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I (28, male) am asking this question on my parents' behalf. My sibling, who I'll call Jay (24, nonbinary they/them) is currently in their 7th year of what should have been a 4-year BS college degree program. We are not concerned about the extra expense of it taking longer for Jay to graduate, but we are worried that they will be unable to do so if their pattern of behavior continues any longer. At the moment, we are all living together.

To provide some background information, Jay sustained multiple concussions in middle/high school that never fully recovered. Potentially related to those injuries, they have been clinically diagnosed with depression. Fortunately, they are not currently (but have in the past) exhibited any self-harm or suicidal tendencies, but that may change if their dream of graduating and getting a good job goes away. They have also been clinically diagnosed with narcolepsy. Throughout the years, Jay has gone to multiple doctors and psychiatrists (and continues to have appointments with doctors and psychiatrists) who have prescribed several medications in an attempt to manage both issues. Throughout Jay's previous college years, we accepted that poor performance was due to improper medication not enabling a sufficient physical or mental state to succeed. For example, some depression medication made them sleepy, some narcolepsy medication made them sad, and some medication just didn't work for them at all.

The medication that Jay is on now is "good" at treating both and allowing them to function, but only when they remember to take it. Occasionally (about once a month), they won't feel up to getting out of bed and taking their medicine. This leads to them being unable to get out of bed and take their medicine the next day, resulting in days of missing classes and not doing any work. Missing classes and work causes them to fall behind, which stresses them out, and the stress prevents them from getting caught up. This cycle of a brief slip spiraling into them being unable to complete the class has repeated multiple times, and Jay has had to drop multiple classes.

Jay is smart. In the classes that they complete, they average A and B grades. In the classes that they fail, it is because they don't complete assignments and/or they sleep through exams. Due to their medical issues, they are permitted extensions on assignments to complete over the break between semesters. Often, they procrastinate, do not complete those assignments in time, and request additional extensions, delaying until no more extensions are allowed. Often, work still isn't done by the time the next semester starts, and the additional workload leaves them unable to complete anything. Even with a smaller workload, they still procrastinate and still end up not doing all their work. This semester, Jay took 3 classes: 1 A, 2 incomplete, and I do not expect them to turn those incompletes into letter grades. On top of this, by my calculations, Jay needs to complete those classes now and complete 5 more classes over the next two semesters (or possibly even complete all 5 next semester, but they get angry when I ask them to confirm their plans with their academic advisor, who admittedly hasn't been very helpful) or their earliest credits will expire and they will certainly never graduate.

So now I get into the current problem. While Jay is feeling good, they don't want to do schoolwork. Instead, they spend hours playing video games, chatting with friends, and researching obscure topics that they obsess over, while intending to do productive work later. They claim that this relaxes them, diminishing the stress from the schoolwork they need to do. Once 'later' comes, they are too tired to do any work. (This behavior only applies to schoolwork for some reason. During their internships previously, as long as they managed to get out of bed to go to work, they completed their workday without complaint.) If anyone attempts to remind Jay that they should be doing their schoolwork, they respond aggressively: "I can't do it because you telling me to do it stresses me out." Merely acknowledging to Jay that they have work that they need to do, even indirectly in the form of saying that they will have more time to spend with grandparents visiting for Christmas if they aren't busy with schoolwork, stresses them out too much to even get started; they instantly become exhausted and are useless for the rest of the day. Jay is never physically violent.

Here are some things that we have attempted after previous semesters when Jay had incomplete assignments:

  • Respect Jay's wishes and never comment on college at all: they don't complete the assignments anyway. There is no change in behavior, so the "let them fail, and they will try to do better next time" approach doesn't work here.
  • Attempt to be persistent and involved against Jay's wishes, trying to assist in scheduling out a timeframe for getting everything completed, and staying with them to make sure they remain focused: Jay refuses to cooperate, claims that they have it under control, and doesn't. Trying to divide big tasks into small chunks gets them stressed out over the size of the big task. Hours pass with no progress because they can't figure out where to start.
  • Being as positive and encouraging as possible, suggesting that Jay try to get some work done while they are awake, alert, happy, and capable of making progress: they get upset and suddenly aren't "awake, alert, happy, and capable" anymore.
  • (This idea was suggested by my parent's therapist.) Being as positive and encouraging as possible, suggesting that Jay try to get some work done the next day once they are ready to sleep: they get upset and remain unlikely to work the next day.
  • Bribe Jay by offering to pay for a big family vacation after they graduate: that apparently isn't enough incentive to get past their natural procrastinating tendencies.

How can I encourage Jay to complete their assignments without procrastinating to the last minute (where the stress then prevents them from completing their assignments at all), when all attempts at encouragement backfire anyway? We would prefer to only solicit advice from therapists, and we are still requesting advice from our therapists, but we are desperate at this point.

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  • If you were in the US I'd suggest asking for an additional accommodation of extending the graduation deadline. Laws and regulations concerning disability accommodations vary from one country to another so I don't know about other countries. In principle it seems to me like a reasonable accommodation for your sibling, though. / One of my children is in college and has a lot of trouble meeting deadlines. To get his allowance he has to show he's caught up (e.g. submissions, reading). I can't do this on a weekly basis for him -- it has to be on a daily basis. (He likes to eat out.) Dec 28, 2021 at 0:46

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It took me 11 years to graduate with just a bachelor's degree. I remember feeling much like you describe Jay as feeling: unable to buckle down and do work when I felt good because even confronting the work or thinking about it was overwhelming. And when I did feel good, over-indulging in feel-good things because you're so worn out from feeling bad. And that downward spiral of not being able to get out of bed is frighteningly familiar.

I saw therapists and took anti-depressants, dropped out, and then started back again of my own inclination. Part of it was maturity, maturity I needed because I'm bipolar, which made everything in life more difficult. I wasn't diagnosed until I was 35, though, and finished college undiagnosed.

Bipolar is now regarded by some as a type of neurodivergence. I am definitely prone to getting overloaded by sensory stimuli. Like overloaded to the point of shutting down or getting paralyzingly anxious or getting extremely angry.

Jay's overload reminds me more of my autistic daughter's overload. Jay might well be experiencing very real and extraordinarily taxing sensory or emotional overloads. You seem super empathetic to your sibling's plight--I would love to have a sibling care so much about me--but the "I'm overloaded" excuse can wear thin quickly. Keep respecting it until you have solid evidence otherwise. It's hard to be in someone else's head to know exactly how overloaded they might be.

As a neurodivergent person with a neurodivergent daughter, reading what you describe, I would encourage you to rule out autism or some other form of neurodivergence. Do note: when my daughter was diagnosed a few years ago, because autism presents so differently in boys and girls, there were two separate questionnaires for those genders (the one our psych used was even color-coded pink!). I don't know if there is a questionnaire that is gender neutral. I would definitely discuss with the testing psych how they planned to adjust for that in working with Jay.

You may also want to test for specific learning disabilities. You say that Jay had a concussion with lasting results. Are they working with the disability office at their university for specific accommodations? This stamp of approval that says "you're different, but you still belong, and we want you to succeed" might relieve some pressure to be academically exactly like everyone else.

The thing that you won't be able to rush is maturity. I got married young and went back to college with a husband, a mortgage, a job, and a toddler. I was much more focused when I had better coping skills and other responsibilities. (I made the Dean's List, even.) Jay may need some time off. Again, I would work with the disability office on this, to try to hold onto as many credits as possible. But don't let fear of losing those early credits keep Jay from doing what Jay needs to do mature and learn more coping skills for their specific difficulties. Credits are just money and a few weeks of time. You're trying to prepare Jay for the rest of their life! One is far more important than the other.

Jay is in therapy and that's always a great start (NOT ALL THERAPISTS ARE EQUAL!), but what are they working on? Is the therapist mentoring Jay in coping skills because with the brain injury and high-stress response? This seems to be exactly what's needed--may or may not help them finish college, but it's just as valuable in the long term. Some therapy I've done has been little more than "tell me how this last week was" instead of deliberate strategizing on what went wrong and how to prevent it or bounce back from it.

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  • "Are they working with the disability office at their university for specific accommodations?" They very explicitly are, according to the OP. "Due to their medical issues, they are permitted extensions on assignments to complete over the break between semesters."
    – nick012000
    Dec 24, 2021 at 20:42
  • It is just wonderful that someone else on this site has such a similar experience to share!
    – ribs2spare
    Jun 22 at 16:47
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Configure the situations to allow for natural consequences.

Make Jay pay for their incidentals, such as their phone, haircuts, clothing they want to wear, video games/entertainment/eating out, etc. Pay Jay for good grades. You don't have to make them do the schoolwork, but you also don't have to reward them with benefits that are not essential for survival.

At my home we have two wi-fi networks. Parents is 24/7, but the other is 6am-9pm. The kids hate it when their streaming show or Fortnite game would suddenly shut off at 9pm. When they turned 18 they assumed they would get the password for Parents... Nope. We told them they need to buy their own Wi-Fi if they wanted it 24/7. So far, 3 have moved out successfully and are now enjoying unlimited internet in their own place.

Leveraging natural consequences sometimes requires some creativity and fortitude to implement, but it is much less stressful in the long run, and the "teacher" will stay with them their whole life. :)

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