Help or enable — what if the person is mentally ill?

A reader writes:

My adult son plays me like a fiddle, but I am confused as to where do I draw the line because he is mentally ill. I am so stressed about this that I can barely function and I am going broke and he isn’t getting better. Can you provide any advice? Thanks.

Mental illness and addiction seem to go together.  Some people learn that they can self-medicate by using alcohol or other drugs, thereby moderating their symptoms.  Others may be less mentally-ill than simply suffering from messed-up brain chemistry due to the drugs.

In any case, the presence of chemicals always complicates treatment for other disorders. In fact, it’s nearly impossible to treat mentally-ill people effectively if they are still using.  How, for example, is a physician to treat depression in a person who is addicted to alcohol or opiates, both of which cause depression?

Would that I had an easy answer, but there are none when it comes to addiction and other mental disorders.  So let’s approach this problem from a different direction.  You write, “I am so stressed about this that I can barely function and I am going broke and he isn’t getting better,” so let me ask you a question.  If you are going nuts and broke, how are you ever going to be able to help your son?  Would it not be better to get your own situation under control, keep your sanity and whatever resources you have left, and stop banging your head against the wall?

The fact is, your son is quite aware that he can “play you like a fiddle,” and he has no reason to try to get better.  It gets back to the simple fact that when you make his life easier, you remove any incentive to change.  You did not state what his mental problems may be, but one thing is sure.  You can’t help him if you’re losing your own ability to function.

So I suggest you start taking care of yourself.  Begin by attending some support groups — I suggest Al-Anon, and perhaps one for people dealing with mentally disabled dependents.  Your local mental health association should be able to direct you to some of the latter.  As for Al-Anon, there are meetings all over the world, and I strongly urge you to avail yourself of the understanding and companionship of people who know where you’re coming from.  Only by dealing with your own confusion and coping problems will you reach a state where you are able to help your son when — and if — he decides to accept effective assistance.

In the meantime, I would suggest that you minimize any “helping” that in any way facilitates his drug use.  If he is unable to care for himself, then perhaps throwing him out is not the kind of tough love that would be helpful.  If, however, he is capable of fending for himself, even at a low level, let him know that he has a choice: give up the cushy life at your house and take over his own life, or go get some treatment.

In any case, you need to take care of yourself first.

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