My sister-in-law is somewhat crazy. She has a family history of depression, and is on medication and seeing a therapist, but appears to be getting nothing but worse. My mother-in-law just got home from a visit with her, and reported that the situation has gotten so bad she feels something needs to be done. The family agrees. The question is not whether to do something, but what to do and how to go about it. Keep in mind that we are all scattered across the country, and can’t just take her out for lunch and a we’re-concerned chat. Or offer immediate practical support, which would of course be the best place to start.

I could write a novel about the issues here, but to give you the essence of the problem: She has two children, one who was born extremely prematurely two years ago and has continuing special needs, and the other the brightest, cutest, six-year-old boy you ever saw. Her husband has a job that requires mostly night work, and in addition to physically not being around much, also seems to have emotionally checked out a long time ago.

They have a multitude of pets (and keep getting more, against all common sense and advice), some of them also special-needs, and largely neglected; a typical evening in their house will begin with the two adults arguing over whose turn it is to let the dogs out and end with dog crap spattered all over the walls…leading to a second argument over whose turn it is to clean up the mess (this is a multi-weekly occurrence that’s been continuing for years). The kitchen smells so badly of cat pee I can’t even walk through it without gagging, much less cook and eat in there. My mother-in-law said that when she went into my nephew’s bedroom on this last visit, his room was not only so messy that you could barely get into it, but his sheets were stained with evidence of multiple bed-wetting incidents with no clean-up. Everyone’s house gets messy from time to time. Some people leave socks in the living room, or put off doing the dishes a little longer than they should. But this isn’t messy, this is dirty. This is basic human hygiene being neglected here, and with small children in the house (one of whom, remember, has relatively severe medical issues already).

And it isn’t only the house. She shows little to no interest in her six-year-old, and when she does pay him attention, it’s mostly to yell at him. I worry that when the smaller one gets older and less dependent on her, her attention to him will diminish as well. She and her husband…well, I think you can imagine. And she’s so needy and demanding (she’s the type of person who would respond to an offer of the shirt off your back with “What, you’re not going to give me your pants, too?”) that her family, while loving her and trying to support her as best they can, cringe at the thought of calling her, because they know what they’re in for if they do.

Everyone is concerned about her — her health and happiness, her obvious and painful decline in self-confidence, and the loss of the funny, deeply intelligent, vibrant person they used to know. But almost more importantly, we’re really concerned about her kids. If she doesn’t get her act together and take care of her mental health, I’m frankly scared of the way those children are going to grow up. It’s a miracle that the six-year-old is still as sweet and highly functioning as he is (though every time a family member visits, he bursts into tears and begs to go home with them) but it’s only a matter of time.

Here’s the actual question: They want to write her a letter and all sign it, but I’m pretty skeptical about how well that’s going to be received. I can only imagine if I was trapped in a bad marriage, trying to mother two needy children, hated my job, was overwhelmed by basic life demands like putting peed-on sheets in a washing machine, and was generally so depressed that every conversation turned into a sucking black hole of “why me,” I wouldn’t exactly be thrilled to get a letter from my entire family telling me I need to get it together, no matter how gently worded or well-intentioned it might be. None of us live within several states, and as much as we’d like to convene in her city and have some kind of personal intervention, it’s just impossible. And that’s kind of where the ideas end.

Is there a way for her immediate family to get through to her that they’re seriously worried about her and her kids and think she needs to get more/better help without just shutting her off and making her defensive? They’re prepared to deal with her being angry at them, but ultimately the most important thing is that she does get help, and if she JUST gets mad and cuts off the family or something, that’s going to make things worse, not better.

Any insight would be most appreciated.

Sort Of Objective, But Not Enough

Dear Sort,

I agree with you that a letter won’t work, but I have to tell you, an in-person intervention is not “impossible” when you have two children living in filth.Make it possible.The kids marinate in shit and piss, and the older one begs to leave.This no longer qualifies as an inconvenience; it’s an emergency.The situation is abusive.If your sister-in-law is so depressed that she’ll tolerate that level of squalor, herself and for her family, do you really think she’s feeding them square meals, or attending to their clothing needs, or making sure they get adequate medical care?Because she isn’t.She isn’t, and her worthless husband isn’t either.

I don’t know what went wrong here — I can imagine that, post the second child’s birth, she may have sunk into a post-partum or post-partum-related depression that she never got treated for, and it spiralled out of control.I’m not unsympathetic, because that’s not her fault, but it’s not a six-year-old’s fault either, and something needs to be done.Done, not said.The issue here should not be whether she gets defensive; the issue should be how to improve the children’s living situation, short- and long-term.

No letters.Plane tickets; ultimatums.It’s time to get serious.The whole family doesn’t have to go, but someone does, and that someone needs to lay it out for your sister-in-law — the family loves her, cares about her, doesn’t judge her, wants her to get help.But if she doesn’t get help that day — doesn’t go to an ER or a physician and get checked out, doesn’t let you take the kids for a few days and hire a professional hard-core cleaning service to de-animal-waste the house, doesn’t adopt out all but one or two pets, doesn’t make a yeoman effort to get her shit together — the family will either have her committed or notify the department of child services in her community.They don’t want to, but they will.

This decision can’t be left up to her at this point; she’s proven herself incapable of making good decisions, and again, she’s depressed and trapped and this happens sometimes.But her children are getting fucked as a result and it’s got to be stopped.

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