Dealing with adult son with mental health: Parents want to share?

This pain is unbearable. He didn’t have to die. He needed help but couldn’t see through all the lies his brain was telling him. God help me

My issue is not as severe as those I am reading about but….. we have an adult son in his 40’s. He is hard to communicate with. He lives across the country from us but his work enables him to visit frequently, for weeks (or occasionally a couple of months) at a time. While he a a very good guy with a big heart he is also quite fixed in how things should be. He says things like:
Our yard isn’t as well cared for as others in the neighborhood, my husband leaves everything to me, or if he does something it’s only done half way, why don’t we get something repaired, and so on.
He is on us regularly when here about home maintenance, our relationship (hubby and me), how we organize things ( or in some cases don’t organize them), why we live with some things not working ( fan over the stove is an example). We eventually get things fix but unless something is critical we don’t rush right out for repair. It is very hard to communicate to him that we have 52 years of marriage behind us, raised 2 successful and kind children, are ok with how we relate to each other and with the time we take for getting things done. At 75 years old we don’t much care for what others think about our yard, how efficient we are, or how we act with each other. . You can’t argue with him, he’s always right. This post is because this AM we had a blow up and I just can’t take it. He will be here for 3 weeks. He says he comes so he can help us. Yet, I asked him to go to a Dr. appointment my husband about a 45 minute drive away on day he is free. My husband is having some memory issues on occasion and can also be uncomfortable after these visits, so I always drive him. First he wanted to be sure his dad would drive the car, then if they could stop on the way home at a couple of places in that area, then, if not, could they leave earlier so they could stop at the places, then eventually, it was his “off day” so he would might get up early to go to the gym and should be home to leave on time (10:15 AM). I finally said to forget it. I’d cancel what I had to do and take my husband. That started our the blow up. I usually just go with what my son wants so to avoid confrontation since I know he will be going home, but at this stage I’m just tired of putting up with it. Ended with him telling me I was passive aggressive and should look at my ego and how I respond to things, closing the door and saying kindly he wanted to give me some time to myself.
Any advice for dealing with regularly occurring differences of opinion, or dealing with adult kids who think they are right and you just don’t do much of anything right, is appreciated.

This pain is unbearable. He didn’t have to die. He needed help but couldn’t see through all the lies his brain was telling him. God help me

I did think of that...and ironically I am a former psychiatric RN. I know first hand how that can go having done it myself for my patients in need of immediate psychiatric services and in a crisis.
I would have to call his clinic and state he is a danger to himself or others. They told me they would call the police to go to his condo. If he does not answer the door, they would break it down. Of course, he would refuse any intervention because with PPD he doesn't think anything is wrong with him. It's everyone else. Depending on his actions, most likely he would have to be handcuffed and taken out of his condo, an ambulance will be called to take him to the ER for a psychiatric evaluation. He would certainly know it was me...and this would be unforgivable by him to me especially if he is released from the ER. I am trying to speak to his psychiatrist but the clinic says I can't if he is not a danger to himself or others. I don't believe he is suicidal although no doubt he might have passive suicidal ideations...having lost his best friend of 30 years suddenly, without warning at the age of 39. Best friends since age 8.
I actually have a video appointment with his psychiatrist in November - posing as a "patient" but wanting to discuss my son. My feeling is his MD can not tell me anything about him due to HIPPA laws BUT I can report to him. When I was working many times I had family members call me to report their loved one was in a mental health crisis. I listened but did not report anything to them. Of course, there were times the crisis team had to be called (by me) to go to the home. Very, very often the family does not want to be the "bad guys"...& call the police. Now I truly get that. I am in those shoes now. But I do get you. And yes, I am very sick over this. I am trying to help myself. All I do is think "what can I do". No doubt he is lying to his psychiatrist and saying all if "fine"...which it is in his mind. I don't even know if his MD diagnosed him correctly. I believe it's depression and ADD. But that is not what is truly going on with him...yes, depression for sure but the PPD is overtaking everything. Many thanks again for your thoughts and help.

@briarrose ---
It is completely ethical, legal, whatever to mail a personal letter to your son's psychiatrist. Moreover, it is legal, etc for the psychiatrist to read it.
-- This thread is more than a year old, I pray things have improved---even if the improvement is the big task of your accepting how your son is and that you're seeking therapy for yourself. -- For 8 years my son was an addict of weed, alcohol..and the monkeying around with his bipolar medication.
Since October --3 months ago--he has been living with husband & me
About 2 weeks before he came here, unbeknownst to me his childhood seizures had returned (don't worry now he is working with a great neurologist) but it was a beautiful surprise to learn he'd stopped 'cold turkey' all his addictions.

Today, he sleeps on the couch in our small home. And when he's not recovering from a seizure (focal/partial) or reacting to the powerful RX he has to keep upping the dose on (per doctor's explicit instructions), my son tries to help me and/or husband by doing small chores we've put off for a long time.
Having son here has been so beneficial to all of us! -------I am so grateful. ---
PS: Here's a question, do you love your son no matter what he says or does?-- When I asked myself this, about 6 months ago, I realized that Definitely, I did NOT love him in this way. My love was conditional.
And so I began looking at this barrier within me.
I prayed to be more accepting of the pain of being with him when he was acting 'awful' --most importantly, I prayed to LEARN from the pain/suffering I was experiencing
AND to know 'my part' in all of it... also, ultimately I asked to forgive son and myself.
Part of this process was to keep quiet and watch my labeling, judging, & blaming him/his friends (blaming in subtle and not subtle ways)-- when he'd become verbally abusive.
It took several weeks for me to simply be willing to even want to do this.
Ultimately, I did start this process. And
I saw how I was into pointing a finger at him rather than working on myself....
--
One day about 5 months ago, while he was going off & I was about to get up from the chair I was sitting in to calmly leave (even though he was going nuts, I felt it was critical that I leave as CALMLY as possible)....but on this day, after I said the usual, kinda cheery "Ok, I'm going now, 'til the next time"
I added:
"No matter what you say or do, I love you."
-- I cannot describe his expression, maybe "disbelief" is what I saw.
But it seems this is one of the factors in his deciding to become clean & sober--. It was THE factor for me becoming more accepting, for me to start healing.
We waste so much time telling our 'story' our point-of-view to others: friends, professionals, even on Redditt (please know I am NOT judging you, because I've done the same) but it is my opinion that we need to look in the mirror, kindly/with compassion but yes, do LOOK in the proverbial mirror & do an inventory on our behavior, our mindset etc. Write it down as if you're talking about someone else.. that's what I did.
YET,
please do this honest accounting/this 'let's get real' personal inventory with kindness, with tenderness towards ourselves.

Big hug.

@bearbayou - your message was insightful, compassion and kind. And, yes, I have looked in the mirror many, many times. No question he was raised in a dysfunctional house hold. I divorced his father after 30 years of marriage. But you see, it's generational. I was emotionally neglected terribly from probably the moment I was born. My mother never bonded with me. And as a result I had to do immense therapy work to even realize this. I was numb for so long and to this day see a therapist/psychiatrist for panic attacks, anxiety & PTSD. I know my son has PTSD also, multiple layers like myself. I gave my son my very best loving care...but did I fail him at times throughout his formative years? Yes, I did. There were times I was completely in a fog. The abnormal became normal to me b/c of my surroundings. I literally had NO support system of any kind from the moment he was born on both sides of the family. And b/c of my PTSD I had no friends either. At his age right now, 41, I was drowning in life but trying to do my best - which, I know, wasn't good enough at many times.
At this point in time, my son's mental health has gotten worse, sadly.
And I continue in a state of confusion as to WHAT exactly is going on with him...if I could get a grip on it, I would be more at peace. He lives far away from me, (but only a 2 hour flight away) and won't move from this city despite nothing but pain since moving there. Yes, I most certainly love my son unconditionally and deeply. My only child. But I don't like his awful and rude behaviors he has exhibited so many times in the past when visiting...Christmas 2022, 2023, 2024 and 2025 were so unhappy because of how he treated me. Not yelling, no violence of any kind but a level of mean passive-aggressiveness that had me/his step father, walking on eggshells so we didn't "make" things worse. If confronted he would challenge me and twist things around, so it became "my" fault. I had to back off as he was making me physically and emotionally ill/stressed. I believe he has/or continues to abuse his prescribed medication Adderall despite his claim of stopping it in November 2025. I snooped while visiting me in August 2025 and found evidence he traveled to where he use to live/work in Canada, saw another psychiatrist there and received 6 month refills ( in May & November 2024) of not only his Adderall but 2 other amphetamines and Xanax. This, in addition, to his refills by his US city psychiatrist. Was this doctor-shopping? He had the gene sight testing done and can not metabolize many medications. He reports to us now severe depression. He works from home and does manage to get out to buy food, MD appts, etc. But that's it. Completely isolated, he dropped all his wonderful & loving friends and not kindly. He lives alone, weekends I believe he spends mostly in bed. Is this from the crashing after amphetamine use? Or it's the depression? I and his father simply don't know. My son has refused x2 to give his permission for me to speak to his psychiatrist who is exactly his age (41) and, I believe, inexperienced to treat him. He now has been under his care for almost 4 years. Has gone through several therapist, claiming he "knows more than them". Several antidepressants have not worked. A low dose anti-psychotic off label to treat his depression has just failed. And his anxiety is very high...if one suffers from depression the twin is anxiety. Is this all drug abuse related? I don't know. I found him out in many lies to me. But b/c of some memory loss, he will say he "told" me something else. This past Christmas he never came to visit. The first time in my life he didn't spend Christmas with me. He missed his first flight & reported he was simply "unable" to get on another. He said he felt like a "failure". But "pretended" he was at the airport at times over the course of 10 days during the holiday. I believe he was in bed, on the United web site, just like I was. He texted me x2 and never answered my Happy New Years text. I had to reach out to him to reestablish contact the 1st week of January and then all he did was say he was sorry and cry on the phone and how "terrible" he felt he never came for the holidays. I have researched so many resources for him, suggested so many self care activities for him, sent his multiple books to read for help, messaged him 100s of encouraging, loving emails/texts to him. Written letters to him...for positive inspiration. All so loving, kind and understanding...trying and trying to encourage him to get his life back on track. At the age of 37 he lost a job he loved (boss stole his thunder) and never recovered. Then his best friend of 30 years died suddenly. Triggers?
Of course. But my son was always so motivated and a very high achiever. Went to the best college and grad school. MBA received in the best international business school in the world in France. Speaks 3 languages. Always at the top of his class. Traveled the world. From the age of 17 he left for college and never looked back. I never held him back, gave him wings to fly. Despite being in a terrible marriage I waited for him to graduated college before divorcing. Should I have divorced when he was 5 years old instead of 21? I don't know. So, yes, I do continue to work on myself always...yes, his life was, at times, in turmoil. Mine was also...but I managed to survive it and thrive in my career, etc. I am sad and disappointed my son can not get back up. And so much more disturbing is I truly don't know WHY...is it substance abuse related or treatment resistant depression?? If I write to his psychiatrist, won't he tell my son of my letter? And knowing my son, he will ask his doctor to read it himself. I am 70 with heart disease and May 2025 has a bilateral mastectomy. I just fell and fractured my elbow. I am not well and time is passing so quickly. I need to see my son well before the Good Lord takes me. I am so afraid I won't see it. Thank you for listening to me and for your insightful posting. So many questions are unanswered and my hands are tied to discover the truth...I would move mountains to help my son...but he simply does not listen to me and, at this point, I am unsure of what HIS truth really is.