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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4661
Experience:  MD Psychiatry
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My 17 year old nephew is failing out of school, doing drugs,

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My 17 year old nephew is failing out of school, doing drugs, has been arrested twice, wears black, has no friends, is overweight, and lacks motivation. My sister is at her wit's end. He seems like a would-be school shooter to me and to his parents. He has been diagnosed with ADD, however it is difficult to get him to take medication. A military academy has been discussed as an option, but is expensive. Do you feel that a radical intervention is necessary? Have you had success with similar cases?

Hi there,

It seems to me as , your nephew is suffering from A Conduct Disorder, which is a psychiatric condition seen in adolescents(youngsters/teenagers) .

Conduct disorder is a psychiatric condition characterised by a pattern of repetitive behavior where the rights of others or the current social norms are violated. Symptoms include

1)verbal and physical aggression,

2)cruel behavior toward people and pets,

3)destructive behavior,

4)lying, truancy, vandalism, and stealing.

Conduct disorder is a major public health problem because youth with conduct disorder not only inflict serious physical and psychological harm on others, but they are at greatly increased risk for incarceration, injury, depression, substance abuse, and death by homicide and suicide themselves.

After the age of 18, a conduct disorder may develop into antisocial personality disorder.

I believe your nephew is also a victim of such a disorder.

So. my earnest suggestion to you is that you show him to a Psychiatrist or Clinical Psychologist, who will assess him by carrying out a thorough physical and mental examination and required investigations.

As for the treatment of such a condition is concerned it mainly comprises of Psychotherapy( Professional Counselling) which is supposed to be carried out by a trained psychiatry expert.

For your knowledge the different types of psychotherapy that may be given as a remedy to treat conduct disorder are-

1)Behaviour therapy

2)Parental therapy and training programmes

3)Anger management

4)Group therapy

5)Residential care- such as residential placement in a foster home, group home or special school.

This condition needs utmost attention of your nephew's parents as at this age he needs to get his act right before it is too late.

I hope you consider the options which i have mentioned in my answer and hopefully are satisfied with it.



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Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4661
Experience: MD Psychiatry
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HiCustomer Conduct disorder is a possible and likely diagnosis, but your nephew may have a problem with depression as well. Children often express depression as externalizing behaviors such as irritability, aggression, or impulsiveness. Many teens that are depressed become withdrawn, amotivated, and experience anhedonia (a loss of interest in previously enjoyable activities. Drug abuse is also a possible problem leading to his behavioral problems that likely could be addressed by substance abuse treatment. Bipolar disorder could also be considered, many individuals with bipolar disorder initially present to the doctor with depression or with irritability and impulsiveness. Depression and bipolar disorder are treatable conditions which can be managed by psychotherapy, psychoeducation, and medication management where appropriate. I would suggest seeking professional help, preferably a child psychiatrist, for your nephew for a thorough evaluation of his symptoms and behaviors. Thanks and good luck with your nephew.

Hi there,

Well i always welcome responses from fellow experts, but to me it seems that it is more likely a conduct disorder , though one cannot rule out depression But it is unlikely that your nephew is suffering from it as a depressed person lacks physical energy , exuberance and aggressive attitude and is very ulikely to commit any kind of misdemeaner that would land him in police trouble as depressed person would want to be left alone and does not want to bother others.

As far as Bipolar disorder is concerned , as i have told you that it certainly is not depression and nor it is mania, because a manic has infectious gaiety and he likes to make others around him happy and so is very much liked by others, but since you have mentioned that he has no friends which itself contradicts the presence of mania.

So if it is not depression and not mania then obviously we cannot term your nephew as someone suffering from Bipolar disorder as one of the mentioned two must be present.

So , i would like to stick to my diagnosis of Conduct disorder and leave it to you to choose for yourself which answer appeals to you more.



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