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Dealing with Depression/My Brothers' Depression

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My 24 year old Brother has been struggling with depression for 5 or 6 years. My family and I have talked to him but whenever we try to approach him he gets extremly defensive. We've done everything humanly possible to help him . We've asked if he'd want to see a therapist , but has always refused. He has a lack of confidence and has diferent personailties. I find myself always having to watch what i say around him , because the slighest thing sets him off. For example, I was at our house with my brother. It was a sunny day so i had opened our house windows. When he woke up  he immediatly closed all the window blinds and when i tried to re-open them just a touch , he would get angry and have to have his way. Another time he had called me over into the den where our compouter was. He wanted to show me a  video he thought was funny. I chuckled a bit, and for no reason , he shook his head as if i'd done something wrong and told me to get out and also stated mocking me. He acts differently around me than he does around others, its hard for me to explain who he is through writting. My family is fully aware of his different personalities and how he acts ,but whenver we try to talk to him he denys everything  and we can never come to a sollution. He also is very disrespecfull toward our Fathers grandparents. For example, what he will do is whenever they would call his name to ask if he wanted to eat, or if he wanted his bed made, he would mock them and tell them to shut-up or in some cases  swear at them. My grandparents have a hard time hearing , so he says it in a tone in which they wont be able to hear him,but he says it loud enough for myself and my father to hear it whenever we are there without him knowing. Other pointless things set him off , such as say if someone moves his shoes, or folds his cloths. He currently lives with them now due to our parents getting divorced. Our father has built a house next door to them. My Brother complains about living with our grandparents when he could easily move next door with my father or with our mom,or our grandmother on our Mothers side of the family. When my dad trys to have a conversation around him, say when he arrives home from work, he gets angry for no reason and acts like a rebelious 12 year old. My dad will ask him how has his day been, or if there is anything new going on at work. Over the past 2 years , his depression has come to my attention, and ive taken him out to movies and gone bikeriding with him to see if this would boost his confidence. Lately he hasnt been talking to my dad. They got into an argument over his disrespectfull attitude towards everybody. He hasnt been talking to my dad for 2 months now. Lately , he's been trying to start verbal and physical fights with my dad for no reason, and his disrpesectfull habbits towards his grandparents have gotten worse. He isnt saying Hi or goodbye when he leaves to go to work , he just walks right infront of them then out the door. Our family cant approach him about this because when we do, he denyies it , and you cant come to a solution when all that person is going to do is lie. Growing up , he physically and verbally abused me. I am fifteen now, and have forgiven him for what he did. I am now trying to help him to overcome his depression, but i feel as though the decisions he makes have no explanation for why he does it, and that depression isnt his only problem. My family feels he thinks the world revolves around himself. Its hard to put my thoughts and feelings into writing but i hope you understand my familys cenario. We are always kind towards him but always have to watch what we say around him. My brother has everything anyone could ever want, a family with people who love him unconditionally , and place to stay , food to eat. My brother also has a lack of concern for the needs and priorites of others. For example, there was a day when we had a family dinner at our grandparents house on our Mothers side.It was on the weekend so i was staying at my Fathers house. Dinner was at 6:00 pm . He took almost 2 hours to get ready and we didnt leave until 5:55 pm . He was drving , and i was the only one in the car . We arrived at our grandparents house at 6:45pm, and when our Mother had asked why he was late he simply replied there was traffic. Now i would've said that wasnt true, but he would've gotten angry at me and would've just lied about it. I find him always lieing, even about the smallest things , and i cant say the truth because he will just deny it and become angry. I feel trapped when ever i am around him, yet i am trying to help him. Although he is my brother and i do love him, if i had to describe him in  two words it would be Disrespectfull and Immature. My family has talked about him and tried to wrap our heads around what we can to do help him, but the thing is , we've done everything humaly possible , and whenever we attempt something, say arraging a therapist , talking to him, or getting someone else to in the hopes he will open up and share whats on his mind , its like setting off a snunami and nothing gets solved , we only make him more angry. So my question is , how should we approach this situation, what should my family do, and what should i do, and how should i act and treat him when im around him ?

Thank you
Andrew,

Answer
Hi Andrew,

Who diagnosed depression? From what data you provide your brother does not meet the conditions of depression which is a mood disorder:

Major Depressive Disorder requires two or more major depressive episodes.
Diagnostic criteria:
Depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day

1.    Depressed mood most of the day.
2.    Diminished interest or pleasure in all or most activities.
3.    Significant unintentional weight loss or gain.
4.    Insomnia or sleeping too much.
5.    Agitation or psycho-motor retardation noticed by others.
6.    Fatigue or loss of energy.
7.    Feelings of worthlessness or excessive guilt.
8.    Diminished ability to think or concentrate, or indecisiveness.
9.    Recurrent thoughts of death


The symptoms you describe are indicative of another type. I won't specify what that other disorder might be for fear that you may take that specification as a diagnosis and thereby create inaccurate and unnecessary assumptions about your brother or how you may react under those false assumptions. Further, I cannot diagnose nor hint at any disorder since that would be unfair to brother. Plus, I do not have enough information to make a diagnosis. I have not examined your brother under session so any notes made upon the situation are second hand at best and that is not best practice to base a decision on. Your brother has not provided information specific to himself and his condition so under those conditions I would not qualify myself to confirm any assumption based on the lack of data.

However, regardless of the disorder, there are two key conditions to any disorder which helps to clarify which one you are dealing with. Those who want help and those who don't.

Depressives usually want help and often reach out to others for it. They are not as inclined to move into full blown denial, or deprive others of their rights, dignity, respect, or become prone to violent outbursts like your brother.

There are other disorders whereby "not wanting help" is a key component which  makes professional treatment a must to deal correctly with them. Families just lack the proper training, skills, and abilities to deal with these types of disorders and the ensuing resistance to treatment by the sufferer. Some of these full-blown denial types are very serious due to the symptoms manifested which impact society in harmful ways and in these cases I would recommend that families contact mental health for links to professionals in their areas for more help.

You and your family are walking on egg shells and no one should have to live that way. The fear your brother generates, his lack of cooperation, his lack of respect, have impacted those around him in negative and harmful ways. The fact he denies the symptoms, this labels the severity of the issue. Unless he accepts that something is wrong, communication will be difficult, and familial relationships will continue to suffer. Someone needs to break through the "stubbornness barrier" since that is a detriment to learning and communication. Breaking through that barrier can be a long and difficult task. It is  not impossible, just hard.

Breaking through requires changing world view perspectives by "challenging" that world view. Once the person comes to accept that something is wrong then change can happen. Challenging beliefs "without passing judgements"... repeat, "without passing judgements"... permits the patient to "hear" how they think. It permits them to play out their views using vocalization and auditory senses and once this happens they now have another tool with which to help them localize and process the areas of dysfunction within their perspective of things. Once they hear how odd their views sound they will pass their own judgements. This will often be done in retrospect, once they are left alone to their thoughts. The mind will begin to self examine, absorb, and process the events when there is time to do so.

Rather than tell them to change, lead them to change. Rather than ask them to explain themselves, cause them to explain. Create the challenge through a statement of their beliefs For example, when your brother disrespects your grandparents you might try something like, "grandpa is an idiot and doesn't deserve respect". You are not passing judgement on your brother, you are just stating his viewpoint and leaving room or validation, or clarification by him on that viewpoint. It doesn't matter if you are wrong because they will correct you if you are.  They will either confirm, deny, or elaborate on the comment. "That's right! He is an idiot."  This is where you want them because this opens the doors to communication. "He's an idiot because he makes you angry." "He's an idiot because..." Using this challenge continually opens the person up to communication and self-exploration. You can lead them to hear and vocalize their world view and permit them the ability to recognise the absurdity in it without causing conflict or passing judgement.

Challenging alone is not enough. There are other techniques used in combination with challenges, such as probes, empathic and advanced empathic highlighting that help to lead the person to change perspectives within their world view. They all work together to break through the "stubbornness" barrier". You can read more here on my HubPages about those techniques. The article transposes across spectrumís, so what works for communication in relationships works for communication in any type of exchange, or any exploration of dysfunction.  

Dealing with Depression

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Amper Sun

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Depression, anxiety, self esteem, guilt, loss, grief, spiritual uncertainty!

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Thirty years treating individual, families, at-risk-youth in counselling and psycho-therapy.

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http://anomaly.x90x.net/anomaly/ http://ampersun.hubpages.com http://ampersun.blogspot.ca/

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Master Practitioner of Counselling and Psychotherapy - M.P.C.P. designation.

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