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Romashka comments on The Problem (TM) - Analyse a conversation - Less Wrong
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The most alarming part of that conversation for me was "A few weeks ago I punched a housemate in the face ten times, breaking her nose;"
If I was having the conversation, I would ask him more about this, and talk at least a little bit about how he could stop hurting other people.
I'm not sure what you mean by the bottom of the problem. I will say some things that I think are problems. These are speculations. I don't have enough information to be confident in these answers.
1) I think it is a problem that, as far as I could tell, no one intervened and taught him not to be abusive after the punching incident. This is a problem with society.
2) I think it is likely that he has a brain injury from a head injury of some sort and/or from taking drugs such as meth. He mentioned both a head injury and meth. I would say to get treatment for brain injury, but doctors are still pretty clueless about how to treat brain injuries, though there are experimental possibilities.
3) I think it's possible that he's a sociopath, but there's not enough info to figure that out. The combination of not finding pleasure in life, and feeling no remorse, and not thinking about the effects of his actions on other people is suggestive. (Although there can be other reasons for that.)
4) I think there's likely something else wrong with his health. Maybe bipolar, since the bipolar meds are helping a bit, but I'm not convinced that accounts for everything.
5) I would guess that he did not have opportunities in childhood to be self-directed. His sense of not knowing what he enjoys, or what he wants, or how to make a plan, might be from lack of education and training in those areas, not just from physiological problems affecting his judgement.
Is it really the most alarming part? I would think suicide ideation more so.
If he kills himself, he hurts only himself. If he's violent toward other people, he can end up doing a lot more damage than that. He mentioned that one incident, but given his casual attitude toward it, there are probably more. It wouldn't surprise me if he was beating his girlfriend. Domestic assault (I call it domestic because it was against someone he lived with, even though housemate is not as usual a target as partner or child) is a huge huge huge warning flag. He had a bad day, and trouble sleeping, and suddenly someone else has to deal with the consequences of having a broken nose for the rest of their lives. The consequences for each of them are disproportionate, asymmetric. If he has another bad day, what next?
His girlfriend's life might be in danger.
The combination of suicidal thoughts and violence toward others is worse than either alone. There are lots of ways to commit suicide that hurt more people more seriously than one broken nose.
I considered this at the time, but I also decided not to dig at it. Z is still around, but I imagine Z would protest when I suggest that the summary of the punching incident was a throw-away line of "I'm too crazy for treatment".
If the inquirer took the bait, they would end up arguing about a specific incident that may or may not have gone quite like that and may or may not have had motivations that actually make in the bigger picture. (i.e. ongoing arguments, several-directional fights) Setting that down, and not delving into it, was me maintaining composure and actually having the rest of the conversation.
Upvoted both you and Dagon, because I agree with what you say.
Still thinking that a housmate whose nose was broken and who, to our knowledge, doesn't have depression, has better chances of survival, though.
If I were to focus on the suicidal ideation I would have missed every other problem that came up. And Z would have shut down, Z was not interested in talking about solving the suicidal ideation so I deliberately left it untouched. Lobbing an accusation about suicidal ideation is not a great idea for getting people to open up about their problems. As it is - I got a lot of information out of Z by not idling on suicide or the punching incident or other incidents.