How do you tell someone they need to seek mental help?

[Madrone]

And how do you do it without them freaking out?

I have a friend that's always been kind of prone to "moodiness". I tend to let things go easily, so I don't always recognize the extent of something until my nose is being rubbed in it. Plus I get wrapped up in my own world and issues and don't hone in like I should.

Anyway - there have been multiple times over the years that I've actually been taken aback with a "Whoa! He's pretty unstable" thought ... and it just seems to be getting worse. I really think he has mental/emotional issues that could be easily remedied with medication. But I have some issues:

#1 - How do I tell him? I don't know that it would go over well at ALL.

#2 - He has not been to a doctor for 15 years - AT LEAST.

#3 - He does not believe in medicating. Self or otherwise.

He's mentioned suicide to me on more than one occasion in the past (while not "threatening" it) ... I've seen him emulate behavior that I know for a fact he HATES (passive aggressive, whiny, needy) ... He can at times be completely irrational .... etc.

I don't really know how to deal with someone like that in the sense of a REAL medical chemical imbalance type problem - though I am used to dealing with the ones that are attention seeking whiners. NOT the same thing, obviously - and while I have numerous issues of my own *thankfully* the chemical imbalance thing is not one of them - which leaves me completely lacking in any understanding of how to deal with it. It HAS gotten to the point where I feel like I have to say SOMETHING though - he's a friend I care about. And I care too much to just sit idly by and watch him wallow and suffer.

So...???

[LeftyFingerPop]

1. Madrone...

Probably the best you can do is to sit down with your friend and have a conversation about YOUR concerns.

Tell your friend that you care about him, and that you are very concerned. Express your fear in talking to him about this.

Reiterate what you said in your OP.

Keep the focus on your feelings about what is going on with him from your perspective, and ask for his opinion.

I would tend to stay away from the whole "you need to seek mental help" thing unless the conversation naturally evolves to that point.

Also, don't expect complete understanding of your concerns by this person immediately. He will most likely think about what you have said for several days.

Again, try to keep the focus on YOUR concerns, and not his behavior. The goal is to get the person to think about what you have said, without him becoming defensive and closing his mind to the possibility that he may need some help. :hi:

[Madrone]

The defensive thing is what has me worried...

but it's interesting what you say about expecting him to chew it over for a few days. That's common behavior for him actually - often coming back a week later with something I said and immediately FORGOT, while he'd dwelled on in for a week convincing himself I meant something entirely different than the reality of the situation. And sometimes finally understanding something I'd said too. ;)

Yeah - I DEFINITELY won't lay out the laundry list of irrational behaviors. I was thinking of approaching the medication angle (when it got to that point) as a comparison to diabetes. ie: You wouldn't think someone with diabetes should be able to just "get over it" and that medication weren't crucial to their physical health, would you?

*sigh* I have an unusually small reserve of mental/emotional energy for dealing with this kind of stuff - but I also know that there's no one else BUT me in this case.

[LeftyFingerPop]

4. It is...

a slippery slope Madrone.

It's personal for him, and it may be more complicated than anyone, even him, knows.

Not being a professional, I hesitate to give any further advice than basically "express your concerns".

So much depends on the relationship that you have with him.

If you think it is serious enough, you may want to solicit a face-to-face discussion with a professional to get some advice.

Good luck.

[Random_Australian]

2. One thing to add - no need to say anything about it, but you might want to keep in the back of your

head a loose version of the definition of mental illness (DSM-IV).

That is, they display a combination of:
- Distance from social norms
- Danger to themselves or others
- Distress
- Dsyfunction to the point where it interferes with their daily lives

Mind you, it needs to be a combination. For instance, a soldier has a lot of distress and danger, but it is part of social norms so it is not mental illness.

You've not been trained to tell if they are mentally ill or not so you can't do that, but I thought it would be useful to have something to compare his actions to - as in, it will be useful if you find yourself wondering how if their problems are severe enough to warrant proffessional attention.

This post has been a bit loose in the wording though, so this is only a rough guide at best.

[Madrone]

Many thanks.

And yeah, I really do believe it IS a medical issue - but of course I am not a doctor. It really seems beyond his control though - not just "the blues" which we ALL get, or situationally related, etc. Thanks for the list - I definitely can see varying degrees of all 4 things listed.

[Haole Girl]

3. Well..

This will sound awful, but it is what prompted me to see a counselor after my mother died. My younger sister refused to talk to me until I went.

It turned out, my theories were right on about what happened with my mother... and that one sister and I still don't see eye-to-eye about the subject... but my sister's "tough love" worked for me. And I am grateful, as painful as it was for me, that I sought help.

Good luck with your friend. :hug:

[Madrone]

5. It doesn't sound awful -

Sometimes those tough-love situations are what do it. I'm glad you came through it for the better. :hug: And thanks. :hug:

[GreenPartyVoter]

6. Well, you have to get by two things

1) I am not sick.

2) No meds for me.

If you can get past those hurdles you might make some real progress.

I will say as a bipolar person that the meds have really been worth it for me. Yes, they can be a pain and have some side effects, but when I think of my very worst, sickest moments, they are always worth it. I also found kind and compassionate medical assistance, and also informative books and websites (like this one: http://psycheducation.org/ ) to help me along.

Good luck with your friend. He is really lucky to have you there for him. :hug: