Tuesday, November 20, 2007

When Friends Slide Over the Edge

Thanks to Sue from Kannsass for this topic. What can you do for friends who are clearly suffering from depression, mania, or whatever mental illness manifestation?

You want to help but how? Your friend has withdrawn to the point that it's interfering with their life or is so out of control whacked out that you can no longer ignore the behavior. Well, not being a mental health professional but someone who has dealt with a sibling who suffers from depression, here's how I handled it.

First of all, tell the person that you love them. That's it. Don't talk any further, just hold them, give them physical reassurance. That goes a long, long way, especially for depressed people. I know myself that when I have been depressed, having someone who just gave me a loving hug did enormous good.

This can loosen up the toughest cases, I think. Once you feel that the person is receptive--you've built trust with the physical contact--then tell them that you are concerned (not worried, don't use that word) about how they feel and that you will support them in any way possible. You want the person to feel positively about getting help. Don't condemn, don't shame, don't get frustrated with their lack of response, even though it's often hard to avoid these feelings when dealing with the mentally ill. Understanding is huge in getting people to face their illness.

However, if the person is completely over the edge and incapable of making a sane decision, it's time to intervene.

If the person is actively suicidal, do not pass Go, do not collect $200. Contact a family member, if you are a friend, and emphasize the seriousness of the situation. Often the family members are the last to know how ill your friend really is. It is a life and death matter, no drama intended. If your friend has no one, call 911 or the local crisis intervention center, and get them hospitalized. Immediately. Don't be afraid of overstepping the boundaries. This person is no longer responsible for their actions.

Suicidal people can hide their intentions quite well, especially if they are bound and determined to off themselves. I know, having worked in a psychiatric hospital, that oftentimes, there are signs so subtle that even professionals miss them. If this is the case, ultimately the person will be successful and kill themselves, with little warning to those close to them. And therein lies the hideous tragedy--those left behind berate and torture themselves for not having "saved" their loved one. Sometimes, you just can't save someone from themselves. They have to have a glimmer of insight in order to pull themselves up from their depths and get the help they need.

Mania is another kettle of fish entirely. People in a severe manic state can do really dangerous, off-the-wall stuff, especially when the condition is severe. Grandiosity is a key symptom, as is paranoia. If your friend is convinced that they need to go to a casino with their life savings because they know they'll win big, you may or may not be able to talk them out of it.

Manics don't listen well. So the best you can do is gently but firmly suggest to the manic friend that their behavior is inappropriate and could cause them a lot of trouble. Their behavior. Not them. Don't say "You are crazy and you'd better stop this right now!" A more effective way of addressing it would be, "You know, your behavior lately has been pretty reckless. I'm concerned that your actions might get you into big trouble. Is there anything that might help? Can I help?"

By and large, helping someone who is in the throes of mental illness can be at best tricky. You can do what you can, but in the long run, the person who is ill either will accept their illness on their own and get help, or they'll be committed to a hospital. Either way, as a friend, just love them, listen, and be there. If you do that, you're a true friend.

Finally, don't be afraid to ask a mental health professional for some guidance for you. In fact, I would do that without hesitation. Because living with and loving someone who suffers from a mental disorder can be a strain on those who are the support system.


torKNITtoh said...

Hey. Thanks! By reading your post, I guess I wasn't all that far off in what I'm doing. I'm glad you started this blog up again.

Sue said...

Does it matter which types of medications you are subscribed? Do some work and others not? And does it make a difference if you see a regular medical doctor or a psychiatrist?

Sue in Kannsass

Anonymous said...

Dear Marilyn,

Thank you.