### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My child is very violent and abusive towards me. He is nine and has ADHD and PDD. He threatens me by saying he is going to kill me one day with a knife and punches, kicks and verbally abuses me. What is wrong and what can I do? He already sees a psychiatrist and a therapist and takes Adderral, Paxil and Trazadone. Something is wrong with him and it is getting worse as he gets older. What could it be and what can I do?

### output:

Your son may have bipolar disorder.  The things to consider are: Is there a family history of severe mood disorders? Does your child seem to have Chat Doctor.  If these seem to relate to your child, he needs to stop the Adderall, wean the Pail and start a mood stabilizing medication like Regret.  Once he has been stabilized on the Regret and the episodes have stopped, remaining ADHD symptoms can be safely treated with a stimulant medication.  These episodes are seizure like events arising from the amygdala and the use of a stimulant medication makes them more frequent and more severe.  So does the use of Pail.  When he starts Regret, you will immediately notice a few things.  He will be happier, will be able to sleep well, will not have such severe rages.  As the body builds a tolerance to Regret until the maximal metabolism of it is in place, you may notice backsliding and need to raise the dose repeatedly over a period of a week or two until he saturates the ability of his liver to metabolize it after which this level will remain steady, and he will stop having rages.  When this happens, you will notice what I call the Bigger stage, where he will be happy and very hyperactive, impulsive.  This is the time to start the stimulant medication to fuel the parts of the brain in the frontal area that have not been well fueled because the rage activity has been such a great consumer of fuel. Make sure his doctor is taking all of this seriously as interruption of this process will eventually extinguish it and prevent long term psychiatric disability.  Allowing these episodes to continue will cause the development of permanent neutral pathways of responding to life in the manner he does when in a rage and therein lies chronic psychiatric disability.  He is young and with proper treatment you can have your child back and assure his good future. Best of luck to you a feel free to contact me again should you run into difficulty or have further questions.  Remember, he is the child you love.  His symptoms are not him, and he is not in control of what he does during episodes of rage.