Depressed relative supported financially - attach conditions to $ or no?
February 3, 2014 6:37 PM   Subscribe

A close relative has been struggling with depression for a few years. She's in her early 20s. Until now, she's been supported financially by her parents in her own apartment, because it seemed that being near her friends and therapist was important (as opposed to being forced to live at home in relative isolation). Now she seems to be doing a bit better, and her parents want to see her take some steps towards independence - working, volunteering, or taking classes. They are considering tying that to the money - something along the lines of "have something to do 4 days a week or we stop paying your rent." Is this a good idea? Terrible idea?
posted by malhouse to Health & Fitness (23 answers total) 1 user marked this as a favorite
I think that's great. My parents have in the past supported me under certain conditions (stay in school, attend class, complete a professional training program). If I had not been doing responsible-thing-that-was-good-for-my-life, they would not have continued to support me.

I would give her some transition time, though. Maybe a month or so to figure out what she'll be doing 4 days a week (whether it's working, volunteering, or taking classes).

Also consider how they'll be gauging her success at doing so. I don't think they should be micromanaging her. They need to trust her as an adult.

I also think they should start talking to her about a long-term plan for financial independence and weaning her off their support, even if it's just a part-time job to supplement their stipend and slowly reducing their contributions.
posted by amaire at 6:49 PM on February 3, 2014 [1 favorite]

While her therapist wouldn't be able to discuss her case with them, it might be a good idea for them to run this idea past them to get their opinion. The therapist will know better whether she can tolerate the incentive or whether it will push her further down. And it can only help to understand the parent's motivation if the therapist is going to guide her through the change in expectations.
posted by cecic at 6:52 PM on February 3, 2014 [2 favorites]

I think it sounds good but as someone who's struggled with mental health problems, what happens if she has a relapse? Are they going to stop paying rent because she's unable to leave the house again? If so, that seems like not a great recovery plan. And if not, it doesn't mean much. Her getting out is a GREAT thing for her getting better, but I'm concerned about the difference between that feeling coercive versus feeling like it's her decision.

Which is not to say that, like, if they can't comfortably afford if they need to support her forever; if they can't afford it, they can't afford it. But if they can still afford it and do intend to continue supporting her for at least awhile longer, I would not try to use that as a stick. Try to find carrots.
posted by Sequence at 6:54 PM on February 3, 2014 [1 favorite]

I don't think an ultimatum sounds good at all. Especially when the threat is having no place to live. Isn't there another way to be encouraging? Having depression and working on yourself and getting better can already feel overwhelmingly stressful and anxiety producing. I know that the worse I am the less well I handle pressure of the slightest degree. It's not at all the doing of the task itself but any sense that it MUST be done can make me feel very scared and overwhelmed. So largely, we can't really answer your question. It depends on this girl, her personality, her relationship with her parents, and how they would go about it, among other things. But as I said, it seems potentially like a bad idea. Maybe she should discuss with her therapist what might be some good ways to elicit the support of her parents in becoming more "independent".
posted by Blitz at 7:03 PM on February 3, 2014 [8 favorites]

The heart's in the right place, but what happens if she can't pull things together and doesnt meet the target? Do they throw her out on the street?

Realistically I don't think anyone would want the safety net suddenly yanked away if it was genuinely needed. Why not approach it collaboratively, with a joint goal of her working towards independence, agreeing on milestones, but without the catastrophic doom scenario if the goals prove too ambitious? Cutting off support sounds, to me, like more of a last resort when the support is enabling dependence and the recipient shows no signs of any desire to move past this situation; a last resort because it is basically a gamble that she would learn to swim, yet she could sink like a stone. You take that risk only when you have to. Bases on the deacription, it sounds like things arent yet so dire.
posted by PercussivePaul at 7:05 PM on February 3, 2014 [10 favorites]

Start the conversation with HER plans for her life - where does she want to be going, what does she think the first steps might be towards getting there. Then add in the expectation that she should be moving along the path, that the parents are willing to support her towards her goals.

If she is depressed and in her early 20s, she may have missed out on some normal growing-up opportunities to learn about make plans, budgets etc. so it may not be easy for her to figure out how to get started. Her family might see if she can get some help from a life coach or social worker who can help her think through what she wants and support her in all the micro-steps to make that happen. (Much better if it isn't the parent, much more likely to happen if it is someone who is a capable, fully-functioning adult.)

She is absolutely going to have ups and downs - the parents need a plan that will be fair and they will feel comfortable following up on. For my kid, I wouldn't threaten to stop paying rent at this point. The family might want to think of the financial support as three tiers: basic expenses that they are willing to pay until she is willing and able to support herself, even if she is messing up and not meeting standards. (eg. rent and medical bills). An allowance for expenses that they will cover as long as she is moving towards her plan (e.g.. doing volunteer work or taking a class that is good but doesn't produce income) that she can pretty much count on as along as she is more or less making an effort and then a smaller share that is a reward for trying hard (e.g.. 80% attendance at volunteer job, B or better grade in classes).
posted by metahawk at 7:09 PM on February 3, 2014 [8 favorites]

Depression robs you of self-preservation instinct. It makes negative outcomes seem much more likely than positive outcomes; it disempowers you such that you take more disempowering choices than empowering ones; it lets you believe you don't need those positive outcomes anyway. At my lowest I'd have taken homelessness (and the following downward spiral) in such a situation, because it would have seemed right to me by all these measures and more. Don't do the thing.
posted by lokta at 7:09 PM on February 3, 2014 [11 favorites]

It depends on her particular self and circumstances - there's no one clear way to deal with this, or we'd all be doing it.
posted by amtho at 7:17 PM on February 3, 2014 [3 favorites]

I think the medical example: we'll only pay your rent if you work towards productivity with cancer. It makes no sense.

And therapy is work. Seriously hard work. Don't discount that. Therapy can easily be a full time job.

Yes she should be encouraged to try new things. But she does need room to fail, have relaspes and rest. Work with her to make reasonable goals and affirm how crazy difficult life with depression is. She's lost years of her life. Friends are moving on: getting married, having children, getting stable full time real jobs...and all she has to show is a struggle of mental illness. She has been robbed and most likely realizes it. Give her as much as she needs. She most likely wants to succeed. Let her keep working at it.
posted by AlexiaSky at 7:18 PM on February 3, 2014 [13 favorites]

I think it's necessary. I assume her parents aren't planning to support her forever, so there needs to be some kind of transition at some point. Long-term dependence does a number on one's confidence, too, so giving her a push might be the best way to get her to see that she can be independent, or at least productive.

I'd encourage her to seek help in the community as well. If she does intend to go to school, suggest she check out her school's Disabled Student Services -- they can help enormously with financial aid (including targeted scholarships), admissions, everything. If she happens to be in California, have her check out the Department of Rehabilitation -- they can help set her up with a job or a volunteer gig, and give help in going back to school. Probably other states have similar programs. Even if she has private insurance, calling the local Department of Mental Health service center can turn up other resources available to her.

Lest it sound like I'm unsympathetic to your relative -- I have bipolar II, and was dependent on my parents for an ungodly long time. But they insisted that I do something with myself, as my illness got under control. This was the best thing they could have done, and, I think, the best thing any parent can do: encourage independence.
posted by pH Indicating Socks at 7:24 PM on February 3, 2014 [5 favorites]

I would seriously run this by the therapist first. It can work if there are good contingencies for depression getting worse or for problems finding jobs and so on. I have a relative who has done well with this situation when the family member managing the situation had a good relationship and communication, but when the situation changed to a different family member, it quickly became toxic and sabotaged any successes. This can backfire spectacularly if there are emotional expectations and the money is being withheld to punish.

Personally, I would consider continuing the absolute basic support and tapering it off on an agreed schedule as she gets more stable, but adding another goal (we'll pay for a training program/match what you save towards a holiday) that rewards progress to clear agreed goals, tangible things like attendance not things like "your house is clean or you exercise enough".
posted by viggorlijah at 7:53 PM on February 3, 2014 [1 favorite]

If we are to assume this person is trying to get better and wants to get better, I don't think this sounds like a good idea. Not the same situation, but in high school, my parents tried to punish me for not going to school or physically force me. They didn't understand at the time that I literally could not bear it. I was so depressed and could not handle it at all. When they punished me and took things away from me, it only made me feel more suffocated and trapped or more unable to work toward any progress. I felt very strongly that I wanted to get better but I couldn't force it to happen faster than it could. I was also adamant that I would graduate high school, but I just couldn't do it by physically being in school everyday. I got my parents on board eventually with the help of my therapist and, in my case, I finished high school by utilizing tutors and take-home work just fine. Getting better took longer, with a combination of therapy and meds.

However, if this person isn't getting better and isn't really trying, not pushing her a bit could be considered enabling. A friend of mine has a girlfriend who is depressed and suffering an eating disorder so she doesn't work and my friend pays for everything (and I mean everything). I sympathize with her condition, but my friend found out she was lying about her progress and is really only behaving in a way to keep her boyfriend, not in a way that is actually focused on her own long-term health. He thought she was reaching toward progress she actually never was and he had been lied to. He had to be tough and told her she needs to move out because he can't continue enabling her behavior. He feels (and I agree) that forcing her to stand on her own two feet may be the thing that saves her from destroying herself.

I think this depends on who the person is, what they are doing to get better and maybe it needs to be packaged more as supportive than a threat. "We want to see you get better and we don't want to enable you not getting better. So we would like to offer to support you while you get a degree or a job." Some people respond to being pushed and certainly if she is using depression as a crutch or an excuse, an ultimatum would work. But if she is truly depressed, I don't think an ultimatum would help -- I think knowing she has people in her corner who are rooting for her and believe in her would help.
posted by AppleTurnover at 8:01 PM on February 3, 2014 [7 favorites]

Terrible idea. She's ill, and doing "a bit" better is not the same as being well again. Hanging this sort of ultimatum over her head while she's still ill could easily cause enough stress to trigger a relapse into more severe depression.
posted by Jacqueline at 8:49 PM on February 3, 2014 [1 favorite]

I would add, that if she has been able to do well in these circumstances, is it a great idea to change the circumstances before she is fully better? Maybe it would be best to let her work up to the point where she is ready to take a next step in life. In my case, after graduating high school and doing just OK at a college nearby, I decided I felt ready to move out on my own and went away to a new college and dormed there. That really pushed me to the next level and got me past depression. If I had been forced to move out before that, I'm not sure it would've worked so well. (But then again, who knows -- maybe it would have and I just delayed getting better.) I think communication with the daughter is key to ensure she is ready to take on the next steps. And I think making her feel part of the decision will help her own self-esteem and also help her realize her parents are acting out of love for her. I think if the decision to move away was forced on me and not my choice, it would've been harder to cope with the times I was unhappy.
posted by AppleTurnover at 8:50 PM on February 3, 2014

Yeah, I think it would probably be a great idea when she's doing good and it's in her mental "motivation" box.

But it could very easily jump on over into the mental "looming dread" box when she's doing not-so-good.
posted by jason_steakums at 9:52 PM on February 3, 2014

Her parents can't control her mental health. Not even with money.

I think everyone's heart is in the right place, but this is a bad idea.
posted by rue72 at 9:57 PM on February 3, 2014 [8 favorites]

Yo, Major Depressive Disorder here too.

This is both a good idea and a bad one.

Good: slooooooooooooooooooooowly transition, understanding sometimes it'll be two steps forward and one step back (or vice versa), to more independence.

Bad: the pitfalls associated with failure.

The best way to approach this is not with the therapist first, it's with her. Ask her, as mentioned above, what she wants in terms of gaining more independence, and figure out how this can dovetail with that idea. Then a group meeting with the therapist to discuss the idea and potential ways it can work to help her transition to more independence. Then she needs to discuss it in 1-on-1 sessions with her therapist to explore more privately how she feels about the idea.

Then think about implementing. But this is the sort of thing that can only work with her enthusiastic buy-in, and support from her therapist/therapeutic team.
posted by feckless fecal fear mongering at 10:18 PM on February 3, 2014

They should take care of her basic needs but nothing else. Then, volunteering gets her some perk like movie tickets every week. Or new clothes or books. Whatever she is in to. Same for school. If she works they should still pay for her basic needs but she has to save half her paycheck. And she gets to spend the other half on whatever she likes.
posted by cda at 10:40 PM on February 3, 2014 [1 favorite]

I don't think this is a good idea. I understand the idea, but the execution isn't right.

By tying performance to housing, you're threatening to remove a support system if she isn't performing well enough. This is just a horrible positive feedback loop of badness waiting to happen; if she doesn't do well or is depressed and misses out on work, she's going to be stressed about not being able to have a place to live, which means that she's going to be more stressed out and more depressed, which means that she may miss out on work even more...

It may appear that you're creating an incentive to work, but you're not. You are creating a situation that is inevitably designed for her to fail.

What you need to do is to create a situation that is designed for her to do succeed / perform well / feel better about herself.

So: I would say that the long arc of independence would involve an unconditional guarantee of a base level of support ("you'll have food and a bed no matter what you do"), and additional financial support loosely based on activity or effort. Metahawk's ideas of tiers of financial support is good.

And: reward effort, not performance is ideal. For that reason, starting out with rewarding volunteer efforts (working at a soup kitchen, or a farm) might be helpful; there's less judgment and thus less anxiety involved with volunteer effort. The long term goal is to provide a scenario in which depression is treated with a therapist, and a message of prioritizing effort over performance induces situations in which one is motivated to work/act/attempt things with less anxiety. Then, as self-esteem grows, ideas of work, independence, etc can slowly happen.

I understand that the family doesn't have unlimited financial resources. But I don't think anybody, let alone a depressed person, is going to benefit from the threat of eviction.
posted by suedehead at 11:03 PM on February 3, 2014 [3 favorites]

If her parents want her to take steps towards more independence they might actually want to do that, rather than setting up hoops and having her jump through them.

Instead, she should be involved in creating the transition plan.
posted by Good Brain at 12:12 AM on February 4, 2014 [6 favorites]

agree with lots of the ideas here - make this a reward system rather than a punishment one; if she's so depressed that she can't get out to volunteer/go to class, it's just an awful idea to push her into the utter hopelessness of losing her home as well. But encouraging her to push herself out of her comfort zone as she is able IS a good idea. It's just -- as she is able.

Something else to consider is to not make this a sudden jump. Volunteering/doing something four days a week is great, but -- first month, make it one day a week. Next month, two. Etc, etc. Going from nothing to /all/ that pressure, all that required interaction and stress is a lot. Ramping it up gradually could be a much easier transition and build toward success.
posted by lemniskate at 4:34 AM on February 4, 2014 [2 favorites]

I was thinking about this, and one of the things that came to me, obviously contingent on how it works with everybody's finances, is something like: If you're out of the house at least 4 days a week, we'll give you a bit extra to cover a laundry service for that week. Or to cover a cleaning service. Or a $25 gift card for a couple of lunches. Whatever. One of the most overwhelming things to me about returning to the Real World is often trying to keep up with housework during the first exhausting adjustment. But being out of the house is better for me than staying shut inside, but when the housework goes to hell my mood goes with it, so that transition can be really fragile.
posted by Sequence at 4:33 PM on February 4, 2014

I lived through this at the same age and beyond, and beyond, and beyond. If the depression were the only issue going on, it would be one thing and there would be lots of varying opinions and advice and things to consider. But just to broaden the discussion here, another thing that's going on simultaneously is the transition into independent, self-supporting adulthood.

It can be hard to let go of the extended apron strings even if you want to. It can be hard to transition into full adult life and recognize it for the self-supporting, no-baloney, hard lessons situation that it is, one which makes you sacrifice, endure, prioritize, etc. It's even harder when you don't have to because somebody else is paying the bills. Why give that up?

Dependence is a real thing and as children it's our entire unquestioned reality. Young 20s may seem to be a long way from that, but really young 20s is the childhood of adulthood. It's the first steps of a new phase of life. It's a transitional period and we haven't yet let go of some of the entitlement and dependence of childhood because we can't quite see it for what it is or what life really requires of us as adults.

I don't know how long she's been provided for like this, but a question to ask is how long is this going to go on? What if she's one of us for whom the depression does not end but simply must be lived with? Play it out. Is 25 too old for her parents to still be paying her expenses while she doesn't work or have to face the challenge of self-supporting adult life? How about 28? Longer? At what point are they enabling stasis in her development? Picture an eight year old breast feeding and you begin to see how parental support can in fact linger too long and be detrimental to development.

She is facing the challenge of depression, which I can say with intimate authority is horrible and can ruin your life. But she is also facing the challenge of leaving the nest and flying under her own power. At some point, like it or not, painful or not, she will need to do for herself. A planned transition, with some degree of flexibility and contingency, makes sense.

In my own case, my parents let me come back and live at home while I tried to stabilize after a couple years out of college. No conditions or anything, just support and encouragement. Then I started doing temp jobs while living there. Then I got a full time job. Then I moved out of their house after a year or so of living there and moved in with some buddies. And I moved forward from there, rotating through medicines and therapists over the years, dealing with it as best I could, but still suffering and flying low. I never was able to get rid of it and it has caused me to live a crippled version of the life I might have lived. But having my parents pay my way longer wouldn't have helped. I had to get on with life one way or the other. So must your family member at some point.

Episodic depression is one thing and chronic is another. I'd be more inclined to patience and kid gloves in the former situation than the latter since it can often be resolved well enough over the shorter term to get somebody in a good position to pick back up where they left off. But either way the issues of dependence and independence loom as large for her as for any other young 20something not yet moving under their own power. It's an important time of life that requires both patience and forward motion.

I think the thing to do is for them to have a talk with her along these lines. I remember when I was a teen thinking it was cruel that my parents said that I would have to leave once I finished school, but it was the very best thing they could do - push me out of the nest so I'd have to learn to fly. That was before the depression. Her situation is different because they're paying for her apartment, but they still have the parental job of helping her to get herself moving. It's time to talk about it. More gently than with a non-depressed son or daughter, but still in that direction. Some of these things they're talking about having her start doing can actually help her. You don't get exposed to much sitting at home. There's stuff out there in the world. Stuff to get reconciled to and stuff that can change perspectives and assist with developing momentum.
posted by kookoobirdz at 7:17 PM on February 4, 2014 [1 favorite]

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