How to lessen a depressed teenager's absences?

Question

Some context

Parents died horribly and unexpectedly years prior. This has caused a myriad of problems for us. It's just me (26) and my brother (16) left so I have to to be a parent figure to him. Due to these events, I was diagnosed with mixed depression and anxiety and my brother was diagnosed with major depressive disorder. Due to the symptoms of this disorder (mostly suicidal thoughts), he was forced out of an exclusive scholarship school on grade 9 (but still passed), and dropped out on grade 10 from a private school that I chose. He is now continuing grade 10 on a public school. If it matters, he is living with my aunt and only visits me on weekends so I am mostly managing him remotely.

Currently his teachers report that he is capable and intelligent and gets high marks in his tests so far. He was previously a consistent honor student before the diagnosis.

It is the last of my mom's unfulfilled dreams to have us complete our education. So the pressure is on us to accomplish it.

Problem

He is absent 1 to 3 times a week with any of a few reasons:

• Health issues: Stomach aches, headaches
• The most prevalent: Dark days. He describes this as mentally unable to do anything and physically fatigued.

Although teachers have expressed concerns on his absence, it is likely that he will graduate junior high but I am worried that this behavior is carried over to senior high and college which might be more strict.

I am trying to balance how not to stress him out (esp. to the point of having suicidal thoughts) but still being able discipline him.

What I tried

• We are both seeing a therapist (separate) and a psychiatrist (shared). We are assessed to be doing well since there are lesser suicidal thoughts and we are in the process of tapering off our meds. His therapist has given him techniques to survive dark days like grounding and joining. Both doctors agree that he should not stop school even temporarily as doing so will be detrimental to his mental health.
• I have offered incentives. (e.g. "If you have no absences for a month, I will buy you that headset that you wanted.") No incentives have been claimed so far. Harsh ultimatums/negative reinforcement (e.g. "If you are absent one more day this week, I will have you delete Mobile Legends forever.") has worked but I'd like to avoid it if I can.
• We have an agreement where he has to go to school even if it is a dark day and just go to the clinic to rest if it becomes unbearable. The therapist agrees that this deal is reasonable. He is sometimes able to do this.
• Since I am also experiencing dark days myself and am working full-time, we have an agreement where we limit both of our absences to once a week then slowly work it down to once a month. Based on his performance, I will decide whether or not to fund his college education. He will instead go to college on his own pace, terms, and resources. My logic is 1) some colleges are attendance-based. You will be dropped if you don't attend your classes regularly. 2) I refuse to invest my money in an uncertainty and 3) having no college education is not the end of the world. There are lots of successful people that are not college graduates. My brother has failed to uphold his end of the bargain so far. Therapist says that this might cause too much stress and I must dial it down.

Question

What other ways could I lessen his absences? What am I doing wrong?

Answer 1

It sounds to me like you are doing your best to help your brother. Kudos to you for the therapy, for both of you. And for trying to help bear the burden of the crushing depression that you both must be feeling right now. My heart really goes out to both of you.

I know first-hand what that kind of depression feels like. When I was in college I suffered from depression so bad that I would at times lay on my bed, physically unable to move. There's a weird kind of paralysis that can happen. It feels like a heavy weight crushing you down. It was hard to concentrate, or even to think at times, when bad feelings fill your head.

Punishment would have been completely ineffective, as would incentives, because my behavior had little to do with any choices that I was consciously making. Honestly, time was the only healer that did me any good. I wish I had told anyone that I was suffering from depression. I wish that I had gotten therapy. Any of those things might have helped.

My advice to you would be to just understand and share. He needs to get through this walking on his own feet. You can't carry him but you can walk with him. His grades won't be great while he is healing, but as long as he manages to keep moving forward he will eventually come out okay. My high school GPA was a bit over 1.0. yes, that's right. A "D" average. It's amazing that I made it into college. But I eventually graduated with a 3.0 and although I still have occasionally bad days my life is mostly on track. Therapy and the love of family helped me get here.