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Rock Bottom May Be Too Late — Do Something!

Photo by lunamom58 (Creative Commons License)

Photo by lunamom58 (Creative Commons License)

A commonly heard phrase is that you have to let someone hit “rock bottom” before they will be willing to accept help, seek help for themselves, or make positive life changes.

The problem with “rock bottom” is that for many people, “rock bottom” is death (or in some cases, irreparable harm to health, relationships, and career). Substance abuse, remaining in abusive relationships, mental illness, dementia, gambling addiction, untreated chronic health conditions, and many other life circumstances can lead to a grisly end and premature death. In many cases, an early intervention by family, friends, and/or the state can preserve and improve quality of life for a person for many years.

The “rock bottom” trope is a convenient rationalization for friends and family members who (for many valid reasons) do not want to jump headfirst into the messy, unpredictable, time-consuming, expensive, grueling, no-results-guaranteed process of trying to help someone whose life is going off the rails. I have personally made good use of this rationalization at several points in my life.

I’m in the process of helping out someone I’m close to, who is not in a good way. I’m part of a team helping this person. It’s not the first time. It’s stressful, it takes up time, there are serious opportunity costs, but it’s worth it.

It’s almost always worth it. When you don’t help, when you turn away and cut someone off entirely, you’re killing part of yourself (and not always a small part). This post is about how you can help effectively, and protect (and possibly even enhance) your sanity in the process.

Summary: For friends and family suffering from illness or addiction issues, “rock bottom” can mean death or irreparable harm. It’s better to do something to help, rather than taking a “hands off” approach.

Some General Observations

After struggling for many years with the question of “when, and how much, should I help?”, I’ve come to some of the following conclusions:

  • Some (but not all) forms of “helping” are counterproductive. While it can be an act of kindness to bail out a friend or family member and protect them from harsh consequences, doing so over and over again enables the behavior that is getting them into trouble. This cycle is called codependence. The other extreme is total disengagement: cutting someone off entirely. Some “in-between” alternative are offering support, being part of a support team, and in some cases being part of an intervention.
  • You can’t control other people, and trying to do so leads to anxiety and despair, or abuse/coercion. What you can do is try to persuade them to get help and/or change their behavior, using both soft and hard tactics (intervention).
  • Helping someone has real, tangible costs (time, money, emotional strain), and if you overextend yourself you risk losing your own health, sanity, means of supporting yourself, and important relationships.
  • You may put in a great deal of effort, at great personal cost, and still not succeed in helping someone.
  • Helping someone also has real, tangible benefits (the person might get better, you may feel like you are doing the right/moral thing, other people may consider you to be a good person, or even heroic).
  • You might feel resentful if you overextend yourself. You might feel guilty if you don’t help enough. You might feel both emotions; regardless of how much you help you offer.
  • You have to decide for yourself if you want to get involved, and how much. You may be negatively judged (and even suffer tangible consequences) for your decision to help or not help, depending on the social norms and values of your peers and family. There is no “right” decision; you have to figure it out for yourself.

Nobody is exempt from these decisions. At some point every person will have to make a decision about helping a family member or close friend who is in very poor shape. This is a choice 100% of us face, at some point in our lives.

Summary: There are benefits and costs to helping someone. There is no “right” decision in terms of how much you should help.

Do Something!

There is almost always something you can do to help a person in trouble. Some of the items below may seem “small,” but never underestimate the possible impact of making a “small” gesture to help someone. They may remember the act of kindness for the rest of their lives, and what seems “small” to you might actually be a huge turning point for the person you are helping.

  • Learn about the condition, so you’re not flying blind.
  • Tell the person that you love them and care about them (frequently).
  • Acknowledge that the problem they are facing is difficult, and commend them on any positive steps they take (no matter how small).
  • Research social services and programs that might be available to help the person in question.
  • Let the person know about social services that are available to help them (support groups, treatment programs, healthcare, assisted living, etc.)
  • Encourage the person to take advantage of any support resources that are available.
  • If the person is resistant to accepting help or seeking treatment, keep suggesting it (but don’t threaten or cajole or bully; it needs to be their decision). You might get stonewalled at the first suggestion, and by the fifth they are happy to go along with whatever you suggest.
  • Offer temporary assistance in the form of basic necessities (food, paying utilities, rides, etc.). This kind of helping is not necessarily codependent, especially if the person is in the process of trying to get better. Don’t offer more than you can afford (see below).

Summary: There is always something you can do to help that is within your means and abilities.

Stay Sane

When someone you love is in bad shape, you’re going to have a bad time. There’s no way around it. But there are ways to mitigate the bad feelings, to manage your stress, to preserve your sanity, and to protect your life and well-being. Here are some suggestions:

  • Don’t go it alone. Build (or join) a support team, focused on help the person in trouble. If the people you ask first aren’t willing or able to provide much help, keep expanding the circle until you feel like “we’re in it together.”
  • Don’t put your life on hold. Keep doing the things you love, keep meeting your responsibilities. Never go “all in” trying to help someone; you’ll just quickly deplete yourself and end up needing help yourself.
  • Don’t put yourself in physical danger. Leave dangerous and highly volatile situations to the police. If you feel physically threatened, get out.
  • Don’t expect a quick fix or resolution. The healing (or dying) process can take years. Provide support at a level that you can sustain, and think long-term.
  • Experience and constructively express your own emotions. Don’t bottle it up; talk about it. At the same time, don’t fixate on emotions, or endlessly process your feelings with everyone you encounter to the extent that you become tedious and a downer.
  • Understand and use your stress. Stress is a physical response to 1) provide energy to deal with a situation (adrenaline) and 2) seek emotional support (oxytocin). Acute stress does not have negative health consequences, especially when that stress leads to constructive action. Watch the video below for more information (there are some “association vs. causation” issues, but valuable information nonetheless).

Summary: You’re no use to anyone unless you maintain your own sanity and well-being. It’s not selfish to continue living and enjoying your own life; it’s common sense. Also — stress isn’t necessarily bad for your health.

A Final Thought

Helping someone is not an all-or-nothing question. There is always something you can do to be helpful, something that is within your means and abilities. When someone you love is in trouble, figure out what that thing is, and do it (and keep doing it).

Please feel free to share your own perspectives and experiences below.

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18 Comments

  1. You are dead on. You are right you can not tell people how to live. They will not listen and if it goes wrong it will be your fault anyway.

  2. Yeah, again, you can not help people some times. I work as a nurse in a hospital and I wouldn’t have a career if people took the time to actually take care of themselves that benefits their health. The same is said with drug abuses as I constantly see people not wanting any help at all. For some people it takes years for them to realize they’ve hit rock bottom. Some people never realize they ever hit it.

    One thing about hitting rock bottom though is that amazing things can come out of the ashes from time to time.

  3. Maybe I didn’t emphasize that I don’t think the “rock bottom” concept has much value. The earlier loved ones can “get in someone’s business” and intervene, the better. The trick is maintaining your sanity while doing this, and acknowledging that you can’t control other people. “Hands off” rarely leads to much good. Here’s what I’m trying to get at:

    Action instead of inaction.
    Persuasion instead of coercion.
    Support instead of criticism.
    Connection instead of detachment.

    I’m not advocating martyrdom, and I realize we all have limited resources; we can’t help everyone we encounter. But a little compassion can go a long way. Even if a person has given up on themselves, we don’t have to give up on them.

  4. Cathy

    I really enjoyed the TED talk. I have never thought about stress like that. I liked the last statement she said about “staying and doing something is healthier than running from the discomfort”. I have read everywhere that stress is bad for you and causes all various health problems plus obesity/metabolic syndrome. I do just wish life were simpler like when I was young, but its not. I will more than likely rewatch the TED talk as well as read the post again. There’s a lot there.

  5. Jay

    JD – love your heart and your spirit. In trying to help keep someone I love from hitting that rock bottom, I lost the friendship. It breaks my heart to have lost my friend and the helping was incredibly hard and gut wrenching. But if I hadn’t tried, I wouldn’t be able to live with myself.

  6. Having gone through a few struggles myself when I was younger and more naive (and helped others get though rough times) I found that sometimes people don’t understand a situation and make it worse in their haste to solve the problem and get on with their own lives. My brother encouraged (or rather obligated me) to go to the ER because I was having headaches and was not feeling or looking well while temporarily staying at his house, as I could not get a doc appointment for another 2 months. At the time I was financially stuck in a nasty, toxic renovation without enough money to finish it and no way to back out of the chaos and mortgage debt without losing my shirt. I’d been a little overly optimistic based on other’s advice The house was full of lead paint, mold and stray cat shit and had major drainage problems any one of which could make you really ill (if the stress of holding up the house and replacing the foundation in the heavy rain while having small earthquakes didn’t kill you first – the classic money pit. He told the intake doc that he thought I was suicidal behind my back without any indication from me, directly influencing the doc to put me in a psych ward for observation while I think I am just begin prepared to get an MRI then forced to take debilitating drugs. He has yet to apologize and now tells me that I imagined it. This has deeply affected our relationship for the worse as I am now and will forever be a “former mental patient” and had to pay multi-thousands of $ for the privilege of their “observing” me. If you want to help people you have to have empathy for their predicament and not force your preconceived notion of how they should approach their own problems. Asking “how may I help you” instead of forcing an intervention on them is an excellent way to start the conversation. If they don’t want help leave them be.

    • Wise words Jonathan, and thanks for sharing that story. California’s 5150 laws are there for a reason — to protect people from being confined against their will simply because their family members are concerned.

      I completely agree that “intervention” is only helpful when it is to express concern and support and to offer resources, as opposed to strong-arming a person into receiving treatment they don’t want (and that might even be harmful).

      The “discipline boot camps” for teens are maybe an extreme example of “help” that might be harmful. There are too many cases of teens being abused and/or injured in such programs.

  7. Do you think adults today try to shelter everyone from everything, like trading freedom for safety (give a little bit of freedom for the illusion of safety). Do you think it can hurt a lot of kids in future that they won’t be prepared like adult 10 or 20 years ago, since you got totalitarian idiotic freedom fascist who want to come at others and force believes on people instead of letting others develop their own believes. I think there is no guide book to develop because we all go through it. (but it was a lot harder when I was a kids) What’s your take on the matter?

    • I know it’s a difficult decision to make as a parent — how much to shelter and protect your kid, and how much to let them figure it out themselves. No easy answers.

  8. Kelli

    I love your post. I am struggling with this issue with my adult mentally ill and addicted son, and it is a hard one that I wrestle with every day. I have made mistakes both ways, helped too much and too little at different times. Thank you for your words of encouragement.

  9. beentheredonethat

    hi tks for that. my husband suffers rom cross addiction and knows thid but doesnt want to change. ive known him 17 yrs and i dont recognise the person anymore. yrs ago he would have got annoyed ar someone not paying child support & now he does it himself. ive tried everything to help now ive accepted it and cut all ties as the children were getting effected. in and out of their lives emotionally abusing them so i had to get the courts to step in and have him summoned for a barrong order the court date is in jan. if he wants to drink himself to death and insanity i respect his decision now he can accept the judges he can fool me but not the law. i lost myself in every way with his illness i became co dependant. im out now and never going back i hope he gets well as life is a beautiful gift and he is missing out on his children. in ireland theres a huge drinking culture and men are sucked into it. none of his friends are real his own family are abusive as they feel putting fear into people is the way to get people to do what u want.. ive learned alot have grown alot and have HUGE respect for those who get into recovery and stick with it. being weak is easy courage takes strength when were at our lowest for me my kids are my everything and will do whats nessacary even if ive to protect them from their own father. bless you all xxxx

  10. Great post. Unfortunately the idea that someone has to hit “rock bottom” is still the common belief of some mental health workers. I have found great resources and support at SMARTrecovery.org in their families and friends groups.

  11. Matt

    So for the all or nothing thing, if you have someone who has pretended to try to get help, becoming a voluntary patient and as soon as it got hard had themselves released (because they were voluntary they couldn’t be held) what would you advise? Partial help seems to be enabling this person and they won’t listen to reason enough to truly seek help. We do not want to aggravate the situation because there has already been one or more attempt on their own life. Our one chance at real help was thwarted by a social worker who admitted this person needed real help but wouldn’t sign the paper saying so just because of a whim. (Both doctor and psyhiatrist disagreed with that decision)

    • I would focus on what you can do, such as keeping open lines of communication, directing them toward services and support when they are ready, and offering whatever direct support you can afford (emotionally and financially) — healthful food and the like. I don’t know the details of your situation but it sounds like the person you are trying to help may not be ready to change. Just keeping your heart open to them and continuing to reach out (even if you are repeatedly rejected) will have a big positive effect. You can’t control them but you can continue to love and influence.

  12. K Zamora

    Dear Mr. Moyer ,
    This message regarding “rock bottom” has helped me through many dark times . I’ve just returned home from a twelve hour round trip drive to visit my beautiful twenty two year old son in prison . I find your kind words and great advice help me over and over again . Thank you more than you’ll ever know .

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