Q. My son is 12-1/2 years old and has had problems with aggression, rage, sadness, outbursts and many other things since he was a toddler. He seems to not handle any change well. When we moved almost two years ago, he went on a downhill spiral and has been through two schools and is now in a day treatment/wilderness type of school.

Yesterday his older brother told me that he had witnessed my 12 year old cutting/scratching his arm with something. I went and had my 12 year old show me his arms. On the inside of the forearm of both arms he had taken a flathead, sharp screwdriver and scraped the skin. On one arm it had broken the skin slightly to where I could see a little blood. He also had scratches on his shoulder and legs. My blood ran cold. This scares me so badly. I do not understand. He is on 75mg of Zoloft in the morning and 1/2 mg of Risperdal in the evening. We have had an alphabet soup variety of diagnoses down through the years, but this is new. He has recently been in the hospital back in October for threats of suicide and hitting a teacher. We are at the end of our rope. How do we help him? Can we help him? Why is it so hard to find good Psychological help for him?

His story is long, his problems span his entire life of 12 years. How can we first identify what he really has, secondly find a treatment that will work and third keep our family together during all of this? We have a 15 year old and a 2-1/2 year old. I am scared for my child.

A. It sounds like your son is already on a pretty good medication for treating most of the symptoms you describe, and I would assume he is in pretty good hands or he would not be on the right type of medication. I would let your doctor know about your concerns. If you feel the problems your son has are not being addressed, get a second opinion. Most teaching hospitals/medical school affiliated hospitals have good child psychiatry, and this would be a good place for a second opinion.