Convinced we are enabling our son but don’t know where to start

[Sleepless1234]

Hi
Our son is twenty and has been struggling with his mental health for some time. I referred him to CAMHS whilst he was still at college. They sent him details of support groups, therapy etc but he did not engage.

He has never been particularly helpful around the house. If he was asked to perform any chore such as empty the dishwasher his response would be to ask how much he would get for it. I don’t remember him ever volunteering to help. As he went through his teenage years he spent more and more time gaming online. His schoolwork started to slide. We spoke to the headteacher about our concerns but nothing ever came of this.

He moved onto sixth form college but failed to engage with this. I could see he was struggling hence the referral to CAMHS. He just didn’t seem to care about anything other than getting online to game. I did say to him that once he finished college he couldn’t just stay in the house gaming, he had to get a job/apprenticeship/further education. If he planned to just continue gaming he could leave home.

He got a job. Night shifts as the pay was higher. We were concerned about this as his lifestyle/sleeping/eating habits were erratic and night work was not likely to help but it was his decision. He started with five shifts a week, then cut down to four, then three. We didn’t see him. Even on days off he would barely come out of his room because he was tired from the previous night or preparing for the next night. Around the time he turned nineteen he started smoking cannabis. He claimed it was the odd occasion when he was out with friends. He didn’t like drinking, he preferred to have a smoke. We were neutral about that. Is the odd smoke any more harmful than a few drinks? I don’t know.

But it was more than the odd smoke. There were times when he was smoking £150 worth per week. He was spending all his spare money on weed.

He had a breakdown in October. He gave up work - he had lasted almost a year. We encouraged him to see the GP and after several weeks of having him do various online questionnaires he finally was offered a face to face appointment in January. He is now being treated for anxiety and depression, possibly has PTSD and is awaiting an Autism assessment. He has been treated with fluoxetine without much success and has recently started taking sertraline. He has also been having weekly counselling since January which is obviously bringing up things from much earlier in his childhood which he has never shared with us (and certainly never showed any signs of at the time).

He will get up to attend appointments (job centre, doctors etc). If he has no appointment he may come down for a bowl of cereal in the morning but it is often lunchtime or later. He goes back to his room where he stays in the dark. He eats with us in the evening, although he clearly finds this uncomfortable (and has said he finds eating with other people uncomfortable - this has only been the case since around puberty). We then hear him gaming in the evening and he tells us this goes on until 2am.

He has been spending almost all of his universal credit on weed. He says it is the only thing to calm what is going on in his head. He says it helps him relax and to be able to sleep. And I can’t deny that this may be the case but he has been smoking more than his income. And he is smoking so much that it may well be the cause of some of his symptoms.

I have suggested he tries setting his alarm and getting up at a regular time. When he stays in bed until 4pm it isn’t surprising that he can’t sleep the following night.

I have suggested going out every day, even for a thirty minute walk could help him. He says he is too tired.

I asked if anyone else has suggested similar things to him. He said he guessed so. When I asked what stopped him from doing things he said it was hard to get motivated.

But he will go out and buy his drugs. Because we won’t?

I will cook in the evening and he does come and eat that. He will have a bowl of sugary cereal for ‘breakfast’ and a cheese wrap for ‘lunch’ if he has anything. He doesn’t eat fruit. The only vegetables he eats are during the evening meal and even then I have to be careful what I include. He was picky as a child but not this picky. There is always food in the house so he doesn’t need to worry about this.

I have stopped asking for his laundry. He has not had any sheets on his bed for at least 4 weeks. He will go for days without showering. His room is chaotic - but it is his room so that is his business.

I know he is unwell and a lot of his behaviour is down to his illness. But he can do things - he can keep his cannabis supply topped up, he will shower before going to an appointment. It feels like he just doesn’t bother when at home.

We did point out that his UC was for him to pay for essentials. We suggested he pays the majority of it over to us when he receives it, we would ensure he received a weekly amount so he could meet any expenses such as bus fares. We will hold the money in an account for him until he is better. This made him angry, he said he had no choice. I said he could choose to keep the money but from then on he would have to buy all his food. He chose the first option. Whether he will next month

He referred himself to the local drug and alcohol support group, but only when I asked him to.

Sorry for the long post. It is more of an offloading than anything. But if anyone has any advice on how we can help him to begin living in the real world again I would appreciate it.

Thank you x

@FaeryRing I'm sorry but how many autistic sons have you raised? Just out of question. Why would anyone choose to live this way? It sounds fucking horrific. To watch your peers go out into the world and thrive, to see your brothers achieve and not be able to leave your room for fear of being judged or pitied? I'm struggling to see why anyone would choose this life. Where you see manipulation, someone with more emotional insight see an internal struggle.

It sounds like he might be neurodivergent and therefore more vulnerable to gaming and weed addiction. You haven't gone into it but sounds like he has experienced some significant traumas as well. I hope that getting a diagnosis helps him if he is autistic, and that the antidepressants help over time. It sounds like his sleep pattern is not good, has that always been the case? A lot of neurodivergent people have problems with their sleep which can be helped with the right medication (such as melatonin). Cannabis use is only going to contribute to a decline in mental health, however it does sound like he is self medicating with this. If he got on the right mental health medication this might help, and it is positive that he has accessed drug and alcohol support (even if there is a wait). It may be if he is autistic he needs social support to access this, so just because you pushed him to do this doesn't mean he won't be open to the support. I think this is unlikely to be a quick process, but the time and resources you put in now, will hopefully pay off down the line when he has the right support, medication and diagnosis and can move away from negative coping strategies. The old school kick up the bum/ultimatum method won't work if he has autism, will only compound his anxiety and worsen the problem. Sticking to the boundaries around some things (like using cannabis around the house) but giving him some space around other demands might be helpful. I would look up the PDA profile of autism, it might help you to understand why he can seemingly 'perform' tasks like showering in some situations and not others. I hope that he finds his way out of this dark place, and back into the fold of your family.

@Sleepless1234 you'd be better off going to a local community mental health team who are well skilled in working with people with depression, anxiety and autism. A diagnosis is just that, a piece of paper. There's no support

I don't see what good reporting him to the police would do . The police don't have the resources to reprimand an adult smoking recreational weed in their home.

Switching the electricity off at the fuse box would make an impact on him .

@MoominPyjamas He is under a mental health team - although he says they are preparing to discharge him. In our view he seems no better than he did when his treatment started. They also said they would arrange a mental health support worker to help him start to get out and about. According to DS the support worker never contacted him. He has attended all of his appointments.

The issue we have is we set goals eg cook a meal once a week, make sure you bring dirty plates and cups down from your room, empty your rubbish bin when full. He agrees to the goals but then makes very little attempt to meet them

100% this is the course of action for lazy!

This was my DD at 15-17 but she did go to school, sometimes. She smoked a LOT of weed at 15-16 but stopped, before we had even realised the extent of it. It took 3 years for her to get to a good place.

What helped;

Not smoking
Volunteering with animals
CAMHS
Barnado's parenting course
Lots of love with boundaries

Good luck.

What are the consequences when he doesn't meet his goals? What's his incentive to change anything about his lifestyle and choices?

Yes, this is a feature of MH issues.

While you wait for him to complete the forms, could you access support for yourself?

Appreciate the frustration, but realistic expectations and informed thinking would really help you deal with it.

It does sound like you are all uncomfortable being uncomfortable iyswim. He's uncomfortable doing things that require effort (bloody weed! - I hate the stuff) You seem uncomfortable setting and maintaining boundaries. I sympathise. I hate it too and often said to DC: if you don't do X then I have to nag and I HATE nagging because I don't enjoy bossing people around. But I did do it.

For housework when they asked what they'd get paid, I said, no one gets paid for keeping their own house clean - it's a job we do for the reward of living in a lovely home - get the hoover out, mate, while I clean the bath.

In your position I'd have a chat and say: I can't passively watch your life slide like this. We haven't intervened, because you are an adult and we wanted you to have the chance to sort to yourself, but honestly, you need to get a lot tougher on yourself and we need to be part of that. If you live at home, from now on, you need to keep your room clean and orderly - properly made bed with sheets changed at least once a fortnight, washed by you. Same with towels - washed once a week. You need to cook for the family twice a week - healthy food. I'll help you for the first month, to get confident with some recipes (chicken, veggie or fish traybakes, pasta dishes, chillies etc - basic stuff) You need exercise every day - even if you are tired - a gentle walk in the sun. And you must go to NA or some other local drug support place once a week about the weed habit because it has sucked your energy and mood and prospects from you, but you will get them back.

But you then have to do the insisting. That's the hard part. I always always said: I hate doing this. Don't ever think I enjoy nagging and bullying you. I am insisting you go for a walk/cook the dinner/clean the loo because I want you to be an adult who can look after himself and thrive and cope with the small demands of daily life and these are some of them: clean your home, yourself, make good food, take exercise. Every day. So today, we agreed you would have a shower, take a walk, change your bed, cook some chicken. It takes longer if you resist every moment. It takes seconds if you just do it.

I had to do this when DS had MH issues. He wanted me to help but was then so resistant to the help, then blamed me for not helping as much as he'd hoped. I just despaired, but plugged away at it and he did come through it and sort himself out in the end.

Agree with what @Lilacdew posted just above - this You seem uncomfortable setting and maintaining boundaries is coming across to me too in your posts @Sleepless1234

The weed and the gaming are regulating behaviours, they will stabilise his anxiety in the short term. In the long term they will not help at all, but when he is feeling anxious he won't be thinking about the long term. What was he like at primary school? Any signs of neurodiversity before puberty?
I think you need to take this really slowly - perhaps deal with the situation as if he has a diagnosis already.
Maybe even say that to him. 'Let's assume you are autistic... what do you need to make small improvements to your situation?'

You need to support him to meet them.

In all seriousness, if he's under a mental health team and is getting meds and therapy then this is not just laziness.

If you suspect he may be neurodivergent then standard parenting methods are unlikely to work (and they don't work on mental ill teens either).

Focus on what is likely to make a long term difference - and this is not the dishwasher, or emptying his bin, which are merely symptoms of his mental illness.

Focus on getting and keeping him in therapy (so if the nhs are going to discharge look at private), getting meds that work.

Many neurodivergent young people struggle to do forms and keep on track with time. Can you get someone to support him in filling in the form? Probably not you but maybe a relative?

I would call the mental health team. They will not share information with you without his consent but you can tell them that you don't feel there is much change, that the weed is ongoing, that you're worried about low mood, the crying, the lack of motivation, the self neglect. You can ask why the support worker never called etc. Do not let them discharge him with no plan.

Exactly what makes him think he is Autistic may I ask? I'm certainly not dismissing it - but I also wouldn't want to be jumping straight to ND as a way of excusing issues that need addressing.

Life is fucking hard. It is hard for everyone, but when you are an adult you NEED to get your arse up, go to work and pay to live. That is life, it may be unpleasant but tough shit. Yes, you are enabling him. You need rules in place - he is smoking weed in YOUR HOME. wtf!?! He has no sheets, god knows what his room is like as I dare say he doesn't clean, and he doesn't shower for days. That is unacceptable in a shared environment. If he can manage to organise getting weed and gaming, he can manage laundry and cleaning.

What do the MH tean say about the weed use? In my view that needs tackling first. Nothing will improve unless he tackles this addiction.
Are they any carers of addicts support groups local to you. Could you attend/ ring a support line?
I am not an expert in drug addiction but my DD has had severe MH issues and DS 1 too. And a lot of what @Lilacdew said is good sense.
Being a parent helping a DC through a MH issue is v hard work and it makes one very unpopular. But it has to be done. Calm insistence. A lot of distress tolerance.
One of the most powerful things I learned was distress tolerance. Don't make their distress your own. Sit alongside it. Be a presence. And allow it to pass. Because it will. Heightened anxiety will pass. Until the next time. The gaming and drugs are a coping mechanisms for that. Instead of learning to tolerate his anxiety/ his distress he has used destructive coping tactics. My DS developed OCD rituals.That is a different reaction to the same issue. The coping strategies then become the 'major issue.
Helping them tolerate distress and anxiety is key.
But more than that kicking the weed habit has to come first. I don't believe any thing will get better without doing so.

Hi Op.
i am 10 years in with this with my eldest son.
i have only really started to recognise how much I was enabling him.
Ive found this website an enormous help
https://www.youtube.com/@puttheshoveldown

If you let him ignore the non-negotiable rules, then they weren't non-negotiable!

1. He does sound like he could be on the ASD spectrum. This means you need to approach things in a certain way. There are lots of resources on line and you can access parenting classes for parents of ASD children which will help even though he's now an adult

1. PTSD. Doubtful. This has very specific diagnostic criteria, and would be the result of experiencing perceived or actual threat to life or limb. Has he been in this situation? He may have complex PTSD from long term exposure to trauma, but you'd be aware of this I would think

1. Stop thinking about "enabling". Do psychiatric hospitals enable people to be unwell? Strictly speaking, yes, but the difference is that there is a longer term plan to change things while the enabling is going on, which will reduce dependence longer term. There's nothing wrong with enabling as part of a longer plan, but you need the plan!! This is where the achievable goals and non-negotiable boundaries come in. if you ignore these, you are enabling him for no reason, and then it becomes "bad" enabling instead of being helpful

I would start with the ASD diagnosis and go from there

@Basicsandwich He never showed what we thought of as obvious signs of autism as a small child. Sixteen years ago when I first raised concerns my knowledge of autism was limited to the idea of difficulty forming relationships/being hyper focused on things/hypersensitivity. He didn’t show any of these signs.

His siblings are both academically very able and have been from a very young age. For two terms DS and his younger sibling were at pre school together and I raised concerns that my youngest child was meeting goals that DS hadn’t reached. I was told not to worry, he will get there in the end. I assumed that my other two children who differed from the ‘norm’ and that DS was just progressing at a more average rate.

He was happy at primary school and had good friendships. He was a picky eater but not to the extent mealtimes were an issue. He would try new foods. He didn’t like loud bangs so pantomimes and firework displays became things we avoided.

He didn’t like weather though which was more of an issue. It was always too hot, too cold, too windy, too rainy etc. It was rare that conditions were just right for him. However, he would happily play with friends outside so could be distracted fro the weather.

He didn’t ‘flap’ or ‘spin’ or do anything else that I recognised as stimming at the time. But he would chew his sleeves - to the point of making holes in them and his coat would often have a smell where he chewed it so much. I think now this was possibly his stim.

He would never take responsibility and his argument was he was just a child. But, for instance if I caught two or sometimes even all three children doing something naughty, the other two would accept they had been in the wrong and move on. DS would go to great lengths to try and persuade that it wasn’t his fault, so and so did this etc. He could never accept he was wrong. And as a result we probably became less tolerant of his behaviour over the years. There was give and take with his siblings. They would help contribute to family life, doing chores, getting ready for school when asked and as a result they probably got more leeway when they did transgress. DS failed to organise himself and looking back he was likely struggling then but we didn’t recognise it.

Secondary school saw him become more withdrawn. There were bullying incidences, one of which he told us about and the school was contacted and things were dealt with. He didn’t tell us about the other incidents until he has left school. He has never named the protagonist(s) as they were supposedly his friends.

We spoke with the headteacher about our concern over his lack of focus and engagement with his studies. Again we were told they would look into it but they didn’t really have any concerns. He spent more time in his room but still interacted in a positive manner when he was down - and some withdrawal and spending more time in your room is part of normal teenage behaviour, or so we thought. But over time he spent more and more time in his room and interactions became more difficult.

He didn’t sit his GCSES - lockdown 2020. And his college experience was obviously disrupted by the whole home learning/lockdown/self isolation situation. I referred him to CAMHS but he didn’t engage with anything they offered.

He left college with no real qualifications and started working night shifts so we saw less and less of him. Until the breakdown.

And I confess when he said he thought he was autistic at that point in time I thought it was him just making an excuse for his behaviour. But clearly I had concerns from an early age but when I raised the concerns was told ‘not to worry’. I felt like a pushy parent who was seeking answers because DS wasn’t as well behaved or academically able as his siblings.

I wish now I had pushed harder. DS has grown up feeling invalidated. His trust in us has been affected and that makes the current situation more difficult.

All of this. ^

Sorry OP you are having a hard time and no one can wave a magic wand and change that.

Small targets, getting the form filled in for the psychiatrist is something he could aim for.

Try to find something to praise him for, even if it is just, "thanks for coming down for dinner".

@AndSoFinally The PTSD is from an alleged incident that happened in primary school. He never mentioned anything at the time and there were no signs to us suggesting something had happened. But whatever did happen, in his head he believes it was something traumatic and the GP and mental health team are the ones saying PTSD.

I see we need to be more ‘nagging’. We need to sit down with him to see what he feels is achievable and take it slowly.

Will look into the parenting courses.

Calm insistence. It sounds better than nagging!!!

Sorry youre going through this OP, my partner's son is similar and it's so frustrating, particularly when he seems able to do certain things he wants to/enjoys but nothing more. I'm aware that doesnt sound very understanding but his behaviour hurts my partner so much it's hard to always be sympathetic.

If he’s not making any effort you can’t help him.
you can request no drugs in the house (especially if everyone else can smell it and is embarrassed by it) you can expect a level of manners in the house (no telling other people to shut up for example)
you can request rent out of his UC, since he’s clearly wasting it anyway. If you don’t request rent I would say his ‘rent’ would be an expectation to keep his room at a certain level of mess (eg nothing rotten, sheets on the bed) and to engage with whatever services are available to him (eg filling out the forms for support). If he needs help to do any of those things obviously he should know he can ask you for help, if he can’t handle it or doesn’t know where to start.
But He can’t just be an adult with no rent to pay no bills to pay no cleaning or housework or cooking to do and no engaging with the rest of society. I don’t think that’s good for him.

You've described quite a lot of autistic traits in your most recent post, and earlier e.g. him misinterpreting a question you asked as you being angry. I think it would probably be good to proceed as if he was autistic, which might be a bit of a different approach to if he wasn't.
Melatonin often really helps with sleep for autistic people, my 13yo is prescribed it and it was life changing for her.
Have you heard of autistic burnout? It's possible that he's experiencing this. If he's undereating it's also possible that the calorie deficit is affecting his mental health and stamina and motivation so it might be worth having that conversation and seeing if there's any way to get more calories in to him. If he has executive function difficulties then something like body doubling could help him get his room sorted and with other practical tasks. Having visual reminders or a routine might also help. I would suggest applying for PIP because it sounds like he does need support with daily living right now, but with the drug issue you might not want to help him get access to even more money. You are doing quite a lot for him though e.g. with his food (and there are things that aren't being done e.g. showering).