Originally Posted By Mr X Okay, so without going into too much detail, I have a loved one in my life who is insane. To be technical about it, she is paranoid schizophrenic, manic depressive. So, all around a bad combo. For the past few years she has been relatively stable, but recently her letters to me have become more and more disturbing (emails and phone calls are fine...just basic "how are you?" "how's the weather" kinda stuff). The letters have been more and more related to paranoid kinda stuff (like, "a mafia kingpin has moved in above my appartment). And just yesterday I received a letter where she talked about some stuff that happened in the past. I knew that, at some point, she travelled around the world in an insane fashion (running up her families credit cards in the process) ending up in the country of Jordan where she was picked up by the U.S. consulate...this was back in 1982, but she never mentioned it til the letter. In the letter, she explained that she'd been kidnapped, and the king of Jordan had freed her. Anyway, I just don't know how to reply. I don't know much about schizophrenia anyway...and I'm afraid that any comment by me might make things worse! What I really want to ask her is if she's seeing her psychiatrist regularly, and if she has gone off her medication. But obviously, that's a hard thing to ask (we never talked about medication or anything else related...she mentioned her therapist maybe once or twice in passing). She has a heavy history of mental trouble, and a sister that committed suicide and a grandmother who was lobotobized...so the family history is nothing short of classic. I just don't know what to do. I'm afraid that any comment on my part might be taken wrong, and I'm ALSO afraid that if I DON'T mention the disturbing letter (the worst in a series, which I've never brought up in phone conversations yet), it might make her think I'm ignoring her or worse. Any thoughts?
Originally Posted By tiggerdis_ I'm guessing she lives in another city? Is there another family member who lives closer to her? Find out who her doctor is. Could you perhaps say that a friend has moved to whichever city she lives in and is looking for a family doctor? I would contact the doctor, make an appointment and show him/her the letters. If she needs the help that she is crying out for, the doctor will be the one to make sure she gets hospitalized. Just my thoughts...
Originally Posted By Jim in Merced CA Mr. X, I understand what you're going through. My dad suffered from manic depression his entire life. He had only been diagnosed at age 50, and had been taking medication off and on for the rest of his life. I saw him way up and on a high, and in the depths of deep depression. He even attempted suicide and was checked into a psychiatric ward for a time. Depression is hell. The untreated depressive person is in a world of hell. The people around them share that same hell. And it's a very desperate helpless feeling. And yes, there is that feeling of 'I don't want to be the person who puts them over the edge.' Absolutely. While I understand your sense of wanting to help, recognize too that the person you're discussing has to ultimately find treatment on their own. When Dad was at his worst in the mid-80s, I used to feel like it was up to me to not only cure him, but to save my entire family. After all, I could see what was going on, and had the smarts to take charge, right? Eh. Not really. As much as we 'normals' want to help, it's next to impossible to single-handedly take charge of another person's life and force them to get treatment and help. Why am I writing this? To let you off the hook. Just because this loved one is writing to you, doesn't mean they're looking to be 'saved' or helped. Treat it like any other person who wrote you a letter. 'Hey, how are you?' 'Thanks for the note' 'Here's what's going on with me' etc...
Originally Posted By Inspector 57 Hey, X. [I'm going to try to write quickly. It's hot as heck here, and thundering and lightening. Classic conditions for us losing power. I want to get through this. Sorry if it isn't polished.] First, accept what Jim said. You have neither the obligation nor the ability to make everything better for her. No matter what you do, she may go off the deep end. If it happens, it won't be your fault. You're no match for such a deeply entrenched disease. I sympathise with you. As I see it, you do not have a "doing nothing" option. However you react, you'll be doing SOMEthing: confronting her; continuing to be in touch without confronting her; or ignoring her. None of those options is without risk. If you confront her and things end poorly, you'll think, "Man, I NEVER should have done that!" If you talk to her without mentioning anything and she gets worse, you'll think, "I SHOULD have confronted her!" And if you don't respond at all and she gets worse, you'll kick yourself for not doing anything. It's a potential no-win situation. Don't judge the appropriateness of your action based on the outcome. Frankly, it doesn't sound as though the long-term prognosis is especially rosy. For what it's worth -- in MY non-professional experience -- most psychotics are able to speak about their illnesses with surprising articulateness. I counsel people all the time who say, "Yes, I know I should do this but I get these wrong thoughts." That makes it easy to say, "So is there anything you can do to prevent those thoughts? Does anything work for you?" And then maybe, "Why is it that you sometimes don't take your medications? Are there side effects? Are the side effects worse than the disrupted thoughts you get without the med?" Etc. Again, in MY experience, people generally seem relieved to be able to have this conversation with someone who is not judging them. Just asking them honest and "flat" questions about it implies, "Yeah, I know you have mental illness. That doesn't make me like you less. I still regard you as an intelligent person who can make decisions. I hope you'll get better and I'll do what I can to help." If you hadn't guessed, my personal approach to your three options would be to bring up the mental illness explicitly with her. IF she's open to it, I would ask her about it. I'd mention that she seems to be less lucid more frequently in recent communications. I'd ask about medications. I'd encourage her to stick with them, or get back on them, or try to find some other help (different meds, different therapist) if she's not happy with what she has. For me, it would be easier to do that on the phone or by email than in a letter. You can gauge her reaction better and quicker that way. But maybe a letter works for you. I wouldn't shine her on. I think that would ultimately make things worse for her. If she looks to you for advice about aliens that are spying on her, for example, I wouldn't play along. I'd point out that those are wrong thoughts. Depending on her state of mind at the time, that could be a very difficult position to maintain. Don't take it personally if she gets pissed off at you, and don't accept responsibility for her actions. Is there someone closer to her who has more of a "caregiver" role than you do? If so, does that person know about her apparent decline? You might consider either (A) asking her to talk to her "caregiver" about how she's doing or (B) contacting that caregiver yourself. Even if it means violating some confidentiality. If things become uncomfortable for you or you have questions, is there someone else in the situation that you could approach for information and/or support? Mr X, you are SUCH a good person. I hope you recognize and appreciate that about yourself. Good luck to both of you.
Originally Posted By Mr X Thanks, all. Very good advice...some of is scary, obviously, but good. Inspector, that second to last paragraph is going to give me a swelled head. I'll see what happens when I speak to her next on the phone, I guess (letters and emails don't really "cut it" as far as bringing up the disturbing letters, or not).
Originally Posted By Mr X >>Is there someone closer to her who has more of a "caregiver" role than you do? If so, does that person know about her apparent decline? You might consider either (A) asking her to talk to her "caregiver" about how she's doing or (B) contacting that caregiver yourself. Even if it means violating some confidentiality.<< Tigger brought this up too, so I'll try to explain a little more... Up until she passed away, her Mother had always sort of watched over her, providing money for treatment and whatnot. But she died several years ago. She has 2 children, who I am not in touch with, but who don't really seem to care all that much about their Mom (or else, they're "over" her in a sense). It's pretty sad really, she lives in squallor basically, and her kids are a lawyer and a doctor, but I guess they don't have enough cash between them to put out the cash for a better apartment for their mother. I understand the whole "it's not my problem" thing, but I really find that to be pretty pathetic considering how well off they both are. And then, she has a brother who I am sometimes in touch with, but he doesn't really care much either, and also lives in a far away state (*I* live in Japan, and she's on the east coast, so I'm as far away as can be). So the short answer is, no she doesn't have anyone really watching over her as far as I know.
Originally Posted By LPFan22 Inspector said it very well... and I agree with everything he said too. I just want to add that I can't help but think (in my non-professional opinion) that reaching out to your friend in some positive manner would be better than not doing anything at all (not that anyone told you not to do anything). Whether she admits it or not, she may be comforted knowing she's loved and being thought of. I guess just try to be receptive and positive.
Originally Posted By MomofPrincess No words of advice, but I do feel your pain. My sister (who killed herself) was bi-polar, and my brother is a paranoid schizophrenic. I am basically his only living relative (other than our brother who is severely brain injured and living in a care facility). The stress his life puts on me at times is almost unbearable, and the worries are neverending. My heart goes out to you.
Originally Posted By Mr X And to you too, Mom. It's really tragic how these diseases just tear through entire families. The woman I'm referring to is my aunt (at one time, long lost for years), and her sister, my Mom, also had mental illness troubles (never diagnosed properly back in the 70's) which lead to her suicide as well. That's my biggest fear for my aunt, since paranoid schizophrenic manic depressive (nice one-two punch, huh?) often take their own lives. It's really sad. She's remarkably brilliant, actually, and holds TWO PhD's from Harvard University, but she hasn't been employed for decades and has to live off the state.
Originally Posted By Goofyernmost Believe me when I tell you there is very little you can do to influence your friend. My X was diagnosed with a schizoid personality. She was also a very intelligent woman. Two Masters and had almost made her Ph'd late in life at the age of 56. She failed to get that accomplished because her illness took over. She would not listen to anyone and the longer it went the less inclined she was to accept that people were trying to help her. I was her husband of 29 years and all she could see in me was a controlling person that was trying to stop her from doing what she wanted. On the rare occasions that she did take anti-psychotic medicine it would be short lived because she would magnify the side effects and as she got better would consider herself past it and stop taking the meds. She eventually left home, alienated her two daughters and everyone she had contact with. It took a crisis situation involving the near loss of her apartment and constant harassment directed at the mental health facilities personnel for her to be forcibly detained and required to take the appropriate medication to help her stabilize. She is now doing fairly well but has burnt so many bridges behind her that she has no place to turn too and feels to old to start over. So she is collection social security and doing a part time job as a cashier in a drug store. All that was to tell you this. I, as her husband, did not have any influence on her decisions or the outcome. Her children had no influence when she was at her worst. As a friend all you will be seen as is just another one that is now trying to say that something is wrong with her and that you have somehow joined the conspiracy that is "out to get her". All you can do is be friendly and supportive in all areas that are viewed as acceptable behavior and steer clear of anything else. There is nothing good that will come from attempting to intervene. If you feel that her well being is worth the possible loss of a friend then the right thing to do is try to help. The risk is big and the chance of success is small. It is hard sometimes to shield people from themselves. Good luck with whatever you decide.
Originally Posted By Liberty Belle I agree that it's potentially a no-win situation. My best friend for 5 years (we're no longer friends - her choice) had various mental illnesses and was suicidal. Her 14-year-old sister committed suicide, which in some ways saved her life because she wasn't going to do that to her family again. I tried to help her for the last year or two of our friendship (from the time I discovered she had mental problems) and she kept pushing me away. I think I became the bad guy, but I don't regret offering to help - our friendship would have ended sooner or later no matter what I did, and at the very least, my conscience is clear that I tried as hard as I could. I think what it comes down to is that, as others are saying, there's very little we can do to help people with problems like this, but I would suggest it's worth trying something, no matter how small. A sympathetic "how are you?" and "is there anything I can do to help?" MIGHT be all she needs to start talking. Whatever happens, though, I hope you don't hold yourself responsible. Good luck.
Originally Posted By Jim in Merced CA <All that was to tell you this. I, as her husband, did not have any influence on her decisions or the outcome. Her children had no influence when she was at her worst. As a friend all you will be seen as is just another one that is now trying to say that something is wrong with her and that you have somehow joined the conspiracy that is "out to get her".> You wrote this much better than I did, Goofyermost. Try as we might, as as much as we'd like to be able to, most times we can't 'save' the depressed person from themselves. Again, my dad was depressive his entire life -- his mother and father, his wife of 45+ years, his three kids -- no one could do anything to reach him. It's a horrible, horrible disease.
Originally Posted By MomofPrincess Thank you, Mr. X. I thought about this overnight, and decided I could maybe suggest a couple of things. I was thinking about how I would deal with this if it were my brother's ramblings (which, Lord knows, he has many) and how I would respond. It's a fine line; you don't want to discount what they're feeling (it's very real to them), yet you don't want to make them more upset, either. I would probably write back and say that I was so sorry for her concerns and also her troubles in the past, and that I was really at a loss as to how to help--other than by just listening/sympathizing--but that maybe it would help to get in touch with her therapist about these matters if she hasn't already. (Since she's mentioned a therapist in the past, it wouldn't be rude to say, and yet maybe it would be a good HINT if she's not in fact seeing someone right now.) Tell her that you're very concerned for the way she's feeling and think that someone in that position would be more qualified to help work through her feelings. And leave it at that. I would then go on to talk about my life and the regular goings-on and just make small talk--the way you would if you were talking on the phone. Does that help at all? That way, you're not downplaying her feelings, not enraging her, either, and not getting all caught up in the middle of it.
Originally Posted By amazedncal2 I don't have any better words of wisdom than haven't already been written by others who care. I'd just like to offer some hugs from one who knows that "oh cripes" feeling when reading those emails or getting those rambling phone calls. In our case it's a brother in law who comes and goes in our life. It's never that we don't care, more like been there 50 times, done that 50 times and it never changes. Your emotions tend to get a little numb. Do what you feel comfortable with. You have some excellent suggestion here
Originally Posted By Mr X All good advice. Thanks. Still don't know what I'm going to do, exactly. I suppose I'll wait and see how it goes the next time we talk (as I said, it's hard to bring up BECAUSE she is usually very lucid on the phone and never brings up what she writes in letters). Thanks everyone.
Originally Posted By DVC_dad Mr X, I enjoy your posts...until THIS one. Just kidding. You strike me as someone who has a very level head, so I am sure you will be able to do whatever the best thing TO do is. Good luck and hope it wll works out for you and your loved one(s). Keep us posted!
Originally Posted By ShivaThDestroyer Mr X, I have nothing to add other than to say that I feel for you. My mother was a paranoid schizophrenic alcoholic (another bad combination). Our childhood was not pleasant and, at 8 years, old I remember actually being relieved when my sister and I were removed from her custody. Mom never had the life she should have had and passed a few years back. It took me many years to come to terms with my conflicting feelings for her. As I matured, I eventually learned to separate the illness from her. That's harder to do than you think. With Mom there was always that feeling of "walking on egg shells" because you never knew when and what might set her off and other other times she would be perfectly lucid. I don't think there are any real answers but you have some great advise from others here, who care about you, and the respect and support of some of us who have walked the same path.
Originally Posted By Jim in Merced CA <With Mom there was always that feeling of "walking on egg shells" because you never knew when and what might set her off and other other times she would be perfectly lucid.> Totally identify with that -- as a kid, my Dad was the same way. One minute easy-going and lucid, then 'something' would set him off and he'd be crabby and bitchy. As kids, you're never sure how to deal with it. Fortunately, I had the opportunity to develop a relationship with him as an adult. It wasn't easy, but with the help of my awesome wife, I kept working at it until my Dad and I were able to talk 'man to man' so to speak. In other words, I was no longer playing the part of 'Little Jimmy' his son. He was still maddening and frustrating at times, but we learned to develop a new friendship with each other. It was a fascinating process for me. I'm not sure if Dad really liked it that much, but I think so. Unfortunately, my older brother and younger sister chose to withdraw from him -- and as adults, they chose to not take that step with him. After Dad died in 2004, they've had some regrets about that I think. I would hate to have lived with Dad's brain for all his life. I can't help but feel bad for him. Again, depression is such a horrible, horrible disease.
Originally Posted By Mr X Thanks all. Still haven't heard from her on the phone (she calls like once a week or so)...but anyway I've been thinking that this latest letter was her way of "letting me know" in case I heard the story from someone else. Of course, I've known for years but she never mentioned it so neither did I. So, I'll see how the call goes. I'll let her know I got her letter and take it from there. Anyway, thanks a lot everyone. Much appreciated. And to those who shared some very intimate details of their own lives, I REALLY appreciate hearing those similar stories (always nice to know we're not alone, right?) and I know that it's not easy to talk about. Thanks.
Originally Posted By Inspector 57 Stories people have shared in this thread are heartbreaking. I'm so sorry you and your family members have suffered those experiences. Mental illnesses -- including depression, manic depression, and schizophrenia -- occur on a continuum of severity. Most stories shared here are about people whose illnesses were not controlled or controllable. Those stories are tragic and there are far too many of them. I want to acknowledge, though, that there are countless people who have mental illness that is more or less effectively managed. Mental illness is far more common than most of us realize. Part of the reason for that -- and part of the difficulty of dealing with mental illness -- is the societal stigma that surrounds it. It's a cycle, of course. The stigma prevents people from discussing mental illness openly, which keeps people from understanding it and knowing its prevalence, which allows myths and unnecessary fears to continue, which feeds the stigma... Even though this thread has been mostly about severe cases of mental illness, I think it's wonderful that Mr X brought the issue up and that others have shared so openly. Thank you all.
