Dear Dr. Michelle:
My 23-year-old stepson suffers from depression and is considered obese according to doctors. He showers every 5 - 7 days and sometimes he won’t shower for 3 weeks. He is also not working. My husband refuses to lay down adult rules and I feel stuck without his back-up. This young man needs help, yet he refuses to see a psychiatrist or a counselor. Please advise.
It is hard to watch those we love, suffer from the effects of depression, particularly when they do not want to seek help. I am sorry for your situation and that your stepson is living with depression without relief.
Try to understand that your stepson is not behaving this way because he is manipulative, lazy, or resistant to your expectations. Clinical depression can shut a person down and lead them to experience emotional, mental, and physical despair. When depression symptoms are high, the very thought and actions to care for oneself or to put effort into work can be extremely overwhelming and debilitating. Sometimes depression can be so severe that even getting out of bed requires too much effort.
What Is Clinical Depression?
If he is truly experiencing clinical depression, you are right that your stepson needs to seek the proper treatment. Research shows that the most effective treatment for depression is a combination of medications and talk therapy. Depression results from a chemical imbalance in the brain and body. Like other types of medical conditions, it is not easily managed without the proper medications, which act to restore the necessary chemical balance needed to lift people out of depression.
Unfortunately, you have no control over your stepson’s desire or willingness to seek help. Only your stepson can change the trajectory of his life. What you can do is support him, love him, care for him, and try to provide him with information about his situation in the hopes that he will choose to seek the necessary help.
More importantly, no matter how many rules you have in place, rules will not motivate your stepson or help him overcome his depression. This does not mean that having some basic limits is wrong or inappropriate. Rather, it is just a caution that the problem is not a lack of rules, so don’t set yourself up to believe that more or different rules will reverse the effects of his depression.
When it comes to establishing rules, you are right to mirror your husband’s responses. Not only is your role different for your stepson, but it is always best for the adults/parents to be aligned. On the other hand, you share in the marriage and it is important for you and your husband to both understand and compromise on what you both need to make the family work.
Start by trying to understand why your husband does not want to take any different action. Is it possible that your requests are too extreme for him? Perhaps he knows that more rules will not solve the problem so therefore he doesn’t bother trying to enforce them. Seek to understand your husband’s perspective. Listen carefully and try to put yourself in his shoes. Once people feel understood and listened to, they are more likely to engage in a compromise and more willing to take the needs of others more seriously.
If you can agree to seek a compromise, create a list together of the most basic rules or limits for your stepson. The goal of this list is not to pull him out of his depression or change his behavior. The goal is to teach him that even though depressed, he is still responsible to contribute to the positive functioning of the family.
Some examples of the most basic rules could include:
- Pick up after yourself
- Keep your belongings in your room (allow his room to be his space)
- Seek permission before having people over to the house
- Do not take items or money that does not belong to you
- Do not use other people’s things without asking
Under regular circumstances, it is appropriate to expect an adult child that is living at home to make some type of monetary contribution to the household for food/bills, even if it is a very small amount. But given your stepson’s level of depression, coupled with his lack of earned income, this expectation might be unrealistic. You and your husband need to assess together your stepson’s true abilities given his depressive limitations. If he is not able to make any type of monetary contribution, assess if he is capable enough to complete some regularly assigned chores as his contribution.
The chores should be things that can be easily achieved. For example:
- Vacuum your bedroom once a week
- Wipe down the bathroom once a week
- Complete laundry once a week
- Take the garbage out
Try to pick chores that are not time sensitive so that your stepson can take control of what time of day or time of the week these tasks can be completed.
No matter how much it pains you, the reality is that your stepson’s situation is one that you will have to choose to live with. If you cannot live with this situation, then you need to have a conversation with your husband about next steps in your marriage or alternative living arrangements for your stepson. Only you can determine what you are willing to live with and what that means for your marriage. Try to remember that this is an issue between you and your husband and not between you and your stepson.
Dear Dr. Michelle blog posts are informational in nature. The posts are not meant to take the place of consulting your physician, mental health professional, or other qualified health providers regarding your well-being or the well-being of others. Submitting a question does not establish a client/therapist relationship.
Submit Your Question on mental health and/or family relations to Dr. Michelle K. Murray.