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How do we best support our son who seems to have given up?

answered 06:11 PM EST, Thu January 09, 2014
What is the best way to support our adult son? His wife left him and is having an affair, he hasen't been able to find a full time job and now he has turned to drinking? His father and I are so worried about him.
He can't sleep and has barely got back to eating. This has been going on for 3 months now. How can we help? He is tired of us telling him why to look for work. He currently works part time at night which just gets him by.

Art Matthews Says...

I can understand your concern for your son as the symptoms you've described could indicate that he is experiencing a serious disorder such as clinical depression, addiction/dependence or, at the very least, disordered adjustment to this traumatic event.

Not that I don't believe what you've reported to be the truth, but in many situations where an adult child finds himself in this position, the chronology is a little different from what the parents have been led to believe. Often the reason for the marital strife that preceded the separation and/or affair has to do with behaviors that the spouse found intolerable. Often this will include what you have described: substance abuse, withdrawal, lack of motivation and escapism. When this is the case, the adult child is in denial about what their behavior has created and use the separation or affair as an excuse to keep doing what they were doing.

In any event in order to change, your son has to face the facts of his life at this moment: he's engaging in behavior that is not healthy and will not lead to regaining his function. His need to change is not for her but for himself. The problem is, you can't make him accept this or move to action. All you can do is provide emotional support, challenge him to see reality, and allow consequences to happen (or set them in motion) so that he has no other option but to act.

How you can best help is to get him to see a physician and mental health professional to get assessment and treatment. What that treatment is will depend on the results of those assessments and requires honest and complete information from your son -- and likely the two of you, as well. The substance use HAS to be a focus of that assessment. It should not be downplayed or left out because of the belief that depression might have come first or that this is somehow a "normal" response to these events. The inappropriate coping mechanisms he's has utilized following these events -- or that were already occurring before these events happened -- are as much a part of the problem as the depression. Make sure you trust the professionals have heard the whole truth and that you trust their competency to treat him.

What will not be helpful is to enable him with money, a place to stay, food, cigarettes, liquor, etc. while he tries to "find himself" or work this out on his own. Make any assistance you provide contingent on him seeking qualified help and following through by specified timelines. Maintain a tough love stance and keep boundaries and expectations in place. He may be very unhappy with you, but you can have an unhappy son who does what you demand of him or you can have the same son you see before you now.

The priorities I see for your son are:

1. Get alcohol (and any other non-prescribed psychoactive substances) out of the way -- Rule of thumb: any behavior that doesn't help, is hurting! Remove it from his repertoire of ineffective coping. It's likely an escape or diversion rather than a support.

2. Treat the sleep disturbance and depression through talk therapy and/or medication. Talk therapy coupled with medication is often the fastest recovery and the person can always discontinue in the future (but commit to at least 6 months to a year).

3. Explore career and vocational options with a professional career counselor or job coach. It may be time to get some additional training to become more valuable in the job market or perhaps it's time to take a complete different direction entirely.

4. Work on communication/interpersonal skills.

Look for mental health professionals who have worked with "dual-diagnosis" clients (that means substance abuse/dependence and another mental health problem) and see if you can locate an expert in the field of Motivational Interviewing, a form of therapy that is designed to work with clients who appear resistant to change. The Substance Abuse and Mental Health Services Administration site defines MI as: "a collaborative, person--centered form of guiding to elicit and strengthen motivation for change. It is an empathic, supportive counseling style that supports the conditions for change. Practitioners are careful to avoid arguments and confrontation, which tend to increase a person's defensiveness and resistance." http://www.samhsa.gov/co-occurring/topics/training/motivational.aspx Practitioners trained in MI have worked extensively with all sorts of clients who are immobilized by what they have, whether they engage in substance abuse or not.

The two of you should consider therapy for yourselves or engage in family therapy with him to make sure you know how to best follow through and avoid enabling. You could look for Al-Anon groups and groups for parents of adults who abuse drugs or alcohol.

The tone of my response may not sound as warm and fuzzy as you might have expected, but that's because I want to stress the seriousness of what he's doing to himself and the need for you to not make things worse by trying to make it better. If he trusts you, will listen to you, will act if you direct him to; use that in your arsenal. This is a fight and he needs you on his side, but the enemy is within him. Sometimes it will feel like you are betraying him, when you are setting limits and boundaries in an effort to get him to make better choices.

For some ideas on how to approach him or script a conversation, read this information from the experts at Hazelden: http://www.hazelden.org/web/public/cholderadultadultchild.page

Best of luck to you all.

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Page last updated Jan 09, 2014

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