If you are signed in by someone else, like the police, you are held until the doctor in charge determines that you are doing better and can be released.
This is not the case. Civil committments are far more complex than that.
There is no predictable pattern that anyone else other than the police committing/and or bringing in the person results in a 72 hr hold and that the police bringing the person in means the person will be held longer than the 72 hr hold or 'until they improve'.
And even a psychiatrist needs to go to a judge and get a judge's order, in most states, to extend anyone past the 72 hrs hold.
The admitting has full power to even decide if the person will have the 72 hr hold, in most cases, regardless of what led up to the trip to the hospital.
In a great many cases the person will be out in 45 min and won't even get the hold. Or they will be out in 5 days after having received NO treatment and done nothing more than 3 hots and a cot. There is NO guarantee that a trip to a hospital will even result in TREATMENT OF ANY TYPE. Or anything more than a brief discussion. Most people will refuse medication and be discharged. 'If you won't take medication then you have to leave'. Generally, to the horror of the person's family, the person will be back out on the street, angrier, sicker and with no treatment or anything useful or progressive happening. Don't kid yourself. These trips to the hospital usually amount to nothing. No one, in most cases, can compelll ANYONE to accept ANY treatment.
The son, at this point, hasn't done anything that would result in police taking him on a trip to a mental hospital.
Nothing you describe suggests Asperger's Syndrome, even a mild degree of it. I think the answer may be that Aspergers has become very misunderstood. Aspergers is a form of Autism. It isn't necessarily milder than autism as far as how disruptive or difficult people can be, and some doctors are lobbying to have Asperger's dropped and describe these folks as having 'mild' or 'high functioning' autism.
Bipolar? There is nothing you described that indicates Bipolar either, in any degree.
First of all, a good many people simply 'are like that'. No psychiatrist or psychologist would ever find a good many of these people to be diagnosable with any mental disorder.
As annoying as a lot of stubborn and manipulative behavior is to us, it does not always prove there is a mental illness. Some people simply are 'immature' and 'manipulative'!
It is very likely that people are 'like that' due to very subtle or slight brain defects. But today, those defects are not known to us, and it is not something we could treat or would diagnose - and in most cases, it is not something the person who has it, would agree to have treated. Because he would be sure any problems are someone else's fault(though that's often the reaction you get with ANY mental health problems - even with the most severe, chronic diseases).
The most obvious and common treatment for these 'problems in daily living' or 'adjustment failures' is counseling, but again, most people simply won't agree to do it.
We have to not jump to too many conclusions when we see hurtful, manipulative and stubborn, selfish behavior. There may be no mental disease at all - or it could be just the surface signs of a rather long LIST of mental disorders!
Sometimes, sometimes there is an underlying depression. All others see is poor behavior. Depression isn't always poetic or pretty and it isn't always typical-looking. So, some annoying, manipulative people are actually having depression, and feel better and cope better when treated for depression.
However, IF his behavior were extremely severe and destructive, especially if his behavior was extremely unvarying and rigid(rigid means that no matter what happens, even if he TRIES, he can't seem to handle his life any other way), it might be possible that he would be diagnosed with something by a psychiatrist.
If this behavior you describe is very very rigid, meaning he always takes the same tack in every single situation with every person, like an actor in a play, he might have a Personality Disorder. Personality disorders mean the person acts this way nearly ALL the time. He has trouble at work, at home, at school - everywhere. And he rarely if ever 'breaks out' of his patterns.
The person with Personality Disorder typically functions adequately. He HAS relationships, even though they are chaotic and dramatic and hurtful. He HAS a job, but he may not have it for long!
You said he was on 'anxiety medication'.
Well. Keep in mind that very often, people with problems do NOT tell their parents the truth about their mental health medications out of embarassment - or other reasons.
Why do I doubt his medicine is for 'anxiety'?
Well....because I have seen many people tell relatives they have 'depression' or 'anxiety' when they have something else. And because anti-anxiety and antidepressant medicines are very often used as drugs of abuse. So I take everything in and make a note of it, and assume until proven otherwise...nothing....LOL. Perhaps he DOES have anxiety and a doctor prescribed him medication. Or perhaps not. I just take it all in.
Why I start out slightly doubting he has anxiety? Because there is absolutely nothing you describe that suggests any anxiety at all. Perhaps there is a lot going on that you haven't mentioned - you may be focusing on the behaviors that hurt you the most(that is extremely normal and natural), and there may be more that he does that you don't even know about. But assuming that you've given a full description, no, nothing suggests anxiety.
I tend to imagine it's more likely he has a personality disorder. It's impossible to say without actually being a psychiatrist who interviews him at length and gets to see his detailed medical history, but that's what is suggested.
There's a couple possibilities. Borderline Personality Disorder, though he lacks much of the really severe drama that tends to go along with it. CBT (cognitive behavior therapy) is no longer the 'best and only' treatment for Borderline. Instead, psychiatrists are using more of a 'multi-pronged approach'. Supportive counseling, CBT, medication, structures, all together.
Narcissistic Personality Disorder - though that is a diagnosis that many people feel should be dropped, as it is so much 'on a continuum' - psychiatry speak for 'it's really hard to say at what point this moves from a 'normal annoying person' to a 'sick person needing therapy'.
Some doctors like to call narcissism and similar disorders, 'coping styles' and not even refer to them as 'personality disorders'. 'We are nervous about 'medicalizing' what is basically, 'being an annoying person'', as one psychiatrist told me. So there is some opinion and naming arguments going on about where to draw the line and what to call it, but the fact is, your son has a behavior that is likely to be persistent.
Counseling would help, medication would often help any underlying disorder, but people with these disorders are more likely to manipulate medical people to give them drugs they enjoy, than to diligently take medications that help them.
In other words, whatever you want to call it, whatever his doctor calls it, it's likely to be a persistent 'style'. It may or may not indicate a more serious underlying disease.
As for you, you will need to take a deep breath, tell yourself (AGAIN AND AGAIN) that this is not anyone's fault, including your own, and simply decide where you need to put your boundaries so he disrupts your life as little as possible.
You do not need to 'throw him out of your life'. You CAN LEARN SKILLS THAT WILL HELP TO DIRECT HIS BEHAVIOR AS WELL AS KEEP YOU A LOT HAPPIER!!!!
'Tough love' does not always mean disconnecting yourself from the person. And it doesn't always mean confrontations and 'interventions' - these tend to work very, very poorly with a long list of mental problems.
For example, he plays you off against your husband. There are ways of dealing with that - you may NEVER 100% stop him from doing it, but you may find ways to minimize it and keep you and hubby a LOT happier. For many parents that's the 'united front' - both parents always interact as a team. On the other hand, in some cases, you want to keep contact and won't jeapardize it by doing that - you may (rather accurately!!!) feel that the you are one of the only reasonable influences in his life, and make a strategic decision to keep that line connected to him. Be assured, though, there is NO one approach that is most effective in ALL situations.
Keep in mind that hurtful, disruptive behavior does NOT mean the person is enjoying hurting you, or gets ANY pleasure out of doing so. We only know how we are hurt - we rarely get to even glimpse the person's inner life - we interpret it based on how WE feel - which is - HURT! We ASSUME they enjoy it, have a choice, and are doing it deliberately TO HURT US.
That is not always the case, but tends to color our actions a lot. Much of our anger assumes this hurtful behavior is deliberate, calculated and intended to hurt. With many disordered people, this is not the case. Even the most manipulative and annoying person isn't always 'enjoying' himself.
That point at which each parent decides they have to withdraw and have 'had enough' - that's going to be different for every single situation.
