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July 17, 2018 - Welcome Guest!

Advice » Mental Health

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Depression in family member

Question:

I think my brother has a depression problem among many other problems he thinks he does not have. How did I come to think this way? Here are issues:

  • He thinks about killing himself.
  • He stays at home often, weeks at time not going out.
  • He does not have any friends, or girl friend etc.
  • He starts a job and quits often.
  • He is running after money -- like money will make him happy.

He says he wants a girl friend who will understand him and listen to him. I hope he finds this girlfriend but till then he does not open up to me or anyone else. He says I have hurt him by my words. I may have but not intentionally. Sometimes he gets mad at my husband for giving him an advice, he will yell at my husband "butt out, this is our family". I know he does not intend to be mean but it hurts my husband though he seems to understand. I invite my brother out for a movie or to come over but he denies most of the invitations and stays inside his apartment. I want to help but he will not let me.

I think he should get help for his depression but how should I tell him without hurting him. He does not think rationally. I am worried a lot about him. Please help.

For my brother (30 year-old woman)

Answer:

Dear For my brother,

Making appropriate and effective interventions with a family member who may be depressed and in denial about it is not easy. For now, he does come over to your place, or go out with you sometimes. That's good. Make those contacts with you reinforce his desire to be outside his apartment, that is, worth it. He may be resisting your desire to help because you or your husband is coming on too strong. Keep away from advice. Encourage without lecturing. Take it slow in your responses, making sure you spend more time listening than lecturing. Fill your communication with your brother with both empathy and positive messages, both directly and indirectly. "You can get help", "you deserve to be happy", "I know you're going through a rough time", "I'm here for you", etc. because these are voices he may not be able to speak to himself at this time.

Although you might not want to hear this, your job is not to save your brother, but rather, to reach out to him according to your conscience. And even though "you can take a horse to water, but you can't make him drink" is a truism, I believe you can put some salt in his mouth, which means you can direct your efforts to help instill in him the thirst for peace, and to become more whole in his life. Frankly, if he doesn't want it from the inside, though, nothing will move. Rather than preaching, by all means, model the "good life" with all the non-materialistic values you hold dear, as you would wish it for him. Your own happiness, and your genuine concern for his welfare are the two strongest lifelines to help him out of his abyss. Not lecturing.

You say he doesn't open up to you, and yet you know he's thinking about killing himself, so he's said some intimate things, or dropped intimate hints. Does he talk about it in general, vague terms, or does he talk about the specific way he would do himself in? If it's the latter, and you get the sense that he's serious about suicide, be prepared to call the police. That's the point where respect for his autonomy goes down the priority list in your approach. Until that point, continue your invitations and expressions of concern.

You may want to write him a letter or a card where you can express the deeper aspects of your care, without the possible awkwardness of face-to-face. I encourage you to get the rest of the family involved, so that you're not carrying all this by yourself, and because of the combined power of more than one person reaching out to him. Short of the direct suicide-prevention intervention, respecting his autonomy must ultimately dictate your course. He's still free even to make bad choices, or choices you disagree with or disapprove of. In one sense, how he lives his life is none of your business. Remember, an invitation to a party has more persuasive power than a prescription. If you're having a good life, then your invitation for him to participate carries great magnetism for him to change. If you are telling him how to live and judging him, that might decrease the chances of your having the effect you'd like to have. Balancing respect, concern, worry, loving confrontation, and letting go, make for tough waters to navigate--but you can do it!

Good Luck,

Andy Bernay-Roman

This question was answered by Andy Bernay-Roman, RN, MS, LMHC, NCC, LMT. He is a nationally certified counselor in private psychotherapy practice in South Florida working with individuals, couples, and families with a deep-feeling therapy approach. Andy's medical background as an ICU nurse contributes to his success with clients with difficult medical diagnoses and/or chronic physical conditions. He also serves as head of the Psychological Support Department of West Palm Beach's Hippocrates Health Institute.

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