How do I help my friend get help?

March 31, 2006 7:21 PM

I have a friend (seriously) who has serious problems with social anxiety, to the point she is sometimes paralyzed with fear or depression. She cannot hold a job because of it, and therefore has no insurance for medical attention - what can she do?

I'm no doctor, but based on all of the reading I've done and her descriptions of problems she's had, I imagine she would benefit greatly from cognitive behavioral therapy. She has been on anti depressants in the past, when she had a job and insurance, but they were only minimally helpful.

Are there financial assistance programs for someone in this situation? She is located in central Illinois, if that matters.

I feel so terribly for her that I would try to help pay for the medical expenses myself if I could afford it - but I absolutely can't handle that kind of expense at this point in my life.

She currently lives with her parents, one of whom does not work, the other of whom gets a modest disability check that supports them all due to a job injury. She's too old to be claimed as a dependent on her parents insurance.

She seems so stuck in a downward spiral due to the catch-22 she's in, and I'm at a total loss for what to do to help her other than be a supportive friend. I thought maybe the wizards of AskMeFi might know something I don't about how she may be able to find affordable help.

posted by twiggy to health & fitness (15 comments total)

I know that some people who suffer from social anxiety have gotten "companion dogs." They dampen down the stress level so that they can be out among people. Also, I work for a state disability agency (different state, though) and I know that people who suffer from social anxiety have gotten help. She (or you, if she is unable) should call up your local disabilites' office to see what they can do.
posted by Kattullus at 7:29 PM on March 31, 2006

Remember, you are not her therapist, and taking on that role could drag you down as well. Then you would be no help to her or yourself.
That said, you should give her the Anxiety and Phobia Workbook. The book contains a lot of CBT exercises which may help.
posted by nprigoda at 7:32 PM on March 31, 2006

Local universities often offer CBT therapy (therapists are grad students in clinical psych programs) for as little as $20 (and sometimes free) per session, depending on income.
posted by availablelight at 7:39 PM on March 31, 2006

Many therapists will work on a sliding-scale. You just need to ask.
posted by ryanhealy at 8:08 PM on March 31, 2006

There is little doubt that CBT would be helpful but I can almost promise you that if her social anxiety is that severe she probably needs to be on antidepressants (actually the term antidepressant is increasingly a misnomer because they are the drugs of choice for managing chronic anxiety with and with out depression)--it is not a magic bullet and she may need to experiment with different drugs (with or without augmentation). It may take many trials but it is often as essential as a diabetic being on insulin (diet and exercise are extremely important but often they can not do it alone). Having said that it does not help with finding affordable care. Let me (us) know where you are and I might be able to help or make suggestions. I want to stress, this in no way minimizes the importance of CBT. Finally, you say that antidepresssants were minimally helpful--it is possible that this will continue to be true but dosage, augmentation with other drugs and swapping SSRI's after a full trial can often be extremely helpful. It would be unusual that the debilitating anxiety associated with severe social anxiety could not be significantly ameliorated with proper medication.
posted by rmhsinc at 8:08 PM on March 31, 2006

If she has an internet connection, there's always this intro to CBT as well.
posted by availablelight at 8:08 PM on March 31, 2006

OK, are you in Illinois? You need to be persistent but start by identifying available resources through your local chapter of NAMI (National Alliance of Mentally Ill) or your local MHA (Mental Health Association). All things being equal I would try NAMI. Check out local Community Mental Health Agencies. They should have sliding fee schedules. Also, if she is significantly disabled she may qualify for Medicaid (or even Medicare). Community Mental Health Agencies usually have access to samples or a state supported pharmacy program. Is there a medical school in the area? Is there a speciific suuport group in your area for persons sufffering with severe anxity disorders (NAMI would know). If so go to it and try and identify sympathetic psychiatrists or agencies. If all else fails feel free to e mail me and I will attempt to identify some local resources for you. You need to think of this as a medical problem, just as you would any other serious and chronic problem (Diabetes, hypertension, lupus, etc) and relentlessly persue appropriate services. Finally, given the nature of her illness she may need a friend/advocate who can support and work with her as she embarks on this journey. That does not mean you need to be her therapist just a friend--and not you alone.
posted by rmhsinc at 8:30 PM on March 31, 2006

I know that where I am (upstate New York) there are church related not-for-profits that are providing various types of social services for the needy. Some local governments have even contracted with Catholic and/or Jewish "child and family services" groups to provide certain services since they already have a structure in place.

No, this is not one of those Bush faith based initiatives things. I am sure that you don't have to belong to a particular religion to avail yourself of these services. They've been providing these services long before Bush came into office -- and will be doing it long after he leaves, too.

A quick google on "catholic charities" in central Illinois, for example, came up with this. Depending on your exact location, I'm sure you can find something similar in your area. Your friend should take advantage of it. Someone I used to work with has been heavily involved with running the not-for-profits for years. They do good work -- non-sectarian work.
posted by bim at 8:56 PM on March 31, 2006

She has been on anti depressants in the past, when she had a job and insurance, but they were only minimally helpful.

Finding the right anti-depressants treatment is a trial and error process which must be dilligently managed over time. Did your friend try one dosage of one drug and conclude that pharmacopia has nothing to offer her? If so, that might be a hasty conclusion. Don't consider the door closed on meds forever unless a real good faith effort has been made. Not that I'm advocating drugs, just advocating keeping the option open.

My personal prescription would be for some nice marijuana. That might sound flippant, but I have seen it transform people's personalities in good ways, subtracting from their tension and anxiety, at which point they are freer to step forward and actually get more done with their lives (contrary to the lazybones stereotype).
posted by scarabic at 9:07 PM on March 31, 2006

I would highly recommend an audio course produced by the Social Phobia/Social Anxiety Association. The course is a little expensive but if you can get you hands on, it is very helpful and much cheaper than seeing a therapist on a regular basis, while providing a lot of the same benefits. Also, to get started with CBT, a great book is Feeling Good by Dr. Burns and its accompanying handbook.

P.S. The audio series is also available through various bittorrent sites. Let me know, through a comment here, in case you would like to know more about this.
posted by sk381 at 9:16 PM on March 31, 2006

sk381, I'm not the OP, but I'm interested in the audio series you mentioned. My email's in my profile.
posted by needs more cowbell at 4:21 AM on April 1, 2006

Feeling Good works.
posted by Ironmouth at 7:41 AM on April 1, 2006

sk381: I'm a member of a torrent site that has it, actually, but it's not being seeded, so if you could point me in the right direction, I would appreciate it. Email in profile.
posted by twiggy at 11:12 AM on April 1, 2006

Sliding scale therapy is frequently available in a big city. Use the internet to explore this resource.

If she is a member of a church/synagogue/etc, she should seek assistance from her priest/rabbi et cetera. They will serve as a valuable resource for pointing her in the right direction to services that can help (and serve as someone to talk to in and of themselves).
posted by anjamu at 4:19 PM on April 1, 2006

Try the county's health department, or the county mental health department.
posted by cass at 8:57 AM on April 3, 2006