Q: A month or so ago my 16 year old son told me he thought he might be bipolar because he experiences intense feelings of rage over little things, like someone making a rude comment to him at school. We talked about it and I said I thought some of his feelings were normal and he needed to learn how to deal with those feelings, maybe use techniques such as relaxation and visualization when he got upset. This past week, his girlfriend broke up with him, but was also kind of stringing him along, saying she didn’t know, and wanted to stay friends. On Friday, she told him she was going on a date with another boy. Later that night, my son called & the other boy answered the phone and taunted my son. My son went into a rage and drove over there w/several other boys ‘to beat him up’. My son had a baseball bat, and they broke out the window of the house. The police were called, all the boys ran. My son then went back to fess up, and he was arrested. Aside from the arrest issue, I am very worried about the rage. This morning my son told me he wanted to be prescribed medication, because if he had gotten into that house he would have beaten that boy to a pulp. He said he was so angry that he couldn’t see and just wanted to smash something, preferably the other boys face. When we talked, I asked if he had been drinking, and he said he had, and that might have prevented him from stopping action on his rage feelings. I will seek out counseling for him, but I don’t know what type of counseling he should have or what type of psychologist to look for. Or even how to start the search. Is this type of issue commonly treated with medication? Should he see a psychiatrist? How do I verify the counselor is a good one that can help? I don’t want someone to just prescribe medication and not also do counseling, how can I be sure the 2 are combined appropriately? I do feel that this may in large part be biologically based, as he has always been a moody child with temperament extremes, even as a baby. There has never been middle ground w/him, he is always up or down and he is very reactionary, usually in a verbal way. He does work out, and sometimes takes supplements, and I also wonder if that has impacted his moods. But on the other hand, he has never been in trouble, he makes good grades w/a heavy academic load, he is goal-oriented, he has no discipline record at school, he keeps himself busy w/athletics. If you could provide some guidance as to the steps we should take to deal w/this issue, as well as what outcomes to look for, I would appreciate it.
A: I agree with your plan of having him evaluated for both medication and therapy. There are several ways to find good practitioners in your area. Some people just call their insurance company or get on their website and look for people who list the specialties you want, such as anger issues, adolescents, mood disorders, etc. However, many people feel more comfortable starting with a more personal referral. I would suggest asking around for a recommendation. Talk to your family doctor and ask friends, coworkers, family, and neighbors. Chances are that someone will know of a practitioner who they have gone to or they will know someone who has. You may also check the phone book ads or online advertisements, again, looking for the specialties relating to your son’s issues. Many times you may also find educational anger management groups run by the local community mental health center, youth center, school or possibly even juvenile court. Reach out to everyone you can so that your son can get the help he needs before he finds himself in a worse situation than the one you described. Many times both depression and bipolar disorder can appear as anger and irritability in teens. It will be important to address both the biological aspects as well as the psychological ones. Sometimes it makes sense to try to find a therapist and therapist in the same practice or agency so they can share information. However, there are also times that this just isn’t possible or the referrals lead in different directions, in which case, you can sign releases so they can still communicate with each other. The good news is that you are involved and you care enough to get him some help. The even better news is that he is asking for help and will most likely cooperate. Maybe getting arrested was the wake up call he needed to realize that this issue is bigger than he is. It may also be good if he ends up on probation as a juvenile because many times the PO’s are social workers who really care about the kids and want to help them. Good luck with your situation and be persistent until you find the right match of services for your son and your family.
Last reviewed: By John M. Grohol, Psy.D. on 18 Nov 2006
Counts, H. (2006). Teen with rage and anger issues.. Psych Central. Retrieved on September 1, 2014, from http://psychcentral.com/ask-the-therapist/2006/11/18/teen-with-rage-and-anger-issues/