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?

That is outrageous and he's trying to guilt trip you by saying if you don't let me come, I'll kill myself. Not acceptable.

Gosh, lots to catch up on. Fortunately I was too late to see LadyGabriella's post before it was taken down.

OK. We've spoken to him. Firstly, before I forget, whoever suggested he moved back to his area but into a shared house (sorry, it's a long thread and posting on my phone so can't do a CTRL-F to find your post) - you're a bloody genius. This is now included in the plan we've come up with.

They both came home and DH came upstairs and was emotionally exhausted. We talked for a bit about how to talk to my brother and then went downstairs.

I took the lead and started by getting a rundown on how the session went and what the plan was. He didn't see the Dr today as they were called away, but had a 2 hour talk with the team. He said they were lovely and he'd not had a talk like that ever, not to the detail they went into. He then said the plan was for the Dr to call him within the next 24 hours to discuss a new antidepressant and get a prescription to him. He also had a referral for online CBT and relationship therapy (they honed in on his inability to have a successful relationship). He went on to say he expected to be with us for some time. That's where I stopped him.

I'll be honest, I broke down a bit but I did explain that, after what happened to DH, how damaging to DD it would be for him stay for any significant length of time at such an important stage and (DH then interjected), how difficult I was finding it and the stress, that he couldn't just stay. I pointed out he was going to loose his job soon and he'd loose his flat and then we would be his default home. I said we needed a plan for the short and mid term, with the goal to access all the services he could to get him to being a happy, independent and fully functional member of society.

Anyway, to cut a very long conversation to a slightly less long one; he very surprisingly agreed with or understood everything I said. He did a lot of crying, as did I, he said how he now realised how hard this is being on us all and how grateful and lucky he was for having us. The plan is for him to stay with us in the very short term to cover the period when he is being moved over to a new drug and any initial side effects he may struggle with, we're thinking a couple of weeks. Then for him to basically have a managed move home, with him starting to look for a shared house or be a lodger as he cannot face being alone any longer - not for mental health support but just being around other people makes him feel normal and gives him happiness. So he'll give up his current flat. He's lived with plenty of people before both as a lodger or flatmate and it's been a success. We will continue to support on the phone of course, and he can still come to ours as a visitor. He is going to start his therapy as soon as it's available and then continue it at home (it's online).

I asked him if, under normal circumstances, he liked his job and he said he loved it and doesn't actually want to lose it. So the plan is for him to get his full sick note renewed for a couple of weeks and then a part-time one issued and he will start to do part time hours, hopefully actually in the office, and then back to full time. I've said he (with me there if he wants) needs to have a proper chat with his boss and explain all of this - i.e. that he desperately wants to stay, that he now has a plan and this is what it is and hope to god it's enough. He is now saying that he wants to be independent, that he doesn't want to leave his home city - I said that we would help him do that to the best of our ability, but what we couldn't do is facilitate him effectively running away from his problems to ours.

I think it went as well as could be expected, and actually positive in many ways. I did stand firm when he was talking about timeframes and expectations, and he accepted these. I think he feels better for having a plan and I certainly do and feel comfortable that it's not just throwing him out tonight, but supporting him through an initial potential crisis period whilst his drugs are changed, and then back home.

Funnily enough yes I have some knowledge of MH. I care for my adult son who had severe long term depression from his teens before having a break down 7 years ago, then a psychotic episode and now 7 years of hell trying to get him help, deal with suicide attempts, deal with him going awol from hospital and units every 6 months, sort out and push for support from GP, social workers, crisis teams, community teams, early intervention, the police, solicitors, advocates, AMHP, consultants and all sorts.

I also worked in MH for several years and the system is on its knees both in the NHS and community so trying to get help for yourself let alone loved ones is very hard and can take it all out of you. It can wear you down and make you ill when it’s pretty much non stop and no happy ending in sight.

So yes what I’m saying is OP must be knackered and can’t continue like this. MH services need pushing to step in or her brother needs to seek more help if he has any insight or capacity to understand how his actions are impacting others which it doesn’t sound like he does.

OP is your brother diagnosed autistic? Not sure if I missed that but I'd say he's probably ticking a load of boxes, anxiety is highly comorbid, his inability to have a successful relationship, his assumptions that he's fine to stay with you while not realising the impact, his self absorption, even IBS is commonly comorbid with ASD - not to mention you've got neurodivergence in the family. The balance thing also could be POTS or a vestibular thing, which is not unusual to have issues with when you're autistic.

I'd bet my bottom dollar that he's autistic if he's not already diagnosed.

The bar for being sectioned is unbelievably high. Simply wanting to end your life does not cut it.
The one person I know who was actually sectioned was back out two days later with no support at all.
I think many people believe in a safety net that does not exist in this country with the NHS.

It has occurred to me that he might be.

I also strongly suspect my father is. He's an academic, brain the size of a planet when it comes to his subject, but wholly lacking in a lot of the "softer" skills.

My brother is also insanely intelligent (it's too outing to say what he does/where he works) but is a senior scientist.

Send him to your parents.

That sounds so difficult OP. I too have lived with a brother suffering with depression for years and it's exhausting and just awful. Thankfully, he's never had to move in with us. I don't know how you cope.

In your situation I would tell him he needs to go to your parents. Neither you or your husband can cope just now, you're not in a good place to give him the support he needs.

The only time I had to tell my brother to take a step back with me was after I had my second child. I was so emotionally vulnerable and spent so much of my master toy leave stressed and worried about him. It all came to a head when I was having heart palpitations from the stress. Thankfully my mum stepped in and took the brunt.

It's so hard to not feel guilt and to put yourself first. But even if you can't do it for yourself, I think you need to make the decision for your DH. He may be patient but it sounds as if he could do without any additional stress so recently after his own mental health issues. I wouldn't jeopardise his recovery tbh.

@OpalSpirit "The one person I know who was actually sectioned was back out two days later with no support at all.

DH was visited and monitored by the crisis team at home for about 10 days after his attempts and then left with nothing once they discharged him from their service. I had to go looking for counselling privately - and we weren't really in a position to afford it at the time. I felt so abandoned and desperately scared of if he could recover and if i could provide him with what he needed to stop him trying again. It was awful. He's doing well now - but i know he should have had much more therapy than what we could afford.

What a great update OP. Well done for having the difficult conversation and it sounds like it went as well as could be expected.
You're a good person

OP thanks for update. Great plan short and long term and glad your brother stepped up and was pro active in helping plans
Hope things continue to improve for you all.

Bloody well done. That sounds so positive and so glad he can see the support you're giving him and that he does need to get back on his feet. Great result!

There are ways you can support your brother that do not involve him living with you OP. You need to give some thought as to how much you can really do for him and what that might be.

Your own health (physical and mental) needs to come first, as without that you can't support anyone else anyway. It's not your job to rescue your brother.

You also need to prioritise your child and your marriage. This is a really important time for your DC and you need to be supporting them and not spending so much time on your brother.

I would suggest that you tell your brother he can't stay with you for extended periods of time and while you are ill yourself it's not possible for him to stay. It's his decision then to go home or go to your parents' house. Let him make it.

Maybe consider some therapy for yourself to work on maintaining healthy boundaries and not to get stuck in a role of rescuer.

@Princessfluffy yes I'm now kinda seeing how i feel a responsibility for too many people/things/events (you name it).

Changing your approach to your bro is not the same as letting him down and in fact a different approach might be better for you both. There are a lot of different ways to support someone and show that you care.

Goodness OP what an update. Your brother's reaction has been remarkably positive although I daresay it won't be a smooth road.
That conversation must have taken a lot out of all of you, and so much courage required to follow it through and make plans.
I imagine you are exhausted!

Sounds like a really productive conversation. Well done for sticking to your guns.

The tough bit now will be sticking to it. Things are OK right now - and there's always a bit of a 'high' when everyone's had a good chat and it's gone well. The tricky bit is when this has worn off, you're all back to the daily grind and then he has a downwards turn.

Keep reminding him of the plan. Have little milestones to aim for, so when things do get difficult, you can remind him to keep aiming for the next bit rather than being overwhelmed by the whole plan.

I also think you need to involve your parents. They have a role to play here as well, in providing emotional support and encouragement for your brother. They may not be able to have him to stay, but they can keep in regular contact and make sure they are providing moral support and a listening ear to help keep him on track.

Good luck. Don't forget to take care of yourself.

This is a great update. Happy for all of you that you had the difficult but necessary conversation and he was so amenable to reflecting on how it affects you and your family and listening to suggestions for the way forward.

It's also worth telling him that sometimes you have to keep trying with therapy and therapists, until you find something and someone that you click with. I found CBT on its own to be quite unhelpful. However EMDR combined with CBT was very effective.

Op, it all sounds incredibly draining, you must be totally exhausted.

I empathise - my brother is similar but leans more on my parents than he does on me. I do wonder what will happen in a few years when they can no longer cope with it.

Massive well done for pushing through today and coming up with a constructive plan.

They are wise words. I'm conscious that it would be easy for things to slip, so I've got to be strong and resolute. Just got off the phone from my parents - have given them the update, mum is worried that I won't be able to cope with the 2 weeks, but as long as he does what is asked of him, and doesn't keep me awake at all hours I should be OK (there's nothing like sleep deprivation to annihilate you mentally and physically). I know I've got their support - dad is awful at the day to day living as mentioned in an earlier post, but great in a crisis.

Well done on having the conversation OP. My 87 year old mother is still supporting her 84 year old sister. Actually what has helped has her being a church goer as lots of people are happy to drive her places, get her shopping in etc.

Ohhh i did EMDR a few years ago after a massive post of pulmonary embolism nearly killed me (I really do have all the luck) and i was struggling with PTSD/depression. Felt very odd at the time but it really did work.

Yes, he's now committed to taking anything that's offered to him.

*post op pulmonary embolism

Utterly knackered and still quite tearful. I really need a food night's sleep!