Brother is Self-Medicating. How To Help?

By Kristina Randle, Ph.D., LCSW

For over a year now, my little brother has been showing serious depression/anger. He went from being THE MOST happy-go-lucky kid I knew, to an aggressive, seclusive, frustrated 17 year old overnight. This began almost simultaneously to his taking the medication Accutane. However, he ended the treatment early and he has never been the same since. He has been drinking and doing drugs (mostly pot), to an extent that must be self-medicating. I’m not living with him currently, but i know he spends A LOT of time in his room and he has little/no respect for my parents or their rules, which has been growing for some time – he lies to them on a constant basis, and even to me at times. He seems to have minimal interest in anything productive, aside from exercising. (For the past several years he has made his body mass a serious hobby) Although, he will go through periods of losing a lot of his body weight/muscle, and then gaining it back. I would normally be glad that he still shows pride/interest in his body, but it doesn’t seem healthier, as he has been known to drink before he works out and he doesn’t eat well.

For a while, I played this off as the usual teenage angst and just made a bigger effort to talk with him and get him involved with stuff I was doing. I have always been very close with him, and very protective as well. When I come home I still can see the old him every now an then peeking through – I can even sometimes sense when he “snaps”. I’ve pushed my parents to getting him a therapist that specializes with boys his age, and just yesterday they set up an appointment. But they don’t want him to go on medication, in part due to his sensitivity to them, as well as his addictive tendencies.

Beyond depression, I’m concerned he’s developing a psychosis issue. I feel he’s losing touch with reality and believes people are ganging up on him (I’ll mention that my parents are loving, and do remind him how much he is loved -in fact, he has been catered to and has had no real responsibilities, which i think has only added to the problem). At this point, I know something needs to happen, but what I don’t know. I’ve considered everything from rehab, counseling, military school, to volunteer work… I’m exhausted and I know my parents are as well.

A. I think your parents had it right when they scheduled a counseling appointment for him. You said they did not want him to take medication. Going to counseling does not mean that he will have to take medication. Some counselors suggest medication as do some psychiatrists. Because it is suggested doesn’t mean he has to take the medication. He has a choice in the matter. Your parents or your brother could simply tell the counselor he is very sensitive to medication and that he is strictly interested in psychotherapy.

You’ve expressed many concerns about your brother and I’m wondering if you shared that information with him. Does he know how worried you are about him? Have you approached him about your concerns? Has anyone approached him? He doesn’t seem very receptive to your parents at this point but he may be open to talking to you. You should talk to your brother and be honest about your concerns. In talking with him you can express the importance of getting help. You could even make the offer that you’d be willing to attend therapy with him, or at least be part of the process in some capacity. This might include you driving him to his therapy sessions or participating in several if he’d be open to it.

If none of these suggestions work then you and your family should come together to create a plan about how to approach this problem. A family therapist may be very helpful with this process. This means that even if your brother is not willing to attend treatment the family could see a therapist to receive guidance about this issue. Let me know how things turn out.

Photo

 

 

Last reviewed: By John M. Grohol, Psy.D. on 29 Jun 2009

APA Reference
Randle, K. (2009). Brother is Self-Medicating. How To Help?. Psych Central. Retrieved on October 21, 2014, from http://psychcentral.com/ask-the-therapist/2009/06/29/brother-is-self-medicating-how-to-help/