Q. I think my brother is really depressed. I have noticed that over time my brother seems to get more depressed. He is 18. He graduated from high school last year. He goes to college online because he does not want to attend school. He does not want to get a job. He does not want to get his drivers license. He makes no attempts to contact any of his friends from high school (he never really spent any time outside of school with any of them in high school). He wont talk about future plans for school or work. He does not want to spend any time with me doing anything. He sleeps everyday until the middle of the afternoon. He spends most of his time in his room alone or on the computer. When he talks he mumbles, you can not really understand him even if you are standing right beside him. He gets really mad if you ask him if something is wrong or try to encourage him to get out and do something. He has started to read the Bible alot and will pray for two hours straight. Depression does run in our family. My mother seems to be in denial about it. She says that nothing is wrong with him, but she will talk to him and take care of it. I have no idea what to do. My parents are no help at all. He won’t talk to me about anything. I am worried that it will get worse.
A. Please understand that I am basing my opinion of your brother’s clinical situation on a short letter and it is not possible for me to be certain about his condition; only a doctor who met with him in person could accurately determine his diagnosis.
I would agree with you that your brother may be suffering from depression but it’s also possible he may be in the beginning stages of a psychotic episode or experiencing symptoms of schizophrenia. You mentioned that your brother has a sudden interest in reading the Bible. If he read the Bible regularly or had even a casual interest in religion, his reading of the Bible may not be a concern. But if he suddenly began reading the Bible and this behavior is uncharacteristic, this should be a red flag.
Generally speaking, if someone suddenly begins behaving uncharacteristically or out of the ordinary, then it is appropriate to be looking for the reasons for the change. In therapy for instance, it can take years to alter an individual’s personality and behavior so when there is any abrupt change, it should prompt concern.
Drug use can alter an individual’s behavior and personality and therefore should be considered as a reason to explain your brother’s symptoms.
You also mentioned that you cannot understand your brother’s speech because he mumbles. You also said he is socially isolative, not interested in employment or gaining a driver’s license and that he has been displaying anger. These aforementioned behaviors may also be indicative of an impending psychosis.
Your mother seems to be in denial that anything is wrong with your brother. This makes the situation difficult. You should encourage your mother and the rest of the family to urge your brother to see a doctor.
If that strategy is not effective, then continue to observe his behavior. If you believe that he becomes a danger to himself or others alert the police or the local mental health crisis team. That may be all that you can do at this time.
“Danger to self and others” can include making suicidal threats, not eating or drinking, or a refusal to take life sustaining medications. Other signs of mental deterioration that should prompt you to call the police or crisis team might include lack of bathing, being mute or seemingly unable to speak, locking himself in his bedroom, a notable increase in his anger, hitting walls, screaming, or expressing paranoia, delusions or hallucinations.
Please write back if you have any further questions.
Last reviewed: By John M. Grohol, Psy.D. on 20 Oct 2008
Randle, K. (2008). Brother Depressed But Refusing Help. Psych Central. Retrieved on March 8, 2014, from http://psychcentral.com/ask-the-therapist/2008/10/20/brother-depressed-but-refusing-help/