‘How do you help someone who won’t help themselves?’

Dear Sarah,

I have a question I’ve been struggling with for the past few years. My fiancé and I have been together for six years. For four of them, he’s had serious issues with his stomach. A few years ago, he lost a lot of weight because he was barely able to eat. Now he has a lot of weird, random symptoms, usually having to do with his stomach/intestines.

He went to see a doctor once who told him to stop eating gluten, dairy, and all these other things to see how he felt, but it didn’t make a big impact. Then he never made a follow-up appointment or received a final diagnosis. Many of his symptoms are still occurring along with some new ones, but he won’t see another doctor. At least once a week, he can’t eat, doesn’t feel well, is physically uncomfortable, etc.

It’s upsetting to hear him complain about the way he feels, to cancel plans, back out of holiday dinners, and watch him act lethargic and anti-social among friends and family. I’ve suggested dozens of things he could try including a nutritionist, alternative medicine, and going back to a traditional doctor. He nods, agrees—or disagrees, but never, ever does anything proactive about it.

I love him, I want him to get better, but I’m not his mother. I am not going to make him appointments. I’m tired of having the same conversation over and over. I don’t want to sit around and let his refusal to advocate for his own health to negatively affect our life as a couple.

Sometimes I feel offended or hurt that he won’t help himself. At other times I feel useless and helpless. If this is a dangerous or serious condition it makes me feel like he doesn’t care about either of our futures. Why wouldn’t he want to be happy and healthy?

—Worn Out in L.A.

Dear Worn Out,

It’s exhausting, worrisome, and sometimes exasperating to be around someone who is chronically sick or depressed or even just stuck in a rut but won’t take action. At the same time, because you know they are miserable, it’s easy to feel guilty about your own frustration. The first thing to do is let yourself off the hook for the negative emotions you are experiencing—given the situation and how patient and encouraging it sounds as if you have been, your internal turmoil is completely understandable.

On a practical level, if he’s been ailing for many years and is undernourished and in discomfort, he may have passed a point where he’s emotionally or physically incapable of seeking care. Long-term pain and illness go hand-in-hand with clinical depression—I’m no doctor, but I am suggesting that making a few appointments for him might not be over-“mothering” at this stage. You’ve probably already researched his symptoms, so sit him down and tell him lovingly and firmly that while he may not be able to take care of himself right now, its very important to you that he get healthy, so you are going to make x and y appointments with a medical specialist. Can you enlist some of his family members to intervene with you and perhaps accompany him to his appointments? Ideally, if he’s properly diagnosed, he’ll get a tiny glimmer of what a healthy life could be like again and he’ll be more motivated to help himself.

If he’s completely stubborn and won’t get on board with some sort of treatment plan, then I think you should ask him to go to couples counseling with you. A neutral, expert third party may help budge him and will also give you a supportive sounding board. It also sends a message that you’ve reached a critical place in your relationship.

Meanwhile, it’s perfectly appropriate for you to go out and have fun. Attend holiday parties, be with friends and family—with or with out him. Of course you wish you he were there by your side, but that shouldn’t stop you from pursuing a full and vibrant life. Like they say on airplanes, you need to put on your own oxygen mask first before you can help anyone else.

Love, Sarah

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