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How to help an adult child with depression

answered 09:08 AM EST, Tue November 29, 2011
My son is 26 and he has major depression. It first got really bad when he was in his early twenties but he was in remission for a couple of years and was back at school this year. He has now dropped out and he is back in a deep depression. He is living off campus, still and we are paying the rent on his apartment and helping with his living expenses. I think the stress of school may have been more than he was ready to handle.

The problem we are having is that he does not want to go back to his old doctors or go back on any kind of medication (antidepressant have never worked very well for him and he complains about the side effects). He seems just content (although content is not the right word at all to describe him) to just sit in his apartment all day and do pretty much nothing at all.
I know that his lack of motivation and energy and concentration are all symptoms of the disease but it is very frustrating for me to watch him suffer so much and not have him doing anything at all to improve.

I would like to see him go back to his old therapists (or new ones, if he wants) and get back to trying to get better. He says he does not want to go and that it does not work. He is a grown man so I cannot make him go, but I am wondering if I should make his participation in some kind of therapy a prerequisite for our paying the rent on his apartment.

It feels lousy to do that though. We can afford to pay it and he is not being purposefully difficult it’s how he honestly feels about the situation. I am kind of torn between respecting his right to choose how he lives and father’s natural desire to want to whatever he can to help one of his children who is so obviously in need.

I am also not sure that he wouldn’t just go live on the street rather than do what we want. He just doesn’t seem to care much about where he is or what he does right now, and the last thing we want to do is put him in a situation where things get worse.
How can we encourage him to get back into therapy? Should we try to force him by threatening to withhold rent money?

Art Matthews Says...

Sadly, your situation is not uncommon and is heartbreaking to be in the midst of, but you seem to have found yourself with rational reasoning to question whether you are indeed helping or enabling him to remain as he is.

Rather than answer directly, let me ask you to consider a couple of questions:

How is it helping for you to support him?

How might it prevent him from helping himself?

Do you know of any benefits he might be getting from not seeking treatment?

You don't mention if your son has had any history with alcohol, drug or other addictive behaviors. In many cases like this, the adult child has learned to self-medicate with substances, gambling, video games or compulsive sexual behavior.

Even though it feels uncaring or coercive to place conditions on financial support, at this point it is the only leverage that you have and your son's illness has impaired his reasoning so much that what he has chosen seems like his best option. You cannot let your love and concern for him allow you to accept his reality. He isn't likely to spontaneously improve without treatment.

Some alternatives you might consider:

Make financial support contingent on him attending family therapy with you, your spouse and any other children you may have. This could get some underlying issues out in the open and provide you with support as well.

Don't make medication a requirement for financial support unless you want to sit and watch him take it every day. Allow him to choose the type of treatment from say three options and then have him sign a release of information to let you know he is attending, but nothing more. You could include psychotherapists, psychologists, psychiatrists (medical doctors), a pastoral counselor, etc. Giving him the choice gives him some control and input, but it doesn't necessarily mean he will cooperate with treatment. He might just try to get the professional to agree that his case is hopeless.

If he objects to that as well, then suggest that he is right and that he may just be permanently disabled and require that he apply for disability so that you will be able to rest knowing he will have some sort of support throughout his life if something should happen to you or your money.

You may feel extremely powerless right now, but truthfully you are the most powerful thing in his life. Use that power for the greater good in his life education, even if it means making difficult choices.

Becoming homeless (or the prospect of living on the streets) may be the motivation he needs to consider making changes for the better.

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Page last updated Nov 30, 2011

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