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I’m having a hard time since the death of my father. I was expecting the grief to be rough, but I thought I’d reached the acceptance stage and was starting to feel better. Then I noticed that my two sisters were able to talk and share memories much more easily with one another than they could with me, and suddenly I felt more alone than ever before. My wife is supportive, but I don’t want her to feel I don’t love her by telling her I feel alone. My goal is to get over this grief.

You probably were starting to recover from losing your father, but that’s when you experienced another loss—a broken connection with the people who should be the most understanding.

When you grieve the loss of parents with your siblings, a major source of comfort is knowing that, whatever your differences, you’re the only ones who remember the world of your family home and share the experience of growing up there. With that missing, you’ve got a double source of grief.

Pain always causes vicious circles, so the biggest danger here is that your feeling of isolation will cause you to withdraw, which will confirm your isolation. Your job with grief then is to fight to keep your perspective, rather than letting pain shape it for you.

Currently, your perspective is that there were good, meaningful times growing up with your father and sisters, and there were memories worth sharing and preserving. Instead of letting hurt stop you, figure out what you want to say, interrupt your sisters, and see if they can respond. After all, you’re the only guy who remembers that time and they need you as much as you need them.

If they can’t listen, talk to your wife, and if your wife’s not available, a pet’s always a good captive audience. You have eulogies to compose for yourself about your father’s contributions and values and what you wish to carry on, and delivering them to anyone or thing willing to listen will do you a lot of good. Of course, you’re the most important listener but there are others who would benefit from hearing your words.

You can’t shorten the grief or change your sibling relationships. What you can do, however, is respect the strength it takes to live with pain and not let it push you to the sidelines or shade your memories of your dad. With all the loss in your life, you should never lose your right to grieve.

STATEMENT:
“I wish I could share memories with my sisters, but that’s not the measure of how well I’m dealing with grief or of how much I took away from my relationship with my father. I’ll continue to treasure my memories and look for ways to share them, and not expect the grief to go away until it does.”

After my mother died, there were an amazing number of people who came to her funeral and told wonderful stories about their friendships and how much they loved her. It made me feel bad, however, because she and I never really got along. We loved one another, but we really didn’t understand one another, and now we never will. The more I saw the closeness other people had with her, the more I wondered what was wrong with me. I miss her, but what I feel most sad about is never being able to have a good relationship and not being able to mourn her as well or as much as her friends do.

Don’t assume that you could have or should have improved your relationship with your mother without first looking at the evidence. After all, you know that many close relationships can’t be improved because whatever is bad about them comes from character rather than things you can change. They are what they are, or they were what they were.

If your relationship with your mother was sub-par because you didn’t try hard enough, then yes, you’ve learned a sad lesson about not waiting until it’s too late. For most people, however, the problem isn’t a lack of trying or an overdose of waiting; it’s blaming themselves for a lack of good results after lots of trying and still assuming they could have done better if they’d tried harder.

Don’t assume that, because other people didn’t have your problem with your mother, you shouldn’t have had it either. You’ll probably find evidence that you tried hard and that many, if not all, of the reasons for your distance were not under her control or yours.

Like the person above, you have a double grief. You miss the mother you had and you also grieve the mother you could never have. It’s a grief you can’t share, because others, especially those who really connected with your mother, don’t understand.

Don’t feel bad then about not feeling bad the way they do. Your grief for her, like your relationship, is what it is. Instead of examining what was wrong, try to remember what worked. Hopefully, in spite of her disappointment with you, she did you some good and tried to be a good mother, and, hopefully, in spite of your frustration with her, you kept your life on track and spared her your anger. These are major accomplishments that need to be celebrated, particularly since they lead more often to tooth-grinding than to pleasure.

Celebrate the strength it takes to make the best of a bad relationship. Hopefully, some of that strength was hers, as well as yours.

STATEMENT:
“I often felt like a failure because I didn’t feel as positively about my mother as other people did, but I’ve come to accept that those feelings are not under my control and to respect what I’ve done with them. My job, now that she’s dead, is to do more of the same.”

I have been wrestling with depression for years now and my maternal side of the family has a history of depression and suicide. I don’t feel that I can do this on my own anymore and need help. I don’t want to just take a medical cocktail of antidepressants. My question to you is how do I go about finding a therapist and/or doctor that will be most helpful to me.

The first step for getting treatment for your depression seems simple– don’t get depressed about treatment for depression. After all, depression’s just another form of pain unless it twists your thoughts into thinking that not getting rid of it is a kind of failure that marks a meaningless life.

As long as you realize depression is a persistent ailment, just like persistent back pain or diabetes, you’ll have an easy time making treatment decisions because you won’t regard using treatment as evidence of weakness.

The fact that your family has had depression and suicides doesn’t indicate weakness or failure on the part of anything but your genes. Suicide is terrible, but it often happens to good people who’ve lived meaningful lives and been good friends in spite of lots of depression, which doesn’t make them failures—it makes them heroes.

If depression causes you a lot of pain or makes a noticeable difference at home or work, the very least you should do is get help in fighting the negative thinking. While using therapy to find the cause of your depression and get rid of it is usually useless when the depression is long-lasting and familial, using many therapies to protect yourself from feelings of weakness and failure is often a necessity.

A therapist is like a thesis adviser for an academic; you have a topic you want to explore, and you’re looking for someone who both understands that topic and supports your approach. If you start treatment with someone and it doesn’t gel, chalk it up to bad chemistry, not your own failures, and continue your search.

Whether a therapy helps you to keep a positive perspective is easy for you to evaluate; you can tell whether a particular therapist is a good coach or has good ideas, or when you’ve got little more to learn from someone and need a fresh point of view.

Yes, a sustaining therapeutic relationship helps, but not if you come to feel it’s necessary for fighting negative beliefs. Sometime that special therapist won’t be there, or your insurance will change and you won’t be able to afford to see him/her, and then you won’t have the tools to manage your depression on your own. Your goal in talking to a nice, warm therapist is to pick up positive ideas, practice using them, and report back on how you’ve done. Don’t cling to the warmth or the need for their approval.

Make sure you try behavioral treatments, including exercise, which at the very least can distract you from depressed thinking (but don’t punish yourself if your depression makes you too tired or listless to exercise regularly). If, as often happens, the non-medical treatments can only help so much, it’s time to consider medical options. Usually, medical options have a higher risk, but they should be considered if and only if you think the alternative is worse.

If you use a sound risk management methodology to make your decision, respect yourself. Never call antidepressant treatment a “medical cocktail” unless you would say the same about chemotherapy for cancer or pills for high blood pressure.

In addition to having a greater (although not terribly high) risk, antidepressants are a pain because they take weeks to work and often (30% of the time) don’t. So after becoming a risk-manager in order to make the decision to use or not use them, embrace your inner scientist and prepare to conduct an experiment—on yourself. It’s hard, risky work, but if you feel it’s necessary, it’s worth taking on.

In the end, do everything you think is reasonable and required. Use the low risk treatments first, the higher risk treatments when needed, and be prepared for mixed results at a slow pace (that in no way reflect on you or your effort). Needing help or medication doesn’t make you weak; it makes you sick, but strong enough to do something about it.

STATEMENT:
“If I found a medication that relieved my depressive pain, it would be hard not to feel that I’ve taken an illegitimate shortcut. I know from experience, however, that there’s nothing illegitimate about treatment that reduces depressive pain as long as it doesn’t create risks that are worse than the pain itself and that the only illegitimate way to treat depression is to regard it as a weakness.”

I’d like your advice in helping my sister, who is starting to act crazy again, but she won’t accept anyone’s help. She was in the hospital several years ago for hearing voices telling her she was a friend of the Virgin Mary. Now she’s starting to talk fast again and calling the company that I think she was fired from, saying she believes they’ve sent her on a special project and she needs to report back. She sometimes sounds ludicrous, and I can’t help laughing, but I’m afraid where this will end. How can I get her help?

It’s tough to respect an illness that makes people act silly and ridiculous, and tougher still to believe you can’t get through to someone who seems, in many ways, to be in control of herself and able to care about you in the way she usually does. If only mental illness came with a rash or flu that made it easier to recognize and accept.

You’re right, however. Your sister’s illness is serious, it could get her into big trouble, and, in spite of her apparent lucidity, it can be very, very hard to help her. Especially if she’s too sick to know she needs help in the first place.

As hard as it is to be depressed (see above) and to respect yourself when you have depressive symptoms, depressed people usually know they’re sick and are ready to accept help, even if it feels humiliating. With mania, however, people often can’t see themselves as being ill. If respect were measured in nothing but feelings, you could say they respect themselves too much.

If you push your sister too hard, you may provoke a fight, which does no one any good. Manic people are often irritable and ready to fight or flee (often on motorcycles, cars and airplanes, and in the middle of night, and often while underdressed). Don’t let your concern for her become an impassioned plea that triggers her great (naked) escape.

Persuade her, if you can, with calm reason, emphasizing the positive. You think she’ll feel better and calmer if she sees a doctor, and you’ll be happy to drive her to an emergency room and wait with her while she gets an evaluation. Don’t argue about what’s wrong with her, just express confidence in your belief that there’s good help available and that you can lead her there, if she’ll let you.

If persuasion fails, be aware that your ability to intervene depends entirely on her demonstrating dangerous behavior. The moment she says or does something that shows, in an obvious way, that she could hurt herself, put herself into danger, or hurt someone else, you have acquired the critical information that allows police to take her to an emergency room and emergency room clinicians to commit her. At that point, the hope is she becomes lucid enough to want treatment herself.

Until that day comes, it takes great patience and restraint to live with a manic person. Respect yourself for your kindness and tolerance, be patient, and remember, no matter how unreasonable or naked she becomes, you’re doing the right thing.

STATEMENT:
“It’s agonizing to watch my sister act crazy and feel like I’m doing nothing, but I’m really doing a great deal by waiting, caring for her, trying to steer her towards help, preparing to intervene if she gets worse, and tolerating the helplessness.”

I’m wondering whether I should try to do something to help my ex who I feel is spiraling into unhealthy (mentally and physically) old age (i.e., be my brother’s keeper rather than “let live”). He’s been acting weird, keeping strange pets and stranger company, and he moved to a rough part of town though he has the money to live wherever he wants. It’s like he’s having a late-life crisis. I know he’s got a bunch of medical problems and I wonder whether he’s taking care of himself. My goal is to figure out how far I should push him to get help.

Whether or not you should be your brother’s, or your ex’s, keeper is a meaningless question if you expect the answer to be yes or no. Nothing involving exes is simple (even their pets).

If you’re actually wondering how far you should go, that’s a terrific question for which there’s a good way to develop an answer of your own.

The trouble is, people usually approach this question in terms of weighing the pros and cons of the feelings involved: the bad feeling of anger, disappointment, resentment, vs. the good feeling of helpfulness, loyalty, and caring for your fellow man.

In real life, it’s a lose/lose, and you wind up reacting too much to your mood, the other’s guy’s attitude, your anger at his attitude, your guilt about your anger, and your determination to help someone across the street whether or not he wants to go.

After all, some people are naturally angry while others can’t stop giving and never get angry. So, as I always tell you, don’t let your feelings be your guide, or you’ll probably end up going off the cliff.

Ignore your anger (although that’s not your problem) and your desire to help (which sounds much closer to your natural style). Instead of being driven by your feelings, consult your values and draw up guidelines for balancing your wish to help an old flame vs. your right to live your own life and not waste time on old, unwinnable struggles.

In other words, if you know he won’t listen (because you or someone more persuasive has tried), save your breath. Be sure, however, that you’ve considered every reasonable possibility.

If you think there’s something helpful worth trying, do it, unless it’s someone else’s job; you’re the ex-wife, but there may be others who should step to the plate first, or he himself may be the only person who can do what needs to be done. Figure out where your boundaries are, and don’t overstep them or you’ll make things worse.

Finally, before trying to help him, figure out whether you can afford the cost. After all, you have other obligations, including taking care of yourself and managing your own possible rainy days, so remember, you’ve got a budget, and helping can become an obsession.

If you can think of any complications that these rules don’t cover, let me know. That you want to help is wonderful, but be careful to follow your guidelines and not push yourself to the point of danger, exhaustion, or conflict. Evaluate the situation on your terms, act accordingly, and you won’t end up getting hurt (by him or his menagerie).

STATEMENT:
“I wish my ex-husband well and want to honor the life and love we once shared. As always, however, I must keep in mind the limits of what I can do, accept possible helplessness, and remember my other obligations.”

I can’t count on my family for anything, and it’s gotten to the point where I think it would be best to cut ties altogether. Recently, when my father died, my brother, who was my dad’s favorite and the executor, managed to give himself most of the money, buy off my sister with a big gift, and give me nothing (he said he needed it more and my sister went along with it). I know I’ve always been the responsible older brother who worries and nags and takes responsibility for everyone, but I’ve finally woken up to the fact that no one worries about me. My goal is to stop feeling responsible and never see the jerks again.

The main reason to be your brother’s keeper is not to get gratitude or recognition, but to know that you’re being a good person. That’s why it’s important to do it and not overdo it and maybe become your brother’s occasional-watcher instead.

It’s likely you started taking care of them when you were younger, because people praised you for it, or it helped your family survive as a family. There’s always a good reason, but knowing why you did it usually doesn’t make a difference.

Now the question is, how good should you be to a brother and sister who have turned out to be jerks. It’s too bad they’re jerks, but you came out of your early family time knowing you did good and they didn’t come out as well. So, whether they’re ungrateful or avaricious, you still come out the winner.

The sad thing is that they didn’t turn out to be good people you could be friends with, which is what happens to many people with their siblings. If you don’t accept this fact, you’ll spend your time trying to get them to see their mistakes and improve. So accept it, mourn your loss, and prepare your own guidelines for being decent to sucky sibs.

As in the case above, don’t be guided by your feelings. Your values tell you that you will always have a connection and should always see to their basic safety. At the same time, their bad behavior will probably cause problems that you can’t fix, so don’t hold yourself responsible for fixing them. Their personalities are their problem, not yours.

Letting them know that you’re angry or critical usually does more harm than good, so don’t bother; instead of feeling guilty, they’ll just blame you and get nasty. This is a classic example of a Feelings Fart”™, when an explosive, emotional emission gives you temporary relief that actually poisons the air, and your relationship, for much longer.

That’s why it’s smarter to act nice, stay superficial, and keep it short from now on. You were a good brother growing up and you’re a good brother now, but you weren’t lucky, so you won’t get much satisfaction or reward from the sibs you helped raise.

Still, they are your family, so it’s better to keep them at arm’s length than cut them off entirely. You were your brother’s keeper, but you’d be better off just being a brother instead.

STATEMENT:
“I’m proud of being a responsible brother and I wish my sibs and I could be close, but they didn’t turn out to be people I could be friends with. Fortunately, I now have less to be responsible for, other than accepting them, keeping it pleasant, and looking elsewhere for trust and friendship.”

My boyfriend went through hell from chemotherapy, but I don’t know what to do with his depression and irritability. We’d been dating about a year and planning to get married when he found out he had a nasty kind of cancer and, since then, he’s been brave about chemo and going on with his life, which has meant working when he’s feeling OK, and our moving in together and being partners. Usually, we get along well, but lately he’s been depressed and telling me he knows he’s a burden, he can’t get much done, and he just wants to be alone. I want him to get help for his depression and stop the negative thinking but I don’t want to attack him or make him feel I don’t respect the fact that he has cancer.

One of the things you always hear from people in pain is that you, the lucky one, “just don’t understand.” It’s the rallying cry of the suffering, whether they’re coping with cancer, or just being between the ages of 10 and 18.

What sick people often fail to realize, at least at first, is that people who aren’t in their position understand things that they can’t; after all, you might have the good luck not know what it’s like to have cancer, but you know what your boyfriend’s like when he’s not depressed, and you know this isn’t it.

If you want to get through to him, put aside your guilt about his bad luck and your fear about hurting him when he’s down. You believe his negative thinking is doing more damage right now than his cancer, and that he needs a better perspective. You’re right, so guilt-be-gone.

Then, remind him about the way he and you usually think of your life together. He’s had the worst kind of bad luck, but you admire the way he’s managed it and continued with his life and you’re happy to share his fight.

After all, you’re not with him because you pity him for having cancer, but because you love his courage and find it gives you strength, and because you hope for the best and are happy to share as much time as possible.

Maybe his cancer, chemo or pain tells him he’s a useless burden, but you don’t accept that and you know he wouldn’t if he were in his right mind, because those things are mean and disrespectful. What he should be saying is that he’s fighting a good fight, respects what he’s doing, and is proud of the way the two of you have created love and closeness in the midst of chaos.

Maybe he needs therapy or medication to put a lid on the negative thinking, but in any case, reminding him about what he values and challenging him to protect his self-respect is good therapy in itself, and you can do it. You don’t need to fully understand his experience with illness in order to help him through.

STATEMENT:
“I can’t rescue my boyfriend from attacks of hopelessness about his cancer, but we’re together because we share the belief that life is worth the pain he’s gone through and, so far, nothing has changed my mind. Sickness has made him forget his beliefs and accomplishments, so it’s my job to stand up for them until he’s ready to reclaim them.”

I don’t know how to tell my wife that we can’t afford for her to continue her present business because she’s losing too much money. She used to be good at it, but cancer and chemo had a bad effect on her brain 2 years ago, and now she gets too distracted and drops the ball. I admire her courage, and I owe her for supporting the family all these years while I raised the kids and taught painting. Now I’m making more money and have taken over the finances, but it’s not enough. I’ve tried to help her keep her business organized, but it just doesn’t work. I feel angry and guilty. I can’t get her to see that she needs to find a new job that doesn’t require her old attention span and can make us some money.

It’s hard to confront your wife about about a new, cancer-related, permanent disability without feeling you’re destroying her hope and confidence and adding to her pain. On the other hand, if she doesn’t accept her disability, you’re all sunk and she’ll never have a chance to make the best of what she has.

Remember, you’re not inflicting her pain—the real cause is life and cancer—and the only reason you think she needs to face her disability is that the alternative is worse. That’s your decision as her partner and someone who’s stepped up to assume a greater share of responsibility for the family’s welfare and survival.

After all, you’ve risen to the occasion. You’re not preparing to confront her because you’re angry about the way cancer has robbed you of her strength and old personality (although you may certainly have such a feeling). If you confront her, it’s because you’ve done your homework, weighed the alternatives, and decided it’s necessary.

Begin by accepting her disability yourself; don’t see it as a treatment failure, or as a problem the two of you have failed to solve, just as a wound imposed by the sucky side of life. Respect the way she’s tried hard to return to a normal life, and respect the way you’ve picked up the load, because you both did the right thing. You needed to know the limits of her abilities, and now you do, but you just got a bad result.

Once you accept her disability without shame, you’re prepared to put it in a positive context. Tell her, without guilt, how much you respect her efforts, and that, though most of her mental equipment is functioning beautifully, there’s something wrong with her attention span that won’t let her make money at her old job.

Don’t sound as if your mind isn’t made up or as if you’re waiting for her to agree; her ability to perceive a business plan realistically may be included in the brain damage, or she may not be emotionally ready to accept it. In either case, sound like someone who has made up his mind.

In your opinion, she shouldn’t continue her old job and, if it’s up to you, you won’t support her doing it. You will, on the other hand, support her in finding something new to fit her current limitations.

STATEMENT:
“I miss my wife’s old strengths, and so does she, (or she would if she was in her right mind), but our idea of partnership was that one of us would take over if the other was injured, and that’s what I’m doing. I will raise painful topics if I think it’s necessary and respect myself for doing so.”

I need to find a doctor who will tell my daughter she needs to take her medication. She’s always had a problem with depression, and she did well in high school when she took antidepressants. Now, however, she’s 24 and very reactive to however she’s feeling, whether it’s not getting out of bed, or not working, or feeling dizzy and deciding it’s the medication and stopping it. My husband and I can’t get her to stick with anything, and she won’t listen to us in any case, so our goal is to get you, or some professional, to tell her what she needs to do.

Whenever parents want a doctor to tell their kid what to do, you can be pretty sure they’ve lost faith in themselves and overestimated the power of communication/a medical degree.

And no, it doesn’t matter how old the kid is or how many Harvard degrees the doctor has; the doctor doesn’t have more power than the parents, no matter how powerless the parents feel.

In your case, I don’t know whether your daughter can be induced to take her medication, but I do know that she’s not going to be persuaded by the authority of a doctor at the age of 24 if her own experience and your words haven’t done it by now.

The probable reason for her unresponsiveness, by the way, isn’t stubbornness or a lack of respect, but a lack of control over her own impulsivity (probably enhanced by depression). In other words, it’s not clear she can make herself take medication regularly, even if she sincerely believes she needs it. At some point, other impulses take over, like the impulse to stay in bed indefinitely.

Fortunately, even though persuasion is probably useless, you have other tools that a mere doctor can’t touch. You can access them if you believe you know what your daughter needs, regardless of what she has to say about it.

For instance, if you believe that she needs to get up early and follow a daily activity regimen, then let her know that’s what you’ll pay for. If she says she’s too blah, tell her you know it’s hard, but she needs to try, and that she might be able to do it if she puts together a schedule and asks friends to help her keep it.

If she argues that she can’t do it until she feels better, tell her that you don’t know when she’ll feel better, so she’d better start trying to keep busy now, and maybe that will help her feel better later. Your tone should say that you believe what you believe, and there’s no point in arguing.

If she tells you that you don’t know what she needs, tell her that you’re the mother and you have a good idea what she needs. Don’t ask a doctor to be the authority– get whatever information you need from the doctor, and then assume you’re the authority. At 4 or 24, your kid needs to hear the same thing; you’re the mommy, that’s why. End of discussion.

If your incentives don’t work, don’t blame her or yourself, because, again, you don’t know whether she’s too sick to have the control she needs. By putting a priority on self-control, however, you provide her with a blueprint for moving forward that is not reactive to negative feelings or thoughts or painful side-effects.

You’re urging her to embrace goals that arise from her values and that she can stick with, regardless of how she feels or how much she accomplishes. Knowing medicine isn’t as important as knowing your daughter and what’s best for her. If she won’t listen to me, you can, and I’m telling you you’re the most qualified professional for the task.

STATEMENT:
“I’d like to think my daughter could respond to persuasion from someone she respects, but I suspect it’s not true. I’ll push her towards doing as much as she can, regardless of how she feels, and hope that incentives for good habits will take over where persuasion has failed.”

I need an answer about what’s wrong with me, medically. I’ve always been healthy and athletic, right into my early 70s, and if there’s something I can do to improve my health, I’ll do it. Along with my husband, I ran a small company before I retired, and I’m good at getting things done. Lately, however, I’ve been having bowel problems and dizzy spells and fatigue that no one can explain, and I’ve gone to some terrific doctors. It’s gotten me down, and I haven’t been exercising or getting out as much as before. I need some answers about my medical problems so I can get going and get my old life back.

The weak side of being a great problem-solver is that it’s hard to change your expectations when you hit a wall, and old age is a wall. You’re accustomed to believing in the value of hard work, perseverance, intelligence and ingenuity. That’s a dangerous belief when their value happens to be zero.

What happens when hard work, and your belief in hard work, don’t work, is that you feel like a failure, try harder, and feel worse. You can’t undo the effects of aging, but you can always make them worse. I’m sure that isn’t a comfort, but it’s the truth.

Give yourself credit for getting yourself the best medical care, and then suck it up and admit that there’s nothing more you can do to get a diagnosis or find a cure. Cry if you must, but then figure out what comes next (besides death, which is everyone’s sad conclusion).

What comes next, once you give up on getting to the bottom of your medical problems, is using your good, well-developed discipline to get yourself going and re-claim as many of your old activities as possible. If being strong means achieving great results every day, then you may never be strong again. If you decide, however, that being strong means achieving all you can with limited equipment, then you’re about to become stronger than you’ve ever been.

Once you accept that there’s no curative treatment for aging or mortality, you can explore a wide range of treatments, including medication, that may improve your symptoms. Nobody lives forever, but there are plenty of ways to live a little better, and do what’s meaningful despite diminished capacity, at any age.

STATEMENT:
“It feels like a defeat to accept the limitations of age, but it’s actually a bigger defeat not to. Once I’ve completed a reasonable search for a definitive answer, I need to stop myself from searching further and re-order my priorities. I’ve got defective equipment and correcting the defect isn’t my department. I will do my best with the equipment I’ve got.”

I was a wild girl as a teenager and took drugs and cheated on my boyfriends, but one of them stuck by me and now I’ve got a good marriage and 2 nice kids. Life has been pretty good to me, but lately, I don’t know whether it’s getting older or having some acquaintances die, but I feel preoccupied with death and a feeling of not being a very good person. I mean, focusing on those things makes me feel ungrateful, because I’ve been so lucky, but then I feel guilty that I’ve had so much while people I came up with didn’t get the same things I did. I wish I wasn’t so worried about death and thinking about what a jerk I was and how I didn’t get what I deserved.

What we all deserve is a good childhood and a decent set of genes. What most of us actually get doesn’t come close.

Instead, most people end up with a random mishmash that easily includes an extra dose of wildness and parents who are too wild themselves to help us manage our own impulses (the apple, and the genes, don’t fall far from the tree). In a world that’s this unfair, nobody can claim to deserve anything.

If you’re disturbed by the unfairness of life, especially the way it doesn’t punish you the way you deserve, you’re not alone (although it might not comfort you to know you’re in the same company as Woody Allen). Think of it as an instinct, a need for justice, that’s both good and bad.

The good side is that a passion for justice helps you be fair with your kids, and keep your mean side under control. The bad side is that it gets you mad and upset when things aren’t fair, which causes you to try to straighten things out, which, in this messy world, usually winds up with causing more unfairness (see: Vietnam). Instead, you need to get used to living with the feeling and keeping your hands folded in front of you.

The awareness of death is another one of those painful feelings that can be good or bad. The bad part is that it’s painful to lose people or die before your time or die almost any time (unless you’ve been previously softened up by a long, punishing course of illness, suffering and disability, and that’s another story).

The good part is that death-awareness helps you get your priorities straight. Yes, you’re gonna die, but that should make you think hard about what matters today. Hint: it’s not about feeling better, being happy, or owning more. It’s about doing whatever you think is important.

So what counts is what you do with this mess. If your boyfriend loved you enough to stick by you, you were smart enough to appreciate and take advantage of what he was doing, which means you both deserve credit. You’re not into drugging and excitement, but building a family together.

You’ve done the right thing, but don’t expect it to make your pain go away. Life isn’t just unfair, but painful and difficult. Don’t feel guilty that you’ve avoided so much of that pain, but proud that you’ve achieved so much in spite of your flaws. Doing good things, in spite of losing friends and facing death, is what makes us great.

STATEMENT:
“Life has been better to me than it was when I started out, and that’s partly because I’ve done the right thing and I’m on a good course. Sometimes I feel like I don’t deserve it or that I should be more happy than I am. Wrong. Unhappy feelings are part of the territory, part of what I work with. Fuck’em. I’m proud of my ability to ignore them.”

I don’t know why, but my grandmother always relies on me whenever she has a problem with her health, her roof, her taxes, whatever. She doesn’t rely on my mother, because she’s a flake, and she doesn’t rely on my brother, because she sees him as an important lawyer who doesn’t have the time to spare on her little problems. I’ve always pitched in because I’m a good guy who likes to care for people, (I’m a social worker), but I realized, recently, that my grandmother has willed the largest part of her estate to my brother because she assumes I can take care of myself and besides, I’m gay and don’t have any children. My goal is to deal with how angry I am and get my grandmother to see that she’s being unfair.

There’s no way you’re going to make things fair in your family (see above) or change your grandmother, so ask yourself instead what you can do with the situation as it is. I know that doesn’t take care of your anger, but that’s the idea, because almost anything that makes your anger better makes things worse. Anger is only useful to actors, professional fighters, and hack comedians. For everyone else, it’s a detrimental, dangerous pain in the ass.

It’s nice that your grandmother has money; that means she can pay for services without your having to worry about what will happen to her if you don’t help. Which allows to me to review the Three Laws of Giving.

1) Don’t give unless it will actually do some good (not a problem here, because your grandmother doesn’t misuse help). 2) Don’t give beyond what you can afford (meaning you’ve got other responsibilities). 3) Don’t give when it would be better for someone else to do it, and that’s the one that applies here.

If you charge market rate for your services, then your grandmother gets what she needs from someone she loves, and you get paid for your time and a little bit of the lost inheritance. Everyone wins, no one blows a gasket.

You can always try to overcome your grandmother’s prejudice by noting how much you enjoy helping people and how much more you could do if you weren’t as tight for cash. That’s the same pitch you would make with any potential funding donor. Beyond appealing to her rationality and generosity, however, you don’t want to go.

Most prejudiced people tend to feel it’s the other guy’s fault, so confronting them usually causes nothing but conflict. You might feel proud of yourself if you stand up to her, but when you add in the pain it causes her and everyone else involved, and her inability to understand where you’re coming from, it’s probably not worth it. You’re not an ultimate fighter, you’re a put-upon grandchild; don’t get angry, get paid, and then, get over it.

STATEMENT:
“I’m proud that I like to help people and I’m getting smarter about doing it while keeping other things in mind, like my obligation to take care of myself and consider other values and priorities. I can’t help but feel angry at my grandmother; but I will keep that feeling under wraps, if necessary, while I stick with my original goals.”

My partner cheated on me while I was pregnant with our baby, and kept ME the secret. He told lies about me and told people that we were no longer together so that he could openly date the other woman. I’m struggling to stop thinking about it all, and the whole ordeal has triggered a particularly intense bout of depression and self-harm. I have hundreds of questions I feel I need answers to, but my partner is 100% unwilling to discuss the matter, seeing it as “dragging up the past”. My goal is to be able to get through the day without memories of the betrayal and the gossip that surrounded it intruding on my life.

When a guy hides his relationship with you when you’re pregnant, you don’t have hundreds of questions that need answers; you’ve got a few simple, sad, unpleasant answers that need to be accepted.

After all, you’re not doing a PhD in trying to understand him. That’s a waste of time and, like most inquiries into the sad “whys” of this universe, a sneaky way of avoiding acceptance.

You could see it as him not being that into you, but the reality is that he’s not into anyone, at all, except for himself. At this point, the only important question is one you have to ask yourself, and it’s figuring out what’s the right thing for you to do, regardless of what your should-be-ex might think.

First, stop calling him your partner, because, as he made perfectly clear by his actions, he was a partner in sex, not life. Partnership means you work together and have each other’s backs. If you turn your back on this guy, he’ll move on to some other woman’s front before your shadow hits the ground.

There’s probably no way you can avoid some intense depression if you care about him a lot and expected more of him, but don’t make it worse by trying to figure out what went wrong, or where you failed, or why he doesn’t care any more. The only thing you did wrong was fool yourself about your relationship and his character and let yourself care too much. No big crime, but unfortunately, you can suffer horribly from such mistakes without ever really having done anything wrong.

So don’t make things worse than they have to be. It’s too bad you’re feeling depressed and suicidal, but the pain will pass. Nothing has happened that should lower your respect for yourself or change your priorities, and now that you know he’s not good for much more, you’re free to stop worrying about his ability to remain faithful and look elsewhere for someone who has that ability, period.

You’re now free to plan a better future; a lawyer can tell you how to secure financial support, friends and family can provide emotional support, as could a therapist or therapy group to address the issue of self-harm.

When a guy rejects you and acts like a total jerk, it may hurt more in the short run because you feel humiliated; the fact, again, is that you’ve done nothing wrong and he has. You’ve done nothing to be ashamed of, other than to trust someone who doesn’t know enough to know when he should be ashamed. The answer might hurt, but the truth will set you free.

STATEMENT:
“It’s scary to find out that you’ve let yourself trust someone who’s basically untrustworthy, but love is blind. Recovery is going to hurt like hell, but better now than later. I’d much rather be gullible and hurt than nasty and cold, so my goal now is to be a good mother and take care of me and my baby in a way that he can’t and never will.”

If you were to have a casual chat with her, my wife would seem sane and reasonable; she’s a fine accountant and mother, but ever since she flipped out 7 years ago and spent 2 weeks in the hospital hearing voices tell her the FBI was after her, she’s had paranoid ideas about my having affairs behind her back. Sometimes, she knows it isn’t true, or I can joke her out of it, or she’ll talk about it as a symptom of illness. Other times, I see her giving me an uneasy look and pulling away, and I wonder whether I’ll ever have her trust. I wish I could persuade her to try new medications and get her paranoia under control, but she resents taking or being told to take medication, so I don’t try. My goal is to get her paranoia under control and save our marriage.

It’s sad to see weird, intrusive thoughts that come from nothing but mental illness tear a love apart, but it happens. Love can’t conquer all, and one of the worst things it can’t conquer is a paranoid delusion.

Your partner looks and sounds like the person you always knew, loved, and counted on, but a sudden flare-up of suspicion where there used to be comfort and love means you may not really have a partner any more. It’s hard to imagine anything other than a fairy tale curse that could drive someone away from the one they love, but the weird neurologic disturbances of mental illness can do it; it’s a real life evil spell.

Unfortunately, you can make it worse by trying to make it better. If you express your love, sadness, fears, concerns, sincerity, anger, you name it—you can’t change how she feels, except to make her feel discredited and blocked, which leads to more paranoia.

If medication hasn’t stopped it by now, it probably won’t. Theoretically, it’s possible she might be helped by some medication not yet tried, but not likely. For one thing, medications don’t always stop paranoid thinking, and, for another, paranoid thinkers don’t always take their medication (because, surprise, they’re paranoid about what it may actually do). So pushing her to take it may do nothing other than to make her feel annoyed, controlled—and paranoid. You see the pattern.

Your best bet is to accept her paranoia, and your loss. Don’t push her to be different, just see instead whether life together can be bearable for her, or not.

Don’t let sadness make you, or the kids, feel like failures. Success isn’t staying together; it’s finding the best compromise that eases her symptoms while allowing you to work together, if possible. What makes this task heroically difficult is that it leaves little room for your own needs, but you have no choice.

In the end, you need independence and other sources of support. You welcome what she can give you, but you dare not ask. Learn to roll with the punches of her paranoia, and if you can’t and they knock you out, defeat is never disgrace.

STATEMENT:
“My marriage is dead and what I have is weirdly similar, but basically different and subject to change without notice. For any number of reasons, particularly the kids, I’ll accept what I must and take pride in doing so, but I do so knowing these circumstances are hard, possibly impossible, and nobody’s fault.”

I have arrived at a destination in my life after a long period of study, with a two year gap to overcome the burn out, and a return to the mammoth uphill battle to complete the certification requirements, where I thought, never again will I feel apathy, scared, bored, hatred of employment. I was a passionate dedicated student and I loved being a student up until the last couple of years, which were made worse by a university in turmoil and academics who lost interest in my specialist field when it was cut from the university. I was dedicated and driven to succeed, but after a immense effort to find any work in my new chosen field or related field with not much luck, it then struck me, that at the ripe old age of fifty-two, I don’t care much for work, of any kind. I am now living on welfare, because I could find work initially but now I don’t want it. I have to do something with my life, I can’t just up and retire and I don’t have the money anyway. My friends seem to be getting on with their lives, buying houses, but do I want to slave away and struggle on my own to pay off a mortgage only to be probably too old to enjoy it when I get there? I have developed some medical issues over the years, but I do not see myself as disabled. My goal is to become unstuck, find meaning in life/work balance again, get my mojo and drive back.

One of the good things about being 52 and unemployed is that you’re old enough to see your priorities more clearly than when you were younger. You now have the experience to know what you can and can’t do with none of the messy hopes and dreams.

One of the bad things, however, is that you don’t have that much time left on this earth and your material needs are obvious and more and more pressing.

You need to do what you have to do, regardless of whether work is interesting or fulfilling, because when you’re in your fifties, living like a grad student isn’t just depressing, it’s potentially unhealthy.

I’m assuming from what you say that you could work if you wanted to, but that you’re discouraged by your inability to find anything meaningful or related to your training. Please confirm this assumption with yourself by doing a thorough review, because it’s sometimes not true, even when you believe it is.

One way to evaluate your capacity to work is to set yourself a series of simple tasks, like reading or composing a letter, and see how you do. If you find these tasks difficult, keep in mind that some discouraged people become impaired by depression, often in subtle ways, and are actually less able to work than they appear, or believe themselves, to be.

If this is true for you, you will need to adjust your expectations accordingly; settle for a less demanding job (or the dole), or decide whether it’s worth getting treatment so your job options can improve.

If there’s nothing wrong with your ability to work, ask yourself how much you need to work. Don’t get distracted by whether the available work is interesting or meaningful, just consider your long-term needs, including worst-case scenarios, and the ability of your current resources, including welfare, to meet those needs.

Keep it simple and unemotional. Ditch the therapist and use a financial advisor, because financial necessity is often a stronger and less complicated motivator than ambition, mojo, or drive.

If you can’t work, or can afford not to work, you can become a man or lady of leisure (and modest means), even if that means never being a property owner, just the proud renter of a studio apartment and a sturdy futon.

If you can work and your basic needs demand more resources, it’s time to start looking for work. It probably won’t be the job of your dreams, but you’re old enough to know that it’s worth taking a shit job to avoid living a post-grad nightmare.

STATEMENT:
“I feel disappointed and burnt out at 52 after investing heavily in a career that false-started; but I’m experienced enough to know that hard work often fails to guarantee success because the world is unfair. I’m proud of what I’ve done. Now my job is to figure out whether I’m fully functional and do what I need to do to survive, regardless of how dirty the job.”

I love my work, but I haven’t been able to find a partner, and I wonder sometimes if I’m missing out on something important. I’m a top performer in my industry and jump at new challenges, even if they require me to move around the globe. I always find time to enjoy myself and I have wonderful friends, including a few who are in similar fields, or just share my vagabond ways. While I do wonder what it would be like to find someone and start a family, I just can’t imagine getting off the fast track and rooting in suburbia because my partner couldn’t give up her job, or because my kids didn’t want to change schools. My goal is to be less selfish, or find a way to have a family without changing my life.

Being as engaged as you are by work that requires high performance, special talent, and a love of globe-trotting is both a great gift and a burden. Obviously, it’s hard to imagine settling down with someone when you can’t settle on a continent.

Meanwhile, it’s clear that you don’t consider yourself lonely and that you don’t really see yourself as selfish. Your life doesn’t contradict your values, it just doesn’t allow you to fit yourself into conventional expectations.

The expectation of being partnered is a dangerous one, in any case. After all, you know how hard it is to find a good partner under the best of circumstances. Anyone who expects to find one as part of their definition of a successful life is more likely to make a dangerous compromise and/or feel like a failure if a good partner doesn’t show up, and that’s true regardless of the time zone you happen to be in that day.

Instead, take on the hefty task of asking yourself whether you’re doing your best to support yourself, offer a good day’s work, and be good to your friends and family. Other people (or your internal voices) may say that you’re missing out because you don’t have a special someone, but it’s white noise.

Add partnerhip to the list of the many things that might make your life happier but that you don’t control and so shouldn’t think about. Value what you’ve done with what you’ve got, and where you’re going next.

Your life style isn’t normal; but, as in the case above, you’re old enough to know that normal is relative and that the hopes and dreams that aren’t bullshit don’t come without a price. If you’re doing what you love and doing right by yourself, then don’t settle for anything less.

STATEMENT:
“I’m unusually good at what I do and get unusual pleasure from it, but my life makes other things unusually difficult. I like what I’ve done with my life, even if it wasn’t what I or my family expected. I would like a partnership, and I’m open to one, but I’m determined to live my life fully in the present, which is what I’m doing, and not hold my breath waiting for something that might or might not come along.

Please Note: In responding to suicidal goals, as in the case below, we do not presume to offer emotional support. If you’re at risk of hurting yourself, you should, of course, go to an emergency room, discuss your state of mind with a professional, and decide how much support you need in order to remain safe. In most of the cases we encounter, however, our correspondents are not simply suicidal; they are familiar with treatment and have come to believe that it won’t help. Often, we must agree that their feelings are unlikely to change in the near future. What we try to demonstrate, however, is that negative feelings create falsely negative and hopeless beliefs and that there are ways to recover your strength and perspective, even when the pain won’t let up.

I’m considering suicide. My life is a joke. I am in my late 30s and female and I have never had a relationship with a man. Several men have used me for sex and at least 2 of them begged me not to tell any of their friends they’d had sex with me. I’ve never been loved, been held, been listened to, been cherished. I’ve just been used like a toilet. On the outside I’m pretty. I can hold a conversation and I have a reasonable number of friends. But I hate myself and I don’t feel good enough. I was abandoned by both parents and I was raped for the first time when I was about 2-years-old. It’s like men I meet can smell the self-hate on me and they treat me accordingly. I do not have even one person in my life who cares about me or who I could trust. My friends are there to go for drinks or dinner with me if they can find nothing better to do but they are not there to be supportive ever, in any way. What is the point of me continuing to live?

It’s horrible to feel that you don’t belong to the human race, except for your ability to satisfy the needs and cravings of jerks.

Remember, however, that those feelings almost always beget more falsely negative beliefs, particularly about relationships. Whether or not you’ve done anything wrong, you feel infinitely rejectable, comfortable in the company of jerks, and anxious around people you respect, since you know they will reject you for your anxiety and fundamental worthlessness.

You distrust other people, but it’s your feelings and instincts that are far more suspect. In turn, you can’t trust your feelings to guide you in relationships (even more so than the rest of us).

If you do, you will seek out jerks and excoriate yourself after real or imagined rejection, and of course, life will appear meaningless and full of relationships that always end badly. Being needy strips away the friendship filters that would otherwise keep jerks away and it makes non-jerks look like jerks or, even worse, like people whose rejection would be devastating.

For instance, after starting to trust a potential friend, you might be so hurt after noticing that she was slow to answer your calls, even if that dearth of calls was due to a busy work week or broken phone, that you would feel you could never trust her again and would feel like hurting yourself. It’s hard to make real friends when your own sensitivity is such an enemy.

Don’t give up, because there are other ways to build a more rational, positive set of beliefs that can protect you from dark feelings, even if they can’t ease the pain. They don’t require you to risk a relationship; all you need do is assess your own response to the hardships of your life, using reasonable criteria for judging your effort and the difficulty of your accomplishment.

If, while bearing the scars of neglect and abuse, you’ve picked up skills, earned a living, and treated people decently, you’ve accomplished something you have good reason to admire. Forget whether anyone else knows, understands, or respects what you’ve done. Then forget the fact that you continue to hurt like hell, (when you’re not feeling numb). You know what you know, and it’s your opinion that matters most.

If only therapy could help you make better choices and avoid negative distortions, or at least give you a sense of being respected and valued; but it often doesn’t work that way. Instead, relationships with therapists often fall victim to the same false beliefs that ruin potential friendships.

Because of your age, I’m assuming you’ve tried therapy and it hasn’t worked. You aren’t alone in having that experience, but it is possible to see beyond it. Don’t be surprised if a relationship- or emotion-focused therapy or support group hasn’t helped. Don’t give up hope, because there are other approaches that can help you grow stronger.

DBT (dialectic behavioral therapy) is a kind of cognitive-behavior therapy that can help you maintain your perspective and fight negative thoughts and actions. It’s taught as a course, and discourages participants from sharing strong feelings or engaging in intense relationships. As such, it doesn’t offer relief from loneliness, but it does provide ideas and mental exercises to root your self-worth in your own values and actions and thus protect your beliefs from distortions caused by fear, sensitivity, and loneliness.

When emptiness consumes you, it’s almost impossible not to feel like a disposable loser. If, however, you can make an honest assessment of your accomplishments, and acknowledge that there has also been triumph and survival despite tragedy, you will get stronger and find reasons to live and respect yourself.

If you review the things that you’ve done without the approval or involvement of others, jerks and not, you’ll see that you’re not just a member of the human race, but an exceptional one.

STATEMENT:
“I’ve never found a friend and often feel that life has no meaning; but abuse left me determined to be independent, treat people with respect, and be a good person, and I value what I’ve accomplished, regardless of self-hate or loneliness. I will build self-respect on my own actions, and hope that someday I will have the strength and luck to find a friend.”

My mother only has one sibling, but I’ve never met my uncle because he’s had severe agoraphobia for the past 30 years. My mother says that it started right before he graduated high school (he stopped talking to his friends, stayed in his room more, washed his hands compulsively, etc.), and it’s been going on since then. The only person he regularly communicates with is my grandmother, who also supports him, and while he sometimes talks to my mother, he doesn’t let her see him, and, like I said, I’ve never met him because if I’m in the house he won’t talk to anyone or leave his room (this is how he treats anyone who isn’t my mother or grandmother). My mother says that my uncle’s too macho to admit he has a problem, and “too Italian” to ever leave his mother’s house. I guess my problem is that my grandmother isn’t in the best health, and I know that nobody else in the family has the resources to take care of my uncle when she’s gone. Plus, I mean, he’s sick, so my goal is to get my uncle some help.

If almost every chronic illness is a test of character, agoraphobia is one of the most challenging. The fear goes far beyond anything you’ve experienced; think of it as a migraine headache where, instead of pain, you’re flooded with fear and the only relief is to hide out.

Yes, there are treatments that can dull the fear and help people recover their lives, but they take effort, they’re not a cure, and, somewhere along the line, they require people to leave their caves and endure some additional anxiety. It’s no wonder many people with severe agoraphobia will accept tranquilizers or use alcohol, but will not stick with any other kind of treatment, particularly if they have to leave home to get it.

So don’t blame your grandma or your uncle or put responsibility on anyone, including yourself, to get help. That bird has flown, leaving much pain and helplessness behind. Respect your grandma for carrying an extra load and your mother for bearing the sorrow of losing her brother.

Now that you’ve given up on helping your uncle directly, however, consider an alternative. Ask yourself whether he would accept behavioral treatment if he had no place to stay. Consult with experts and find out what would be available to him if he were flushed out of his hideout.

Obviously, eviction would make him more anxious in the short run, and might make your grandmother and mother guilty and anxious as well. If you believe there’s a positive alternative, however, encourage them to consider offering it to him. Urge them to trust their idea of what would benefit him in the long run and to ignore their gut response to seeing him in pain.

If they’re ready to push him out, good for him. If not, your mother will encounter this option further down the line, after your grandmother dies and the family can no longer afford to keep her house/his prison.

You’re right to fear for your uncle’s health and your family’s future, but as long as fear imprisons your uncle, you are all, to some degree, stuck.

STATEMENT:
“I’m sorry my uncle has a painful mental illness and I don’t want to add to his pain, but his current dependence on the family can’t last forever and he might do more for himself if he had less support and more encouragement to man up and get treatment. There are 2 generations ahead of me with responsibility for his care; but if, after learning more, I think they’re overprotecting him, I’ll let them know I respect them for caring for him, I’m concerned about what will become of him when grandma is dead, and I have a plan that might allow him to get stronger, regardless of his fears or urges to disappear.”

I don’t consider myself a lazy person—I take care of the kids and sell some of my paintings—but my husband isn’t crazy about selling cars and would really like to stay home and take care of the kids himself, so he’s always making remarks about having to carry the harder load and asking me if I could find a way to make more money. I’ve tried to find better-paying work, but I’m dyslexic, and what I’m doing is probably about as good as it gets, given my skills and the flexibility I need for the kids. Anyway, he’s been nastier lately because car sales are down and it’s getting to me. My goal is to get him to stop putting me down.

You can’t stop someone from putting you down—haters gotta hate, as the kids say, even if the hater is your husband, and most husbands are haters, at one time or another.

On the other hand, just because someone you love is trying to put you down doesn’t mean you have to take their criticism to heart and sink, doomed unless you can get them to take it back and promise never to do it again.

There are usually two obstacles to staying buoyant. The first is the emotional impact of being put down, which causes you to act like a slacker or a jerk, which loses you your self-respect and makes it impossible to stand up for yourself to yourself. When you don’t even have your own back, you’re in trouble.

The other problem is that, as with most people, the pain of a partnership besieged by too little money and too much childcare has its own illogical power to make you feel like a failure, even when you’ve done nothing wrong and everything right. To further paraphrase the kids (in a dated way)—no money, most problems.

You assume that, if you were successful, you’d be happy and your spouse would be happy with you, which is bullshit, of course, but that’s what happens when you use happiness as your rating system.

One good thing you’re telling me is that you haven’t let feelings of failure or anger slow you down—you take care of the kids and do your work, regardless—so now all you need to do is get used to the idea that successful parents often feel unhappy and get no respect from their spouses. See: Homer, Marge, Hillary, etc.

Forget about happiness and your husband, and judge yourself the same way you would judge a friend, by whether you’re doing a good enough job with what you’ve got. Don’t hold yourself responsible for doing things that your brain isn’t equipped to do.

Remember the dyslexia—you can’t cure it and there are certain jobs it won’t let you do. Don’t pay too much attention to the outcome, which you don’t control, but to the process, which you do.

Finally, give yourself a bonus. Assuming you’re doing a reasonable job as a partner, you should also pat yourself on the back for carrying another burden: putting up with your husband’s complaints. You deserve, as the kids say, mad props for staying afloat.

STATEMENT:
“I know you feel you bear an unfair load in this family, particularly when we’re short of cash, but I’m proud of what I do, and I think you’re doing a good job, and the only thing that’s isn’t so hot is your focusing on what I can do better when I’ve already told you I’ve considered your advice and disagree with it and don’t expect us to agree. So I think I’m doing both of us a favor by insisting that we respect ourselves for the work we’re doing and let the other matter drop.”

I know I always feel super-responsible for my brothers and sisters, maybe because our parents died when we were young, but we’re all pretty close and, and, at the same time, independent, except for one sister with Downs Syndrome who lives in a group home. I’ve never minded bringing her to stay with me for the weekends, but lately she’s becoming demented and it’s getting me down, because she’s irritable and sleepy and it’s hard to get her to participate in things and I hate feeling angry at her. My goal is to find the patience to take good care of her.

The more you love someone who is now dementing, (which happens early and rapidly with people with Downs Syndrome), the more impossible it is to feel kind, gentle, supportive, and, in the end, like you’ve ever done a good enough job.

For one thing, the more demented they get, the more they complain, show their unhappiness, and expect you do take care of them, even if, when they were strong and in possession of their strength, they encouraged you to live your own life.

To whatever degree your nurturing instincts drive you nuts until you can make the crying baby stop crying, you’ll feel terrible, and that’s on top of the terrible you feel for watching a loved one decline. It’s an emotional car crash.

For another thing, few people are comfortable with how irritated they get or how well they control their irritation; you can understand how elder abuse can take place. Most of us don’t abuse our elderly relatives, or come close, but we can’t keep our irritation totally hidden and the guilt is hard to bear.

The biggest danger is that, between your guilt and inability to ever feel you’ve given enough, you keep giving, more and more, until you’re drained dry and not taking care of yourself and your other family members are criticizing you for being a grump whenever you see them, if you ever do. That’s the point when people are often referred for treatment.

The answer, as usual, is to ignore your feelings and rate yourself reasonably. In this case, reasonably means helping your sister to the degree that helping her really has a positive impact, while keeping in mind your other obligations, both to yourself and others.

Forget about whether you can make your sister happy or whether you need to prove your love by knocking yourself out. Given her circumstances and your own, the best outcome isn’t good. If you can achieve mediocre results, however, while doing things the way they ought to be done, you’re in the running for brother of the year.

STATEMENT:
It’s hard to feel like I’ve honored my love for my sister, and taken good care of her, when she’s never happy and so often irritating; but I see to her safety and I make her happy when I can and, to do so when the process is painful and thankless is an achievement to be proud of.