Ask a therapist: My son deals with substance use, how can I help?

In the “Ask a Therapist” series, I’ll answer your questions on all things mental health and psychology. Whether you’re struggling with a mental health condition, dealing with anxiety about a life situation, or simply looking for the insight of a therapist, Submit a question. Find my answers to your questions every Friday Healthy Minds Newsletter.

asks a reader

My grown son is depressed and he is an alcoholic. He often calls when he’s drunk to tell me how awful he feels, but he lives in another state and I don’t see him often. How can I help him?

-Johnny, 66

Amy’s Answer

Sending long-distance help to someone with substance abuse problems and mental health problems is difficult. And I’m sure it’s hard for you to hear her share her pain knowing she’s so far away. Fortunately, there are steps you can take to support your son if he wants to make a change.

Provide emotional support

You said your son calls when he drinks. Remember this conversation when he was sober? Do you ever discuss those calls when he’s not drinking?

When he calms down, talk to him about what’s going on. You don’t want to embarrass him but you want him to know that you can hear that he’s hurting.

Instead of saying, “You called me last night crying about how terrible you were feeling,” say something like, “I’d like to continue our conversation from last night. It sounds like you’ve been feeling pretty bad lately.”

Then, just listen.

Allow her to talk openly about what she’s doing without giving advice—at least not now.

Validate how she’s feeling by saying something like, “It must be hard to feel this way.” Resist the urge to cheer her up and don’t tell her things will get better. For now, meet him where he is—in a rough place.

There’s a good chance he doesn’t want to talk about it when he’s calm. He might be embarrassed to call you after he’s been drinking. Or, he may feel a little better when he’s not drinking—and therefore, insist that the things he said were no big deal.

If he doesn’t want to talk, don’t force the conversation. Just let her know you are there for her. Continue to invite him to talk regularly when he is calm.

Visit in person if you can

If you are able to meet your son in person, it may be a good idea to meet him face to face. Seeing him can give a better indicator of how he’s really doing.

It can also give you insight into how much he is drinking. And that can tell you how depressed he really is. He can minimize these things while talking to you on the phone.

A personal visit may give you an opportunity to present some information to him. Saying something like “You’ve lost weight since I last saw you” or “I’ve noticed you’ve started drinking every afternoon” can open the door to sharing your concerns.

Provide resources

Encourage your son to seek help and provide him with some basic information on where he can turn. He can start by talking to his doctor who may refer him to a therapist, substance abuse counselor, a psychiatrist or even an inpatient rehab center depending on his needs.

You can encourage him to try therapy. If he is hesitant to talk to someone in person, he can try online therapy.

There are many online therapy services and providers equipped to handle mental health and substance abuse issues online.

Remember, you are only there to encourage. Don’t waste your time researching her insurance options or therapists who are open in her area. If he’s interested in getting help, that’s his job.

take care of you

Of course, you can’t force your son to get help if he doesn’t want to. But, there may come a time when you decide to set some healthy boundaries.

For example, you might decide to stop talking to him on the phone while he’s been drinking if these calls bother you. You can say something like, “I want to talk to you about this when you’re sober. I’m going to end this call now because you’ve been drinking, but I’ll talk to you about it tomorrow.”

Your boundaries should not control your son’s behavior but rather address the steps you need to take to take care of yourself. And if answering the phone when he’s drunk puts too much stress on your life, you don’t have to be on the phone.

If you need someone to talk to, get professional help for yourself. Dealing with a loved one’s substance abuse and mental health issues can be a lot to deal with. Whether you join a support group like Al-Anon or you see a therapist on your own, get the support you need to feel your best while dealing with this difficult situation.

Get advice from the Very Well Mind Podcast

Hosted by editor-in-chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares tips on how to set boundaries.

Follow now: Apple Podcasts/Spotify/Google Podcasts

Written by Amy Morin, LCSW, Editor-in-Chief

Amy Morin, LCSW, is editor-in-chief of Verywell Mind. She is also a licensed clinical social worker, psychotherapist and international bestselling author. His book, which includes “13 Things Mentally Strong People Don’t Do,” has been translated into more than 40 languages. His TEDx talk, “The Secret to Being Mentally Strong,” is one of the most watched talks of all time.

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