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Congenital Laziness


Our 46 y/o son has been diagnosed with possible mild manic depression (cyclothymia). A couple of years ago he worked with a psychiatrist for a year but the doctor has died and no visible changes occurred during the therapy. Our son is pleasant, does work around the yard, and plays computer video games at night for a few days and then “doesn’t feel good” and sleeps day and night for 4 or 5 days. He only gets up to eat and go to the bathroom. When we try to get him up, he is irritable and nasty. He had aseptic necrosis with hip replacement surgery over a year ago, hasn’t worked since, but has no disability from the surgery. He is a licensed vocational nurse but “doesn’t want to do that any more.” He has seen at least 4 psychiatrists since he was in his 20s and only one of them actually came up with a diagnosis. It was “congenital laziness.” He is so pleasant and intelligent that I think the doctors think we (his parents) are making up–or at least exaggerating the situation. Our family doctor put him on Zoloft for a while, but it didn’t help much. We are at the point of forcing him to leave our home. However, he is a recovering speed addict, which he claims was therapeutic for him, and we fear that he will become a street person or go back to dealing drugs. He is impulsive and careless so he will probably end up in prison if he deals drugs. We only see three options: Put up with the present situation, which isn’t too bad for us but is terrible for his future. Pay for more psychotherapy, which over 20 years has been fruitless. (We are not rich.) “Kick him out” and go to visit him in prison. Can you give us any suggestions?

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It seems to me that your analysis of the situation is clear enough. You have an adult son, probably ill in some fashion, who isn’t willing to care for himself. His main problem seems to be one of motivation; he doesn’t have any save for being motivated to indulge his whims and possibly to pursue an addict’s lifestyle. He is able to lean on you for support at present, but you are rightly concerned for the future. Your problem is one of control; whether to hold on, or let go. You would like him to be motivated to care for himself, but he isn’t. In lieu of that, you’d like to help him stay out of trouble. You can only do that by being a very direct support system for him; a situation that is troubling for other reasons – because it teaches him that if he dodges taking care of himself, someone else will do it for him – an unsustainable proposition. I don’t have any answers for you, but I can recommend that you both yourselves consult with a variety of advisors, including peers (possibly in a support group), a mental health doctor, and an estate planner. You need local advice and support from a variety of solid people you can trust and you need to cover your angles emotionally, ethically and financially so that you are able to make an informed decision. There probably isn’t a ‘right’ answer here, and possibly there isn’t even one that will leave you feeling satisfied. However, systematic exploration will at least help you to understand what your options are as a support system for your son, and how your peers will judge you based on different scenarios you might choose to pursue. Having done your homework, a solution that is most workable will hopefully appear. Good luck.

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