Carolyn Hax: Tough love for relative who refuses to get treated for anxiety

Dear Carolyn: I have a close relative who is living with anxiety – diagnosed by a general practitioner, but never treated – and, I think, at least some mild depression. This person resists any suggestion that some real treatment might be in order, arguing that talking with friends is all she needs, and downright rejecting medication because “that doesn’t change reality.”

I don’t bring it up much anymore and try to be supportive where I can. It’s not debilitating, but she’s often in a “rut” or constantly worrying about or focused on something she can’t control. I know it’s not fair, but at those times, I find myself growing impatient and almost resentful, because nothing I say helps, and I feel like she brings me down, too.

I love her, and I’m worried about her, but it’s getting to the point where I’m starting to limit contact rather than get frustrated and snippy with her – which, again, I know makes me sound awful. What should I be doing differently? – Family Member

She sounds unfamiliar with the nuances of both reality and medication, since both are only as good as our responses to them.

And you don’t sound awful, you sound human.

You also sound like you aren’t a trained and licensed mental health caregiver.

This close relative is leaning on you and others as if you are one, though, and that’s the real problem here – not your impatience or frustration.

So that’s where you can make a difference: acknowledge openly that she has assigned a role to you that you aren’t qualified to fill. “I hear how worried you are. I wish I could help you, but I am not qualified to treat anxiety. I hope you’ll make an appointment with someone who is.”

Repeat, repeat, repeat. An abridged version is fine once you’ve made the details clear: “I’m sorry, I’m not qualified to help you.” Or, “I’m in over my head.”

If she disagrees, then you have the fact of her ongoing struggle to back you up. If talking with friends were all she needed, then she would not be “in a ‘rut’ or constantly worrying.”

This last part is ultimately more for you than for use in discussion with her. You want to steer her gently toward proper treatment by denying her the alternative she prefers – dumping it on you. If you get into a debate with her over the effectiveness of her dumping it on you, then that debate itself will just be another way for her to dump. For your own health and for hers, you need to seal off the access completely.

Gently, again, and lovingly, but completely. “I am not comfortable with this. Just say the word and I’ll help you find someone qualified to help you.”

Dear Carolyn: I recently got into an argument with my father. He was being dismissive of my feelings and gaslighting me, which hurt, so I aimed to hurt him back by saying something ugly. I cursed at him. I realize that once I did, it negated any argument I might have had.

I apologized, and he began to lecture me about how inappropriate it is to speak to him in that manner, at which point I reminded him that he was the one who taught me how to speak to people like that. He used to be quite verbally abusive when I was growing up.

He said he will not speak to me until I write him a formal apology and have my husband sign off on it.

That really ticked me off. It seems patriarchal, and my husband has nothing to do with the argument. Can you please help me form a response that is appropriate? – Feuding

I will as soon as I scrape my jaw off my keyboard.

“Seems”?

One response that won’t cost you your soul is to remind him he already has his apology from the only person responsible for the ugly remark, and it is his prerogative to accept or reject it, but no other apologies are forthcoming. He may opt for estrangement, of course, but you at least will have set out and stood by your terms.

Another response is just not to respond at all, though that makes you the agent of estrangement, and that has a soul cost of its own.

This might just be arranging furniture around the elephant, though. You were raised by a verbal abuser who is still in your life and still working you over, and you are struggling (still?) to come to a healthy response to those circumstances. If this recent argument is more rule than exception, then please enlist the help of a good family therapist, or at least read up on healthy emotional limits. “Lifeskills for Adult Children” (Woititz/Garner) is a quick, cheap and excellent teacher of Boundaries 101.