How to support depressed adult son (23)

[HowDoIEven]

My son has had issues with depression for years, after having a difficult childhood - his other parent (we weren't together) had issues with alcohol use and narcissistic traits, and died when he was a teenager. In the years since then both grandparents on that side of the family have also died.

He dropped out of university (not helped by Covid lockdown happening the year he went), spent a year not really doing anything, finally made some positive progress and got on an apprenticeship to get into teaching, but then has lost that job, as far as I can tell through no fault of his own but issues at the college where he was working.

He's never been diagnosed but probably has both ADHD and ASD traits. He's told me he has terrible problems sleeping, and motivating himself to do anything, has problems with rage and can be set off by minor things, is socially isolating himself as a result (he lives in a shared flat, not with me), is consumed with self loathing.

He's been to the GP in the past, but not had much support - has been on and off anti-depressants.

I'm extremely worried for him and scared at where this might end up. I'm pushing him to make another GP appointment - he says he spent half an hour filling in forms then it crashed and he can't face doing it again. How can I help him more? I feel like he needs face to face therapy of some sort - he's had some CBT but I don't think it's really helped. Getting him to do anything to try to help himself is a massive struggle, but he's an adult so I don't know how much I can do on his behalf.

If you can afford it, the best thing you could do for him is get him private therapy. Having been in the position of your son I can tell you the NHS are absolutely awful at dealing with anything like this. You have meds thrown at you and if you are lucky a few sessions with someone who will put pressure on him to speak and if he struggles to open up wil be kicked out of it for not engaging.

Thank you - I'm not sure where to start with trying to find some form of private therapy for him, it feels like he'd benefit much more from face to face than from something online.

There is a professional body that psychotherapist's need to belong to. Some also offer rates that are slightly cheaper for people on benefits. I have had extensive therapy on the NHS and also some private therapy.

What he needs is a therapist he gels with totally so picking your own is better. I have had 5, I only ever really felt 100% ok with 2 of them. The last one really helped me more than all the rest put together, though they did assist to an extent.

To get extensive assistance on the NhS you need to be a real threat to others or yourself. I got the help I needed when I admitted some stuff to my MH professional it’s stuff not to be proud of.

It's hard to know whether we should be looking for a psychiatrist of a psychotherapist, seems there's a lot of different professional bodies. At least I've managed to get him to make a GP appointment now, so that's a start.

I'm in a similar situation with adult son, 23, with diagnosed adhd, now v low, lack of any motivation or energy, and I think suspected autism/autistic burnout. He/I are not very far into process but from being alongside my son I'd say
a. fill out the gp forms for him, to his dictation, filling in the gaps;
b. be with him in the gp and assessment appointments (with permission obviously) and
c. prep the narrative with him beforehand and
d. take notes while there. My son, left to himself in this mood, would have given so little information or so many gaps, or not remembered what said afterwards so benefits little. Liaising with the NHS on his own is beyond where my son is at right now. (If it is adhd, the medicine needs titration, - lots of dosation tweaking over time - which in retrospect I now realise was beyond my son in early days when living independently. So the assessment hard got, then failed as he failed to make the follow up online appointments to get the dosage right...)

My son has recently returned in distress to live with me for a while. I needed to be very directive to get this to happen. Is this a possibility for your son? I get they are adult, but mine had regressed, and was really at risk and not looking after himself in shared house. He seems grateful to have me being much more actively involved right now.

We did get excellent short term support from mental health crisis team, - accessed where I am by phoning 111 option 2 (I'm in Wales). Or you could look on your local nhs trust website under Mental Health Crisis Team. I'd really recommend seeing if the same is available for you, as we did get an urgent next day assessment, access to antidepressants, and 2 weeks intensive support, which did make difference then. There was a virtual ward, where you had access at home to similar levels of support you would have access to if they were sectioned, - of course only if this were an active risk, and it keeps costs and bed space down if people can be kept at home. However we are now several months on, urgent referral for actual psychiatrist isn't till Feb, and I'm now wondering about going private. It might be possible for you to talk through your concerns with this team to get their advice too, - this is something ours offered.

I'm trying (at suggestion of mental health crisis team), alongside antidepressants, to focus on a. initially getting him to eat more and wider range; b. getting him to sleep c. helping on routine, d. trying to get him to take exercise, by doing it with him. Nudging on timings; sleep routine; baths etc. Small steps but he is no longer actively suicidal.

Have recently bought a grounding sheet for beds for both me and him, and while it might be a load of baloney we are both sleeping far better. Plus a weighted blanket each, seems to be helping better quality sleep.

I've bought some books for myself so I have a sense of what I can be supporting on in the meantime. Autistic Burnout Workbook by Megan Neff is very good if autism might be in the picture. The self help groups like ADHD UK have good websites too.

My understanding (may be wrong) is that you'd need a psychiatrist for assessment (eg is it adhd/autism, prescription of medication). Is this your/his main focus? Or support now? Would he be up for / have energy for psychotherapy or counselling? If so I would choose someone who is registered with professional body (eg BACP or UKCP or others - these sites have list of people on their sites), and say they have experience with eg adult adhd/autism. If you're wondering about the difference between the different roles, and training and professional bodies Explore roles | Health Careers is an NHS careers site, which you can search for brief explanations. My understanding is psychiatrist is also medically trained (and can prescribe); psychotherapist more on talking therapy side and deals with more complex issues potentially than counsellor.

There is a local wellbeing centre in our city, which has groups like Mens Sheds and Neurodiversity peer groups. There are also mental health walking groups etc. All seem excellent ideas (for someone else) but my son not yet in place where these seem viable for him, but I mention them in case there might be something similar local to you.

I think reassuring that there is hope, that you love him and care, that he isn't alone, do all make a big difference. Plus a good meal. But I am finding it very stressful and lonely, and uncertain. And I am finding it hard to be consistent, in part because his condition is inconsistent. Good luck, and do pm me, - or continue the conversation here, if it would help. What you're doing matters.

I found it helpful at that age to do some voluntary work and then I alsp spent some time working overseas.

There was about a year build up to it while I was living at home where I was saving but also felt supported. Being abroad gave me loads of confidence as it was away in a different environment.

Was dx with ADHD later in my 30s. Would teaching abroad at an international school interest him?

I’m sorry you’re going through this, my DS was in a similar position for many years.

one thing that did help was getting him a psychiatrist after trying various therapists with no lasting success.

the psychiatrist really listened and prescribed a drug which helped a lot for a few years, and I think DS has now tapered that right down (he’s 31, married and lives away so I don’t get much detailed information these days).

I think my DS may always have some background MH issues but it’s nowhere near as bad as it was.

you sound like a lovely mum, I would however advise that you try to take care of yourself as well, having a severely mentally ill adult child can take over your whole life if you’re not careful.

you can best support him by getting some support for yourself as well as your son.

good luck

Sorry if I didn’t make it clear, you’ll need to pay privately for a psychiatrist and even then, there’s such massive demand you may have to wait q a while for an appointment.

I feel for both of you, he’s obviously struggling and you’re trying your best to help him. Would he consider coming home for a while to take the load off? Could you sit with him and make the initial GP appointment? This will sound pathetic but as a professional, adult woman, I’m quite scared of the dentist and get a mental block about booking in so DH makes my appointments with me next to him and it helps me hugely even though it sounds like a trivial thing. Just having another capable adult able to step in when you’re having a wobble can be a big support.

He needs to be diagnosed
Clinical Partners are very good. My son used them. They are private so you will have to pay but can get an apointment in a less than a week

appointments also online so less of a worry about your son being anxious or stressed
email
[email protected]

They are recommended by the nhs

Just to note the wait at my son’s clinic ( as above post) was a week for depression. Then he booked another appointment ie an assessment for adhd/autism. Again he had the apointment within a week.

look for a chartered Psychologist, search the bps register.

Thanks for your helpful messages, sorry for disappearing for a bit. His GP seems to have been reasonably helpful and he should shortly be able to try talking therapy on the NHS. If that doesn't help, will start investigating private options for him.