My Story: Advice for Aging Parents of Adult Children with Mental Disorders

It’s a good thing that therapeutic support groups are available for parents managing all kinds of issues with their children. The Child and Family Institute specializes in this, in fact. What’s harder to find is help for older parents of adult children whose paths diverged from the expected. That is, something derailed the life course of our children and, at the age of independence, they are neither independent nor under our control. They can accept our love and compassion (and our money)—while rejecting our advice and efforts to help them change unhealthy behaviors or find work.

A little more about me. After a 45-year career, I retired in fall 2019. Until then, I fully supported my now 32-year-old son, who has a debilitating mood disorder. As long as I worked, I could afford to support him, but that didn’t make our relationship easy. Once, he was hospitalized, I went with his wife to visit, but he wouldn’t see me. Later, stabilized with medication, he called to apologize. These cycles repeat. Rejection, blame, anger—contrition, love, gratitude. His dependence on me inevitably fosters resentment.

I turn now to psychotherapist Dr. Laura Grashow, not to discuss my son or others like him—nor to rail at the meager support from government and insurance entities—but to get some advice for parents like me. We are soon to retire or have retired, yet carry the financial, emotional and psychic burdens of care and support for adult children unable to make it on their own. Compassion and love may be infinite, but money is not. Nor is lifespan.

Dr. Grashow, have you had a client like me, someone anxious over how to manage a situation like this?

Definitely, a number of them. One of the most difficult cases is a client I’ve worked with for about seven years, who has an adult daughter with juvenile onset diabetes. This client has had ongoing struggles with anxiety and depression about her daughter’s future and health, especially given her daughter has had immense difficulty acquiring important developmental skills for her age. This family has resources, and this client’s daughter has been enabled on many levels. She has resources, but doesn’t make good choices when it comes to her health.

I’ve also worked with parents of adult children with developmental disabilities, such as autism spectrum disorder, in which they historically have difficulty setting limits. This pattern continues for their children into adulthood. Life becomes both easier and more difficult for them on some level.

I assume in another era, families could take in troubled adults. For a lot of reasons, that’s mostly not feasible in today’s world. How do you see these changes?

If you’re referring to the value of extended families living under one roof and sharing burdens together, I agree with you. There is tremendous possible benefit to living together as extended family, especially in a case like this. People can potentially not only share the responsibilities of limit setting, but create an overall ethos and culture under one roof that can be a powerful behavior-shaping mechanism. With the nuclearization and fragmentation of the American family, there can be more isolation and more burden on one or two parents. In addition, response patterns between two people living together without the input of others can become ingrained and unhealthy.

Over the years, with my clients and my own neurotypical daughter, I have found a missing or broken part of the American path to adulthood. What seems to be missing are intermediate steps between high school and college, or college and adult independence. Small organizations pop up offering communal living for college students or recent college graduates on the autistic spectrum. This created a community and taught real-world practical and social skills.

A lot of my stress would be lifted if my son could manage a part-time job from home. But the trick is finding and keeping such a job, where he could take a mental health day, if needed. And getting him to try, without him thinking I’m trying to control his life. Your thoughts?

My thoughts are consistent with the kind of limit setting we talk about in therapy with younger kids. A parent has to both find motivation for the child (e.g., without a part-time job, you won’t have money for X) and be prepared to set the highest-level limits. This might include refusing to give in and give complete monetary support or calling the police if there is the threat of violence. Of course, it’s also necessary to attempt collaborative problem solving (a technique I like is explained in The Explosive Child by Ross Greene, PhD). Ultimately, we’re talking about an adult child recognizing and accepting their parent as an emotional, feeling human being, growing out of an earlier stage of development in which a parent is seen largely as a source of resources, or denial thereof. Even when the adult child hasn’t internalized this knowledge in an emotional place, it can be used to their benefit as practical, intellectual information.

Finally, what about finding support for people like me? Do I live out my years, terrified of what will become of him? What advice would you give here?

I often talk about this with the client I referenced above, in a spiritual and philosophical sense. We discuss the difference between “giving up” and “surrender.” Firstly though, in a more worldly, practical sense, it’s fascinating to see these adult children “rise to the occasion” after the death of the primary supporting parent—though that admittedly doesn’t always happen. Taking care of practical matters, such as estate planning, can unburden a parent’s mind. There is surely a loss of control upon death in every arena, and this is a most sensitive arena.

Back to giving up versus surrender, parents need to allow themselves to accept what they can and cannot control. Instead, they can lean on techniques, such as mindfulness-based stress reduction, to calm and quiet their minds and bodies. Cognitive behavioral therapy can also help challenge and balance automatic negative thoughts that fuel intense worry and sadness.

Finally, while there are a multitude of other effective techniques, I’ll mention somatic psychotherapy. This helps clients become more aware of the bodily sensations that accompany sets of thoughts and emotions—how to calm and soothe themselves with breathing exercises, physical exercises and stretching, for example.

Thank you, Dr. Grashow, on behalf of all parents who find themselves in my boat.