Boundaries ,psychotic delusions and grandiosity.

[Listener3981]

My adult son , aged 21,has moved home . He was recently hospitalized and was released as the latest psychiatrist felt they cannot help him there.He exhibits many traits of BPD. He has also been placed on the autism scale , although a recent ,more in depth diagnosis by a psychiatrist believes he also shows traits of schizoaffective disorder. He is often emotionally disregulated. He became  psychotic a little over a year ago. During his most recent hospitalization he stated believed he was " the antichrist". He was emotionally labile, going from anguish to laughing to threatening within minutes and running around in his apartment in very high states of agitation. The psychiatrist that initially treated him on this hospitalization took him off of Vyvanse, an oral amphetamine, he had been taking for about 1and 1/2 years. It was about 2 months after he was prescribed the next to maximum dose of the Vyvanse that we noticed extreme agitation and emotional regulation. We were not aware that amphetamines can exacerbate BPD traits, as we had never been aware he was suffering from BPD until he was admitted for the first time 17 months ago. The psychiatrist he saw on his most recent, involuntary admission, worked very diligently with us and an assistant to try to help our son. He scheduled a hearing to have our son's stay extended as he believed his condition would worsen were he to be released.  The board agreed with him and allowed an extension. 2 days after that extension that psychiatrist left our city for a job elsewhere. Within two days of him leaving, his new psychiatrist discharged him . He said our son was not cooperating and later told us that his psychosis my last several more months , if he can stay away from the amphetamines which have been discontinued. A year ago, the GP that initially prescribed the Vyvanse for him , tapered him off of  the Vyvanse as he was convinced that the maximum dose he had prescibed him had induced psychosis and extreme agitation. Unfortunately , our son quit that doctor, as soon as he could ,after not having the vyvanse prescription anymore. Our found a nurse practitioner to prescribe him the Vyvanse again at the next to maximum dose within days and his psychosis deepened. He was admitted ,voluntarily, three more times. His most recent admission was involuntary, initiated by my wife and I, as  he was always agitated,emotionally labile and was now saying he was an antichrist developed by the CIA and that he could kill anyone at anytime by simply wishing it.  He had told me he needed to annihilate all the people in his apartment block the same day we got the order from a court for the involuntary stay. He was released from hospital 3 weeks ago , and within days of release, went around , communicating to various  occupiers of apartments near and above him of their possible demise because of their role in hiding certain friends of his that will be the only survivors of a human extinction event triggered by our son, the antichrist. Surprise! He was evicted. He is residing at home right now as we do not feel he will do very well living on the street. I believe he is just exhausted from trying to be good enough to be loved and now is taking the extreme other tact, trying  to be so abhorrent that he doesn't have to try. Anyone have advice on dealing with delusions and extreme grandiosity?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Swimmy55]

I am very sorry to hear this about your son.   Dealing with delusions is extremely difficult . Reading between the lines, I take it your son has no interest in seeing another therapist/ psych? I agree with his former psych that his mental status may last for a while ..  How is he doing currently at home?