The question is, is his depression a cause or an effect. The chicken or the egg. Which came first? Certainly, his multiple failures in life and lack of success would cause depression. Depression as an illness and cause, would cause failures in life. No one will be able to tell you which is the cause and which is the effect.
There are basically only two possible treatments. If his depression is based on a physical problem, then only a physical treatment will be effective. Physical treatment, would consist of drug therapy or ECT. The only nonphysical treatment would be talk therapy of some sort.
Your problem appears deeper. Your son refuses treatment. How can you possibly think that he might improve without treatment of any sort? You are willing to help him with his treatment but he rejects your help and refuses to attempt to help himself. Refusing mental health treatment, keeps many obviously psychotic persons on the street, where many end up homeless, imprisoned, or dead.
Your son should not have the right to reject treatment. Legally he does but legally he has no right to receive money from you nor the right to live in your home. I know that your only concern is helping your son but that is not always easy. Many books have been written on the subject of tough love. If you haven’t read them, you should. For parents that have practiced tough love, they know how very difficult and painful it was for them to accept the idea that the only way to help their child or tried to help their child, was to practice tough love. They did not practice tough love because they had little love for their child, they paid, instead, a heavy price emotionally because they loved their child so much. It became clear to them that the only way to help their child and possibly save their child’s life, was to take control and instill rules that the child must follow or the child would no longer receive any help of any kind, from them. No money. No place to live. Nothing.
Hundreds, if not thousands of books have been written on the subject of tough love. My several paragraphs has made no attempt to fully explain it and I have no expectations that I have done even a modest job of explaining tough love.
Speaking of tough love, here’s a tough question for you. Are you his enablers? The concept of enablers has been well-established, documented and proven in drug therapy. In almost every case, someone has enabled the alcoholic to survive as an alcoholic. Are you enabling your child to reject therapy?
I have made it perfectly clear in the answers that I have provided in print, for many years, that I cannot diagnose over the Internet and I cannot. In addition, I don’t know anyone who actually can. There are those who say that they can and in addition there are those who say the earth is flat.
Though I cannot diagnose over the internet, I can share with you my experiences. I have dealt with many persons who are your son’s age and younger, who are depressed because their life is not moving forward as they had expected and hoped. Their depression was removed as their life improved and their successes increased. As you pointed out, your son has friends who are moving forward and are being successful in life. How does that make your son feel?
Your son doesn’t have the answers, obviously, or he would cure his own depression. Rejecting therapy, could not possibly be the right choice. With therapy he has the chance to improve. Without therapy, well you can see the results in your son’s lasting depression. You say your son is intelligent. I will accept that. Please also accept the fact that therapists are highly skilled and are of high intelligence. They have succeeded in college. They have succeeded in being accepted into a graduate program and they have proven their intellectual ability.
A non-cooperative client, someone who doesn’t want to be there, can mislead a therapist but cannot deceive a therapist, over time. Not all car mechanics are equal. Some are much better than others and our life experience shows that to be true. Maybe all therapists are qualified to repair cars but some are just much better at it. Perhaps, he just hasn’t found the right therapist. No more qualified, no more intelligent, just not the one that he “clicks” with. Moral of this answer? Don’t stop trying, in fact try much harder. I wish you the best of luck.
Dr. Kristina Randle