How to help my adult son who lives at home, is depressed and withdraws from the outside world?

Question

My 26-year-old son is in trouble. He went to college and graduated. He had a very tough time at school in West Virginia almost to the point of having PTSD now.

In high school he was very bright and very kind, but went to a private school as a day student because he was bullied at the local high school. He began to have anxiety, anger and depression and we put him on medication. Then at college they stole the medicine and he couldn't get more because in West Virginia there is a huge drug problem, so he ended up taking himself off the medication and going into unhealty withdrawals. His anger seemed to begin to increase.

Then, once when he was home from college, he became violent and angry and I called the cops. They put him away for 2 weeks at a mental house and then said there was nothing wrong with him. This was horrible. Back at school more anger and depression, doesn't fit in and gets kicked out of fraternity. So he graduated feeling alone and left out. Now he has been home from college for 2 years.

We have tried everything to help him but he won't accept any of it. No counseling, no medicine, no hope, no friends, no job. He still gets angry and we just deal with it until it passes and then he is sorry. I do think it started many years ago and we just didn't see how serious it was. He did have a couple of counselors in high school, but they all said he was great.

I don't know how to keep him invested in the outside world as he is becoming more reclusive and old friends think he is a loser. I read as much as I can but none of it is helpful. Not even prayers! We've tried everything.

So yes he is depressed and won't accept help. I fear suicide and he has said he wants to be dead. I cry when he says this and then sometimes later he apologizes. Since he won't accept outside help I need to be the one to help him (and my husband). What can I do?

Answer 1

Although it's not clear exactly what you're asking, I can sense your frustration and it sounds like you are fresh out of ideas. So I am assuming you're looking for new ideas, and with that said:

When he is in a good mood, sit down with him and ask him what he wants. As in, what he wants out of life in general. What kind of career, family or experiences does he hope for in his future? The idea is simply to hear him out and let him express his ideas, his hopes and dreams. It shouldn't be too serious. If having a big conversation about this stuff would be too out of the ordinary for you and your son, you could start by asking him a question like:

• Where would you travel if you could go anywhere, all expenses paid?
• If you get married one day do you see yourself having kids? How many kids?
• If you won a contest and received $20,000 to start a business, what kind of business would it be?

Ask thoughtful follow-up questions like, "what do you like about that?" Or, "what do you think would be the best part of XX?" Questions that will get him to keep exploring his ideas. Avoid being judgmental in any way whatsoever. An example of a bad question is, "how do you think you can achieve that?" ...let him do most of the talking.

This could be a game that you play at the dinner table each night--an approach my dad used when my brother and I were angsty teenagers. We would've sat in silence if we had it our way. Instead my dad made up this game where each night he'd ask a question, much like the examples above. It led to some really interesting conversations and we loved it. Only in hindsight is obvious that he was breaking down our angsty-teenager barriers.

Regardless of whether it is a game or one long conversation over tea, this might seem like a strange idea because I'm suggesting that you do NOT talk about any of his "issues" (for lack of a better word) when doing this. And I do not imagine that this will solve anything per se. But, this exercise came to mind after reading your question for a few reasons.

• First and foremost, if he is not willing to imagine his future or even fantasize about an ideal version of the future, that would indicate that his level of depression is quite serious. (Of course, if you and your son don't normally chat, it might be the case that he doesn't want to talk to you about those things, so I am not suggesting that if he is unwilling to play along that he is necessarily severely depressed. There is a difference, and what I mean is if he is actually not able to imagine his future, then that is a sign that his mind is in a state of depression).
• This kind of exercise might give you some insight into what your son thinks about his life. And so one reason for doing this is to provide you with reassurance.
• A third purpose is simply to prime your son to be thinking about his future. Perhaps his wheels will be turning a few hours after your conversation, and this might prompt him to action.
• Part of this exercise is about letting everyone express their ideas without judgment, and so it makes people better at respecting that everyone has their own ideas and opinions about things. This seems relevant because I get the sense that there is a difference between what you want for your son and what he wants for himself. This is very common, but it becomes problematic if you are not hearing him out. For example, not being on psychoactive medications is a totally legitimate choice that an adult can make, even if they do have a clinical diagnosis (though what you wrote indicates your son does not).

So that's my idea and why I think it's relevant. It won't fix your problems, but I think understanding what your son wants is an important first step. Wishing all the best for you and your family.

Answer 2

This doesn't sound like the kind of problem that will go away if left alone to follow its natural course. In fact, it sounds like it will get worse (before it gets better).

Telling him to "man up" is unlikely to help. However, you can do the same sort of contingency management you did when he was younger.

As a person of faith, you're probably aware of the story of The Prodigal Son--the reckless son who is always welcome to come back to his father's home. That's where your contingency planning should start: is there a path where he just needs to be kicked out. A lot of planning you start with from "today" depends on whether or not that's the end game, or if he always has the option of hiding out doing nothing. That's a brutal choice.

If he did better on meds, I don't understand any of your or his arguments for avoiding them. Even if we're talking ADHD and amphetamines, there are plenty of non-narcotic options which aren't technically addicting. And yes they may need to be tapered up and down by a responsible physician to avoid withdrawal effects, but that seems like a minor risk.

To me, this sounds like "how bad things happen." I don't think you have a ton of time before engaging him with some sort of intervention.

Answer 3

almost to the point of having PTSD now

This is a diagnosable problem. Perhaps your son feels the need to self-medicate because he is not getting help from medical professionals? Is it possible to try another doctor?

Yes, your son does have the right to refuse treatment and counselling. However, you also have the right to protect yourself and other family members. He has to control his temper.

If he threatens suicide, please call emergency services, in the USA and Canada, it is 9-1-1.

I agree that talking to him and not judging him is a great place to start. However imo, he owes you the same respect. He is not the only one in this situation. This hurts you, too. I think he has to give a little to get your support. This is taking a huge toll on you and your family. (In hospitals, medical professionals treat families with very sick relatives as pseudo-patients because they understand this so well.)

If he is rational, he will know that you care; that you love him and want the very best for him, and that he needs to care too.

If he won't get help, you still can. Counselling works for people having to deal with 'secondary' problems as well. A professional might be able to teach you how to help your son as well as help you make decisions about his care. I highly recommend that you get this help even if your son does not.

My heart goes out to you. It is easy for me to say "Don't be an enabler." It is anything but easy for you to be able to even begin to take that advice. You also may have emotional problems because you are living under such stress.

I honestly believe that this or any other web site cannot help you until you've seen a professional face to face. Then I'd suggest you find support groups online that are for people who truly understand what you are living with. I can't pretend to know.

Best of luck. Edited because I made an error.