I’m very sorry that your family is facing this situation. I understand how difficult it must be. It is concerning that he has been in two major accidents due to falling asleep at the wheel. That’s highly unusual and cause for concern.
My first thought, when reading your letter, was whether or not he may have an undiagnosed medical condition. He is working quite a bit which certainly could be contributing to his tiredness but some of his symptoms may potentially be signs of a medical condition. Perhaps he’d be willing to undergo a medical evaluation. Consulting his primary care physician would be a good start.
Though a potential medical problem is possible, his mental health also seems to be a problem. Emotionally, he is demonstrating potential signs of depression or a related condition. Most concerning is when he stares… “blankly as if he did not understand” as you stated. Something is wrong.
The most challenging aspect of this situation is his unwillingness to consult a therapist or even speak about the issue. Many friends and family in these predicaments feel helpless. It’s very difficult to assist someone not open to receiving help.
I would recommend reading more about these issues on the National Alliance for Mental Illness website (NAMI). NAMI is an advocacy organization that focuses on family members with a mental illness. One of the best free resources they offer is the NAMI family-to-family educational programs. These are specifically designed for family, significant others, and friends of people with mental illnesses. It focuses on improving the coping and problems solving capabilities of the people closest to a person with a mental health problem. These programs are typically offered in person, and they may still be, however they may have moved online due to the pandemic. Check their website to learn more about these programs. Many people have positive feedback regarding their experiences with NAMI.
One potential solution may be a family intervention. This would involve your family getting together and developing a unified message of asking your brother to seek help. Family interventions can be powerful but they often require the assistance of a trained family therapist. You might consider meeting with a family therapist or even an individual therapist for advice on how to interact with your brother. They can advise you on how best to proceed.
I wish I had an easy answer for you but the reality is, attempting to help someone who is refusing to even discuss the issue can be a very difficult task. It’s important to adjust your expectations accordingly. Hopefully, some of these above strategies will help. I wish you and your family the best of luck. Don’t hesitate to write again with additional questions. Please take care.
Dr. Kristina Randle