I am having a really hard time right now, accepting a big change in a dear friend's life. She has the same sponsor I do, but I haven't seen her in over a year, as I just assumed she was "doing her thing", and I was just doing mine. i had going through a bit of a depression last winter, and was kind of in isolation mode, while getting it all sorted out.
Anyway, she reached out to me over the phone lately, saying she wanted to work on some steps together, as she has been having some problems. To my sponsor's knowledge, and per my friend's report, she has not been using.
But the issue is this: She had a "breakdown" last year that landed her in the psych ward several times. My sponsor warned me that she has been extremely paranoid and somewhat even "dilusional" lately. I did not understand the full weight of what is going on with her until today.
She had called yesterday and said she was driving around trying to sort out her thoughts, and i told her she was welcome to come over here. She ended up heading over to our sponsor's and spending a few hours. Then today, on my way home from a half-day of work, I gave her a call. She wanted me to pick her up, and I asked if she wanted to bring her doggy and we could get my dog too and go to the dog park. So I picked her up, and she was very suspicious of me. For years, this beautiful friend of mine had been bubbly, bright and whimsical, creative, and overall just confident and happy. She would light up a room when she walked in.
My friend today was walled-up, suspicious, paranoid, and just completely not herself at all. I had to be very cautious about everything I said, in order to help her feel comfortable with me. She seemed like she wanted to badly to get some stuff out in the open, but she would stop in mid-sentence and shut down.
I prayed the whole time for God to use me in some way, just to be able to be there and listen, or whatever she needed. There was a lot of uncomfortable silence throughout the couple of hours I spent with her.
I talked about MY issues with depression/seeking help last winter, hoping that she would see me as "safe". She seemed to be interested in that part of the conversation. I asked her if she had been put on some medication or anything lately and she said yes, and then she would not talk any more.
Friends, I am devastated. And sooooo very powerless. I think I take for granted at times, that I/we have the "power" to manipulate our friends' feelings and moods, when they are low, by encouraging and being loving and nice to them. I was totally powerless over her emotions and mood and paranoia, no matter how gently I treated her today.
It is so scary for someone you know and love to all of a sudden be someone else. I am just in a state of shock. I know that her problem is definitely beyond my capabilities. She needs her psychiatric help. I just don't know if there is anything I CAN do. Can anyone help me to step outside the box, and figure out how to handle this situation?
Thanks so much, Joni
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~Your Higher Power has not given you a longing to do that which you have no ability to do.
Joni, that situation sounds really difficult to deal with. I empathize with what you went through. I have seen a few people go into psychotic breakdown and it is really disturbing. I also worked with the population of chronically mentally ill for quite some time and that includes people with major psychotic illnesses. It sounds to me like she probably has paranoid schizophrenia though it's hard to know without really knowing more of the story. Sadly, you are powerless over the situation. On the one hand, I think it's good that she called you and wanted to hang out. That suggests she is still functioning somewhat and is not in a full blown psychotic state at the moment. She may be on some hard core meds right now and those can totally "zombify" a person with that diagnosis. Schizophrenia has positive symptoms (meaning symptoms which are tacked on to normal functioning, not that they are positive to experience at all). Those symptoms include hallucinations (typically auditory), delusions, tangential thoughts, paranoia, and bizarre ideation. Then there are negative symptoms which include blunted affect (like the zombie sort of state), social withdrawal, some depression, lethargy, and such (parts of the personality/functioning that are taken away). Antipsychotic medications like zyprexa, invega, risperdal tend to work better to take away the positive symptoms and the person is typically left with more negative symptoms. What you described to me sounds like a person who has had a major psychotic break, is on meds, and has only gotten back to partial functioning. She may be hovering on needing to go back into the hospital again right now...who could say? Schizophrenic breaks occur in males typically in the late teens and early 20s. In females the typical age of onset is in the early to mid 30s. Of course there is a massive genetic component. People almost never return to their full level of functioning, which is very very sad, but many do reach fairly high levels of functioning that you wouldn't expect from someone with that diagnosis. If you are going to be part of her support network, I think you need to know what you are taking on. Paranoid schizophrenia is the most common of all subtypes. It is possible she might need to be periodically hospitalized for a long time until she stables out. If you are close to her, you might be put in the position to have to make that call if she is a danger to herself. I guess I would want to know if she has family, friends, adequate mental health support because it would be WAY to much to be the main support for a person with that diagnosis. They need multiple supports, a case manager to check on them, a day program sometimes... It's confusing since you know her from AA and there's the anonymous component here...plus she's paranoid. But clearly her mental functioning is the larger issue and the only real thing you could do is try to find out if she is linked to appropriate services, has other supports, and then be there while knowing what the deal is. My prayers go out to the woman and bless you for your caring and wanting to help her.
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thank you SOOOOOOOOOOOO much for your reply. I know from your other posts that you do work in mental health, and all that you said to me here helps me immensely.
My friend is indeed extremely paranoid, she was questioning my motives al day long for picking her up, which she had ASKED me to do, and she was at first acting like I was "setting her up" or something. My sponsor also mentioned to me that she had become extremely paranoid when a man came to her area to re-wire the lines on the utility pole outside her house. I have no doubt that her diagnosis is something in the area of paranoid schiz, although I don't know that for certain, but it only makes sense.
My sponsor is concerned that she might be OFF her medications, actually. She is going to see her doctor on Wednesday. Hopefully she will be in FULL paranoid mode, so he can see and assess what she really needs right now. I do know that she fluctuated in and out of sanity today. What was so painful about it was that at times I thought she was coming out of it, and being her old self, and then she would be "gone again". Devastating.
Her father is a prominent figure, and takes care of her right now, she has her own home and lives alone, and her needs are met for the time being. But I don't know enough about him to know if he fully accepts what is happening to his daughter. He got down on her for something really stupid recently, she told me.
I do know that she has a support network though, in that she has my sponsor, and also has a family who is willing and bale to care for the "necessities", and see to it that she gets medical care. I just hope that her doctor can see what I was seeing today. I wish there were some way I could get involved in that way, but of course, for the moment, not my stuff.
I thank you again, and if there is any site that is reputable where I could log on and really get a GOOD synopsis of what to expect with this medically, in a little more detail than just typical layman's terms, that would be great. I could check out the DSM-IV as well on this. You are so right, in that I need to at least KNOW what she is going through, so I can develop some boundaries and some practical responses as we go forward.
Thanks again for your help.
Joni
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~Your Higher Power has not given you a longing to do that which you have no ability to do.
I can relate to that feeling of powerlessness. I find that one of the biggest challenges I have in life can be trying to figure people out, especially when you see a shift in someone you already know (knew) well. It's darn right frightening at times when they freak us out with bizarre behavior. My only experience with mental illness is when I answered 911 calls from such people, I found it near impossible to deal with them on any rational ground. I came to realize that the meds played the biggest role in their behavior. I guess patience is your best friend in this situation. Mark, you should be a doctor, lol....awesome factual info man!
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Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned. ~Buddha
You are welcome Joni. One of the main reasons why people go off the antipsychotic meds is because the side effects are so harsh and they feel like a zombie on them. Also, this woman is in recovery and probably does not like the experience that her thoughts and feelings are totally numbed by powerful antipsychotics which are really termed "major tranquilizers." When she is well, she might want to check out dual diagnosis meetings. I think they call them "double trouble" meetings for some reason though that sounds pretty pejorative. You could find out most anything about the diagnosis of paranoid schizophrenia from googling around. The DSM IV will tell you all the hallmarks and prognosis and such. You might get good literature on being a support to a person with mental illness from NAMI (National Alliance for the Mentally Ill). That is also an awesome place and resource for her family if they are coming to terms with what's going on. People with schizophrenia frequently need case managers so that the family and friends don't bear all the responsibility. A case manager would be the one to check in, coordinate services, make sure (or try to) that she is taking her meds, make sure her house isn't a wreck, make sure she doesn't need to be hospitalized, stay in contact with family members, and they would probably even aid her in getting to AA meetings as mental health services are leaning more and more towards client-centered meaning that, if it's important to her, they will make it happen if possible. There is usually a local community mental health center in every county. Sometimes the organizations are government run, but lately private organizations have been taking over. Down here, Henderson mental health has almost a monopoly on those services. Often people who have money don't avail themselves of them because their families try to take care of them too much. With that diagnosis, she would qualify on her own for med waiver, disbility/SSI, and all sorts of other things, but her parents would have to pretty much drop her financially and she would need to be considered indigent. They could pay for all these services through private insurance, but it likely wont cover all she needs and the bills will be outrageous. Antipsychotic meds are incredibly expensive just alone... Could be that she is one of the ones who functions very highly IF she takes her meds. She might be capable of being her own advocate in that case. If she keeps going off and winding in the hospital, eventually her family will probably need to have her declared incompetent sadly...unless she complies with what they tell her. Good luck and it is awesome to even be trying to be a friend to this woman. Seriously mentally ill persons do deserve friends even when their illness makes them difficult to deal with. Glad I could help Joni. It just happens to be an area in which I can call myself an expert. You've helped me a lot in areas where I am clearly still that newcomer alcoholic in recovery :)
P.S. Joni, people who experience paranoid delusions often wind up developing a complicated delusional system in which they come to believe that not just individuals are after them, but groups of people. I would not be surprised if she is forming some delusions about people in AA or AA in general as it is an organized group and the one she is most involved with probably. So...watch out for that.
P.P.S. Scott, I almost did become a doctor. I completed all my coursework for my Ph.D in clinical psychology, passed written, and oral comps...then hit a wall at the dissertation/internship phase when I came out of the closet, dumped my fiance, had my own mental health breakdown and just couldn't deal with being in school any longer. Over time in recovery, I hope to turn all the education into a license, but have been stuck in fear of success mode like many of my other fears ruled me while drinking. -- Edited by pinkchip on Monday 20th of July 2009 09:29:37 PM
-- Edited by pinkchip on Monday 20th of July 2009 09:41:26 PM
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Keep coming back. It works if you work it. So work it. You're worth it!
Joni...It sounds like you did well with your friend the intention was to be loving, kind, supportive and there and you were. When I worked in the field and found myself up against something which seemed over my capabilities the very best I would do was be there and be quiet until they decided to peep out of the hole and say something. Often times even if they did this I would ask them if they wanted me to respond to it rather than to just assume anything. stand by and stand quiet often times is simplest and what works best. (((((hugs)))))
She sounds SO much like my sister in law, who due to her childhood molestation, coped by burying the memories DEEP down. Now, with the discovery of my daughter's case, she has been forced to deal with her memories. She is now delusional, catatonic and suicidal (with a plan) ... she is on meds and is doing MUCH better ... but we keep an eye on her.
Talk to her family ... get her to a psychologist and a therapist who can evaluate her meds.
thanks all, for the support here. I really think that just being there and trying to listen helped a lot. I am dealing with the shock and the powerlessness right now of it all. Called her tonight and just left a message that it was good to see her. It is so hard to NOT feel like I "should" be able to do SOMETHING. Our support group of women has been so tight and so helpful to one another for so long, it is strange to not be able to rally together and "fix" this one. But again, it is totally outside the realm of recovery, and there is nothing I could say or do that would turn on some "light bulb", like when we work with other alcoholics who are not mentally ill.
The big lesson here for me is to truly be still, I guess. So hard.
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~Your Higher Power has not given you a longing to do that which you have no ability to do.
I have a good friend who has schizophrenia. I too, new him before his disease surfaced. It's scary. I know he's in there, but his mind has completely over taken him. I just try to be the best friend that I can and leave the rest up to his doctor. I don't mean that you friend has schizophrenia, but I understand the power that a mental disease can have over a person. I'll pray for her.
