When do you draw the line with somebody who's mentally ill?

LegacyUser

Im not just talking about depression or anxiety, I mean someone whose mental health has been deteriorating over the years, they have very odd behaviour, the friendship for years has been me listening to their thoughts and issues while she barely asks me how I am let alone listen to my response. I leave with a headache and feeling incredibly drained, she sees me as her personal counsellor but her problems are far beyond anything I can help with and its clear she has a deep mental illness that I don't think there's any coming back from. This isnt just depression...I was genuinely scared listening to her and the things she was saying. I dont want to cut her out but I cant see how I can help. Listening to her wont help as all her problems are things shes created in her own head and her behaviour is very worrying, she cant afford adequate mental health care. Its really sad to watch someone slip into madness and there's nothing you can do to stop it.

Wanderer78

Been there and walked away, unfortunately most of us are not really equipped to deal with these kind of issues. Look after your own well being

Taltos

Does she have family you can flag your concerns with or if not do you know her GP. While they can't discuss any of her details with you, they should at least listen to your concerns especially if you've any specific details you can share with them.

Shint0

I have posted in The Gentleman's Club forum here where there's a somewhat related discussion at the moment around being in a relationship with somebody experiencing mental health difficulties but it would equally apply to any close relationship/friendship. It sounds as though there could be more serious difficulties there from what you describe which left untreated over time become more insidious and makes it more difficult for the person to gain insight and awareness.

I'm not sure from your post if you are suggesting the irrational thinking may even be in the form of paranoia and delusional thoughts. That type of thinking really does only respond to medical intervention if that was involved here and you would be banging your head against a brick wall to try to rationalise with somebody with that type of thought process who would need to be under medical supervision. I'm not clear about what you said in relation to not being able to afford medical care. If somebody doesn't have private health insurance they can still access the public health system through a GP referral and will get seen in time. So I don't know if that's being used as a cop out by this person to avoid facing up to their issues.

From your perspective, yes, dealing with some people with mental health difficulties can be extremely emotionally exhausting and I say that as somebody who has experienced mental health difficulties myself and would have some difficulties still. When you constantly have to reassure somebody, try to offer positive words of encouragement, try to help them feel good about themselves but it's just a one-way street and you get nothing back in return then you do have to weigh up if it's worth it or do you just leave them be to deal with their issues themselves. Walking away isn't always selfish. It's about recognising how to protect yourself as well but try to make sure you can provide them with information on resources if they do decide to seek treatment. You would have done all you can by that stage.

nkav86

I'm going through anxiety and depression at the moment, got so bad that it cost me a job. I went to my gp who referred me to therapy, there's a wait list but its free. So I would suggest her doing that although I know some people just won't want to do that. I've also just put the breaks on a friendship quite similar to what you've described as it was all a bit too much. You have to look after yourself too, sometimes people's problems are too advanced for us to handle. There's no shame in telling her it's beyond your capability and that you feel overwhelmed and need time for yourself

Wesser

Is the problem that she is extremely manipulative/ angry / self obsessed negative ?

Or is the problem that she has a true psych diagnosis such as delusions/ paranoia or severe depression eg no interest in any activities no motivation/ staying in bed all day...

Big difference.

zcorpian88

Made posts about this in the gentleman's club in the thread entitled "Dating a woman that is unemployed" the convo regarding the topic steered towards mental health and I started posting about being in a relationship with someone with anxiety and depression.

Sometimes you have to walk away if their condition drags you down and you can't cope/adapt or aren't qualified with whatever they have, it's even more agonizing when you're in a relationship with someone that has a mental illness and the typical daily life struggles that set the illness off, then for days/weeks or more can go by before you start getting any enjoyment out of the relationship.

Draw the line when you feel your own mental health starts to become shaky and you find yourself a wreck from worrying and to be honest it sounds like you're going in that direction op, and if you're that worried maybe mention it to her family that you're worried, there is help but you have to be willing to ask and look for it.

http://www.boards.ie/vbulletin/showthread.php?t=2057640108

PressRun

Has she ever been given a formal diagnosis? Has she ever seen a doctor? If she hasn't, I would suggest that you bring that up with her and encourage her to make an appointment with her GP. Tell her that you're not really qualified to help her with what seems like some very serious issues and that you think she should speak to a professional. If she gets talking to a doctor, that could be the first step towards gettting therapy of some kind.

Does she have any other close friends? What about family? You could bring it up with them too and see what they say. I would explore other avenues of support for her before opting out.

LegacyUser

Taltos wrote: »

Does she have family you can flag your concerns with or if not do you know her GP. While they can't discuss any of her details with you, they should at least listen to your concerns especially if you've any specific details you can share with them.

No her family dont speak to her anymore, she's always been very vague about the details and what happened, she lived with different family members, they gave her jobs and everything as allot of them own their businesses and things, but it always ended in them kicking her out, they tried to help her.

Telluric

I'm sure this is tough for you OP. I've experienced both sides and I can empathise quite a bit. It's really important that you look after your own mental health when dealing with this, but it's also important to keep in mind that your friend has an illness and she's not being a bad friend on purpose.

I don't recommend that you share your concerns with her family because it simply isn't your story to tell. If she's confided in you, you have to respect her privacy here.

I realise that you feel like this is all too much, but just imagine how your friend feels. She probably knows she's not being the best companion in the world, but if she's struggling with her health then how could she be? I suggest that you try to guide her towards free or low-cost resources that could aid her recovery, or towards talking to anyone else whom she might have a good relationship with.

LegacyUser

Shint0 wrote: »

I have posted in The Gentleman's Club forum here where there's a somewhat related discussion at the moment around being in a relationship with somebody experiencing mental health difficulties but it would equally apply to any close relationship/friendship. It sounds as though there could be more serious difficulties there from what you describe which left untreated over time become more insidious and makes it more difficult for the person to gain insight and awareness.

I'm not sure from your post if you are suggesting the irrational thinking may even be in the form of paranoia and delusional thoughts. That type of thinking really does only respond to medical intervention if that was involved here and you would be banging your head against a brick wall to try to rationalise with somebody with that type of thought process who would need to be under medical supervision. I'm not clear about what you said in relation to not being able to afford medical care. If somebody doesn't have private health insurance they can still access the public health system through a GP referral and will get seen in time. So I don't know if that's being used as a cop out by this person to avoid facing up to their issues.

From your perspective, yes, dealing with some people with mental health difficulties can be extremely emotionally exhausting and I say that as somebody who has experienced mental health difficulties myself and would have some difficulties still. When you constantly have to reassure somebody, try to offer positive words of encouragement, try to help them feel good about themselves but it's just a one-way street and you get nothing back in return then you do have to weigh up if it's worth it or do you just leave them be to deal with their issues themselves. Walking away isn't always selfish. It's about recognising how to protect yourself as well but try to make sure you can provide them with information on resources if they do decide to seek treatment. You would have done all you can by that stage.

Yeah its gotten progressively worse over the years, shes been to low cost councellers but honestly theyre not very good, she's been to her GP but they fob her off and stick her on medication which doesnt appear to be benefiting her. Shes always been very paranoid and was always irrational but now shes been reporting people to the guards...ive been reassuring her for years, trying to keep things positive but shes paranoid and irrational, takes silly things as a personal offence, trails off when shes speaking, shes vague when she talks about things like everythings a secret, the conversation is entirely one sided, if I try to lighten it or change the subject she sits in silence and wont respond or interupts to talk more about herself, she only speaks when the conversation is directly about things concerning her, its hard, shes beyond help.

LegacyUser

Wesser wrote: »

Is the problem that she is extremely manipulative/ angry / self obsessed negative ?

Or is the problem that she has a true psych diagnosis such as delusions/ paranoia or severe depression eg no interest in any activities no motivation/ staying in bed all day...

Big difference.

She's manipulative, angry, self obsessed and paranoid. Shes been in therapy but hasnt been diagnosed I dont think... its become progressively worse. Its so hard to watch somebody unravel.

LegacyUser

Telluric wrote: »

I'm sure this is tough for you OP. I've experienced both sides and I can empathise quite a bit. It's really important that you look after your own mental health when dealing with this, but it's also important to keep in mind that your friend has an illness and she's not being a bad friend on purpose.

I don't recommend that you share your concerns with her family because it simply isn't your story to tell. If she's confided in you, you have to respect her privacy here.

I realise that you feel like this is all too much, but just imagine how your friend feels. She probably knows she's not being the best companion in the world, but if she's struggling with her health then how could she be? I suggest that you try to guide her towards free or low-cost resources that could aid her recovery, or towards talking to anyone else whom she might have a good relationship with.

She hasnt really confided in me, its not like a bad patch shes going through with depression or anxiety or an illness shes aware of, she doesnt seem to notice how her behaviour and thoughts are erratic or unusual... shes been threatening people with legal action, reporting people, her family dont speak to her anymore, im trying to help.

Shint0

Anon1234567 wrote: »

Yeah its gotten progressively worse over the years, shes been to low cost councellers but honestly theyre not very good, she's been to her GP but they fob her off and stick her on medication which doesnt appear to be benefiting her. Shes always been very paranoid and was always irrational but now shes been reporting people to the guards...ive been reassuring her for years, trying to keep things positive but shes paranoid and irrational, takes silly things as a personal offence, trails off when shes speaking, shes vague when she talks about things like everythings a secret, the conversation is entirely one sided, if I try to lighten it or change the subject she sits in silence and wont respond or interupts to talk more about herself, she only speaks when the conversation is directly about things concerning her, its hard, shes beyond help.

It could be any number of things going on. She might not even be disclosing everything to the GP so might not even be on the right medication if that were the case or some people don't even know which symptoms are relevant so don't even report them. She might not even be complying with the doctor's medical advice. In cases where it might be a personality disorder rather than a mental illness it would require specialised therapy rather than the type of low cost counselling you mentioned and medication might be less appropriate than the right form of therapy.

Unfortunately people can go for years sometimes without getting a proper diagnosis and their condition can become worse over time if not managed effectively. The positive thing you mention is that at least she seems willing to engage with seeking treatment and support rather than being totally opposed to it. It might be a case of finding the right doctor or therapist who will take her seriously rather than fob her off but if you think her behaviour is becoming more irrational you could suggest to her to ask her GP to refer her to a mental health service for a proper evaluation. That's if she's willing.

Big Bag of Chips

I wouldn't be too quick to dismiss low cost counsellors as not being very good. Your friend sounds very difficult and very manipulative. Counsellors, GP's, even psychiatrists can only do so much. The patient has to engage a bit. A friend of mine was in a bad way for a long time. On a road to destruction. Something eventually happened to give them a bit of a wake up call. They went to their GP who referred them to the psychiatric services and through certain channels they were seen within a few days by someone from the psychiatric services and from there were referred to an addiction counsellor and seen in a couple of weeks. Once 'in the system' the addiction counsellor was able to refer them to the psychiatrist and they are seen by them now every month or 6 weeks. All free. All done through the HSE.

This person spent years avoiding any sort of psychiatric services. Took medication but didn't want to discuss it with anyone. It was only when something happened to shake them up a bit that they decided they needed to engage. And they have had every opportunity given to them. And the gratefully accept it and gratefully do everything they are advised to do.

Your friend sounds like a difficult person in a difficult situation. From what you say the psychiatric services don't even know about her. And your opinion of how good or not her counsellors might have been is coming from her opinion. The person who is going around spreading lies and threatening to sue various people for whatever reason? There is only so much people can do with little cooperation from the person themselves. I know your friend is probably at a stage now where she doesn't even realise how bad she has gotten. In her head everyone else is wrong. People who work in mental health have a difficult enough job as it is. People like your friend are very very difficult to work with. You see yourself first hand what she is like. She won't be any different for a counsellor, or even a psychiatrist. No matter how trained they are, or what their level of expertise is, a patient still has to engage.

Unless she has 24 hour mental health care supervision, there's only so much the services can do for her. She needs to do a bit for herself too. But, she won't believe that.

It's tough.

Wesser

I think the first step is To get a formal mental
Health diagnosis. She may have a personality disorder from what you are describing. This is quite very difficult to treat and can be tricky for film / friends to manage. I think the key here is getting a full psych diagnosis.

looksee

You can only get a diagnosis if the person is willing to be involved. It sounds as though the OP has done everything to try and help this person but they are not responding. They are happy with the situation of having someone to complain to. At this stage it is down to the OP to decide whether to hang in and continue listening, or walk away.

If you do meet them again try not engaging with their problems, change the subject, talk about what you are doing, lighten things up a bit. You will soon see whether you are just being used as a handy listener, or whether the person does really want to change their situation. Given the family situation (they have dropped the person) I suspect that this person will just go from one listener to another; once everyone has given up listening they may decide to go and get professional treatment.

Even the professionals cannot do anything if the person will not engage. I don't know what the solution is, but really you cannot allow yourself to be dragged down into this person's issues.