Ask Ralph: How do you help a wrist-cutting friend?

Friends enrich our lives and we love them.  But how do we deal with friends who are depressed and may even have a psychiatric condition?  That is the concern of our friend from Selangor, Malaysia. The person chooses to be anonymous.  Here is the letter posted in verbatim:

I have a friend who constantly make herself feel depressed, and is always hungry for attention even though all her friend give her attention all the time.  She wants us to think that she is top priority, but “not a b***h”, although she acts like one all the time.

Whenever she feels depressed she tries to bring everyone down with her as well. She used to cut herself, carve words and lines on her skin with a pencil, but lately that isn’t enough and she bangs her head on the wall, and she has talked about committing suicide.

Her mother is exactly like her, or rather the other way around, but her mother doesn’t hurt herself physically, and so it seems pointless to tell the mother of my friend’s behaviour.  She doesn’t like listening to the truth and only wants us to tell her what she wants to hear, otherwise she shuts herself away from us, which is scary.

Her sister and her friends are worried about her, and they feel like they can’t get on with their lives because of her. I’m not in Malaysia at the moment and i feel helpless, I’m just worried is all.  Any advice on this?

Terima kasi — thank you — for your letter and for opening this concern.

You have a delicate and difficult situation in your hands.  And it is hard to be a friend to someone who is difficult to deal with.  It is normal for you to feel the challenges of being a friend to such a type of person.  And during a time like this, your friend will benefit from a person like you, her friend, to help.  Of course, you will only be able to do so much.  You cannot do everything.

The most urgent matter to address is your friend’s behavior and to make sure that she does not harm herself.  I am no expert or doctor. But clearly, your friend may have symptoms of a mental or psychiatric illness. Doing self-harm is a sign of a disorder.

Bring your friend to a doctor — or bring the doctor to her

Your friend needs to see a doctor.  The best you can do is to convince her family to bring her to the doctor the soonest.  Aside from counseling or therapy, she may need medication.

Telling the family means also telling her mother because she needs to know the situation.  And she may even be the best person who can convince her to see a doctor.  If she is not convinced, then get other members of the family to talk to your friend.

Also, if you cannot bring her to a doctor, is it possible to bring the doctor to her home? If it’s possible, do so.

Continue being her friend — but set boundaries

I understand how difficult it is for you friends to deal with a difficult person like your friend.  But remember, even if she brings everyone down, she may be doing so as a result of a sickness she did not want to happen. She may not be saying or doing those bad things deliberately.  Remember too that she is still your friend, and that she needs you most during these difficult times.

Continue showing that you care for her.  Show that you listen to everything that she says.  But do set boundaries between what is right and what is wrong.

If you feel hurt, or feel that she is bringing you down, tell her honestly and calmly. Tell her that what she is saying is hurting you and request her to stop. Tell her that she is pushing her friends and family with her behavior.  Then tell her positively.  Proceed to “selling” the positive benefits of good behavior.  Tell her she’d be able to get what she wants if she treats people around her in a civilized manner.  Assure her that her friends will always be here for her, but cannot be there if she continues to hurt you.  And then tell her what you want to happen and what good behavior she should do instead. In short, give her a reason or reward for treating other people in a more positive manner.

Don’t let her bad words affect you.  Just ignore any bad words she says.  You would be able to do this if you are always aware that she is acting in a certain way because she has a condition. Don’t allow yourselves to be harmed by your friend.

You may also wish to immediately change the subject or topic of the conversation to something more positive.

Emphasize the good that she has done. Remind her of her self-worth and her talents.  Remind her that many people love her and would be greatly saddened if she were to end her life.  Assure her that she is always loved.

One other thing to lessen the burden of difficulty is for you to think of the good she has done to you friends.  Think of the good times you had with your friend too.  These can help remove that feeling that you are helping her as part of a difficult task — rather than helping your friend because you care for her.

Listen to Understand

You can still show that she’s top priority by simply listening. You would also be able to understand more clearly what is bringing about her irrational behaviors, and share any new information to the doctor.

Listen to your friend and also discuss among family and friends the things that cause your friend to be upset.  What triggers her irrational behavior?  See how you can make it easy for her to avoid these things.

Help friend avoid self-pity

Make an effort to talk more about positive matters rather than talking about things that will bring about self-pity.  Don’t talk about failure or anything that will depress her more.  Get your friend to do activities that will distract her and help her avoid thinking of things that will trigger her depression.  Encourage her to help and serve others to make her think of others more rather than herself.  For example, being of service to the poor can help her forget her depression.

Hope

Lastly, don’t lose hope about the situation.  There is reason to hope because psychiatric problems can be treated — as long as the first step of seeing a doctor is made.

Don’t give up.  Do help your friend especially because she needs you and because you can do it.  I wish you all the best.  Keep me posted.

Always,

Ralph

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