Mental health issues. Am I being unsympathetic?

This whole situation is so complex and difficult. My sil is 14 years older than my dh, and has struggled with depression and anxiety her whole life. She has disordered eating and is morbidly obese as a result. She has never had a relationship or a job (in her 50s now) and has lived at home with parents. This suited mil and they were very codependent. She has never claimed benefits as she is scared of the system, and won't go to gp despite several serious health issues as she doesn't like being told she is overweight. She has depended on in laws for financial support her whole life.

Both In laws passed away suddenly in last few years and we were left in a position where she had no money coming in but still wouldn't claim. We had to use 'tough love' to tell her to go through the system as we supported her for 6 months (financially, emotionally, physically) and she attempted suicide, but in a way that she knew she would be found. My dh wanted to leave it as she was scared of what she wanted to do next, but we physically can't afford it so had to push it again. She's actually sorted with benefits now after 50 years of never having money coming in. However, she has had massive health scares and been told to lose a huge amount of weight and won't / can't do anything at all about it. She is at huge risk of clots and been told to move around a bit more, but refuses to even try (and I mean to kitchen, front door etc). Both dh and I work in mental health fields and do understand them, but from a family and personal level it's so hard and frustrating as we are picking up the burden - and I love her to bits, but it is a burden caring for her completely with both working full time, two young kids and aging parents on my side to care for too - while she will do absolutely nothing to help herself and it feels like a legacy of many many years of her parents allowing her to live like this while not supporting her to make any changes.

My 9 year old son also struggles with anxiety and I'm so scared he will end up like this. If it was left up to him he would sit and read and game all day. I feel like we are constantly pushing him into activities that challenge his comfort zone. We have 3-4 sleepless nights before every day out and weekend away, but then he enjoys it every single time when he goes. I don't know what the answer is, and am scared as he gets older he will push back more and more and his world will get smaller and smaller. He's had a referral for his anxiety and is on an 18 month waiting list...

if you ask any of them about things like hobbies / applying for jobs / plans to leave home / friendships or anything that might help them move on, they get angry and you get attacked for not ‘understanding’.

Well, if you are expecting any of those things to "help them move on", then you don't understand.

They are young men who have their whole lives ahead - how can it be more reasonable to think 'well this is just how things are' than to try and help them?

But you aren't helping them. You are judging and needling them with these pointed questions, as if they should just "snap out of it" and "move on".

I would suggest you just mind your own business. On a practical level, someone (a doctor, a therapist, a counsellor, a therapeutic self-help group, eg) may be able to help them, but it won't be you.

it feels like a legacy of many many years of her parents allowing her to live like this while not supporting her to make any changes.

@10storeylovesong This is a far more extreme version of one of my SIL’s relationship with her parents. Thankfully she works and has her own home, but she’s “borrowed” a lot of money from them that will never get paid back. The emotionally codependent relationship is scarily similar and I’m concerned what will happen when they pass away as they’re now in their 80’s. I don’t think she’ll be able to cope.

I also find it hard hearing that an octogenarian who gets dizzy spells has been up a ladder cleaning out her gutters. WTF is she thinking asking her Dad to do this?😡DH was fuming when he heard. She seems oblivious to their age and various health conditions.

Anyway, unfortunately, it’s not unusual for these situations to continue into middle-age, I know a few others in this situations and it’s heartbreaking seeing elderly people trying to cope with it. My SIL is one of the “better” situations, tbh.

@Cameleongirl it is likely that your sils/dh parents have gotten something out of the codependency too. In the absence of disabilities it is normally a situation like that because one or both of the parents get something out of keeping a child dependant on them even when grown into adulthood

@Teenyliving I expect you're right. She's the youngest child and has always been treated as the baby of the family. Things will inevitably change over the next few years due to their age and I just hope she can deal with it.
What worries DH is that her expectations of them could lead to a fall, for example. People don't generally ask octogenarians to do DIY, cleaning, cooking, etc. for them!

It’s really hard to know what the right thing to do is. We have a similar situation with an 18 year old man in the family who I can see going through same way. Been under CAHMS for a few years, smoking weed, bunking off school all due to his mental health issues/depression. Now he is an adult he doesn’t want to get a job or do anything with his life and any suggestions are met with tears and suicide threats. He is however happy to spend all hours under the sun gaming in his room and generally behaving like an utter arsehole to his parents who are tiptoeing around him in case the suicide threats become a reality. Sad situation but the family sympathy gets less and less the longer he refuses to get any help or do anything at all to improve his situation.

Of you actually want to help your relatives OP, the three things you need to remember:

1. do not try and fix. Ever.
   
2. do not pass judgement. Ever.
   
3. you don’t have to understand or sympathise. Just hold space. Exercise empathy.
   
   Remember also that it isn’t about you or your opinions or what you think is best.
   
   Change comes from within that person. To help them do that, you just have to be there. It’s not tiptoeing around or pandering. It’s the being there empathetically.

Just to add OP, the “straight talking” snap out of it, move on, there’s people worse off than you approach that has dominated conversations about mental health for decades is a very big part of why poor mental health is such a crisis now. There is a reason why that approach is never seen as a helpful.

Why are people so lacking in reading skills? The OP hasn't mentioned straight talking or "snap out of it" at all.

She is talking about the unwillingness to discuss ANYTHING related to the person concerned by enabling parents. Not storming in and telling them to buck up and just bloody well get on with it.

Why are some people so desperate to read something which just isn't there?

“We are a very plain-speaking Northern family and I don’t understand how supporting someone with MH issues came to mean – tiptoeing around them / never challenging them / never speaking your mind for fear of what they might do. It’s a strange claustrophobic situation and I don’t know what to do for the best. Am I being unreasonable?”

@FamilyTreeBuilder see above. That’s exactly what this means. Use some critical thinking skills.

There is the potential for secondary gain with MH problems. The MH problem feels bad, but having it and not getting better brings benefits - being looked after by others, people lowering expectations on you, etc etc. This can be a big reason people get stuck. It is one thing to have these problems, but another to not want to work on getting better. It does feel overwhelming, sure, but that is what professional help is for. I work in healthcare, and see how damaging this kind of normalizing can be.

@BeetBeats Ideally, change does come from within a person, but sometimes it doesn’t happen. Then what?

it’s difficult when the whole family is affected parents ground down emotionally and possibly financially, the adult child not moving forward.

But the whole point is that it's not a question of their 'not moving forward'; it's a question of their not recovering from an illness. There may be more that they could do about it in terms of seeking and accepting treatment; there may not be. We don't know whether they are having treatment or what treatment they are having. But one can be almost certain that it's not a question of their choosing to have a mental illness, or the restrictions that accompany it; or that they could become healthy again through an effort of will, if enough pressure is placed on them. Asking them about 'getting a job' or 'making friends' is basically asking them 'when are you going to become 'normal' and healthy?' And as long as they are in such a bad state of health, it may sadly be difficult for them to get jobs or make friends even if they try to. Getting jobs and making friends depends on finding people willing to employ you or socialize with you, which unfortunately may be difficult for people who are in a very bad emotional state and unable to respond much to others.

There may be some self-help steps that they could take, but these are likely at least at first to be 'baby steps', and in suggesting such steps, one has to start from an acceptance that they do have an illness. Just as someone with a broken leg may benefit from some physiotherapy exercises, but not from demands that they run a marathon, or even go for a long walk. Perhaps, rather than pressing them to get jobs or make friends or pursue a hobby, you could try to get them to engage in a 10-minute conversation about a specified topic, or to join you in a short card game, or a 15-minute walk, or to wash the dishes under clear instructions.

Sorry- just realized that you are not the OP, so my suggestions in the last paragraph may or may not be relevant to you.

@ddl1 I’m the child of someone suffering from lifelong mental illness so I definitely understand that it’s an illness. I agree there’s a balance to be had, you can’t ask too much of someone who’s ill but OTOH, I do think that effort of will and not being enabled too much have roles to play in getting better.

The poster I responded to suggested that empathizing and waiting for the person to change from within is enough. From my family’s experience, I can’t agree with this as sometimes people don’t change. In the meantime, the family around them falls apart emotionally and financially.

She has brought up ideas she believes would help them (and this is a literal quote) "move on". The notion that taking up a hobby will sort out someone with major depression or whatever their diagnosis implies an attitude that they could and should just "snap out of it". HTH.

but depression isn’t like a broken leg though is it?

the causes of mental health issues are many and varied.

sometimes it’s the result of a “naturally occurring” imbalance, sometimes it’s the result of trauma and sometimes it’s just characterological.

i think the link that it’s just like any other disease is unhelpful. Someone’s mood is directly impacted by what they do. People have vsstly more power to impact on their mental health issues that they do to mend a broken leg or cure themselves of diabetes.

often (not always) people make a choice as to whether they want to do the work or not.

@mustbetheseasonofthewitch but hobbies can help. A lot.

and indeed it’s rarely a case of snapping out of it - but Itnis often a case of making th effort to do the work needed to recocer

Hobbies can certainly help a mild reactive depression. So can writing a gratitude list. But I would never dream of offering pat solutions to other people suffering from any form of mental health problem. We don't know their diagnosis. My point is the OP's attitude, having not suffered any form of depression herself, is that they are just malingering. It's none of her business.

I put this sort of thing on a par with giving an obese person your dieting tips.

I don't think the OP is suggesting they are malingering at all. I think her concern is that they are not getting any treatment. How will the situation change if they are not getting any treatment?

I think her concern is that they are not getting any treatment.

Really?

OP: ...if you ask any of them about things like hobbies / applying for jobs / plans to leave home / friendships or anything that might help them move on, they get angry and you get attacked for not ‘understanding’.

She's not suggesting treatment options. And she's not equipped to suggest treatement options.

There is nothing in OP's posts which suggests she thinks these people are malingering.

So many posters who haven't come across this situation just don't get it. Others have drawn similarities with physical illness so let's run with that analogy. If a teenager develops a physical issue - say asthma - then that's a lifelong thing which will always be there to some extent. And yes, having asthma might mean you will never be able to take part in some activities. But you as the parent/carer of someone with asthma might suggest they see the GP about inhalers or steroids, or start trying to up their general fitness. It's not going to cure the asthma, but it's going to make things better.

It's the total lack of willingness to even try to seek treatment or help which many of us with family members in that situation find frustrating. Parents and other family members enabling the illness by allowing the situation to continue and just accepting that this is how it is going to be, forever. Without even trying options like CBT or medication, or therapy or anything else. And the longer the situation goes on, the harder it is to break the pattern and seek help.

Writing off these people as ill, with no prospects of ever getting better, and just accepting that they will be unable ever to live independently, always will be dependent on their family for basic needs, never get any qualifications, never work, never have hobbies, a partner or children of their own - is that really something anyone thinks is acceptable? Or would want for their own child?

My sister has a "friend" who is similar. An academic highflyer. Won an award at her university for her excellence. Worked in her field for maybe 2-3 years, then just left.
That was the best part of 15 years ago. Since then she's lived with her aging parents (they had her later in life, so both are late 70s), still sleeping in her childhood bedroom, and hasn't worked another day in her life. She can't/won't drive and goes on the occasional bus trip with her mum to visit the crumbling sets of childhood tv shows she used to like.

Regularly reports being "in floods of tears" because of such inane things like "my parents didn't tell me a plumber was coming round" to "dad moved my pen." Then sobbing hysterically all night "because no-one cares about me." She's 40.

She's obviously got massive mental health issues, but seemingly she (nor her parents) do anything about it.