The last three years have been a rollercoaster of chaos and stress. I first fostered and then adopted my son and of course, DCFS didn't tell us all his problems so we went into this pretty blind. After a year and a half of near constant events, my son has been diagnosed with ultradian bipolar, conduct disorder, Reactive Attachment Disorder (RAD), PTSD and a neurodevelopmental disorder due to prenatal exposure to drugs and alcohol. In the last two years he's been expelled from every school, day treatment and residential program we've managed to get him into. He's been to every inpatient children hospital in the area and they only ever keep him for 3-8 days max. It got so bad at once point we refused to pick him up from the hospital so CPS would get involved and help us. The problem is that he's already burned through every Medicaid resource there is and now his psychiatrist wants him moved to the state hospital. So here's where I'm struggling. He's been in a day treatment program for the last month and doing decently well. He has bad days and those days cause me a lot of stress but they're nothing compared to how he behaved before. So I can tell he's really trying. But he's not stable on his medications so he's still having hypomanic episodes that result in me crying until I throw up and it makes us so stressed out that we can't get our work done (we have a business out of our home). The stress of the last 2-3 years has built up and up and up until now even tiny things set me off into panic attacks so bad I had to go to urgent care because I thought I was having a heart attack. The day treatment program he's in is basically teen daycare. It doesn't challenge him or teach him much, they don't have a real DBT or CBT program, there's no psychiatrist on staff monitoring his medications and it's not a lock-down facility. The state hospital has a lot more resources and is a lock-down unit but it's about an hour away and he'd probably have to be gone for six months. He's had bad experiences in previous placements with mental hospitals and I worry that sending him away will reinforce his Reactive Attachment Disorder (RAD) and PTSD. But on the other hand, I worry that if I don't send him, he won't learn what he needs to learn and get stable on his medications so he's safe to have at home. The psychiatrist says ultradian bipolar is particularly dangerous for kids because it's so erratic and deceptive. She says that he'll have periods of being more stable and it will seem like he's getting better but really he's not and a manic episode could happen at any time. She says he needs a structured environment where he can learn to manage his emotions and triggers without the distractions he has around him now. But I know if I send him he'll feel betrayed and thrown away and won't understand why he's being punished when he's worked hard for the last month to do better. I'm so conflicted. I wish I could see the future and know if he really is getting better or if he will relapse and therefore should go to the state hospital. I want him to be happy and healthy and have a bright future, no matter the cost to me. But the stress of making this choice is killing me. How do I make him understand that this is what's best for him? How do I get him to see that the behavior of one month doesn't undo the consequences of the last 2-3 years? How do I send him away without betraying his trust and making him feel like he's being thrown away by yet another parent? I love him so much but I just can't take the stress of walking on eggshells every day wondering when he's going to go from Dr. Jekyl to Mr. Hyde. We have so many other stressers, like finances and work and our own health that we can't focus on because everything is always about our son. So on some level I'm feeling guilt and shame that part of me would be relieved to have him safe somewhere so that I could focus on the other parts of my life. He'll be 18 soon so I'm running out of time to get him help and he's burned every other bridge. It's the state hospital or he stays in the day treatment he's in that's not really doing any good. What should I do?