Help me help my brother

Hello everyone,
I'm new to this site and I chose this forum because I feel the characteristics displayed by my brother resemble Avoidant Personality Disorder. My brother is 36 years old, 5 years my senior. Ever since childhood he's been a scared, fragile kid who hardly played. He had a specific set of people (like his grandparents and a few uncles and aunts) he liked to interact with. He was never a good student and struggled to move up from grade to grade. He never had friends. He is always low on confidence and has not been able to accomplish any tasks successfully, like learning how to drive or play a musical instrument. He has never held a steady job. He lives in this make-belief world where he has his own his of reasons for his inabilities which are always far removed from reality. He is always very negative and depressed because he feels he has not been able to "do" anything in life. He has a very supportive family who have assured his that he doesn't have to worry about his next meal or a shelter but none of it seems to assure him. My parents try to counsel him 24/7 (which is affecting their own health) but he never takes their advice. As a child, I believe, he was taken to psychiatrists but he was never under any sustained medical treatment. My parents have tried the usual things like pushing him to take up hobbies, make friends but they were never successful. I should mention here that he is very close to my mother and always chooses to share his problems with her rather than my father who he is afraid of. Now, we're seriously considering psychiatric help. Will drugs help him at all or will it turn him into a vegetable? Or are there other methods of treatment like group therapies, counselling sessions etc? I'm located in India.

Firstly, I would note that the primary problem for your brother that I am sensing from your description is depression, not social avoidance. Social isolation is a major contributing factor to depression, but if he engages in activities with family this can be enough. So, I am focusing on the depressive symptoms in particular; when the low mood begins to lift and he gains more confidence he might branch out more socially.

Your brother is rather fortunate in one, very important aspect of recovery. Your description suggests that your family and yourself are very supportive of him, and willing to help; this is very important. My suggestion for a starting point would to seek out a local psychotherapist and accompany him there; he will probably be reluctant (perhaps insisting it would be futile and his position is hopeless etc.). However, he should also have some desire to change (as he feels useless etc., no one would want to have abysmal self-esteem). You say he is very close to your mother; perhaps she could accompany him to an initial appointment? I must apologize here for not completing this thought (about getting him the initial motivation to seek treatment); hopefully someone else here can help further if needed as I don't have a very good grasp of motivation myself.

Anyway, a cognitive-behavioral therapist can help you guide treatment, and is a much better place to start than a psychiatrist in my opinion, particularly since your brother's condition seems chronic. There is no magic pill which cures a lack of esteem or social skills; these can only be acquired by action. However, a therapist's assessment might include a recommendation to see a psychiatrist, as certain medications can facilitate the activities required for cognitive-behavioral change.

Support from the family can help with the behavioral tasks of therapy; you might schedule activities to get him active. I believe that emotion is affected by a sort of 'inertia'; apathy, boredom, fatigue, etc. perpetuate themselves through inactivity, and conversely, being active lifts mood and sustains a higher level of 'mental energy' (metaphorically speaking). Engaging him on family outings (parks, museums, zoos, beach, etc. might be interesting locations), for instance, would get him out of the house, which I generally find to be emotionally lifting simply because they get oneself doing something. Getting him to a support group for people with depression/shyness/etc. can also be a relatively tolerable social activity which could help. Another possibility is getting him to take some classes at a local community college or equivalent; perhaps he could find something he could do (computer programming, for instance).

One question, does he have any particular interests? Depressed people tend to be anhedonic, losing most if not all interest in everything, but if he does have something he likes that could also be something to focus on, both as something to do (providing an activity and possibly esteem if he finds it purposeful) and another opportunity to make social connections. If not, classes and other activities can try to help him find something interesting, and I again emphasize computer science as a logically straightforward area which doesn't require excessive amounts of social interaction.

Hi!
I subscribe all Snowball wrote.
Only one thing I like to add. The fact that your family, especially your mother provides your brother with all he needs, for example "meal" I don´t see it so possitive. I understand your mother´s good intentions but perhaps, she and the future therapist could arrive to an agreement so you´re brother bit by bit could become less dependent. But, obviouly, you brother has to go to someone could help him.
I wish your family all the best.

One thing that stood out for me in your post was you saying that your brother is "scared" of your father. Why is that? Does he shout at him? Make him feel ashamed for being so introverted? Does he hit him? Or maybe it is just something more subtle.

Also, the fact that your parents "push" him to take up hobbies and make friends could also be contributing to his anxiety. No one likes to be made to feel inadequate by having their parents constantly "counsel" them to improve themselves. It would probably only make things worse.

I think seeing a psychiatrist and letting him/her decide what's the best approach for your brother would be most effective. Drugs probably won't make him a vegetable, but they won't be a magic cure either. They might just lessen the pain he feels enough to allow him to try and work through some of his issues. Maybe something happened to him as a child that he is not telling you and that will come out in therapy. Either way, seeing a qualified doctor who can work with your brother without judging or pressuring him will be beneficial to him and the family as a whole unit. It will probably take a long time to work through the issues though, so have patience.

Thank you all for your thoughtful responses. I apologize for the delay in responding. I have myself been experiencing relationship issues, but that is a different story.

Snowball, I appreciate your detailed post. Funny that you mention computers because that is the one thing that my brother is really interested in. He has taken classes in computer programming (software) as well as hardware and networking courses. He also likes to play computer games but lately he has been avoiding them. About taking more classes, he has expressed the feeling that since he's not getting a job doing computers, what is the point in taking more classes but at the same time, he has some unfinished software courses and he has expressed interest in taking them. He will be enrolling in them shortly. Hopefully that'll mitigate some of his issues.

Also, like you said, my parents are giving him chores, taking him to the movies, pushing him to go for outings (my uncle's family is visiting) and even though he remains listless during these activities, some of them seem to provide him some boost.

We're consulting our family doctor for recommendations for a reliable therapist/psychiatrist this week. I'll keep you posted on how things go.

Twistermind, I'm in agreement with your view about my mother's over-involvement. Keekles, he's not really afraid of my father (wasn't the right use of words on my part) but since childhood it's been our mother who has been more involved in his emotional life, so he feels comfortable opening up to her. But yes, we are looking to work with the therapist to lessen his over-dependence on his mother.

Thanks again for taking the time to reply. I'll keep you posted on what happens next. I'm feeling better just being able to talk about this and knowing there are folks out there who listen without judging!

Good luck and if you feel it could help talk your brother about this site, so he will be able to see that there are many people with similar problems and you and he are always welcome here.