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[quote=Anonymous]
OP - The best advice you have been given is to get your son into a psychologist for a complete evaluation to get a full mental health screening.  He needs to be seeing no one less trained than this given his threats of self-injury and threats to family for whatever reasons.  You need to research the special interests/experience of psychologists to find one that best suits your son's need - even if it is out-of-network.  The psychologist can then make a referral to a psychiatrist with whom he/she works closely with.  There needs to be continuing consultation between both to manage changes in behavior and meds.  In terms of medication, is there something which your son can be given if he starts to spiral which would bring the anxiety/anger mood down quickly?

You do not mention DH and his role in your son's life and the dynamics of your family.  DH may, in fact, be a key to how DS is acting and he needs to be involved in the entire therapeutic process as well as you.  A therapist for both you and DH is needed so you can get guidance on managing the stress within the family, keep the lines of communication open and clear on things with you and DH, have a plan with DS's medical team on actions and consequences which are for his benefit, but also for your family's safety.  It is now or never to get your son the help he needs because hopefully if DS can regain a sense of balance, he will be willing to do the hard work to maintain it.  I would say it is the middle sibling who is probably also suffering the most in trying "to be good" and make no waves and yet is old enough to see really feel the damage older DS is doing to you hi sparents and the threats to youngest.  Be willing and open to work with a medical team and follow their suggestions if it includes a therapeutic day program or even residential setting for a time.  [/quote]

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