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Expert Q&A

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How can I help my 18-year-old be more responsible forhimself?

Asked by Risha, Sacramento

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My son suffers with anger and low self-esteem but is outrageously cocky toward me. He is almost 18, we don't get along lately, and I feel like he is jealous of my happiness. I feel like it is my fault, as I raised him as a single mom and spoiled him a lot, and now it feels like it has all backfired on me. I am crushed, but I am also starting to have my own resentment toward him. He suffers from ADHD and most likely a mood disorder, but he refuses to make time to see the doctor. When I schedule appointments, he often wants to reschedule, which leads to having to start the whole process over. I don't want to give up, but with no support, I just don't know what to do. I am 35, I had him young, and I want to have a life, too; and I just don't see how that can happen when he refuses to help himself. It's like he wants me to do everything for him. Please advise.

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Mental Health Expert Dr. Charles Raison Psychiatrist,
Emory University Medical School

Expert answer

Dear Risha,

I've been thinking awhile about your question. Often there is a straightforward answer to people's dilemmas, but yours is not one of those. Even if I really understood your son's issues and the problems in your relationship with him, there would probably still not be any obvious, easy way to resolve things.

Having said this, let me tell you about a technique that can make solving these types of complicated problems simpler. Rather than focusing on all the issues you are facing and trying to make them right, try focusing on the outcome you want to achieve. In your case, I suspect you want your son to treat you better and take responsibility for improving his own mental health and functioning.

With this desired outcome firmly in your mind, a first step is to watch closely to see which of your actions move him a little toward this goal and which move him away from it. My guess is that much of what you are doing now is helping to promote his bad behavior and irresponsibility. Try to see this clearly without letting it bother you too much. You know it's a serious problem, or you wouldn't have written in to me. With a clear head, try to identify anything you are doing that results in better behavior on this part, and build upon this.

Very often, relationships will transform only when one member radically changes his or her behavior toward the other person. Your son may be irresponsible and angry in part because you have been doing everything for him. If this is true, you might find his behavior improves significantly if you make him responsible for his own life and leave him to suffer the consequences of his behavior and actions. This is what happens to young people when they join the military, and it is why the military is often so good for them.

I've seen many young adults similar to your description of your son whose behavior and emotions improved significantly when they had to begin making their own way in the world.

But a word of caution: Sometimes, young people with serious mental illness are not able to make this transition and get much worse if and when their parents demand that they "grow up." In these cases -- all of which are heartbreaking -- parents have to decide to either cut the child loose to face dire life circumstances or realize they will need to oversee and intervene in the young person's life indefinitely. However, even in these situations, if a parent watches his or her behavior to identify what improves and what worsens the child's behavior, things can often improve.

Let me leave you with a final thought. Trying to change your son, at the age of 18, is a very difficult undertaking. A smarter way to help resolve the problem is to focus on yourself and your own issues. I never cease to be amazed how profoundly relationships can change when one person gets help for his or her own issues. You might consider seeing a therapist yourself to work on your own reactions and behavior within the relationship, rather than trying futilely to force your son into treatment.

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