I can't cope with depressed brother being so reliant on me. Feel like a bitch for saying that.

[inigomontoyahwillcox]

I'm so sorry - this going to be so long - but I need to get this out. I'm up with this awful cough/chest infection which makes it impossible to lie down and sleep. Been ill since last Tuesday. Have had virtually no sleep since then. Pretty sure a lot of you will think I'm a heartless cow, but I'm getting to my wits end.

Context. My brother (quite significantly older than me) has suffered from depression since he was a teen. He has been on antidepressants since then, except for a couple of occasions when he's taken himself off them for one reason or another, which have ended up in disaster. He lives about 2.5 hours away from me.

For some years now he has been spending more and more time at my house with my DH, DD and I. He lives alone and came to stay with us during lock down, and has often come to stay with us, sometimes for weeks, off and on since then when he's feeling low or had a crappy couple of weeks (e.g. work stress). I've always said to him of course he can come, how can I not, but he's often then stayed and stayed, prolonging his stay without discussing it with me - just declaring he's not going to go home for another week at the end of his planned stay.

He has a fantastic job in the civil service, but has had lot and lots of absences for various ailments over the past couple of years and they are understandably getting serious about his attendance. He seems to think this is very unfair and how they just don't understand. I've tried gently - but seriously - to explain that you can indeed be dismissed for repeated or lengthy absences.

In May this year he started getting some odd physical symptoms - balance issues/vertigo mainly (other very vague things like feeling cold, and out of it) - I rushed down there to him when this initially happened as he took himself to hospital thinking he was having a stroke. Ultimately anything serious was ruled out and after taking him to a few appointments for some further checks I drove him back to mine to stay. He decided that these symptoms were due to his antidepressant (that he'd been on for 15 years), so agreed with his GP to reduce his dose to an incredibly small one (questionable that it was even therapeutic anymore - it was 1/4 of the starting dose, he had been on double the starting dose for 15 years). His physical symptoms did clear up eventually - he put this down to this reduction in his antidepressants - I wasn't so convinced. I also voiced my concern that he was now effectively not on antidepressants and we all know how that had ended up in the past and that he needed to push to try another antidepressant if he didn't want to go back to his old one.

He eventually went back home and to work, and was there for a few months until he started experiencing stomach issues, now diagnosed as IBS (which I know is not fun - I've had it for years myself) and yet again took himself off work. He was working with his GP and a dietician and put on the FODMAP diet which he's still on. Again, he came to ours for a few weeks. His work were getting very ancy by this time and he started to do some hours remotely from ours as he had no choice. Eventually he went home again, he was home for a week only then for his depression to increase so I told him to get an emergency appointment with his GP who told him to double his dose last week. Well all hell broke loose (assuming side effects of increasing the dose). I've been ill for a couple of months now with all these bloody relentless viruses (also been very anemic for a lot longer and recently had a couple of infusions and currently undergoing tests to find out why - so you can imagine how rough I've been feeling), but last Tuesday I came down with proper flu (raging temp etc.) and have been in bed since and have been mainly off work (doing work when needed from bed). I never take time off work, honestly have to be at deaths door - have subsequently developed a chest infection and am on antibiotics. Got a call from my brother at 5:30am on Wednesday with him feeling awful saying I needed to drive down and collect him, after explaining I couldn't as I was ill asked to speak to DH and asked him to go. I said to DH that he couldn't, he had work plus he was helping me out with a work event in the evening which I obviously couldn't attend any more but he still needed to arrange some stuff and be there for a short while. I put my foot down and said he had to either drive, get the train or wait until we could drive to him and if he was in crisis to call his local crisis team immediately. He eventually said he would drive as he couldn't fit all the stuff he wanted to bring in a backpack so the train was out (so he'd get obviously decided at that point he was coming for a while).

Since he's been with us he has been waking me up every morning at silly-o'clock (e.g. 5-6), as he's been experiencing massive anxiety. I've been woken up three times now to him standing in our bedroom crying and saying he can't cope. I am getting about 2 hours of sleep per night due to this chest infection anyway, and have usually only just dropped off when he's waking me up. At this rate I'm never going to get better. DH had to stop him coming into our bedroom the other day when I had eventually managed to doze off. Anyway, called the local out of hours crisis team yesterday morning and sat with him whilst he spoke to them, they're seeing him this morning and have told him to register as a temporary patient at my local GP and they are hopefully going to make a plan going forward - e.g. moving to a new antidepressant (I hope). On the phone he said to them he was going to stay with me indefinitely (no discussion with me) and can't see himself doing his job for some months.

In the past when he's had a crisis like this he's decamped to our parents who look after him for months whilst he recovers and he finds a new job - but he's decided that he finds it too stressful to stay with them (they're getting on now as well). I can see what is going to happen. He is going to loose his job, loose his rented flat as a result and have nowhere to live but here with us. So, unemployed, living with us indefinitely. And what choice do I have?

It's really stressful when he stays with us - just the whole dynamic/routine of the household goes out the window. He has always been single and as a result his life revolves around himself, he spreads himself and his things around the house, and changes/moves/breaks thing (little things, but they all add up) and gets argumentative when I ask him not to do something. My home just doesn't feel like my home anymore; I can't spend evenings chilling out lying on the sofa in front of the telly with DH, as we often do, he's often lying on the sofa watching TV himself, he smokes although takes himself outside but his clothes smell of smoke. He is in our small spare room (well, he's on the sofa tonight for some reason) which we had just recently decked out as DD's study as her bedroom isn't really big enough for a desk; she's finishing her mocks tomorrow and has her GCSEs in May - she has ADHD and it's been incredibly challenging for her academically, but we'd really turned a corner recently and she's determined to get into 6th form, I'm so worried all of this is going to upheave her, stress her out and affect her performance; she's been so proud of her achievements recently and I think if she does badly now what little confidence she'd recently gained will disappear.

I am pretty sure a straw will break the camel's back and I will end up loosing it with him at some point, or just getting incredibly stressed and ill (stress usually manifests itself physically with me as I just try to ignore it and push on through - I've had my own mental health battles). But how can I effectively abandon my depressed brother? I love him dearly, and want him to be well, but he's come to rely on me so heavily that it's becoming too much. He's really not helped himself; taking so much time off work for spurious reasons and now he really needs the time off they are challenging him and his job is in jeopardy; him not taking my advice about not going cold turkey on the antidepressants without a plan to start a new one; just the assumption that we can constantly put our lives on hold. DH is being incredibly understanding - but I can even see him getting frustrated by my brother over the past few months. DH also had a huge mental breakdown last year and attempted suicide twice, he's only just got back on some sort of even keel about 6 months ago but is still recovering. Jesus, what if HE ends up breaking down again and then I've got 2 men in crisis to look after?! I've got my own full time stressful job to do as well, plus a neurodivergent daughter to keep on track. I'm terrified! I honestly don't know what to do for the best. He has very good friends but they don't live in the same city as him, but other than them and my parents, we're all he has.

What the fuck do I do?

they want him to return to his home city to continue his treatment there, but my brother is insisting he be admitted here.

And so the manipulation continues. He's betting on you picking up the pieces when he's discharged. That because he's on the doorstep you won't find it in you to say no.

OP you're going to have to very quickly let go of a lifetime of conditioning and stay strong. He does not come back to yours under any circumstances. You cannot take the risk with your daughter's safety. Or with your own and DH's MH.

It doesn't matter at this point whether he's depressed, autistic or has EUPD. It's his behaviour that can no longer be your problem, not his diagnosis.

I am so sorry for what you are going through.

I too have a brother with serious MH issues, constantly threatening suicide, has been sectioned several times, staying with me for long periods and so on.

It got to the point I couldn't do it anymore so I cut him loose and went No Contact. There was no other way. I had given so much I had nothing left. Strangely I don't feel bad about it. Only relief. The very sounds of his voice used to fill me with dread, knowing that he would be asking to come and stay.

You might have to consider stepping back and removing yourself completely for the sake of your own mental health.

I can see what is going to happen. He is going to loose his job, loose his rented flat as a result and have nowhere to live but here with us. So, unemployed, living with us indefinitely. And what choice do I have?

As PPs have said, you have every choice

Nobody's suggesting turning your back on him completely, but in the area he usually lives there'll be services to support him - inadequate perhaps, but not as bad as you trashing everyone else's lives for his sake

These are the services I'd point him to, and even call them yourself with his permission, so if he continues to spiral there'll be professionals in place to handle it

I agree. Totally off to react like that to OP's desperation.

Your dad is a piece of work, OP, and I'm glad you've rejected his attempt to guilt you. Do not ever allow him to make you responsible for his own care.

I also have experience of this with a male sibling.

Sometimes you have to walk away for your own sanity.

Isn't it interesting that it's often a male sibling that has mental health issues and expects the sister to look after them.

I pointed out to by brother that my own life is not easy, I have to get up early for work and can't listen to a call from him late at night.

He never thinks about my life.

I wasn't there to read the room but I'm sure it's not the first manchild the A&E doctor has seen. Unfortunately due to professional ethics they're not allowed to say what they really think, an eyeroll and a few notes is the most they can offer.
There also isn't the funding or understructure for the full range of services from maximum security to drop in.
A previous poster mentioned failure to do the hard work in engaging with services. That's my brother, short term solution in the pub, meds in the morning, sorted.

I read it as they eye roll was directed at OP for saying DB couldn't move in with her.
I don't think she rolled her eyes at the brother's illness

I wonder if he realises he's burnt his bridges and can never stay with you again now?

I think it's good he said this terrible thing. Now you have the line he can't cross.

It doesn't matter at this point whether he's depressed, autistic or has EUPD. It's his behaviour that can no longer be your problem, not his diagnosis.

Exactly. He and his parents and mental health care team needs to sort out any diagnosis. OP has done more than enough. She now needs to focus on looking after herself and spending time with her husband and daughter and loving supportive friends.

He's disclosed that he specifically feels like he's going to strangle my daughter.

God @inigomontoyahwillcox I'm sorry that you had to hear something so horrific. But as you say, it is helpful, because it means that both you and the healthcare professionals have no choice but to hold firm to the line that he must not be in your house. (The eye-rolling A&E doctor was a dick and hopefully all of the medical notes will accurately state a danger that the docs will have to take seriously.)
At a certain point during a psychotic episode, my son hurt and frightened my other son (wrongly experiencing him as a threat). It really wasn't his fault. In that moment he was too ill to choose how to act, and at other times he was kind, compassionate and gentle. But his care team did then keep the episode front and centre in decisions they made about how and where he should be cared for.

I do of course have sympathy for your brother, but (except when they are in the grip of psychosis) people with mental illnesses do usually have some level of capacity/responsibility to choose (within certain parameters) how to respond to other people and acknowledge their needs. He is making bad choices.

I have no experience of this and feel I shouldn't be on this thread but just wanted to say you come across as very caring and it's so hard to read of the sheer weight of pressures that you seem to be carrying single-handedly. Who is worrying about you OP? Who is feeling guilty about you? Do the people who try to guilt you ever try to take the load off you? Do they support others or you at other times in your life, as you support them?

As others have said, you really need to look after yourself and get some proper rest or you will crack. That your brother was waking you every morning at 5am when you had hooping cough is just so hard to comprehend. Why did your husband not just turf him out the bedroom? It sounds to me like you could do with a really really good counsellor to start to help you think through some of these long-standing and embedded issues. I know that can be expensive and perhaps you don't have the headspace right now. But in the long-term it sounds like you really could do with some help unravellng some of these long standing patterns, responsibilities and ways of behaving. You can't change others but you can start to change those patterns in terms of how you fit into them. In a way it will prob be easier to look at your father's behaviour. The uncomfortable part might be having to take a good examine of the way your mother responds to things. As she is the one who seems to care about your burdens and feelings and sounds lovely and obviously someone run ragged herself, it will feel very hard to analyse that fully and it might be you have modelled your own way of responding on the way she has. But you might have to look more closely at the messages and behaviour she's given you, and perhaps reject parts of that and realise that you might have picked up ways of thinking about others and yourself that is not healthy or good for you. You might have to start to reject some of that thinking (not reject her, just the thinking) - however much you love her and see her point of view.

I think your parents are being very unsupportive.I can understand they might be horrified at having to deal with all of this again as they have had a lot of it in the past, but the phone-call from your father was particularly horrific, loading you with guilt and responsibility like that. How dare he do that. It is outrageous to make you feel so individually responsible in that way, particularly with all you are dealing with already. Doubly outrageous when he is refusing to do anything himself.

I also wanted to add that the numbers of thoughtful posts on this thread from others who have been in similar situations is humbling. It's awful what so many have been through and the difficult situations they are dealing with. I hope you feel supported by this thread. Remember the deadline and plan you all formulated together earlier in the thread. It sounded positive and then unravelled fast. But it's still possible if you stick to it.

Sorry just to add - the plan you formulated obviously can't have him living with you now after all his outbursts and his apparent hostility to your DD. I think you do need to draw a line. There is no way you can deal with that. You are not a mental health or secure setting. He has drawn that line for you now.

But the plan in terms of his returning to his home city and getting help there. It sounds like maybe things have escalated beyond that now. But if he goes for a hospital stay surely it would also be wise for this to be close to his home now with a longer-term plan to access help there. If he is hospitalised near you you will be dealing with this further down the line potentially wanting to be discharged to yours again later.

Your brother is hoping to move in with you once he is discharged from hospital. That's why he's pushing to be admitted at a local hospital.

Make it very clear to him. Even if he were to be admitted to the local hospital, he's not living with you. Ever. Again.

if he goes for a hospital stay surely it would also be wise for this to be close to his home now with a longer-term plan to access help there. If he is hospitalised near you you will be dealing with this further down the line potentially wanting to be discharged to yours again later

This makes perfect sense, @carrotsfortea, though actually a hospital stay may be no bad thing provided OP's prepared to give an absolute no to having him back to hers

At least the drive to get him discharged will mean something has to be in place, whether that's his own home or elsewhere, and it would break the cycle of him living at OP's

Just offering sympathy OP. There is very little recognition and support for the families who are trying to cope with serious MH issues (too much personal experience)

A much loved uncle was schizophrenic. He was absolutely fine and gentle with us kids always, but capable of violence to adults in the family when acutely unwell, culminating in an assault that very nearly resulted in a death. He was absolutely not to blame but that didn't make him any less dangerous at some points and it was very difficult to predict when those would be. It's tragic for all involved.

He absolutely cannot return to your house for any period of time, under any circumstances, because of his self acknowledged risk to your daughter. You had a good plan underway but this really does change everything and you really, really shouldn't blame yourself, because it's out of your control.

I'm sorry @inigomontoyahwillcox ,after all the care you've given your DB it must have been very hard to hear what he said about your DD. At least now you have a cast iron reason why he can't live with you again but your going to have to be very strong, his Drs will presume you'll take him back especially if your DB tells them so.

Just read this whole thread and it's made me cry. It seemed clear from the outside that when he cried and said he understood the consequences on you and agreed to the plan, that he was knowing he was losing his hold over you and going along with the emotions of it all to keep you sweet and keep his place as the centre of your universe. It seems like his 'episodes' are triggered by losing his grip as centre of attention, hence him feeling so much anger towards your daughter. It would probably do him some good if you detached as much as possible and he lost his role as taker in this giver, taker dynamic. He will still be trying to drain all your emotional responses even when back home and even through text etc. This is so much more than just depression. I'm sure you've had depression, as has your husband- has your husband insisted on so much attention from you, and yourself from others?.Just remember, it's not support your brother is seeking, it's attention. Attention is feeding something broken in him and when the attention comes off him, he's left with the broken and has to fix it, but doesn't want to, so acts out for the attention, to avoid having to deal with himself. I have family members who have done the same to me under the guide of 'mental health' and it took a long time to realise and break the pattern and see where other people had manifested themselves in my life to do the same. Please take back some control and focus entirely on yourself and your daughter for the lead up to Christmas, let your brother carve out his own path with the support of all the professionals available to him. He will be okay, but just remember it's normal for the behaviour to ramp up ten notches when they feel their supply running out. You need to focus on healing yourself.

OP this may seem like a small thing now, but as soon as you feel up to it have a look around your house and check he hasn't left any essential belongings there. Its not uncommon for people to 'forget' something like keys or a wallet, to give themselves an excuse to return.

Just lending my support! Youre doing amazing. I have a sibling with long term MH and does have suicidal ideation with some attempts.

I know what a lovely, wonderful person she is but the MH issues can make her horrible, lash out, behave badly when shes in an episode. Its hard because she bends over backwards to make amends when shes not in a crisis but its so hard.

From the outside it's so, so easy to say put in strong boundaries, do this, get professional support. There is so little professional support, the service is on its knees. To anyone working in that industry my god youre a trojan.

At the end of the day if the family withdraw support suicide is a real and present danger. All well and good talking about personal responsibility etc but you fight for your families lives, its natural. I can't take the risk that she will kill herself so for myself I'm not at a point I can step away. Rightly or wrongly, you have to make peace with yourself. I find myself agreeing with what everyone is saying on here but also know how hard it is to action.

All that is to say, youre doing amazing, putting your husband, daughter and yourself first is what's needed to be done and your strength is inspiring. But I get the guilt, the responsibility, the gut-churning fear and that it won't be a straightforward linear process. Can you get help or therapy for yourself?

You're a saint for everything you have put up with over the years, and I hope your brother is now admitted and properly assessed. It sounds like he has been misdiagnosed and incorrectly medicated for decades.

You mention that you suspect he is autistic - that needs to be determined as a matter of urgency. I was unsuccessfully treated with antidepressants/CBT/talk therapy for years until I was diagnosed with autism and ADHD in my early 30s. Once I was given the correct medication (stimulants, to target dopamine instead of serotonin) and accommodations related specifically to autism, my life became immeasurably better. Basically, I was depressed and struggling, but I didn't have clinical depression.

If he is ND, they can adjust his treatment plan as certain medications/therapies (like CBT) are often ineffective in autistic people.

However, I agree with PPs that he may also have a comorbid personality disorder. Obviously I can't speak to every single autistic person but, in my experience, autistic people tend to be the opposite of manipulative - rather they are very straight-shooting and assume everyone else is, too. Your brother sounds highly manipulative and in control of his behaviour, which makes me think personality disorder (which can develop due to illness/trauma/environment, rather than being hard-wired from birth like other ND conditions).

Just want to offer my sympathy and support too. After the thoughts he has admitted to re your DD it is a hard no to him ever coming back to your home. But that must have been so upsetting for you to hear from him, I am really sorry.
I agree that you need to stand firm now and prioritise yourself, your DH and your DD.

I am very sorry about the lack of support you are experiencing and all the emotional manipulation - from your DB, your parents as well as certain members of the A&E team. This needs to be ended now - though it may not be easy as (from the sound of it) you have had a lifetime of conditioning to put others' needs first. But you have already gone above & beyond, do not be made to feel bad about not doing more to your own detriment and that of your family. So find that guilt spigot, and switch it off.

This post stood out for me. My brother has lifelong MH and since our parents’ deaths it’s all been on me to manage his various crises. 2 1/2 years ago he had a total breakdown and was finally sectioned, resulting in an 18 month stay in a mental health rehab unit, which really helped with a 360 sort out of all kind of issues ( amongst them medication, finances, unsafe use of social media , overhaul of his home which was severely hoarded). It gave me breathing space and put things in place, not least the use of Personal Assistants to help him manage life admin. He was also diagnosed with autism, and had an early cancer diagnosis into the bargain , without this he probably would have been diagnosed a lot later. Sometimes you need to hand it over to the professionals.

Funny how all these men with mental health issues like her father, her brother somehow get exactly what they want, are well able to ensure their problems are dumped on the nearest vagina.

They are well able to force the issue of their endless issues, problems, needs on those around them, whilst not giving a damn if the person they burden has their own issues and worries.

My experience was they felt that everyone's life was just perfect and only them had issues, stress and sadness.
They were utterly consumed by themselves.

Not being around them is a blessed relief.

Completely agree with @dottycat123

He knows OP won't kick him out. Long talks and empty words, I'm afraid. The two weeks then back home deadline has now become until after New Year. Extended as it's Xmas and time to settle on new meds etc. If it hadn't been that, it would be something else.

As you say, once he has 'a support system' locally, how awful will OP be to tear him from that. I fear there's no end in sight, just a haze of a victory that when it clears looks like the same place they always end up in.

I'm a little shocked at the offer of a key and free access to the other people's house. Do they know he roams around at night and sometimes ends up in OPs room at 5am crying? I would more than strongly discourage this.

OP he's putting down roots.

Now that he has disclosed that he specifically feels like he's going to strangle her daughter, there is no way that OP can ever have him back in her home.