Supporting a sibling with mental illness
February 8, 2020 12:24 AM   Subscribe

My sibling has been struggling with depression for several years and does not want to seek help from a doctor or counselor. I want to be supportive but I'm not sure how. If you've been on either side of this situation, what, if anything, was helpful?

Possibly relevant background:
We are first-gen Americans from an immigrant culture with a lot of stigma around depression or other mental illnesses. There's a family history of mood disorders on both sides, mostly undiagnosed and definitely untreated. My sibling has always had a stoic temperament, even as a kid, and talking about "feelings" doesn't come easily to them. They have a high-level government security clearance and I believe part of their hesitation to seek professional help is about job security.

I know my sibling has been dealing with this for at least 5 years, possibly longer, after a friend of theirs contacted my parents with concerns about Sibling's mental health. Triggers seem to be romantic rejection, although I know that depression doesn't always have a reason. They are able to maintain a good "front" for family, but it seems like they are unburdening to their friends, who are getting understandably frustrated. Friends staged an intervention about a year ago (parents were present as well, and I was able to call in). Sibling agreed at that time to seek professional help but then never followed through; they continue to rely on their friend network.

I'm worried in general that at some point, their friends will say, "Enough, I need to put on my own oxygen mask first" and Sibling will feel abandoned which will trigger a depressive episode. I'm worried specifically right now because Sibling recently got in to a 1-year master's program that they are really excited about content-wise, but is located in another state away from local support. They also just found out that because it's just a 1-year program, it's pretty intensive, meaning no fall break, spring break, or Thanksgiving (they get Thursday off but not Friday, so not actually feasible for travel). They do get a couple weeks off between semesters, but they will be spending it working at their regular job, which is funding the masters program.

The actual question: How do I continue to support them, especially from a mental health perspective? I currently live about 5 hr drive away -- close enough that I can go see them for a weekend if I need to. I've done that before and we had a great time hiking and seeing a play, stuff that Sibling definitely would not have done on their own, and they told me afterwards that they really appreciated my coming over. That won't be possible during this program. Our parents had to move back to their home country after they retired last year; their approach in general has been "we'll just act like that intervention never happened."

Sibling is aware that their friends are talking to me behind the scenes, with their assent, but any time I say "Hey, X told me you're going through some stuff, do you want to talk?" they clam up or change the subject. The hiking weekend was good because it allowed us to have fun outdoors and get some exercise without having to dance around their feelings. I don't want to push them but at the same time, I want to make sure they feel loved and supported. I found my local NAMI support group and want to go to their meeting next week (but I'm kind of scared to, not sure why because they are supposed to be really helpful?)
posted by anonymous to Human Relations (6 answers total) 1 user marked this as a favorite
Can you find any articles from your native culture about the benefits of professional help? Even if there is a huge stigma, are there a few people speaking up about the importance?

Imagine if you were dealing with someone who has cancer and is afraid to see a doctor. You could potentially take them on hikes and cheer them up, but it is better for their health to encourage them to get actual medical attention.

Your fear about going to NAMI is similar to your sibling's fear of seeing a doctor. You could start your conversation there: "I had fear too, and then I went to NAMI and it was nothing like I feared..."
posted by cheesecake at 4:54 AM on February 8 [1 favorite]

Anecdata: I have a clearance, as do most of my colleagues. I have depression and see a therapist and take meds. Some of my colleagues do too, for various circumstances. We report this officially (it's required). I don't know anyone who suffered career fallout.
posted by j_curiouser at 7:26 AM on February 8

There are some therapeutic actions you can help your sibling take. They provide respite.
Exercise helps re-balance brain chemistry.
Nature has a beneficial effect on depression. Get sibling outside; I'm a believer that sunshine helps. Also, change of venue helps people break out of repetitive thought patterns.
Vitamin D; not megadoses, but a supplement
Good nutrition, especially avoiding sugar.
Music seems to reach people in a powerful way that is outside cognition.

A book that has helped me is Playing Ball on Running Water: The Japanese Way to Building a Better Life, David K. Reynolds. Share Allie Brosh's Adventures in Depression and Depression Part II. Share the Bloggess' Depression Lies. Friends who care enough to do an intervention probably care enough to go hiking, see plays, go to movies and concerts, etc.

Go to therapy is a big task. Depression can make it extremely hard to take action. Help break it down. On your next visit, sit with sibling and get lists of insurance-approved therapists, start calling to see who's taking new clients. With sibling's approval, of course. Focus on Life can be better. You can feel better. You deserve to feel better. Sibling is lucky to have you and a good friend network.
posted by theora55 at 7:36 AM on February 8 [3 favorites]

Building on what theora55 said...The thing with depression is it doesn't leave with bandwidth to do anything else. So can you help to make the next year easily by taking on some practical tasks? Since you are far away, can you arrange for laundry service or meal or grocery delivery? Go out there a couple of times and help do cleaning and organizing? Those are all supportive things you can do that don't put you in the role of therapist or police.
posted by SyraCarol at 7:43 AM on February 8 [1 favorite]

A lot of the people I meet at Al-Anon meetings are there because they love someone with mental illness. Consider attending several meetings as a resource for yourself. One of the biggest issues for the friends and relatives of alcoholics, and people with mental illness, is learning to accept that we have no control over the behavior of other people.

That doesn't mean you need to ignore your sibling's situation. NAMI meetings sound like a great idea. Al-Anon may be helpful for you, and there's lots of other good advice above. I would tell your sibling, if you are willing, how much you want to help support them and ask them what might be helpful. It is exhausting to find a therapist, for example, so if your sib agrees, that help might be invaluable. So ask. If your sibling refuses to answer or does not express a desire for help, that is not your fault. Just keep asking gently, every few months, and do not force the issue. Good luck!
posted by Bella Donna at 3:04 PM on February 8

Things that my family have done that have really helped me when I have a depressive episode:

- sent me goofy memes, funny tweets, interesting articles - something to talk about or just have a moment of pleasure about that doesn't have to be heavy
- come to visit me, without obliging me to play host -- they stayed somewhere else, were ok amusing themselves, but we could do fun things together. One time my mom came and just helped wash my dishes and scoop my cat litter without saying anything about how I should have done it myself.
- ordered meals, helped cook stuff or stock my fridge
- watching tv or movies together -- we used to use an app for this but you can also just press play at the same time and then text or talk on the phone while it's playing

Things that did not help:
- my father coming in and asking me what my plan for the day was when I was living at home - made me feel guilty and obstinate and like more of a fuck-up.
- nagging about seeing a doctor. Note that concrete actionable help can be good ie "I looked up these doctors would you like me to call one for you?", but just saying "hey have you called those doctors yet" or "hey are you taking your meds" just makes me feel guilty and obstinate.

Things to keep in mind
- Depression is absolutely soul sucking. Often you know that eg showering will make you feel better, but it feels utterly impossible to actually get up and take a shower. Let alone things like cooking healthy tasty food, or exercising, or engaging in the stuff you normally enjoy. Not that those things don't help or it's not good to try and engage in them, but it can be really hard to actually do any of it when you're in the midst of an episode.

If they're doing ok now, then prepping a lot and implementing routines and fall backs can help -- I always keep my freezer full of food I can just throw in the microwave bc once I get depressed I will just not eat rather than have to say assemble a sandwich. It literally needs to be "unwrap, microwave, eat" or I won't do it. Stove top ramen is sometimes too hard. Boxes of cereal that can be eaten dry or clif bars are similarly good.

- This is hard on you too, and you need your own support network for that. You want to be able to dump out to people that aren't your sibling, maybe don't even know your sibling.
- You can't fix things for them. You can help, and you can love someone, but you can't Sam Gamgee them through it. I think about these words from Captain Awkward a lot, and they don't exactly apply to your situation, but they also do. "It’s not your fault, it’s not something you are doing wrong or not doing enough of. What that also means is that you cannot love him out of it. You can’t fix him or fix it for him. He’s got to do it himself."
- Progress is not linear. I have been depressed most of my life. I have had years where I thought "wow I didn't know life could feel this good it's so nice to be not depressed" and looking back...I was still depressed. I still don't have a medication regime that really treats me, and for me it does take medication, although therapy helps too. But even when one day things are really truly awful, sometimes the next day is ok. Sometimes I have two good weeks and then one very bad week and then one middling week. What I try to do is to seize those good days or good weeks and store up my energy and coping mechanisms and freezer for the bad weeks. Your sibling may choose to do differently.

I also like this Captain Awkward post.
posted by arabidopsis at 1:57 PM on February 11 [1 favorite]

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