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Question
Posted by: not sure | 2012/04/17

my friend

Hi Doc
This is going to be a long post so I do apologise in advance.
I will start from the beginning so I can paint a clear picture.
I have a friend that i have known from the days we were in nappies, we are like distant sisters. We might not see each other for months but when we get together its like we have''nt been apart. She''s always been miss bubbly and laughing and making jokes, she had a very good self esteem and was very strong. She moved overseas about 6 years ago with her family and she changed, her bubbly self has disappeared she has no friends there, she cant find work so she has been sitting in her flat doing I dont know what, her self esteem is non existent and it takes alot to maker her laugh, at the same time her dad started going downhill aswell and suffers from Alzheimers which she cant deal with. She met a man overseas who moved in with her after about a year of dating and he asked her to marry him, all was fine and dandy until this guy started breaking her down even more and telling her how to dress etc. In this time she started hearing voices (this guy she was to marry) talking about her and saying things like he will leave her but he is waiting for the right time to break up with her, but when she confronted him he was like no I didnt say anything. The voices started getting worse and worse to the point where he suggested she go and see a psychologist, she did and funny enough he was from SA. The psychologist she was seeing built up her self esteem again and just before their last session he asked her whether these voices were in English or her native language, and she told him that they were in her native language. The psychologist then asked her what language do you dream and think in, where she replied in English. He explained to her that this guy must be talking about her and that it is his voice she is hearing and that she is not crazy. Anyway 5 months before the wedding they had a small argument and his sister got involved and said they shouldnt get married and he agreed and left. There was no closure from him, he told her she needs help and he just ''disappeared'' out of her life with no explanation nothing.She went to a friend over the christmas period to get over this, which made sense and when she came back she was herself again and life was good. Then she started hearing the voices again and she decided she needs to come back to SA and try find work again and relocate back here cos maybe these voices will go away. At the airport she apparently had a blackout and people that saw her said that she was runing around babbling. She doesnt remember anything and when she woke up they had taken her to hospital where she saw a psychologist and he said it was stress related, but when she gets to SA he reccomended she see a doctor to do an ECG cos apparently her blood sugar was high. She stayed with us for a few days and in those few days shes just been crying and staring at the wall. She cant put a smile on her face shes just a blank pice of paper, when we talk to her she completely zones out and she says she keeps hearing voices telling her that shes a bad person and a prostitute etc and words she doesnt even understand. Shes now left us and gone and stayed with another friend cause she says we are suffocating her and our households are too busy for her. She told my sister that she feels like people are constantly talking about her and attacking her. We are trying to help her and trying to convince her to go see someone and get some help, but shes not listening to us. She isnt the person we know. On saturday she went for coffee with a school friend of hers and she says she felt like everyone in the coffee shop started talking about her and her life and like she was playing a game. i am so confused, and I dont understand what is going on, I am really worried about her. my mom wants to contact her mom who is overseas and tell her to come here, but if she does she will have to put her husband in a home as he suffers from Alzheimers. I feel like my friend is not telling us exactly whats going on and she jumps from one story to the next. Is she bipolar, skitsofrenic or just plain burnt out? She feels like this other friend she is staying with (who shes only known for a short time) will get her the best help and she feels better staying with her. i am a bit offended cos we are like family and shes not listening to us, but she listens to a stranger. I am not a pushy person and I let her go She is really in a bad state and I dont know how to help her. Please tell me what I can do, or where I can take her or how I can convince her to go with me instead of a stranger to a psychologist. Thank-you for taking the time and reading this post. I really appreciate it.

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Our expert says:
Expert ImageCyberShrink

Moving overseas can often be more difficult than people expect, but its unusual for anyone, let alone a cheerful and outgoing person such as you describe, to spend 6 years without making any friends.
But from your overall description, it really sounds as though she has been becoming sick, and she needs and deserves to get a proper psych assessment and advice based on the findings of that. Maybe with the added stress of her father's Alzheimers, she may fear that she could be found to have the same illness, though this is not at all likely at her age.
I am a bit sceptical about the psychologist's view that hearing voices was a benign thing that didn't deserve to be worried about. The episode at the airport also suggests something FAR more serious at work. You don't mention WHICH country they were in overseas, and that's relevant as they vary in the availability of good psychiatric services.
I dont understand the other advice quoted, either. A psychologist wouldn't know whether or not your blood sugar was high, and whether it was or not, would have nothing to do with an ECG. And if it was a psychiatrist ( thuis also a medical doctor ) she saw, he could have ordered an ECG and/or blood tests himself.
The sort of voices you describe, especially those saying awful things about you, can occur in a very severe Depression ( which could well be what she has ) Further, those ideas about everyone talking about her, etc., are paranoid, and suggest possibly a very severe depression or a psychotic illness of some other kind. This is more than mere burn-out.
If the family is somewhere like the UK, it should be possible for them to arrange for her father to go temporarily into a home so the mother can come out for a while to help sort this crisis out.
Talk with this other friend she is staying with, see what she has observed, and see if she is prepared to help persuade her to see a good local psychiatrist for a proper assessment.
If she is indeed deeply depressed and/or psychotic, don't feel offended because she isn't eager to take your advice - this is about her illness, not an assessment of your goodness or rightness. She is seriosuly ill and needs help, so welcome anyone who she currently trusts and who can assist to persuade her to get the help she so obviously needs.
There are several diagnostic possibilities here, very severe depression, alone or within a Bipolar disorder, schizophrenia, or other possibilities. Only a thorough assessment by a good psychiatrist briefed with a full account of what has been happening ( which she may not herself be able to tell him ) may get to the bottom of this.

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2
Our users say:
Posted by: Liza | 2012/04/17

Your friend doesn''t need a psychologist. She needs to see a specialist psychiatrist for an assessment. (A psychologist cannot prescribe medication while a psychiatrist can) What you''re describing sounds very much like schizophrenia. The voices, blackouts, paranoia and personality changes are all possible signs of schizophrenia - although it''s also possible that it could be bipolar with psychosis.

" ..or how I can convince her to go with me instead of a stranger..."  Is this about her or about you? Are you jealous of this other friend? Why don''t you want this friend to support her? Surely it doesn''t matter who takes her to see someone - just as long as she gets the help she needs? Perhaps this other friend doesn''t have the same confusion over her mental health that you do and has experience in mental health matters? Because honestly - you don''t even know when someone needs a psychologist and when they need a psychiatrist. If this other friend knows more about it than you do, then she''ll obviously be able to give better advice...

You also cannot force your friend to do anything she doesn''t want to do - unless you can prove that she''s a danger to herself or others which is very hard to do.

Good Luck
Liza

Reply to Liza
Posted by: cybershrink | 2012/04/17

Moving overseas can often be more difficult than people expect, but its unusual for anyone, let alone a cheerful and outgoing person such as you describe, to spend 6 years without making any friends.
But from your overall description, it really sounds as though she has been becoming sick, and she needs and deserves to get a proper psych assessment and advice based on the findings of that. Maybe with the added stress of her father's Alzheimers, she may fear that she could be found to have the same illness, though this is not at all likely at her age.
I am a bit sceptical about the psychologist's view that hearing voices was a benign thing that didn't deserve to be worried about. The episode at the airport also suggests something FAR more serious at work. You don't mention WHICH country they were in overseas, and that's relevant as they vary in the availability of good psychiatric services.
I dont understand the other advice quoted, either. A psychologist wouldn't know whether or not your blood sugar was high, and whether it was or not, would have nothing to do with an ECG. And if it was a psychiatrist ( thuis also a medical doctor ) she saw, he could have ordered an ECG and/or blood tests himself.
The sort of voices you describe, especially those saying awful things about you, can occur in a very severe Depression ( which could well be what she has ) Further, those ideas about everyone talking about her, etc., are paranoid, and suggest possibly a very severe depression or a psychotic illness of some other kind. This is more than mere burn-out.
If the family is somewhere like the UK, it should be possible for them to arrange for her father to go temporarily into a home so the mother can come out for a while to help sort this crisis out.
Talk with this other friend she is staying with, see what she has observed, and see if she is prepared to help persuade her to see a good local psychiatrist for a proper assessment.
If she is indeed deeply depressed and/or psychotic, don't feel offended because she isn't eager to take your advice - this is about her illness, not an assessment of your goodness or rightness. She is seriosuly ill and needs help, so welcome anyone who she currently trusts and who can assist to persuade her to get the help she so obviously needs.
There are several diagnostic possibilities here, very severe depression, alone or within a Bipolar disorder, schizophrenia, or other possibilities. Only a thorough assessment by a good psychiatrist briefed with a full account of what has been happening ( which she may not herself be able to tell him ) may get to the bottom of this.

Reply to cybershrink

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