This is on the level. A good friend is at wit’s end with his 18 year old son. the boy has been trouble since 14 (multiple suspensions from HS), due to explosive anger. Most recently, the boy punched a hole through a panel door-and broke a lamp in his room. He has been to anger management classes, and been treated by a psychologist-to no avail. last night, the parents called the police-he was shouting at the parents and breaking things. the police tried to reason with him-but the kid bolted out the backdoor and ran away. Does this sound like a serious mental illness? Would such a case be referred for hospitalization? the anger this kid exhibits is unbelievable-he gets to the point where he can’t be reasoned with-and his fact contorts with rage. Any thoughts?
Well, what did the psychologist say?
An 18 year old with those kind of rage issues is scary; that’s practically an adult’s body they’re swinging around. Any idea what happened around 14 to make this come on?
Well, his mother is divorced/remarried (the boy lives with the mother and step dad). Both are very good people; ans have overcompensated. His mother has given him nice clothes, cellphone, etc. The rages are frightening-I can’t figure it out.
Well, the kid had a medical work-up as well, right? Generally you get medical exam to rule out physical illness or other medical possibilities prior to getting a psychiatric evaluation. For example, if there was a brain tumour causing mood swings. Then one gets the psychiatric evaluation. A psychologist is often a very well-educated therapist. For really abnormal behavior they tend to try to refer you to a medical practitioner who can better assess you.
My son is bipolar. He has suffered some rages akin to what you mention. The first thing in this situation is parsing it out: is this psychological? A reaction to some recreational drug? An adverse reaction to some otherwise innocuous-seeming medicine? Swallowed asks a very pertinent question. My son had severe reactions to some ‘recreational’ drugs which caused some similar behavior.
If it’s psychological, and the boy is out of control, there’s always in-hospital treatment. In one of my son’s fits I mentioned this and it seemed to help him - to know that hospital is always there as a last resort.
I would counsel your friend to take the kid to a good Pdoc and have him evaluated. Believe it or not, these kids don’t want to be out of control - imagine how scary it is for them. At the moment, your friend is still the adult of the situation. It may be tough. At least your friend will know he did his best to help his son.
I send prayers for recovery and best wishes to the whole family.
I have some links to mental health sites which I will be happy to share if you are interested. 
Take him for a complete physical/psychological work-up. Somethin’s not right and it may very well be physical.
Something needs to be done. Being 18 the parents can’t do much. They can however take steps to protect themselves.
Thanks for the replies-the poor mother is at her wit’s end-but at least the boy is now under a doctor’s care. I suspect the illness is the bipolar - I’m hoping the medicine can help him.