Son refuses to engage with treatment

[Louise]

My son had a 'meltdown' over the weekend. His mood has been low for a few weeks, insomnia , not eating properly, lost job & last night he messaged friends re suicide. I was out looking for him at 2.30 in the morning. When I found him he wouldn't talk but came home at 5 am with a girl who he fancies but it's not reciprocated(main problem I think)
I made a gp appointment & he attended but wouldn't talk or comply. He refuses to take meds or see the mental health team. Gp has made crisis team aware & I have their number. Any help would be appreciated.

 

[246819733791]

This is obviously a really tricky situation and I don't think I have much meaningful advice to give. I can, however, try to give some of my perspective, as someone who has in the past been reluctant to engage with people who were trying to help me. One of the big problems for me was that anxiety/depression makes it hard to engage with anything. In situations of getting help, most of my mind was consumed by the effort of just existing with depression and anxiety and I didn't have much left over to devote to introspection or formulating answers to questions. This phenomenon is further exacerbated by the problem of having to think about my problems in order to address them. To this day, I have an instinctive physiological fear response when I see therapists or scenes of therapy (e.g. in movies) because the more I talk about anxiety the more anxious I get.

Another block I faced with this was that I didn't always feel as if I was being listened to or that my autonomy was being completely respected. I have a very hard time telling what I am feeling, but a lot of the mental health system is built on the patient being able to communicate their feelings instantly to a doctor who sometimes acts as if these few pieces of information are enough to truly understand the patient.

It sounds like your son really needs help. It also sounds like you've worked hard to get him what he needs and that you're generally aware, conscientious, and compassionate about this whole thing, so I don't think I need to tell you anything obvious or general. The best advice I can offer, based on what I've described in the previous paragraphs, is to try to engineer ways to let him take the smallest steps possible. For instance, since he came to the GP appointment, he might be willing to go to see another professional. Don't put any pressure on him at all to talk or do anything other than be there; that's a big step on its own. If that's too much, there are plenty of smaller things that would still help him and perhaps put him on the path to getting help in bigger ways; for instance, just trying to have a conversation with him about whatever he wants could be useful for him.

Here are some questions for you: Has he given any reason for refusing medication? Does he think he has a problem/want to get better?

This last thing might be near impossible, but if you can find a way, try to communicate to him that happiness is real and possible. Depression blots out the the vividness of happy memories and dulls the faculties that know how to perceive joy, so happiness begins to feel like a complete fabrication. Forcing myself to believe on an intellectual level that happiness exists (and that some will even come effortlessly as a product of regression to the mean) has got me through some difficult times.

 

[Louise]

Hi
Thank you for your time.
He wants to 'deal with it on his own' & feels medication isn't the answer despite GP explaining very well. GP is also psychiatrist & took time with us today
My son knows there is a problem, but just wants to be left alone. The more I push I feel the more he'll back away.
I'm beside myself with worry & my husbands stance is 'he needs to snap out of it' & I need to stop making excuses for him. This is not supportive or helpful.

 

[Mia]

I'd say this is one of those things, and I've been there, that's a kind of wait and see. If it escalates to an actual suicide attempt that would be the time to get him into care. You can't force him to go for therapy or to take meds, I found all sorts of ways to avoid that.
This sounds a lot like angst and acting out. Understand you love your son, and you want to do everything for him but this is something he must figure out on his own. With your guidance and help if he asks for it and even if he doesn't, you might find ways to help that won't seem coercive to him.

Sometimes taking someone out of their situation for a day or a week changes their mindset, as in to a different place entirely. Visiting relatives that he likes, or doing something he hasn't done before, like sailing or horseback riding or fishing perhaps. Even if for a day or weekend might help. One of my personal helpful activities is going on a roller-coaster, or cycling or swimming. Although no one can actually snap out of a depression, sometimes it helps a little to get away from their situation.

 

[Lady Penelope]

Small steps that are caring but not pushy.
Offer different food ... cook his favourites?
Suggest insomnia relief remedies like warm bath ...lavender oil... reading...
Does he exercise?
Is there a hobby you can assist him to get more involved in?
Ask him for help on something you are working on to engage him.
He may just need some time to process what's going on in his head and could slowly resolve it himself. It is concerning that his eating habits and sleep pattern is interrupted which does not help his state of mind regarding self harm thoughts.
Best you can do is go easy but let him know you love him and getting help is nothing to be ashamed of.

 

[Southern Discomfort]

He wants to 'deal with it on his own' & feels medication isn't the answer despite GP explaining very well. GP is also psychiatrist & took time with us today

If he wants to deal with it on his own that's fine but he needs to deal with it. He needs to learn strategies to help himself. Shutting himself off from the world isn't going to fix the problem.

I think he would hugely benefit from someone you know who has depression. If you don't know anyone know has or has come out with their struggle with depression then I suggest you maybe contact a mental health charity. I don't know where you live but here in the UK we have a good few national ones, they are Mind, ReThink Mental Illness and CALM - Campaign Against Living Miserably. They should be able to get you in contact with someone who has first hand experience with depression and arrange a meeting between the three of you.

Your son doesn't even need to engage in the conversation, just listen to these people's stories.
If he hears the problems that other people have gone through, the things that haven't worked and how they've coped and overcome it then perhaps he will open up to it.

There is no need to think of this as an autism thing right now. Treat it as a mental health problem. He might have preconceptions of what the mental health services are like or what mental illness means - both very common stigma.

I'm beside myself with worry & my husbands stance is 'he needs to snap out of it' & I need to stop making excuses for him. This is not supportive or helpful.

Yes, this is the wrong stance to have. 'Snapping out of it' doesn't work. Full stop. This is a very male attitude to have and is one of the reasons why suicide is up there as the highest cause of death for young males from 18 to 45.

Honestly if I could be there with you I'd talked to him myself. It helps so much hearing other people's experiences with mental health. Do not underestimate it! It really helps.