“My 18 year old, recently diagnosed son, has severe fits of destructive, violent rage. They usually occur late at night when his mind is racing and he cannot sleep or relax even with Xanex. He breaks things, puts holes in walls, kicks, punches, head butts just about anything in site. Thankfully his physical attacks have not been on another person but I’m afraid of that. Very afraid. My question is, what can I do during these rages? He wants me near him but tells me I don’t understand what he is going through therefore cannot give him advice. I know I cannot reason with him during these rages nor can I call 911 every time he’s raging. It’s a vicious cycle I cannot deal with. I’m lost not knowing how to handle him and very afraid his rage will turn on me or his sister and brother.”
I assume that your son is under the care of a physician as he has been given Xanax to control his anxiety and you state that he was recently diagnosed. If you haven’t already done so, contact his doctor. Even if he hasn’t signed a release, you can always talk to the doctor. You may want to send his doctor a letter describing his behavior. This helps the doctor know what’s really going on, and it’s also a great way for you to get it all down on paper and to gain a different perspective. If the doctor refuses to talk to you, then you need to try to find your son a new doctor. It’s possible that his meds need to be changed or adjusted. Unfortunately many of the medications (mood stabilizers) take months to work.
It’s not healthy to continue placing yourself and your other family members in danger. The best thing you can do is set hard boundaries with your son, and make a point to do this when he’s calm and being reasonable. Sometimes a signed contract between the two of you is helpful. You should let him know that this behavior will not be tolerated. Let him know that if you are forced to call the police one more time that you will press charges, have him arrested, and that he will no longer be able to live in your home. This may sound terribly harsh, but it’s sometimes what is needed to compel an individual to start managing their own health and behavior. This will either force him to gain control over his rages—because he does have some control—or push the issue with the authorities and break the terrible cycle in which you’ve found yourself. If you do go this route then you must be prepared to follow through with your threats. Change the locks; let authorities know that he is now homeless; have in place a backup plan for other housing such as the YMCA. Your local NAMI (National Alliance on Mental Illness) is a good source for support for you and your son. They may have housing suggestions.
I found that my own daughter—whose behavior was very similar to what you’re describing—did much better once she was out of the house and forced to take care of herself. It gave her the confidence and self esteem to find a job, stand on her own, and eventually recover. Remember, your son’s sense of self-worth has taken a terrible blow. He needs to rebuild this, but he can’t depend on you to do this for him. It’s good to be there for him when he needs you, but you should never tolerate physical or mental abuse.
Now to answer your question directly: there is not much you can do during these rages other than getting out of his way and protecting you and your other family members. Leaving the house and calling the police is often the only recourse.