot force him to take his medication, but we can impose consequences if he doesn't.  Homeless shelters, psychiatric wards and prisons are filled with mentally ill people who don't take their medication as prescribed. If our son chooses to continue this path, he will likely wind up in one of those three places, but it is beyond my control.  We have to do this form of tough love.  We only hope that people will understand and support this decision rather than criticize. I know many families who have faced this same situation and have had to take the same route. It is not easy and you can't understand how hard it is until you have been in this situation.

One of the hardest things in the world is to love someone with a mental illness.