Mentally ill adult child who will not do anything to help.

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Dc is 24 and autistic. Was suicidal as a teen but not helped at all by CAMHS, or by adult services.
As dc grew up things got easier somewhat and dc needed less support.
Recently things have been more difficult for dc again and the tendency to be in their own head and thinking about all the bad things and suicide has returned big time.
Dc has been on antidepressants in the past but doesn’t want to go back on them (they didn’t help and dc wouldn’t return to gp to try anything else or adjust doses, and once moved out and independent there was little I could do).
I now find myself in a position of heavily supporting again. Constant messages, phone calls, FaceTimes, constant having to talk dc down.
Dc will not do anything to help - won’t come home, won’t go to the dr, won’t try anything that might distract. In the past there was refusal to engage with any therapy and I suspect it would be the same now.
At this point I feel like I’m enabling it with the constant instant support, but I’m not sure how to handle this and cannot just drop the rope due to possible consequences.
Does anyone have experience of this and have any advice?

If you find a solution i would love to know because it’s not an uncommon problem

Sorry to read your post. I'm another mum with a DS, 23, with ADHD and maybe autism, in this situation. Certainly was burnout, but whether it still is or now more depression and overwhelm, can't tell. They have moved back in with me, which does make it somewhat easier, but also it is there under my nose, which makes it harder.

I don't have advice just fellow feeling. I get how hard it is. I am pinning my hope currently on a private referral to a psychiatrist (waiting lists for emergency referral so many months), who was really good in the triaging call. I think there are lots of us out there.

No one is capable of standing between someone and suicide.

Suicide and depression don’t work like that. (Unless you leap to stop a bridge jumper as my cousin did.)

Is it crude to mention blackmail and maladaptive coping mechanisms?

Look after yourself. Boundaries will help both of you. Just because they won’t cooperate…for now, that’s ok.

Don’t be one of those people who produces a problem for every solution like DC does, cos you’re secretly admitting you like the status quo - ie their mental
illness and dependency. That’s dodgy ground.

Not crude at all, and I’ve considered these and I’m certain there’s a level of that, but it’s much easier to identify that than to step back when you’re the only person able to calm dc down.

It’s not a great situation and I know I’ve played my part in it. It’s terrifying to consider stepping back, even though I need to find a way to do it.

You do.

Of course it’s frightening. I can’t imagine anything more guaranteed to press every nerve.

Fear is always worst before you’ve started. You’re doing this for DC’s safety.

I understand your current situation, I honestly don't agree with all the 'retreat' posts. Now isn't the time. Agree some boundaries by all means but absolutely not the time to throw in another thing to the mix by cutting off support.

There likely is some maladaptive coping mechanisms stemming from their undiagnosed parts of childhood, these can be worked on when DC is improving. Wider boundaries can be set at this point also with regard to your role in their emotional health. Having been someone in that position, but in the DC position, retreating now would have resulted in feelings of abandonment and increased perception of 'not getting' people. I don't say that to guilt you at all, im just trying to present a rounded view.

Seek support for yourself through this time, counselling would be a good option and may help you to formulate what and where your boundaries lie around your DC emotional health and nuerodiversity so you can implement these going forward once things are a little less acute.

I sympathise that it's really hard when it feels like they are not doing anything to help, but also agree with a PP that it's that they can't do anything, probably paralysed by the internal monologue that's never ending inside their own head. You are their safe space. For now. Because you've always been their only safe space. But that doesn't have to be forever, and some frank conversations, once things are moving forward abit will need to be had, but with a clear focus and a safe plan for DC to move forward with.

I really hope you both manage to pull through this temporary situation and move forward in a positive way.

I agree with @BeOchreGuide
I've been in the same place for the last seven years with my own DS of similar age (undiagnosed but I strongly suspect ADHD) who has been through two major burnout events where he literally didn't leave the house for a year on both occasions. He's doing really well now and is back in the world studying and working, but will still have the occasional meltdown when things get too much for him. There is usually a trigger - could be something as simple as overtiredness or friends not returning text messages. I'm the one he needs to talk him down and I think I can do that quite successfully. There have been long periods of time in the past where I felt that I could barely leave the house due to his demands and my own fear of leaving him alone. However, these meltdown events are very infrequent now (c. twice a year).

I hope that gives you hope OP. I don't think that this is the time to withdraw if he depends on you so much. My DS wouldn't engage with therapy either but over time, seems to have worked stuff out in his own head and has been able to develop better coping mechanisms - with my help. He has also found short bursts of Sertraline helpful, but doesn't want to take them long-term.

I wish you the best of luck. It's not an easy ride.

Sorry if I missed it, but do you know why they won't engage? My hunch is that it's because the 'support' isn't in the least bit helpful. I'm neurodivergent myself. I don't have MH issues in the way your DC does but I do know that many therapies are not effective for ASD people and some of those that are targeted at ASD people are plain unhelpful.

I would try, not to get them to engage, but to get think about why they won't engage - what's not helpful? That may help them and you to get insight on what might be helpful. It can be difficult, not just to articulate our own feelings, but to understand and know our own feelings. Keeping a diary can be enormously helpful in this regard.

Good luck and if therapy is ever an option again, look for therapist who are asd themselves, they're far more likely to 'get it.'

Totally agree with this. A lot of therapy jist isn’t suitable for someone with ASD.

When the crises is beginning to ease, see if they are willing to at least read about DBT and Autism.

Do they take Melatonin for sleep? That should give them some respite overnight

We know why dc won’t engage. CAMHS was disastrous and triggered months of suicide watch as a teenager. Their offshoots within schools and outreach programs were similarly dreadful. Dc had a mentor at school who dragged dc down even more (but I was that parent for intervening and complaining).

We sought a therapist with ASD thinking this would help, but she (and three other therapists we tried) all projected their own problems onto dc who then rejected all. Sadly this has put me off approaching an autistic therapist again.

Nearly a decade’s worth of help has brought us to this, so it feels like there’s nowhere to turn.

Someone mentioned DBT, I’ve read really encouraging things about it and have a friend whose mental health has improved for doing DBT. When dc lived at home there were no courses available, but I’ll see if there are where dc lives, as that could be helpful.

Sleep isn’t an issue currently, thankfully.

Glad that sleep isn’t an issue. That is one positive at least