Gynomite!

Gynomite is a licensed therapist in 2 1/2 states and she would love to take a crack at your emotional dilemmas.  Write her at askgynomite@gmail.com- all emails stay confidential.  Today, Gynomite takes on being concerned about a friend’s mental health.

I am worried about a friend of mine.  We both live in a big city, and our families are far away, and she has just been acting very jumpy and strange lately.  I’ve known her for about 8 months and haven’t seen anything like this until recently when she started calling me in the wee hours of the morning asking me questions about philosophy and trying to read me stuff she found on the Internet.  But then she’ll kinda be fine for a day or two afterwards.  Then it’ll happen again, and she’ll get sweaty and kinda frenetic when we’re out at a bar, yelling at strangers about weird things.  I feel like I’m the only person who is concerned, but I don’t even know what I should do?  Do I make her go to therapy?  Call someone?

I get this question in person all the time.  It is very scary to watch a friend act strangely and be genuinely worried about their safety without knowing what to do.  It’s especially scary in big cities, where families, i.e. the people responsible, are often far away.

I don’t know what state you’re in, but generally, you cannot force anyone into counseling or treatment.  At all.  The laws are set up to protect the person experiencing the symptoms.  The only way that you can force treatment on a person is if they have indicated that they are unsafe to themselves or others, and “unsafe” means imminent danger.  Not “if they keep going down this path, they could get hurt”, but “she has a knife and called me to tell me goodbye”.  So there’s no making her go to therapy. This may be frustrating to hear, and it is frustrating to a lot of people who care about someone experiencing symptoms of mental illness, but this is the system we have.

I can’t speculate on what may actually be going on with your friend.  It could be a manic episode, it could be psychosis brought on by substance abuse, it could be absolutely nothing but shifting worldviews, it could be a psychotic break.  My first suggestion would be to talk to your friend when she seems to be okay and ask her how she is feeling these days.  Ask her if she feels at all out of control, or like she’s had any changes, or if anything is different with how she’s feeling, and then listen to what she has to say.  Bullying a person who is having emotional issues about their behavior, or telling them what they should do about it, will only serve to isolate you from your friend more.  Let her know, gently, that you’ve noticed some changes in her behavior and you’re wondering if she could use someone to talk to.  If she is experiencing symptoms of mental illness, it’s likely very confusing and upsetting for her.  Be on her team, and put the symptoms you’ve noticed on the other team, so that she doesn’t think you are criticizing her.  If she’s open to it, ask her if she’s ever seen a therapist before or taken any medications.  Tell her you’d be happy to help her find someone to talk to if she wanted help.  (Resources listed below)

I would also recommend speaking to any of your other mutual friends to see if they have noticed the things you have.  They may have been friends with her longer and have seen these things happen before, or they may not be noticing anything at all.  Don’t make it a gripe session, but just checking in with the other people that serve as de facto family.  I don’t want you to feel like you’re the only person responsible in this situation.  Reach out for help yourself.

If your friend decides she’s okay with you finding a therapist for her, (or even if she doesn’t), give her the names and numbers of several.  You may want to call and make sure they’re taking new clients, but you cannot set up the appointment for her.  You can ask about it on occasion, but hounding her about whether or not she’s going will not help.  You should also know that her behavior won’t immediately normalize again- it may take a bit, even with therapy, before she feels “normal” again.

If things escalate to a point where you are becoming legitimately concerned for her safety, or you feel like you’ve done all you can do to help her and it’s not enough, you should call her parents.  This should only be done if you are really actually concerned, because it’s a bit of a harsh thing to pull on someone.  I have recommended that people get phone numbers out of their friend’s phone if they feel like they wouldn’t be able to get it directly, but again, by taking steps like stealing phone numbers and calling parents, you may be damaging your trust with this friend, so it better be worth it.  Don’t scare the parents, but explain to them the behaviors you’re seeing and let them know that you’re just concerned for their daughter.  They will certainly have more information about her patterns of behavior, and they can make decisions about what to do from there.

Mental illness, depression, suicidality, and serious substance abuse are all incredibly crippling for the person experiencing them, and incredibly frustrating and exhausting for the people around them.  Make sure you are reaching out for help for yourself too, and always remember that people aren’t mentally ill, they have mental illness.

Ok, fun time!

Here are some places you can browse/call for help on finding a therapist or just getting more specific info on how to help people you care about.

NAMI is amazing, and helpful both for people experiencing symptoms as well as the people that care about them. Here’s how you find info for your state.  Psychology Today (yes the magazine) actually has a great resource for finding therapists that are not tied to just one insurance company.  I would also recommend googling “sliding scale therapist” and the city and state you live in to find local therapists who adjust their fees for people that don’t have as much money.

Good luck.

Psych today

NAMI