Weathering Best Friend's Cyclical Depression/Anxiety
March 29, 2022 6:59 AM
My best friend K is basically my sister and my family. We are both women. She gets birth control shots every three months, for reasons detailed below. When one shot is wearing off and she gets another one, she gets depressed, has less social and emotional bandwidth, and withdraws slowly over the course of about a month. This triggers a lot of stuff for me, and I'd like advice or anecdotes people have regarding handling this sort of consistent inconsistency in a close relationship, either romantic or familial.
The birth control shots are non-negotiable; without them she has periods that last months, and other super unpleasant symptoms. Other birth control methods have had much worse effects on her mental health. This is not just something I have observed, this is something that K is aware that happens, and has told me what the cause is. Her doctor thinks it might be smoother, mentally, for her to have the shots more often than every three months, but insurance won't pay for that. K is trying to find a better way to handle this, and meeting with various doctors about it, but it's not looking promising and I certainly don't expect any change in this cycle anytime soon.
I am medicated for anxiety and see a therapist regularly. I grew up gay in an area and time where that was not ok, and was ostracized and bullied for being different all my time in school. I married a man who I met while I was at college to try and hide, but he emotionally abused me, used me as a live-in maid, and blew up at me whenever I asked that we spend more quality time together. I divorced him and got myself out of a truly awful situation six months before the pandemic.
I have done a lot of work around the traumas of my childhood and my marriage, but my friend's cyclical withdrawal from what is otherwise a close and supportive (we text each other good morning and good night every day, and generally text back and forth throughout the day; when she's on the downslope I'm always the one to start any kind of conversation or make any kind of plans, and she's more likely to snap at me or react negatively to something that wouldn't have upset her normally) relationship still reliably makes me feel panicky and shitty and triggered even though I know exactly what is going on and why I feel that way, and that she doesn't mean it maliciously and can't help it, and is working on making it not happen. I'm pretty successful at just reaching out to her for a matter-of-fact confirmation that this hormone thing is all that's happening, and then dealing with my emotions myself, but it's a lot of work, and I feel like I get dragged down with her on this slow depression and anxiety rollercoaster every three months, and I'm starting to get resentful, which I don't want to be! This isn't really her fault!
I do worry sometimes, though, that maybe because of my history, I may always end up feeling awful because of this, and if that's the case, I won't be able to handle being on this rollercoaster forever, and may need to take a step back from my relationship with K, and that makes me sad.
Have you had to deal with something like this? How have you handled it? Any ways that have worked for you to modulate your own reactions to a persistent trigger in a relationship that can't be changed? At what point do you decide that you need to take a step back from an otherwise good relationship because of something like this? Or can you habituate to this kind of thing over time? Any advice is welcome.
The birth control shots are non-negotiable; without them she has periods that last months, and other super unpleasant symptoms. Other birth control methods have had much worse effects on her mental health. This is not just something I have observed, this is something that K is aware that happens, and has told me what the cause is. Her doctor thinks it might be smoother, mentally, for her to have the shots more often than every three months, but insurance won't pay for that. K is trying to find a better way to handle this, and meeting with various doctors about it, but it's not looking promising and I certainly don't expect any change in this cycle anytime soon.
I am medicated for anxiety and see a therapist regularly. I grew up gay in an area and time where that was not ok, and was ostracized and bullied for being different all my time in school. I married a man who I met while I was at college to try and hide, but he emotionally abused me, used me as a live-in maid, and blew up at me whenever I asked that we spend more quality time together. I divorced him and got myself out of a truly awful situation six months before the pandemic.
I have done a lot of work around the traumas of my childhood and my marriage, but my friend's cyclical withdrawal from what is otherwise a close and supportive (we text each other good morning and good night every day, and generally text back and forth throughout the day; when she's on the downslope I'm always the one to start any kind of conversation or make any kind of plans, and she's more likely to snap at me or react negatively to something that wouldn't have upset her normally) relationship still reliably makes me feel panicky and shitty and triggered even though I know exactly what is going on and why I feel that way, and that she doesn't mean it maliciously and can't help it, and is working on making it not happen. I'm pretty successful at just reaching out to her for a matter-of-fact confirmation that this hormone thing is all that's happening, and then dealing with my emotions myself, but it's a lot of work, and I feel like I get dragged down with her on this slow depression and anxiety rollercoaster every three months, and I'm starting to get resentful, which I don't want to be! This isn't really her fault!
I do worry sometimes, though, that maybe because of my history, I may always end up feeling awful because of this, and if that's the case, I won't be able to handle being on this rollercoaster forever, and may need to take a step back from my relationship with K, and that makes me sad.
Have you had to deal with something like this? How have you handled it? Any ways that have worked for you to modulate your own reactions to a persistent trigger in a relationship that can't be changed? At what point do you decide that you need to take a step back from an otherwise good relationship because of something like this? Or can you habituate to this kind of thing over time? Any advice is welcome.
You need to have more than one friend, so that you are not relying on K to fulfill your emotional needs during times when K is not medically able to do so.
As another angle, can you pay for K's additional shots?
posted by heatherlogan at 7:18 AM on March 29, 2022
As another angle, can you pay for K's additional shots?
posted by heatherlogan at 7:18 AM on March 29, 2022
Rather than focusing on "my friend withdraws" on a regular basis, focus on the fact that when your friend has the emotional resources to be there for you - they are. They're putting their own oxygen mask on first because depression is a thing they need to muster all their resources to deal with on their own.
It's profoundly unfair that your friend has to deal with this burden on her mental health to preserve her physical health. That's a lot, it's little wonder that "close and supportive" is not doable while they're dealing with that. If support for them means "just leave me alone because I don't have the resources to deal with other humans" then just focus on "I miss my friend, but this is what they need right now."
I'm rarely a "look at the bright side" type person - but here, it seems appropriate. The bright side is you have a great friend who texts you and cares about you more often than not.
Maybe imagine it as if you had a friend who traveled a lot or did tours of duty on a submarine. When they're out to sea, they're not available. But when they're on shore leave? They're awesome. Of course we want awesome all the time, but you have to take the awesome when you can get it. There's not an unlimited supply in the world, and we have to be grateful for the awesome we do get when we get it and try to return it in kind.
posted by jzb at 7:20 AM on March 29, 2022
It's profoundly unfair that your friend has to deal with this burden on her mental health to preserve her physical health. That's a lot, it's little wonder that "close and supportive" is not doable while they're dealing with that. If support for them means "just leave me alone because I don't have the resources to deal with other humans" then just focus on "I miss my friend, but this is what they need right now."
I'm rarely a "look at the bright side" type person - but here, it seems appropriate. The bright side is you have a great friend who texts you and cares about you more often than not.
Maybe imagine it as if you had a friend who traveled a lot or did tours of duty on a submarine. When they're out to sea, they're not available. But when they're on shore leave? They're awesome. Of course we want awesome all the time, but you have to take the awesome when you can get it. There's not an unlimited supply in the world, and we have to be grateful for the awesome we do get when we get it and try to return it in kind.
posted by jzb at 7:20 AM on March 29, 2022
When I'm depressed, it's a lot easier for me to follow concrete social plans ("call every Thursday" or "forward them every meme I see about ______") than vague goals ("initiate more social interaction"). And it's even easier if we've discussed those concrete plans and I know the other person expects them. When things are bad, it's really, really hard for me to convince myself that anything I can do is good enough — so it really helps having an agreement that, yeah, these specific things are good enough.
Also, yeah, if you're this close (and you've got the money), offering to pay for more frequent shots wouldn't be weird. People who are basically family help each other with stuff like that, especially when it supports their relationship.
posted by nebulawindphone at 7:34 AM on March 29, 2022
Also, yeah, if you're this close (and you've got the money), offering to pay for more frequent shots wouldn't be weird. People who are basically family help each other with stuff like that, especially when it supports their relationship.
posted by nebulawindphone at 7:34 AM on March 29, 2022
I'm pretty successful at just reaching out to her for a matter-of-fact confirmation that this hormone thing is all that's happening, and then dealing with my emotions myself, but it's a lot of work, and I feel like I get dragged down with her on this slow depression and anxiety rollercoaster every three months, and I'm starting to get resentful, which I don't want to be! This isn't really her fault!
I think you need to reframe this work as a kindness you are doing for your friend, rather than something she is making you do. This is how YOU support HER. You don't really mention how she feels about or handles these periods apart from how it affects you. What does she need? Ask her what else you can do when she's in this state: maybe she really does need you to check in, so she doesn't feel forgotten, but maybe she really needs you to stop trying to make plans or initiate conversations.
Since these situations happen at regular, predictable, scheduled intervals, make a plan. Maybe she texts you a code word when she's ready to resume normal life. Then you are not suddenly managing big emotions because you reached out in the wrong month and were rebuffed.
posted by We put our faith in Blast Hardcheese at 7:43 AM on March 29, 2022
I think you need to reframe this work as a kindness you are doing for your friend, rather than something she is making you do. This is how YOU support HER. You don't really mention how she feels about or handles these periods apart from how it affects you. What does she need? Ask her what else you can do when she's in this state: maybe she really does need you to check in, so she doesn't feel forgotten, but maybe she really needs you to stop trying to make plans or initiate conversations.
Since these situations happen at regular, predictable, scheduled intervals, make a plan. Maybe she texts you a code word when she's ready to resume normal life. Then you are not suddenly managing big emotions because you reached out in the wrong month and were rebuffed.
posted by We put our faith in Blast Hardcheese at 7:43 AM on March 29, 2022
Even if you're not able to actively do anything for her*, can you think of yourself as part of her care team? The act of holding on until she gets through these episodes, being someone she knows will be there when she's on the other side, is important and I'm sure she'd agree.
*But is there something she'd let you do that would give you a more active role? Could you make and porch-drop food to her 1-2 times a week? Run some errands? Can you talk to her about going into maybe a low-fidelity contact mode (I have several friends I can just exchange a daily emoji or gif or funny animal video if there's no bandwidth for more)? Obviously these discussions should happen when she's on the upswing, but maybe she could help you find ways to feel connected and supportive (and being legitimately helpful and supportive!) without asking more than she can give in the low times.
I would definitely talk to her about helping pay for additional treatments (or help researching how to badger her insurance company to get it qualified as necessary treatment), and if she's been reluctant to use medication to manage what is presenting similarly to severe PMDD, maybe make sure you're expressing support for that kind of treatment and standing up to her care team for better attempts at mitigation on top of appropriate. Emotional suffering often isn't considered important in women, but it's a killer and deserves attention.
posted by Lyn Never at 8:14 AM on March 29, 2022
*But is there something she'd let you do that would give you a more active role? Could you make and porch-drop food to her 1-2 times a week? Run some errands? Can you talk to her about going into maybe a low-fidelity contact mode (I have several friends I can just exchange a daily emoji or gif or funny animal video if there's no bandwidth for more)? Obviously these discussions should happen when she's on the upswing, but maybe she could help you find ways to feel connected and supportive (and being legitimately helpful and supportive!) without asking more than she can give in the low times.
I would definitely talk to her about helping pay for additional treatments (or help researching how to badger her insurance company to get it qualified as necessary treatment), and if she's been reluctant to use medication to manage what is presenting similarly to severe PMDD, maybe make sure you're expressing support for that kind of treatment and standing up to her care team for better attempts at mitigation on top of appropriate. Emotional suffering often isn't considered important in women, but it's a killer and deserves attention.
posted by Lyn Never at 8:14 AM on March 29, 2022
Everyone upthread has given you wonderful advice about caring for yourself during these times. Since your friend's absence is medically related on a fairly regular basis, why not imagine that she is getting some kind of chemotherapy that debilitates her for a few weeks after "infusions?" She's tired, cranky, doesn't feel great. It has nothing to do with you; it's the treatment. Be kind to her when she goes underground, then occupy yourself with gentle distractions, other friends, and your own "me" time.
posted by Elsie at 3:02 PM on March 29, 2022
posted by Elsie at 3:02 PM on March 29, 2022
I think that when you have a friend with a chronic illness, having that illness’s debilitating effects be literally scheduled & regularized to this degree is a great & extraordinary gift. having it take over no more than one month in three, again predictably, is maybe an equally extraordinary gift. I mean, I wouldn’t say so if it were my own friend, nobody wants to hear how comparatively convenient their suffering is for other people to work around, but I would think it. your own anxiety may have predictable triggers but that isn’t really the same kind of seasonal regularity. with this friend, you can block it out on the calendar for yourself if you want to.
it sounds like she doesn’t mind (?) being asked about her hormones every couple of months, perhaps even receives it as a gesture of support. but if it distresses you to do so, you can set automatic reminders, pre-schedule your own temporary planned withdrawals from frequent texting etc at times you know she’ll be unresponsive and irritated by it. that way you would not be in the position of reacting and adjusting to her changing behavior; you could instead lead your own self-protective cycle.
posted by queenofbithynia at 5:40 PM on March 29, 2022
it sounds like she doesn’t mind (?) being asked about her hormones every couple of months, perhaps even receives it as a gesture of support. but if it distresses you to do so, you can set automatic reminders, pre-schedule your own temporary planned withdrawals from frequent texting etc at times you know she’ll be unresponsive and irritated by it. that way you would not be in the position of reacting and adjusting to her changing behavior; you could instead lead your own self-protective cycle.
posted by queenofbithynia at 5:40 PM on March 29, 2022
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I certainly found when I was seeing fewer people during lockdown, that the odd little sharp points in some friendships became intensely difficult to deal with. Previously I'd see someone once a month, they might say one or two things that irritated me through the course of the evening, but then I'd know I'd probably not see them for a few more weeks, I'd forget about the niggles, and they didn't kick the whole relationship out of balance. But suddenly when I was seeing far fewer people, that kind of thing could really knock me sideways, I'd find myself wanting the other person to behave exactly as I wanted/needed, because I had so few other places to get social/emotional support.
I'm making a big assumption about the rest of your social life, which you don't mention at all above! But if you do tend to have K as your main source of emotional/social support, maybe you can take up some new hobbies, find some new buddies in addition to her, then when you know she's at a difficult point in the cycle, you have other places to put your mind, other people to lift you up, for those weeks. Her behaviour becomes a smaller percentage of your overall social world. I don't mean that you neglect her totally, but you can afford to let the friendship coast a little during those times, and eg. pick up the daily texts again when she's back on form and feels ready to reciprocate.
posted by penguin pie at 7:16 AM on March 29, 2022