Ask Dr. Nerdlove by Harris O'Malley

How Can I Save My Friend From Herself?

DEAR DR. NERDLOVE:  I’m hoping you can help me get out of a proverbial pickle.

I have a very close friend, who is very dear to me. She is funny, she is clever and we both bond over similar interests. Unfortunately, however, she also has mental health problems. Due to a troubled childhood, emotionally neglectful parents, and teenage years spent in a toxic and abusive “friend” group, she is incapable of fully trusting people, has extreme self-esteem issues, depressive episodes and often acts like a scared, cornered animal.

She has been going to the psychiatrist and getting treated medically, but is still in extreme denial over her issues. Despite being diagnosed by the doctor with some serious issues, she still considers medication the only thing needed to fix everything. She, for the longest time, was opposed to the idea of therapy, claiming that it might unearth things that’ll make things worse overall. She notoriously misses appointments with her therapist, says that since the therapy isn’t working (she’s gone maybe twice over three months) then it’s pointless. Generally, she seems to be unwilling to get serious help, because that means having to admit things are wrong, facing them and she feels she might be unable to do it.

Our friendship has been taking a hit because of it. I do not fault her for having mental issues, and I do not fault her for being afraid to start treatment. However, over the past six months she has been needing more and more of my attention and energy to tell her she isn’t the worst person to exist and that there is possibility of improvement. I love her dearly, but I didn’t sign up to be her therapist or carer and that new element of our relationship she’s imposing on me saps me of energy. This means I speak to her less, I meet her less and generally interact with her less.

I have tried a few interventions. I explained the situation to her, telling her that she needs help and I am unable to provide it and that our relationship is taking a hit. She seems genuinely saddened by it, promises to do something and does a nominal, one-off action and then makes excuses. I have done this twice or three times and the effect is always short term. She will take any form of negative comments extremely seriously and as a sign of my hatred towards her, so I don’t do this too often as she is clearly very taxed by them (I do believe it’s genuine and not manipulative, but I wouldn’t know, would I?).

Now, since she’s taking way more than she’s giving, she’s forcing new roles that I did not sign up for and she’s sapping my energy, the logical thing to do (I think) would be to abandon the relationship. However, firstly, she is a very close friend of mine and I do care about her and don’t just want to ditch our long friendship. And secondly, perhaps more importantly, I feel she will abandon any hope of improvement, retreat into her shell and never get better – I am a very important part of her support network (she doesn’t trust her parents and I am one of two people who really know what’s going on with her) – and I don’t want that. I also don’t want to give her a get-help-or-lose-me ultimatum, because ultimatums seem like an awful thing to do. But then I don’t think doing nothing will help either, our friendship will suffer, my energy levels will suffer and she won’t benefit from it, eventually leading to our friendship decaying.

I have no idea what to do. Help me Doctor!

Kind regards,

Stumped

DEAR STUMPED: One of the hardest things to deal with in a relationship, platonic or romantic, is when someone needs help but won’t take it. Whether it’s the alcoholic who refuses to see that they have a problem or – as in your case – someone who has mental health issues, it can be incredibly frustrating, even damaging to the people around them. You know damn good and well that they have a problem and the answer is clear as day… why don’t they see it? It’s enough to make you want to tear your hair out. And in this case, you’re being dragged into her drama as she continually demands that you take on roles and responsibilities that you never signed up for.

The problem is that you can’t make someone do the right thing. You can cajole. You can request. You can beg and plead on bended knee. You can threaten. But at the end of the day, they have to be the one to make that decision. Trust me: I let my depression rage out of control before I was willing to do anything about it because I didn’t want to admit that I couldn’t hack it. I didn’t want to be “weak”. It wasn’t until I had to leave school for a while before I could admit that I needed to do something. This is part of the reason why Alcoholics Anonymous talks about needing to hit “rock bottom” before getting help; that tends to be the point that someone realizes that they can’t gloss over the issue or pretend it’s not as bad or not take getting help as seriously as they need to.

Unfortunately, your friend has yet to hit rock bottom. And – please don’t take this the wrong way – in your own way, you’re still cushioning her fall. It’s hard, really hard, to do what needs to be done sometimes when your friend needs help. You don’t want to see them in pain! You don’t want them to think that you don’t care! You certainly don’t want to make things worse. But in a perverse way, that’s exactly what’s happening. Every time you’ve tried to take a hard line to get her to take her recovery seriously, she’s managed to get you to give in. You’ve shown her that if she makes enough of a fuss, you’re going to end up taking on responsibilities that aren’t yours and providing care and support that you’re not qualified to give… and that lets her put off getting help a little bit longer. And worse: it drags you down with her and that’s not fair to you.

You can’t make her do anything but you can draw a line in the sand. You tell her that you love her and you’re her friend but as her friend, you need to pull back until she gets help. Not just pills – which can help, don’t get me wrong – but help. When she starts to seriously work with someone, not just a token effort but makes genuine progress and a commitment to get better, you’ll come back. But you can’t be her excuse for not getting help and you can’t continue to do the work for her.

And then you step away. You don’t answer her emails. You don’t take her calls. You don’t let her guilt you into backing down again. She’s going to fall and if you’re there to catch her, she’s not going to stop relying on you as her crutch and her excuse to not see a doctor. Yeah, she may get hurt. She may get seriously hurt and that will tear your heart to shreds. If you legitimately fear that she’s going to hurt herself or do permanent damage, you can tell her parents or you can call a 911; they’ll be in a position to make the call as to whether more drastic steps need to be taken. Hopefully it won’t come to that. Hopefully, your come-to-Jesus talk will be the smack from the Chair Leg of Truth that will make her realize that she can’t put it off any longer.   But you. Can’t. Fix. Her. You don’t have the training. You can’t live her life for her or take her responsibilities on. She needs to be the one to do it. As much as it will hurt if she hurts herself, as awful and as guilty as you’ll feel, it’s not your fault if she does. You can’t control other people or make the choices for them. You can only do the right and loving thing and that means cutting her off so that a) she knows that she can’t put it all on you and b) so that you don’t get hurt in the process.

This doesn’t mean that you abandon her; you can keep tabs on her from a step or two removed. You can stay in contact with her parents and monitor her that way. But you have to maintain the hard line. And it will suck. You’ll feel awful. You’ll feel like the worst friend in the world. But you’re not. You’re doing what needs to be done, so that she can get the help she needs.

I wish I had something better for you. But at the end of the day: the only person who can save her is herself.

Good luck, Stumped. And write back to let us know how you and your friend are doing.

Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com)