Question: How do I keep sane whilst helping my adult son with depression

Penny Bell Says...:

Caring for someone who is depressed can be exhausting, demanding, and rewarding, all at the same time. As a support person you may feel the need to be the emotionally strong one at all times, but this can come at the expense of your own wellbeing. For this reason it’s really important that you look after yourself as well so that you can be the best possible support to your son.

The way that you can do this is to put time aside just for you. Make sure that you’re physically active in ways that you enjoy, get enough sleep, stay in touch with friends and family who can encourage and support you (caring for someone with a mental health problem can feel quite isolating). And if possible, find a local support group that you can connect into, as well as supportive counselling.

Accept that you will experience a range of emotions such as fear, confusion and guilt. You may feel a sense of powerlessness because you can’t fix or change what is happening for your son or make him feel better straight away. Accept that aspects of the situation are beyond your control and allow yourself to feel your feelings, as difficult as they might be.

Caring for a family member can put strain on the relationship between you so it’s important to care for yourself in that respect as well. This may mean creating boundaries – there’s only so much you can do as a support person. This can be frustrating, especially if your son is resistant to being supported. Keep an open dialogue that acknowledges your feelings whilst encouraging your son to seek other support services as well.

Learn as much as you can about depression – learn the facts so that you can understand what your son is going through and how this affects his behaviour. Avoid using phrases such as “cheer up”, “snap out of it”, “it’s all in your head”, or “you don’t look depressed” as these will make him feel worse. Instead, check in with him by asking if he wants to talk about it, listening (without giving advice) if he does, and assuring him of your continued support.

Keep in mind that your son doesn’t want to feel the way he does – he has an illness that, like any other illness, is largely out of his control to fix. Let him know it’s ok for him to have depression - he is most likely thinking that he must be weak or a failure for having depression - and that you don’t think any less of him as a person.

Have faith in your son’s willingness and ability to recover from his depression, particularly when he doesn’t. Ask him what makes him feel better and gently encourage him to explore these and other options of how he can feel better, for example going for walks, exercising in other ways, taking his medication regularly if his doctor has prescribed it, going to his therapy sessions, and congratulate him when he does things that will help him to get better, because getting motivated to do anything is hard for him.

Question: My son has become isolated over the last decade or so and I believe he is depressed but I do not know how to help him. He is 32 now and he does not have any real friends or social life. He had a steady girlfriend that lasted for a few years after the end of high school but nothing since then. He comes over for dinner with us on Sunday nights. It used to be like clockwork but lately he has been skipping visits here and there. I have tried to get him to come over more often since we are retired and have lots of time but he says he is too busy with his programming work. This does not really make sense since he barley makes ends meet. Since he started coding at home in his twenties he has forgotten how to be social in the regular world. I suspect he is depressed since he seems apathetic about everything and he does not take as much care into his appearance as he used to. To be frank, it smells like he has not showered for days when he comes over. When I try to press him on how he spends his time he gets defensive and retreats into a shell and when I tried to get him to talk to someone and I said I would pay for it he got very angry and upset and left early. This was last week. I wish I knew how to help him break out of this but I just don’t. What is my next good move?

Penny Bell Says...:

It does sound as if your son is suffering from a mental health condition, possibly depression, and has been for some time. What you’re noticing now is that this depression seems to be more entrenched, and he’s becoming even more isolated. I can understand how worrying this must be for you, and how powerless you must be feeling in the situation.

Symptoms of depression include loss of interest in enjoyable activities, staying home more, withdrawing from family and friends, difficulty concentrating at work, feeling overwhelmed, indecisiveness and lack of confidence, sometimes increase of alcohol or drug use, loss or change in appetite, sleeping difficulties, feeling worthless, increased irritability and moodiness, and feeling unhappy most of the time.

Knowing how to help someone with a mental health problem can be challenging, as you have discovered. Your son may not be aware of the impact his behaviour is having on others, and talking about this may be a way to encourage him to do something about the situation. This should be done in a sensitive, non-accusing and non-blaming manner, using ‘I’ statements such as: “I’ve noticed that you’re not coming over as much on Sundays” or “I’ve noticed that you’re not spending as much time with your friends”.

Finding the right time to have a conversation with your son is important – when he is most comfortable and likely to be attentive, and you are less likely to be interrupted. It’s possible that he is feeling a great deal of shame and embarrassment about the thoughts he’s having, and this is the cause of his defensiveness. Reassure him that you have no intention of judging him, only helping him. You may wish to tell him you have found some reliable information which will help put things in perspective, which you could give him to read in his own time (there are some great articles here at Choose Help). If however you continue to experience his resistance to your offers of help, there may be a family friend or relative you could ask to raise these issues with your son.

Offering to go with your son to visit his doctor for a check-up could encourage him to seek help. Before you go to see the doctor with your son make a list of your concerns, including any questions you have, to be discussed during the consultation. Accompanying him to the appointment may also give you more of an idea of what you can do to continue to support your son whilst he is in treatment. If you cannot persuade your son to visit the doctor with you, it may be helpful to go on your own, to find out what avenues there are for your son and for you that are available to help him.

If your son refuses all offers of help then you can continue to support him, make information available and be prepared to discuss things if and when he is ready.

One thing that’s vital is that you take care of yourselves. Make sure that you find time for fun and recreation, to be with friends, and to spend quality time with each other that doesn’t have your son’s issues as the focus. Caring for your own mental health could also involve obtaining counselling for yourselves.

I wish you all the best in your efforts to help your son and the task that lies ahead of you.

Question: I can’t get over my wife’s passing. She died of cancer a year ago last Tuesday. The anniversary was hard. My daughter wants me to see a psychiatrist because she says I am depressed. I am sad and I am lonely but under the circumstances I do not see why this is inappropriate. I know if I initiate this I will end up with a prescription for an antidepressant. There seems to be something perverse about taking a medication to erase sadness about my wife’s passing. I am not sure what to do.

Penny Bell Says...:

Firstly may I express my deepest sympathy for the loss of your wife. You are correct when you say your sadness and loneliness is appropriate, and particularly at this time at the one year anniversary of her death. I am interested though that your daughter is seeing something more – that she is noticing that your sadness is pervasive, I am assuming, and it’s concerning her.

Elizabeth Kubler-Ross was a psychiatrist who introduced the hypothesis that there are five stages of grief, namely denial, anger, bargaining, depression and acceptance (On Death and Dying, 1969). Problems arise when the grieving person becomes stuck in a particular stage, and so cannot resolve their grief. Since then other models have been developed, and I particularly like that of J.W. Worden (Grief Counselling and Grief Therapy, 1991), who suggested there are four tasks of mourning that we need to accomplish for the process of mourning to be completed and equilibrium to be re-established. They are: To accept the reality of the loss, to work through the pain of grief, to adjust to an environment in which the deceased is missing, and to find an enduring connection with the deceased whilst embarking on a new life.

The first task involves coming to terms with the fact that this has really happened, and now life must be continued without the loved one. The person speaks about them in the past tense, and acknowledges that life is different now. For the second task, feelings of sadness, anger, loneliness, despair, and all the other feelings a grieving individual may feel, are not to be avoided but rather experienced, acknowledged, and talked about so that they can be worked through. It may be that as you undertake this task your daughter is uncomfortable with seeing you sad and lonely and therefore is suggesting you do something to change this. On the other hand, this may be a task that you are having difficulty with and need some extra help.

The third of Worden’s tasks of grieving, adjusting to the environment in which the deceased is missing, not only involves your wife’s day to day absence but also the role she played in your life – friend, partner, ally, companion, as well as the practical tasks she carried out and no longer does. It could also be about living alone, doing things alone, and seeing yourself in a new way, without your wife. The fourth task follows on from this, and involves continuing to hold your loved one in your memory whilst finding new things and relationships that bring pleasure and joy. According to Worden, not accomplishing this task is to not live at all; feeling that life stopped when your wife died, and being unable to resume it in a meaningful way with a different connection to her. He says this task can take a long time and be one of the most difficult to accomplish.

Important to note is that grief is not linear. You will probably move in and out of the above tasks, and can undertake more than one at a time at some points in your journey. There is no distinct timeline – everyone is different in the way they grieve and in the length of their grieving journey.

Just one last comment about your concern that taking an antidepressant will erase your sense of sadness. Sometimes we can wish to hang on to our sadness or melancholia because not to do so could mean that we lose the precious memory of our loved one. It’s as if not being sad all the time means we are disregarding or forgetting them, and the sadness is maintain the connection. If this is what’s happening for you, there are things you can do to make sure your memories remain. Some like to make special photo albums of their times with the person, and include in it favourite colours, fabrics, animals etc. Some plant a tree or a rose, frame a memento, journal, write a poem or a song, put aside time to listen to a favourite piece of music or watch a favourite movie, create an online memorial page – the list is endless. If you are finding that you are feeling flat most of the time, are unable to enjoy things, or have other symptoms of depression, it would be a good idea to visit your doctor and have him or her assess you for depression. It would also be beneficial to seek counselling, to assist you to complete your tasks. I hope this information has been helpful for you.