How do you know if a person is mentally ill or is just being…

I think the point I was attempting to make is that even when being on/off meds causes changes in behavior, it is possible to moderate this behavior with relearning, retraining of one's reactions and responses, at least to a degree. For example, if you KNOW you are going to be super grumpy in the morning, is there anything you can learn to do to cope better with this, though you may not be able to change the basic mood state easily? The answer is obviously, yes. So what is happening is a complex interaction of biological/neurotransmitter issues and the need to bring some new learning processes into the picture. As I suggested, a good therapist would be working on this quite directly with you and your son by, for instance re-enacting bad mornings in the session through role plays, practicing responding differently IN SESSION. Sending family exercises home 'cold' without prior family preparation and some orientation and practice in a therapy session is generally, a good 'recipe' for failure and disappointment.

I'm a little surprised that the computer addiction issues isn't being addressed. Frankly, I think you need a different therapist. This is not really something that needs an inpatient, controlled setting to deal with. There are fairly straightforward approaches to this if a child is living at home. That is, the parents rules should be respected and followed and this means access to your wireless home system since you pay the bill. You actually have the ideal 'set up' for helping this kid face his addiction. This needs to be openly discussed and planned in a therapy session with everyone involved. Actually most addiction experts find that going cold turkey from internet contacts is the best way to help the patient gain a more reasonable perspective on this. Yes, the "withdrawal" will be emotionally distressing and upsetting, but it never killed anyone per se! It is simply upsetting! A few days of distress and despondency and sincere efforts to redirect one's attention to alternative activities can quite easily occur. So, I'm not sure why a plan hasn't been put in place to prepare for the process of 'unplugging' him for a time......and THEN using limited, periodic access to the computer as a means of reinforcing prosocial behavior and meeting other behavioral goals you, he and the therapists set for him. Frankly, the prospect of him failing again in a semester of college if he has this compulsion to play games on the computer going in, is incredibly high. My recommendation is deal with the addiction and then find a way to reinforce the heck out of him for learning/attempting proper study skills, completing homework etc. So, I think that you as parents 'get it' and his therapist does not, or really doesn't want to deal with it, doesn't think it is important, or won't talk to your son about it because your son refuses to discuss the topic. These would be my next steps---deal with the internet addiction, press the therapist for more hands-on live practice in how to deal with grumpy mornings, and focus on helping structure his study situation and setting at home so there is good privacy, and utilize access to the internet game sites in a limited way to reward compliance and appropriate study behaviors. This boy is fortunate to have you for a mom, that is for certain.

I hope this answers your question. Please let me know if I have overlooked anything in providing this response.

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