Is It Laziness or a Mental Health Issue? the Signs

Q: Is It Laziness or a Mental Health Issue? the Signs

Hello： You may feel helpless and worried about this matter. <br>Indeed, if what you mentioned is an issue related to "adult children living at home," it is a complex problem that affects families and society. <br>However, strictly speaking, it is not currently recognized as a med

Is it laziness or a mental illness?

Hello Doctor: I would like to ask, my brother has not worked at all since he was discharged from the military (over ten years ago) despite being physically healthy.
Initially, our parents would constantly nag him, but he still refuses to work and spends all day at home.
Our parents are both over 60 years old, and especially my father, who is 66, is still climbing on rooftops.
Watching my father’s increasingly frail figure really pains me, yet my brother remains completely indifferent.
Not only does he not work, but he also acts like a lord at home, leaving his dishes for others to clean and refusing to do any household chores.
At first, he would occasionally go out to play basketball or visit bookstores, but in recent years, his outings have become less frequent, and he has only left the house once in the past eight months (to get a haircut).
I have been telling my mother and my married sister (since my father often works in other counties and is rarely home) whether we should force him to seek medical help (because he would never go to see a doctor on his own).
However, aside from me, the family is very afraid of losing face, so they have allowed his behavior to continue, living day by day without any direction.
I have directly told my parents that if one day they are gone, please take him with them, because I do not have the ability or obligation to support him (why should I support a fully capable brother?).
Not to mention outsiders, I have a very low opinion of him (a typical freeloader).
He is well aware of this, which is why I have had conflicts with him more than once (we even fought a few months ago) over trivial matters, such as doing laundry.
It’s laughable that he has never contributed a dime to the household, and most of the current bills and expenses are borne by me and my married sister, yet he meddles in everything and forbids me from using the washing machine.
My mother and sister are completely afraid to confront him due to concerns about his potential for violence, even telling me to ignore him (but I am very dissatisfied).
Of course, many things have happened over the past decade, and this is just a small part of it! I really don’t know what to do.
How can I force him to seek medical help? Should I call social services to intervene?

Pinggu, 30~39 year old female. Ask Date: 2013/09/11

Dr. Qiu Junda reply Psychiatry

Hello: You may feel helpless and worried about this matter.
Indeed, if what you mentioned is an issue related to "adult children living at home," it is a complex problem that affects families and society.
However, strictly speaking, it is not currently recognized as a medical condition, so there is no way to mandate treatment.
Assistance can only be sought if the individual is willing to seek help.
(However, often individuals are reluctant to seek treatment.) I suggest that you first consult with a psychiatrist at a nearby hospital to discuss this situation with a physician, and to explore how to respond to it and how to cope with the negative emotions arising from this issue.
Thank you!

Reply Date: 2013/09/11

More Info

It sounds like you are dealing with a very challenging situation regarding your brother's behavior and mental health. From your description, it appears that your brother may be exhibiting signs of a mental health issue rather than mere laziness. While it can be frustrating to witness a loved one not contributing to the household or taking care of themselves, it is essential to approach this situation with empathy and understanding.

Understanding the Signs
Your brother's behavior—such as not working for over a decade, withdrawing from social activities, and exhibiting a lack of motivation—could be indicative of several mental health conditions, including depression, anxiety disorders, or even a more severe condition like schizophrenia or a personality disorder. Here are some signs that may suggest a mental health issue:
1. Withdrawal from Activities: You mentioned that your brother used to go out to play basketball and visit bookstores but has significantly reduced his outings. This withdrawal can be a sign of depression or social anxiety.

2. Lack of Motivation: His refusal to work and contribute to household chores may indicate a lack of motivation often seen in individuals suffering from depression or other mental health disorders.

3. Emotional Distress: His behavior seems to be causing distress not only to himself but also to your family, particularly your parents. This emotional strain can exacerbate any underlying mental health issues.

4. Resistance to Change: The fact that he is unresponsive to family concerns and continues to live in a way that is detrimental to his well-being suggests a possible mental health issue that may require professional intervention.

Seeking Help
Given the complexity of your brother's situation, it may be beneficial to consider the following steps:
1. Open Communication: Try to have an open and honest conversation with your brother about your concerns. Approach him with empathy rather than confrontation. Express your worries about his well-being and the impact of his behavior on the family.

2. Encourage Professional Help: It may be challenging to convince him to seek help, especially if he is resistant to the idea. You could suggest that he speak with a mental health professional, emphasizing that seeking help is a sign of strength, not weakness.

3. Involve Family Members: Since your parents and sister are also affected by this situation, it might be helpful to have a family discussion about your brother's behavior. Present a united front and express your collective concerns.

4. Consider Professional Intervention: If your brother continues to refuse help and his behavior poses a risk to himself or others, it may be necessary to involve professionals. This could include contacting a mental health crisis team or social services for guidance on how to proceed.

5. Educate Yourself and Your Family: Understanding mental health issues can help you and your family approach the situation with more compassion. There are many resources available, including books, websites, and support groups for families dealing with similar issues.

6. Self-Care: While it’s essential to support your brother, don’t forget to take care of your own mental health. Dealing with a family member's mental health issues can be emotionally draining, so ensure you have your own support system in place.

Conclusion
It’s crucial to recognize that mental health issues are complex and often require professional intervention. While it may feel like your brother is simply being lazy, his behavior could be a manifestation of deeper psychological struggles. Encouraging him to seek help, involving family members, and considering professional intervention are all steps that can lead to a more positive outcome for everyone involved. Remember, approaching the situation with empathy and understanding can make a significant difference in how your brother responds to your concerns.

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