How to inspire someone to accept help they need when they're so low they won't?

[Charlysunnysky]

DS is 22 and has come back to live at home after uni as he was struggling with loneliness, depression and drinking alone to cope. His friends had all left but he stayed as he had a job in essential retail. He eventually left his course midway through the 2nd year and came home, transferring to a local store for his job. It’s only 12 hrs a week and the only time he leaves the house.

We encourage him to come out on bike rides, lunches etc and he will go to watch football with his dad but the one time I finally persuaded him to try a sports group last week, he said they were much better than him and wouldn’t go back.

He has stammered all his life and the blocks of speech therapy over the years have made him feel ashamed, and a failure. He’s is in a very low place, low self-esteem, no confidence. He drinks every day in his room, cans and whiskey until he vomits/passes out.

18 months ago a friend suggested antidepressants so he went on Sertraline which helped him hugely but gave him priapism so he stopped taking it as he thought he could maintain the improvement in mood and anxiety. Since then he has slipped back to being lower than I could ever have imagined. He has had a warning about lateness at work (he was passed out drunk the night before and overslept), and reading between the lines I think work would happily let him go.

This isn’t good news as the walk there and back, seems to help a little. We are doing our best to support him, listening on the rare times he speaks with us and checking in with him (he's reclusive in his room). I’ve a found a raft of resources, researched more suitable anti-depressants, one to one mental health coaching, stammering peer support, links to accessible training courses, employment opportunities, counsellors, mentoring, but he won’t engage with any of it. He’s in too low a place to do anything about it which is causing him to be a danger to himself, and doing himself a lot of harm.

I don’t think he’s at a point where he could be sectioned though. Historically, whenever he’s been in crisis and he needs help, he will do enough just enough to climb out of the catastrophe then go back to whatever caused it. Today I managed to get the GP surgery to offer him an appointment and encouraged him to see that he deserves to feel well again. But he refused to go and said he’ll not drink today. There’s no point in getting frustrated and angry at him as I know this isn’t his choice, but I badly want him to get well as I’m really scared about the harm he’s doing and the risk to his life.

We have a younger daughter doing her GCSE’s too so I have to balance her needs also in this. Is there anything else I can do differently? I love him so much; this is breaking my heart to see him so depressed and lonely.

Bit of a long shot but would he engage with remedial hypnosis? It's short - initial consultation and generally three 'change' sessions - and doesn't require him to go into lots of background or do much talking as the conversations are with the subconscious rather than the conscious mind.

Thank you. I'll look into that. The issue is more that he won't access the help he needs even via a phone call let alone leave the house for holistic therapies.

He can do it via Zoom rather than face to face as there's no trance involved. Maybe suggest he looks at Tim Box's YouTube channel to get an idea about how it works.

Could he manage an online appointment with the doctors? Is that possible? Perhaps with your support to speak if he can't? Sounds like he desperately needs to try some different antidepressants.

I wouldn't push him going to groups right now, he's not in the right place and it's unlikely to ever go well no matter what. But keep encouraging him to do things with you and his dad.

Do you think there could be something more going on here like ASD?

Don’t give up trying OP. Even if he isn’t showing it, I am sure it is better that he can see that you care and won’t give up on him.
It is hard to ask for help when you are so low but deep down he is crying out for help.

He could benefit from an AA programme - maybe see if he'd be willing to give them a call? It's so loving and non judgemental they will welcome him with open arms.

I think it's more the emotional damage from the feeling of not being able to communicate, and self-loathing because he feels like a failure. He's never displayed any spectrum behaviours and he's been close to health professionals throughout his childhood/adolescence because of the stammer, so they or I would have picked it up. I think

I have more chance of selling him an online appointment - thank you for that suggestion. sounds

Thank you. I do find that if I keep casually mentioning things (like going for a bike ride, or out for tea), he will be more amicable to it.

Thank you also for your encouraging words.

I agree with the previous poster, if he would be willing to try an AA meeting, it's turned my husbands life around. He would meet so many people willing to help him.
And try alanon for you, it's a loving gentle place for you.

I went to Al Anon a few months ago. Really nice group of ladies who had alcoholic husbands/boyfriends/partners, but all bar one had left them and the one who was still with her husband said he was a dry alcoholic and her life was very difficult.

It haunted me how scarred they were from the experience and the only way they could deal with it was to leave their spouses to it or kick them out. I can't do that - he's my son. It gave me a glimpse into the future and it made me more determined to avoid this but not really any skills to help.

I also forgot to say that because he drinks my daughter keeps herself and her boyfriend well away from him and if we meet out, he's not invited which I feel awful about - it's not the stammer, its the drunken-ness. We aren't a family like we were 2 years ago because his drinking is out of control. It's making his MH issues far worse.

Our local addiction services recommend SMART recovery not AA. They also have a friends and family programme, and it focuses on giving the f&f tools and skills on how to cope with the situation and how to protect themselves. Meeting both in person and online. https://smartrecovery.org.uk/smart_family__friends/

of course @Charlysunnysky your son may also benefit from the main SMART programme, but you sound like you need this more.

My parents supported me through challenging mental health problems not dissimilar to what you describe in your son.

I would emphasise the importance of taking care of yourself and doing what you can to prevent your son’s situation from wearing you down. Whilst I appreciate it is worrying and you might desire to fix him, recovery can take many months or longer and if you wear yourself out trying to fix him it likely will not help all that much. If there are boundaries you need to keep around his behaviour you will have to do that, partly for the sake of his sister but for your own wellbeing as well.

Do you have any support for yourself like your own therapist or a friend or family member who works in the caring professions (nurse, teacher, social worker) who can provide a non-judgemental listening ear? This sort of situation in your home can be wearing and you might need support for yourself.

Also lions mane mashrooms and ashwaganda are getting rave reviews from people suffering anxiety and low moods (lots of women in menopause benefit). Check out Holland and Barrett. Also, his drinking will mathematically make him depressed, because of how alcohol affects happy hormone production (seratonin/ dopamine). That he needs to cut for any long term fix. Sending hugs

What are his interests? This is a good starting point.

Has he had blood tests?

Being stuck in a behaviour and not being able to move forward, isolating oneself, communication issues and social issues can all be autistic traits.

Thank you. He's a gamer but that doesn't get him out, unfortunately.

He's not had bloods - I can't get him to see a doctor.

He's had 18 years of being monitored at school, Speech & Language & private CBT, hypnotherapy and none of the professionals have ever thought he was even on the spectrum - I had asked if this was a possibility just to rule it out.

When he is not drinking, and happier, he is empathetic, loads of eye contact and inflection in his voice, uses sarcasm in his humour, as well as idioms & metaphors; his anxiety is tied up with his inability to speak fluently and he longs for close friendships so I can see they were correct in not diagnosing him with Asperger's/ASD.

This sounds really awful OP, I'm so sorry. You sound like an extremely lovely mum.

I think you might need to think less long term with him and concentrate on the first steps. The drinking is worrying but you probably can't help him with that, but you can help him get access to mental health treatment, specifically new meds. Back to basics though. First step is get him to get dressed and put his shoes and socks on.

In the meantime can you talk to the GP on his behalf and see what they suggest? He will have to engage, obviously, but maybe if you have a half-formed plan to tell him about it might help. Good luck, and I'm hugely admiring of your approach

Thank - I'll pick up some Ashwaganda from H&B - he'll probably take that.

As you say though, while the alcohol misuse makes him forget his problems, it also depresses him further. I'm not sure herbal medicines will be enough.

His alcoholism is also causing others around him to react differently which in turn makes him even feel paranoid, sadder and rejected. I checked on him in his room last Thursday night as I knew he had been drinking. He was passed out on the carpet floor, but he's 6' 5 so I can't move him but he was in the recovery position anyway by chance.

However next morning he was 35 mins late for work next day and a colleague had to open the store alone which is against policy and unsafe. So both the colleague and manager were angry and disgusted with him as he will have smelled of alcohol - it's fairly obvious why he was late. This made him feel victimised and bullied because of his problems.

Thank you. Your message was very well put, and I hope you're feeling better yourself.

I'm attending a local group Mindfulness group which is aimed a menopause, but covers all the things I'm experiencing because of my son's issues. I've requested counselling through work too.

The thing is, when he's sober, it's manageable - he's stable, though he could be happier, going out more.

It really is the alcohol abuse/addiction that is stopping him moving forward, getting support to improve his self-esteem, retraining. But he's using alcohol as coping mechanism to ease/forget the pain of rejection, loneliness, and self loathing.

@Spinet Thank you so much. It really felt the warmth in your message and it was full of really good logical advice.

It really is the alcohol abuse/addiction that is stopping him moving forward, getting support to improve his self-esteem, retraining. But he's using alcohol as coping mechanism to ease/forget the pain of rejection, loneliness, and self loathing.

Absolutely right. He has a problem and is using alcohol to medicate it.

Would it be OK to PM you?

I think this may be around transition,from the ongoing structured support in childhood then transitioning to adulthood, overwhelm etc. I'm just wondering if he needs simpler goal setting. Not a therapist per se but more like a coach to help him consistently apply one or two methods towards a goal he is enthusiastic about. Consistent being key.

There is medication the GP can prescribe that puts you off drinking, can't remember what it is. Maybe a group coaching weights session in the gym as an alternative. Maybe look at anti depressants for 2 years to build evidence of coping in order to be able to talk himself through the negative self talk. Maybe a different one, citalopram is better for focus and motivation than sertraline.

@gymgoals2024 This is a sound plan - thank you, and in fact yesterday I spoke with someone from a network for people who stammer and she said they have a mentoring programme and she would be happy to get him involved but he wasn't on board with it all. Just not interested. Same to the ashwagandha I bought. There are people out there (like you lovely people) who want to help and he deserves to feel better but he wont accept the help he needs so badly.

I get that part of anxiety can include fear of change and that is perhaps what's going on here.

I was disappointed that he'd gone back to drinking when he finished work at noon yesterday, but I know i must not get drawn into my happiness being attached to whether he's drunk or sober.

I cut his hair (probably one of the best cuts I've ever done as I was keen to keep him around) and he was really pleased with it and that gave him a lift. It's frustrating to see what a lovely person he is when he's not drinking but that he won't accept any help to move forward.

Your son has achieved a lot over the last few years...he has been to uni, got through GCSEs/a levels; he has had/ has a job. The feelings of "failure" aren't borne out by the facts - that he is strong and copes with many many things. This is something CBT or any decent therapist who specialises in his age group would really help with
He is self medicating for ANXIETY and although you say there are no indications of ASD, he may, just may have inattentive ADHD which lends itself to self medication with drugs and alcohol unfortunately.

I have three teens between 22 and 24 (twins of 22) and the elder went through a crisis at about 21/22 in his last year of uni and then the next year, intrusive thoughts, not getting out of bed, sleeping all day internet all night admittedly it was triggered by COVID loneliness. But it was also an old bugbear of his, vitamin D deficiency. I gave him a big loading dose as he refused to see doctor. Say 10,000 iu a week for four weeks.
I also rang up friends who had been through similar and one recommended an pyschotherapist in outer London who has it happened he talked to by telephone rather than in person. I made the first conversation with her and he literally had to get through the next appointment by phone himself.

Would he be able to talk to someone on the phone or would the stammer kick in? I had to force my son to do that first call and from then on it was between them. She even suggested I put money into his account so he would feel he was paying for the sessions, be accountable etc. He spoke to her twice weekly then once weekly.
It helped enormously his self esteem soared. The sense of purpose increased and the anxiety reduced. He had techniques to tackle the dark thoughts. He slowly got a parttime job, started socialising a bit. Then he went back to uni and did an MA.

My 22 younger son has ASD/inattentive ADHD and has just finished uni. Still finding his way with friends but getting out and doing stuff, volunteering has been our priority for him rather than actual job which pays money. So I think looking at your priorities for your son might also be important. The job may not suit. It may have to go on back burner whilst he tackles the anxiety
Fresh air, people, exercise, vitamin D and your intervention may be crucial. The adolescent brain is not fully developed. He may not be able to help himself. He is living in your house he is isn't independent in that sense so in a way you are allowed to intervene just as you would if he was taking drugs in your house. What would you do then??

It may also be the case that anxiety meds might be better for him than alcohol, or indeed ADHD medication. In our case our children have not needed medication, other interventions worked better. Your son is earning money and with that money he buys alcohol. If he loses his job he won't have money for alcohol or gaming. That will be a wakeup call of sorts. But it doesn't have to get to that point, I would be using carrot rather than stick in this situation.
Carrot being trying to make a plan with him for a more positive version of his life. Could be a trip he plans - literally an overnight. Could be buying groceries for you. Could be going to a show (mine adored musicals) or cinema with you first then solo.

A lot of my friend's children are way ahead of mine in terms of jobs, socialising and independence, romance. And the children feel this too, it's acute FOMO. But you have to keep reminding them that this is not about comparisons. I want them to be them not someones else's Perfect Peter. It's their precious life and everyone develops at different rates, there isn't a race on.