seesaw, I read what you shared and I think you are doing a good job with your nephew and I agree that his parents punishing him will only make things worse. I saw my parents do that with my older brother and it NEVER helped and only made him worse.

YES, individuals with ADHD can be extra challenged when it comes to learning how to control their anger. Actually, Yale has been studying children and what causes them to have temper tantrums and how to better address it instead of punishing. They explained that temper tantrums occur when there is an overload in the amygdala and the child genuinely doesn't know what to do and has a tantrum. So, instead of punishing them the advice is to give them time to calm down and then NOTICE they are making that effort and praise them for it. Taking away things he may already use to help calm him down is also not the answer.

The way you handled your nephew is much healthier because you LISTENED and you can tell how everything going on in his environment is stressing him. When someone has ADHD, they have very busy minds and they like MOTION so being home bound and tossed back and forth from one angry parent to the other is going to definitely aggrivate him and if he has no MOTION, he will have a hard time with the frustration he is experiencing.

I think that when you do talk to your brother, it's better to focus on how his son is struggling, why with his ADHD he can have a harder time controlling his stress and how to give him space instead of punishing him can help him rather than punishing him that is only going to cause MORE limit to him in his effort to manage his challenge with frustration that comes out in anger.

It's very hard to handle this kind of challenge seesaw for someone with ptsd AND a history of dealing with abuse that typically contains anger being thrown at him. It's possible his son triggers him and instead of stepping back, your brother feels anger and loses patience. From what I have noticed by observing my husband who has bad ADHD is they tend to ABSORB. So that means with the ongoing dysfunction your brother is having with his wife, your nephew is listening and ABSORBING. And at his age he doesn't have the coping skills to understand how to navigate with this ongoing problem between his parents. If your brother isn't careful, your nephew may end up using alcohol and that's the last thing your brother wants to happen. I have seen so many that have ADHD in those AA rooms including my husband. All the alcohol does is make things worse and prohibits emotional maturity.

And YES, the wrong medication can make it worse and if he is cutting, that's a red flag that he is probably on the wrong medication and more is not better, and often it can make things even worse.

I do think it's a good idea that your nephew be able to stay with you here and there. Can you take that on?? It's a big responsiblity. Yet, from what you have shared, I think you can provide him with more stability and help him learn to control this anger and manage it better.