My message to you is to try not to worry. I do not think much can be known for sure yet. I would try to keep an open mind. I know how hard it is.
UPDATE - his diagnosis is now "major depression w possible psychotic features
Diagnoses have a lot of subjectivity. Each clinician has to put something, even after a few minutes interview.
I would try not to worry about this, either. My own son did not show either responsibility or compassion for years, and I worried too that he had lost his conscience. Now 27, it is clear that the fears were unwarranted. My son also has serious diagnoses. As he gets older I believe he is outgrowing some of it, or maybe that is the wrong word. Maybe it is he is learning how to cope better and his motivation to act more responsibly is moderating the influence of his symptoms. He is working better with what he has.
There is so much left to happen for your son. I know how hard this is. So much has yet to unfold. Try to ease your worry.
My son did too, when he was 22. I was so afraid.
What is there that you should face? It sounds to me that your son has issues that have not been nailed down. And he is very young. There is every possibility that he will overcome this. I do not see yet there is anything to accept with finality.
Now the brain injury can be something serious, but often not. Have the doctors identified lasting effects? Are they linking his current symptoms to the brain injury?
My son had a serious brain injury. When I told his therapist about it, she wanted to attribute his symptoms to the brain injury. (This infuriated me. Just because he had a brain injury does not mean the brain injury caused his anxiety or lability. He was this way before the brain injury.) Sure enough, now that he is maturing he is less labile. But he is still anxious. He has always been anxious.
Personally, I do not necessarily have a great deal of confidence in psychiatry and psychology. I have more confidence in our kids, in their ability to little to mature and to learn to accept life and deal with it.
I have had a very hard time accepting my son's limitations. I have had a very hard time accepting that my son would be so impaired that he could not have a full and complete life. It looks as if all of this was for naught.
My son is doing better, and I realize that that is all I ever really needed and wanted. He is seeing himself change and he on his own terms is deciding what his values are and he is finding his own motivation.
What I accepted or did not accept had no bearing on anything at all. Our children decide what and when, on their own timetable and terms.
My son's birth parents had AIDS. They were drug users and homeless. Each had some kind of psychiatric diagnosis. When my son was diagnosed as mentally ill, became homeless, was hospitalized and went on SSI, I feared, too, that history was repeating itself. It was not.
Sometimes our kids for a time feel the need to walk the path of a parent. In the case of my own son he is choosing another way now. I see this. Even still, when there is backsliding I fall back into fear and dread. I become as big or a bigger problem.
You refer to acceptance. Which is different from fear and dread. But accepting something that is not yet known and confirmed, is really accepting the worst case when the jury is still out. To me, it is not the best thing for either you or for your son.
It may become necessary down the road to accept something that has been confirmed and re-comfirmed by both multiple diagnoses, over time, and by confirmatory behavior by your son, over time, but I do not thing that time is here.