Ignutah - I could make suggestions, but don't know if they will be of help. My guess is his mental health issues "may" make it difficult to interact with others, but I would bet way more that his personality issues and lack of initiative are causing the majority of that. Part of his being in your home could rest on him developing some healthy life practices. He is a prime candidate for group therapy as it appears mental illness/alcoholism have stripped him of coping skills AND social skills.

I would also not expect your "old son" to appear, but on the other hand, I would be very wary of enabling him and saying there are certain things that he is "no longer capable of" doing. I've had plenty of diagnoses, plus alcoholism. Bipolar - as long as he takes his meds and doesn't drink or do drugs is treatable in many cases. The "air of hostility" and lack of initiative sound largely like dry drunk stuff, but may also be partially a med side effect and residue from depression. If he can work at a job and such, my guess is he has all the skills to interact with others but just doesn't feel like it. Social skills get very rusty when you stop practicing them.

I do not know how to get this across to him, but it does sound like regular therapy, possibly group therapy, and maybe adult case management would benefit him if he can be qualified and have this funded. I might make it clear that you are proud of his sobriety and what he is doing, but feel he may be settling for less in life than he is capable of and you want him to try to take on little bits more of responsibility until he can function at his max potential without needing as much support from you (his parents). Lots of folks come home and need to be reparented for a little while after they stumble. What's the plan for him long range? What is his plan for him? This stuff could ideally be addressed with a therapist.

As far as AA, well, there are double trouble meetings for those with mental illness but sometimes they are hard to find. I will venture to say that about a quarter or more of people in AA have major mental health diagnoses. I have seen myself MANY that come into AA having drank/drugged themselves out of social skills, unable to look people in the eye, unable to speak in front of crowds and they do get better in AA as it is a supportive place to practice social skills after having drank/drugged oneself out of them and/or also having developed mental conditions. Literature shows that people with Bipolar Disorder actually have a better prognosis if involved in a regular 12 step group/program than those who do not (odd huh?). Turns out that the support of AA, fellowship, having a sponsor are also very healthy for those with bipolar.

Of course you cannot make him go to AA, but therapy could be a part of your boundaries for him living there. I think it may be baby steps to get him back to a level of somewhat higher social/emotional/occupational functioning. Maybe he will not be capable of certain things, but he does probably need some outside help and the expectation that he will try to find his best level of functioning and THEN if he struggles, you guys will be there to love and support...but not to let him sit in the house and be a recluse and cop out of adult responsibilities or having a life by claiming to be lower functioning and having had more bad breaks than he may actually have had.

The balance is in the middle for you guys to figure out how much to detach and how much to encourage ongoing treatment for both his addiction and mental health issues. Without therapy and AA, I would probably be non-functional. I am not sure why I was never willing to accept that as my life or my peak functioning when I did have my first mental health break down at age 25. It was bad, but does not sound as severe as your son. I never had psychosis, legal issues, just several crushing depressive episodes and then I started drinking to self medicate and I also went on and off my meds and was unstable. I moved back home once for like 6 months and then back out again. My aunt has had a life of dependency on my grandparents and now parents due to her personality issues and mental illness and she is ungrateful and has been resentful of them too so I never wanted to be unemployed, underemployed and living at home long term. Hence, I pushed myself and got help when I needed it....and then I benefited from it. I pray your son will be open to the idea of pushing himself a bit more.

You guys will need to talk to his therapist/psychiatrist about what he is really capable of. NAMI will also tell you not to put limits on what a person with mental illness is capable of accomplishing in their life....

 

 

Ignutah...alcohol is a mind and mood altering chemical just like drugs.  It is a drug and mental illness is part and parcel of them booth.  Psychologists and psychiatrists have often thought that people drink because they have problems and from my experience as a therapist I worked on the opposite thought...people had/have problems because they drink.  There is a treatment modality titled "dual diagnosis" with mental/emotional diagnosis mentioned first and alcoholism/drug addiction then added on however in the rehab settings I worked in we always treated the addiction first and often found that when the client got clean and sober they didn't have many more problems than "normal" people....this isn't a diagnosis of your qualifier.  It's just information based upon my experience as a therapist.   ((((hugs))))