Q: My 35-year-old son moved back home because he wasn't coping with “life on the outside.” He's seeing a therapist and taking an antidepressant, but I don't think he's really working on getting better. My wife says he's doing the best he can, but I think we should ask him to move out. Am I out of line? — Carlo G., Yonkers, N.Y.
A: Mental illness is often hard for those “on the outside” to understand. If your son had cancer and needed to stay with you while he received chemo, surgery and/or radiation, chances are you wouldn't feel critical of how long the treatment took or if the treatment failed to create a total cure.
You'd understand that's the nature of cancer therapies — even though a person can prevent many cancers by adopting a healthy lifestyle. But people (also the government and the medical profession) sometimes don't feel as sympathetic toward folks battling mental illness.
It may be helpful to understand that in some situations, emotions (response to shock or chronic stressors, for example) can trigger a physical event such as a heart attack or they may cause a mental illness such as post-traumatic stress disorder. In other situations, a physical trigger such as a genetic predisposition can lead to mental illness (depression) or a physical disease (high blood pressure). So which comes first: the chicken or the egg? It doesn't matter.
Interestingly, in a small study, researchers recently identified those who had depression and those who didn't by using a blood test to ID biochemical markers for the disease. This is an important step in putting depression on the same playing field as other disabilities.
It's good that your son is getting therapy and medication. He also should be encouraged to be physically active. Regular exercise creates brain changes similar to those caused by antidepressants: strengthening the neurotransmitter epinephrine, affecting serotonin uptake, promoting nerve growth and reducing levels of the stress hormone cortisol!