I want to help my sister-in-law - any advice?

[AuroraBorealis]

I need a bit of advice. My (future) sister-in-law is worrying us, and I'm thinking about how I could help her. A general description:

She's 19, not diagnosed but I'm sure that she's on the spectrum, like my partner, but in a very different way. She's definitely gifted in the MINT fields, and always flew through everything academic. But she's struggling quite a lot with taking care of herself, dealing with emotions, basically just looking after herself. She moved out about 1.5 years ago to a different city to study, and while it's taken her long to adjust, she's doing a bit better by now. She struggles with most daily things, like shopping and cooking for herself, planning enough sleep, getting some exercise, dealing with "adult" things. Her parents support her a lot, mostly via phone calls because of distance, but they're very close. I know she's still very young and definitely allowed to not be an adult yet, but she's struggling in a way that makes me worried about her. It feels like everything is so hard for her. Like - she can cook, but if she cooks, she will make something fancy, sophisticated which won't nourish her, and get caught up in it - but on the other hand she has no idea what she needs to supply herself for a week. She plans everything like it's a work task. She never leaves any free time where she could just relax without any plans. She's a real perfectionist, I think. And she keeps overworking herself all the time. That was already a problem in high school. She'd get so focused on a project that she wouldn't eat unless you called her out of her room, then she would eat really quickly to run back to her laptop. She basically needed someone to look after her during exam periods because she would lose too much weight otherwise, simply from not eating because, to her, it just wasn't a priority. And she panics when she has any kind of physical problem, like a cold with a little temperature, because she doesn't know what to do then. Other people just lie down in bed with some tea, but she calls crying because she's panicked. (This is in no way meant badly, just to explain). But give her a major science project, and she aces it, being way younger than everyone else.
She's okay with people skills, but I feel like she doesn't have much insight into her own emotions and what she needs. If you ask her about a personal thing, you should be very careful not to pry or she'll brush you off - and often she will say what she thinks you want to hear, it doesn't feel like she really "lets you in". It's a real challenge to get her to talk about something really personal - not because she refuses, but because with her way of thinking and talking, to me it feels a bit like a maze I have to carefully navigate through.

Now, she's doing a bit better, it's not like she can't live by herself - obviously, she's doing it. But the thing is: She's always had stomach problems and problems with getting nauseated quickly or feeling ill from some foods, so far without any physical condition pinned down, and she's been tested for several things. She panics when she gets low bloos sugar but at the same time can't manage to eat regularly enough during her university days to prevent it. Eating was always sort of a thing for her, she's small and really thin - to be honest, she doesn't weigh nearly enough for her age and height, but since that was always the case and just doesn't do any good, we stopped being on her back so much about it. But now she's completely overworked, has more stomach problems than ever before, barely eats anything and just seems on the verge of breaking down.

I don't really doubt that there is something physical to her problems, like gastritis, and I'm supporting that she should keep seeing a doctor to figure it out, but I think that a big part of it is also stress and psychosomatic. She definitely needs a break, some time to unwind, but something also needs to change for afterwards, because she will just go back overworking herself again and again. I want to tell her to see a therapist - I'd be happy to help her find one - to learn some stress relief techniques, to have someone objective there whom she can talk to about her daily things, etc. But I'm afraid that it won't be easy to convince her, or even to bring it up. I have some good experiences with therapists, but other people in her family have also bad ones. And I don't want it to be like I bring it up, she nods and then we never talk about it again. I want her to really consider this.

Do you have any advice on how I could bring this up? I never mentioned to her that I think that she's on the spectrum, and I don't think she considered it either, so that wouldn't be a part of the conversation.

We have a good relationship, although since she moved out we don't talk that often, although we do. But I know that she likes me and values my opinions. I try to text her more often and be a bit more involved, although that's hard for me too because I'm a scatterbrain and forget.

Thank you, and sorry for the length!

Edit: I'm not worried about her reacting offended or hurt or angry - she's very analytical, classic "Aspie-way". Sure, she had her puberty fits, but otherwise, she's an argumentative person whom you can discuss everything neutrally. I'm mostly worried about not getting through to her with this, about her listening, nodding and then forgetting.

 

[Mary Terry]

Can you just tell her that you and your girlfriend are on the spectrum and that you think she may be, too? That could lead to her either getting a diagnosis or at least learning some coping skills to help stabilize her life.

My husband's NT nephew's wife is autistic and now has severe agoraphobia. She has refused to leave their house in Spokane since the pandemic started in 2020. We've told the nephew that he needs to get her to therapy or find a mental health worker to come to their house. He is going nuts because he is tied down by her mental illness, he has to do all the shopping and everything else that is required outside their house, he has a full-time job in academia, his mother is extremely ill and lives in Florida thousands of miles from him, and his wife refuses to seek help. He needs to fly to Florida to see his mom but his wife's current mental illness doesn't make that possible. We don't know what to do to help them.

 

[jsilver256]

She sounds a lot like me honestly. My coworkers used to assign someone to bring me food and drink while on work trips. Autism does come with a lot of digestive issues. If I eat too much, I will get very uncomfortable and frequently vomit, my default state without alcohol is underweight.

Unfortunately, I don't think there's much way to convince her she needs help before she hits that wall, particularly if she's autistic. Part of it is being "blind" to the problems in your body. I will pray for her.

 

[AuroraBorealis]

Can you just tell her that you and your girlfriend are on the spectrum and that you think she may be, too? That could lead to her either getting a diagnosis or at least learning some coping skills to help stabilize her life.

My husband's NT nephew's wife is autistic and now has severe agoraphobia. She has refused to leave their house in Spokane since the pandemic started in 2020. We've told the nephew that he needs to get her to therapy or find a mental health worker to come to their house. He is going nuts because he is tied down by her mental illness, he has to do all the shopping and everything else that is required outside their house, he has a full-time job in academia, his mother is extremely ill and lives in Florida thousands of miles from him, and his wife refuses to seek help. He needs to fly to Florida to see his mom but his wife's current mental illness doesn't make that possible. We don't know what to do to help them.

Thanks for your reply. Somehow, I feel like that's not my place. I could consider telling her about being on the spectrum myself. I wouldn't want to tell her about my partner (it's a him, at least for now) being so, too, since he's less official about it than I am. It's more a thing just between the two of us. I feel like their mom's not very open to the topic - it's an a bit difficult topic in their family, in general. I don't really want to tell her that I suspect her being on it as well. I guess I could tell her that I got a diagnosis, and maybe she'd look into it a bit by her own initiative.However, I'm not sure anyway how much that would help, actually. She's not very much "in tune" with her own emotional and mental health, if that makes sense. She's interested about things in others and in general (like health and medicine stuff), but has a very hard time when it affects herself. Honestly, I have no idea how she might react.

I'm sorry, that sounds hard. I know all too well about situations like these within your family. I wish your family all the best.

 

[AuroraBorealis]

She sounds a lot like me honestly. My coworkers used to assign someone to bring me food and drink while on work trips. Autism does come with a lot of digestive issues. If I eat too much, I will get very uncomfortable and frequently vomit, my default state without alcohol is underweight.

Unfortunately, I don't think there's much way to convince her she needs help before she hits that wall, particularly if she's autistic. Part of it is being "blind" to the problems in your body. I will pray for her.

To be honest, I doubt that something else will be found in her case too. It's not that far off, because there are autoimmune digestive conditions in their family, but those things have been ruled out. But well, I guess there are still some things it could be. I think it's either a combination, or only stress-/autism-related.

I think that she needs someone to at least help to look after her a bit too, to be honest. But her boyfriend (probably on the spectrum too) isn't very good with that. And it's also good for her to get new experiences, it wouldn't be good for her to just stay with her family forever. It's not easy. I think she actually might benefit from a person who gives her regular advice on how to organize her life - outside her family, and maybe just temporarily. It might also just be a close-watching college tutor. But for that she would need to be honest, and if you ask her, she'll always tell you that everything's fine (while obviously being on the edge of crashing).

I kind of feel protective of her, she feels like my small sister, and it's hard to not really be able to help her.

 

[marc_101]

@AuroraBorealis What does your partner say? Could you pass the information to him so he can talk to her sister? That seems safer.

 

[AuroraBorealis]

@AuroraBorealis What does your partner say? Could you pass the information to him so he can talk to her sister? That seems safer.

My partner thinks the same way I do. He thinks that either we suggest it while she feels really low, or otherwise make it seem like it was her own idea. I'm not really happy with either way. Wouldn't know how to do the latter, anyway.
We thought that I might tell her about my autism diagnosis and mention my own experiences with therapists, so the topic is in the open and I see how she reacts. And then, in a seperate talk, I can cautiously suggest it for herself (therapy, not autism).
The thing is that I think that she might benefit from a therapist who's experienced in autistic clients, but don't want to push her into the diagnosis, either. But we'll see how it goes with the first talk.

My partner doesn't think that it makes a difference who of us talks to her about it. And in the past she seemed sometimes more open to advice coming from me - maybe because I'm not her immediate family and have more the "cool adult sister figure" vibe with her who takes her seriously and talks to her like an adult and not like their little girl.

 

[marc_101]

In that case, I think you should just talk to her and be direct. You have good intentions. If she gets offended, not much you can do, but at least you know that 1) you did what you thought was right and 2) you had good intentions because you care about her.

You could be direct. Something like: Look, I care a lot about you. I have seen xyz. I think you'd benefit from seeing a therapist. A therapist has been very helpful for me. In think that it could help you with ABC.

 

[AprilR]

She sounds exactly like me! She is very lucky to have people who care about her this way.

She is still young so i don't know if she would be hurt if you would suggest that she is autistic.

If you have had similar problems or other problems caused by autism, maybe you can talk about those and how therapy helped you and how it is nothing shameful to ask for help. That way, it does not sound like you are speaking from a higher position or are pitying her.

Not bringing up autism, but bringing up the problems caused by autism might be a better idea.

 

[vergil96]

She sounds exactly like me at her age.

This winter, I starved myself, because I couldn't figure out the schedule and mealtimes to not conflict each other. Different hours everyday complicated it so much that I had no clue. Frequent vomiting is also something I struggle with. It's as if there are wrong and right times to eat, amounts and products and if I do the wrong thing - I vomit. I have come to realise by trial and error that many of such symptoms are a result of unhealthy lifestyle and a lack of routine. E.g. irregular sleeping hours, coming back home too late, eating too much vegetables (yes - failed attempt at vegetarianism, eating too "fancy") and irregularly, e.g. once a day (eating isn't interesting like studying is). Going for walks at least 20 minutes everyday has helped a lot in terms of emotional balance, hyperactivity when studying and sleep. Hygene also should be done as a routine, not only when needed e.g. just before going to bed or just before leaving the flat. Maybe I'm not discovering America with all of that, but it was hard for me to figure out, because I have poor interoception (sense of what your body needs). I feel like especially young people in their early 20s don't realise yet how important a regular healthy lifestyle is.

Then, how to get her on board? If someone I cared about was about to starve themself, I'd simply say that I'm worried that she is starving herself, not getting enough sleep and mention that she has health problems from it and that long term that can result in a health breakdown, mention that I used to have similar problems to make it more relatable for her, and ask what exactly her eating habits are and try to help her figure out what to do. Perhaps she is facing problems with preparing food, cleaning up after cooking, doesn't know which foods to buy in a regular manner (rice, bread, cans, cheese, eggs etc.), perhaps buying ready meals is a solution, perhaps snacking in the meantime and taking sanwiches or lunch in a box can help.

As for neusea, hypoglycemia can cause nausea. Maybe this is the issue, she eats too little? Or the wrong foods. Believe me or not, I used to have nausea from eating too much vegetables. I had a failed attempt at vegetarianism.

 

[AuroraBorealis]

She sounds exactly like me! She is very lucky to have people who care about her this way.

She is still young so i don't know if she would be hurt if you would suggest that she is autistic.

If you have had similar problems or other problems caused by autism, maybe you can talk about those and how therapy helped you and how it is nothing shameful to ask for help. That way, it does not sound like you are speaking from a higher position or are pitying her.

Not bringing up autism, but bringing up the problems caused by autism might be a better idea.

I don't really think she would be hurt if I suggested that she's autistic. But I'd feel like the autism-shouting person who figured out the diagnosis for themselves and suddenly wants to pin it on everyone around - get what I mean? I sort of feel worried about bringing this into their family. It's different with my partner because it's a thing just between us, concerning only us, and it's not a topic within their family. But I don't want to be like "I think you're autistic" and then have her parents be completely outraged by me suggesting it to their daughter. Mental health is a sensitive topic with them, especially when it concerns their kids. I'd prefer to just tell her about myself and have her looking into it herself, if she sees any parallels (although I am certain she won't). At least for now.

With the rest, I think you're probably right.

 

[AuroraBorealis]

If someone I cared about was about to starve themself, I'd simply say that I'm worried that she is starving herself, not getting enough sleep and mention that she has health problems from it and that long term that can result in a health breakdown, mention that I used to have similar problems to make it more relatable for her, and ask what exactly her eating habits are and try to help her figure out what to do.

The thing is, we have done that again and again and again. It's like she listens while we're talking about it and agrees with us, but then doesn't change anything. These things don't seem to be priorities for her - but then we see her struggling, getting thinner and thinner, being nauseated all the time, and on the verge of burn-out with only 19. Then she has moments where she cries and feels bad about everything, and you might get through a bit to her during those moments, but the day later it's forgotten and she carries on like before.

As for neusea, hypoglycemia can cause nausea. Maybe this is the issue, she eats too little?

Oh, yes... That's obviously the problem, and we all know it, but somehow she can't really change it. We've suggested detailed plans on when to eat and what, according to her schedule - during this lecture, between those classes. And sometimes it works for a bit, but not in the long run. Always something else seems to be more important.

but it was hard for me to figure out, because I have poor interoception (sense of what your body needs)

I think that's the case with her too. She sometimes seems almost detached from her body and its physical needs, like food, drink, what to do during minor illnesses, what to do when you're dizzy, tired or nauseated. She panics then and needs someone to tell her and reassure her.

 

[vergil96]

The thing is, we have done that again and again and again. It's like she listens while we're talking about it and agrees with us, but then doesn't change anything. These things don't seem to be priorities for her - but then we see her struggling, getting thinner and thinner, being nauseated all the time, and on the verge of burn-out with only 19

Geez, it's tough. I wish I had more ideas. I hope she doesn't learn the hard way what it can result in.

 

[paloftoon]

Does she see a therapist? Maybe recommend that to her and I think you just have to be direct with her 1-1, once, but say it as a recommendation- not like she has to do what you suggest or say. If she feels she's in the right, well maybe she is. She's old enough to be responsible for herself and may have to figure it out on her own.