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gratefulbob
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Trig Jul 07, 2020 at 02:14 PM
  #1
Hi everyone,

I am writing regarding my brother who has multiple mental health issues. He is 39 years old and lives north of Los Angeles. Since childhood, he has had multiple psychiatric diagnoses including ADHD, OCD, depression. He's seen many psychiatrists and psychologists and been on countless medication regimens. He has been on and off abusing substance like adderall, benzos, marijuana, alcohol. He plays video games all night since his early 20s and avoiding other pursuits like employment, dating, friendships, and family. He has episodes of becoming aggressive at times and
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Based on all his behaviors, I believe he has borderline personality disorder.

He is a smart guy in a lot of ways. He earned a bachelors in english, and is well read. However over the last 10-15 years he has progressively struggled with finding stability and independence in his life and is becoming less functional. He was recently living in a subsidized apartment and could barely keep it clean or cook for himself.

Our family doesn’t know how to help him succeed. He has been in and out of many sober living homes over the past 10 yrs. Last year he started working full time after 10 yrs of refusing to work and living off my parents. Every time they tried to establish boundaries, or cut him off, he would say that he’s feeling
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. They were scared so they continued their financial support. He quit his last job because his anxiety worsened. He thought that his co-workers were all talking about him and conspiring against him.

For the last 3 months, he has been in a residential mental health program and living at their affiliated sober living home. Many of the patients who went there had been in horrible shape before and ended up benefiting tremendously, going on to do well afterwards. However, he seems to be getting worse. His therapist there told him he’s the most resistant to treatment patient she has seen in 20 years! He doesn’t want to work. My parents won’t totally withdraw support because they feel like he will be homeless, do drugs, and end up actually
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The social worker says he doesn’t qualify for disability. The psychiatrist says he could write a letter for disability but it would be doing him a big disservice. It seems like almost everyone involved in his care says he can work.

We are trying to figure out where he can go after this. He refuses to go to sober living. We are trying to get him into a group home but the one’s we visited have people who can barely talk and have serious cognitive issues. My parents are getting older, more tired, stressed and don't have the mental strength to set boundaries or cut him off as so many people recommend.

I would be extremely grateful for any advise.

Sincerely,

Bob

Last edited by bluekoi; Jul 07, 2020 at 08:08 PM.. Reason: Add trigger icon. Apply trigger codes.
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Bipolarchic14
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Default Jul 08, 2020 at 04:05 AM
  #2
I am sorry your family is going through this and I am sorry your brother is in so much pain. Unfortunately sometimes you have to let an alcoholic/ drug addict hit rock bottom. ( this is assuming he is still abusing these substances) Supporting a destructive lifestyle will be far more harmful for him in the long run. In regards to work, let’s face it, who really wants to go to work. If it is a job you love, maybe. Speaking first hand, working with anxiety is no fun so I empathize with your brother. I would suggest looking up careers that will be less stressful for him. I heard medical coding is good for people with mental health issues. I don’t have first hand knowledge of it yet but hope to soon! Maybe he could take a job where he is working with video games. If your parents are going to help supplement his income, maybe reward good behavior and not the bad. So like no support if he relapses and/ or quits his job. If there are no consequences for poor life choices, where is the incentive. Clearly it is not for the pride of standing on his own two feet. In regards to the bpd, there is a set of skills he can embrace. Marsha Linehan developed Dbt skills based off her own struggles with bpd. He could look up YouTube videos on it or buy a book. If his attention span is not there, the videos may seem less intimidating. He is most likely learning these skills anyway in the outpatient program. One last thing. I struggle with SI too. I was recently put on lithium. If he is not on it, this may be something they could consider trying. I would ask the psychiatrist about that. I have also been working on being present and getting outside my head by paying attention to what I see hear feel taste and smell This has helped some. Your brother may be using video games as an escape but they can be addicting too.. Good luck with your brother.
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Skeezyks
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Smile Jul 08, 2020 at 01:40 PM
  #3
Hello Bob: Thank you for bringing your concern here to PC. I see this is your first post. Welcome to Psych Central. One additional forum, here on PC, that may be of interest to you would be the Partners of People & Caregivers forum. Here's a link:

https://psychcentralforums.com/partn...ivers-support/

I'm not a mental health professional. So I can't offer you anything in the way of authoritative advice regarding your brother's situation. It's certainly a difficult set of circumstances with no clear pathway to success... assuming that one even exists.

You mentioned a social worker opining your brother would not qualify for disability (which is, at least to my mind, unethical by the way. A social worker is not qualified to rule on whether or not a client is eligible for disability.) And you mentioned your brother's psychiatrist saying he could write a letter but it would be doing your brother a "big disservice". (Don't you just love it when someone who's probably pulling down several hundred thousand dollars a year has the audacity to tell someone who's as downtrodden as your brother that writing a letter in support of SSDI would be a big disservice?)

Of course I don't know all of the details here. And maybe there's more to this than you could reasonably include in your post. But my thinking here would be to hire an attorney who specializes in Social Security Disability cases & get the ball rolling on submitting an application. It's been a few years now since I was actively involved in this sort of thing. So perhaps things have changed. But when I was actively involved in these sorts of things the rule-of-thumb, so to speak, was that every SSDI applicant is denied on the first go-around, especially if they are unrepresented. However if they hire a knowledgeable SSDI attorney, the odds of being approved increase dramatically.

I don't know if your brother is capable of working or not. And I have no idea whether or not he can, in fact, get SSDI. But the fact is he has a right to apply. And I believe he still has the right to be represented in that process by an attorney who works in the SSDI application field. (Where I live there are TV ads all the time for attorneys who do this type of work.) I do understand the dilemma your parents feel themselves to be in. Years ago I periodically worked with aging parents who had sons or daughters who had developmental disabilities. And they almost always felt the same responsibility toward their adult children your parents feel toward your brother. Qualifying for SSDI isn't going to solve all of your brother's or your parents' problems. However, at least from my personal non-professional perspective, it's a step in the right direction & one that should be taken... despite the apparent hubris of the professionals around him. My best wishes to you, your brother & your parents. I hope you find PC to be of benefit.

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gratefulbob
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Default Jul 10, 2020 at 12:13 PM
  #4
Quote:
Originally Posted by Bipolarchic14 View Post
I am sorry your family is going through this and I am sorry your brother is in so much pain. Unfortunately sometimes you have to let an alcoholic/ drug addict hit rock bottom. ( this is assuming he is still abusing these substances) Supporting a destructive lifestyle will be far more harmful for him in the long run. In regards to work, let’s face it, who really wants to go to work. If it is a job you love, maybe. Speaking first hand, working with anxiety is no fun so I empathize with your brother. I would suggest looking up careers that will be less stressful for him. I heard medical coding is good for people with mental health issues. I don’t have first hand knowledge of it yet but hope to soon! Maybe he could take a job where he is working with video games. If your parents are going to help supplement his income, maybe reward good behavior and not the bad. So like no support if he relapses and/ or quits his job. If there are no consequences for poor life choices, where is the incentive. Clearly it is not for the pride of standing on his own two feet. In regards to the bpd, there is a set of skills he can embrace. Marsha Linehan developed Dbt skills based off her own struggles with bpd. He could look up YouTube videos on it or buy a book. If his attention span is not there, the videos may seem less intimidating. He is most likely learning these skills anyway in the outpatient program. One last thing. I struggle with SI too. I was recently put on lithium. If he is not on it, this may be something they could consider trying. I would ask the psychiatrist about that. I have also been working on being present and getting outside my head by paying attention to what I see hear feel taste and smell This has helped some. Your brother may be using video games as an escape but they can be addicting too.. Good luck with your brother.
Thanks for your reply and thoughtful ideas! He has been clean as far, as I know, for 3-4 months. This is only because he's in sober living. In the past, pretty soon after leaving SL, he would relapse.

I think you're right about getting a job that would be less stressful. We had encouraged video game related work many times but he didn't show interest. Actually he only plays ONE game for the last 20 yrs, which I think is related to his OCD.

He was recently working at a call center booking appointments for pet grooming and his supervisors micromanaged like crazy as if they were a Fortune 500 company. He gets restless in office/cubicle type jobs so I'm trying to see if he could do stock room or Home Depot type of work. He currently says he can't work even though 2 therapists and the supervisor at the residential program said he is fully capable.

My parents have bad, ingrained habits of "rewarding bad behavior" He complains incessantly and they take him out for a nice dinner just to get him to stop. At least now when he mentions
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instead of treating him to expensive sushi like before.

I am a huge fan of DBT. This residential program focuses heavily on DBT, but he's not absorbing or utilizing any of it. He's still in full victim mode - blaming everyone else for his problems.

I'm not trying to be insensitive, but he's super difficult to deal with and rejects any suggestions to change.

Thanks again!!

Last edited by bluekoi; Jul 10, 2020 at 08:15 PM.. Reason: Apply trigger code.
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Default Jul 10, 2020 at 12:20 PM
  #5
Thanks for your post Skeezyks. We found a doctor a few years who helped him get disability, but he took a cut so my brother only saw $300 a month which barely cover food let alone other expense.

I will look into more into qualifying for SSDI. I'm not sure on what basis the social worker came to that conclusion.

Thanks!
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Default Aug 19, 2020 at 09:58 AM
  #6
it's weird... some of us with drug/alcohol/impulse issues are quite intelligent and can be super functional (i have 3 college degrees and im a mess). but sometimes all we want to do is run ourselves into the ground. especially when theres pressure from loved ones to be different. as sad as it is, the best thing you can do is let him do his thing and make sure he knows youre there. if you try to control him it will make him worse. i just found new and more creative ways to drink cause i still somehow feel like its literally the only way i can tolerate being alive sometimes without being in extreme distress. and honestly i feel like, if the people closest to me dont like it, fine. ill get craftier and hide it better cause me being sneaky, deceptive and alive is better than me being dead.
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Default Aug 23, 2020 at 11:16 AM
  #7
In my own experience - no amount of therapy, or types of therapy, would help me....until I was ready to do the work myself. No amount of support, be it friends, family, or therapists (psychiatrists, psychologists, counselors) could help, until I was ready to accept it, and do the work myself. I am so sorry to hear that you and your parents are struggling so hard, and keep hitting brick walls. The only possible advice I could give is, follow that link Skeezyks posted. You and your parents can't change your brother, and you can't make him make an effort, and you can't make him stay sober. All you do have the power to do is to find a way of handling what it's doing to you (and your parents.) I pray you all find your way through this time.

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