Should I try to help a new friend who I believe is mentally ill?
April 21, 2015 9:34 AM   Subscribe

I recently met a really nice, intelligent, fun girl my age. She believes her coworker, whom I've never met, is trying to ruin her life. Because of this belief, she is fleeing her job and even her apartment. I have reason to suspect it's all in her head. Should I meddle or simply turn a blind eye? I feel bad because I really, really like this girl and want her to get professional help.

I'm a single 30ish female who met a really nice girl my age about six weeks ago. She is quite introverted but I drew her out in conversation and we really hit it off. She's very intelligent, kind, and witty. She's not socially awkward at all but is introverted to the point that she doesn't really speak unless spoken to. She's very bright and an avid reader and we share a lot of common interests.

Here's the thing: I have reason to believe that she is... um... a few ants short of a picnic. And might benefit from anti-psychotic medication.

Each time we've hung out, she told me very agitatedly about a female coworker her age who is trying to undermine her career and has spread gossip about her to everyone at her workplace, resulting in her getting fewer assignments and suffering from public disgrace and having everyone turn against her. I was surprised to hear this, since my new friend is such a nice and mild-mannered person and isn't the type to provoke spite from anyone. But I believed her since she's in a notoriously demanding and competitive field. (She's also extremely bright and needed perfect grades at top schools in order to enter this field - and she currently works at the most prestigious workplace in the entire field - another reason why I readily believed her version of events.)

She seems very high functioning and is well dressed and has been punctual for every social event we've attended together. In other words... she seems totally normal and together, despite never mentioning any other friends or having any photos of herself with others in her Facebook profile.

We were together most recently last weekend. All was well, and then she suddenly said something that cast a sickening shadow of doubt over everything she has ever told me about her workplace drama: She said that in addition to seeking out a new job because her evil "harassing" coworker has made her current workplace unbearable, she is also seeking out a new apartment. She said her coworker spread gossip to her doormen about her and "turned them all" against her.

I said, "Wait, she knows where you live and she went to your building? How do you know? She spoke to your doormen--really?"

My new friend said, "I can see it in their faces. Of course when I confronted them, they denied knowing her at all -- but I can see it in their faces. Their faces are just like the faces of the people at my workplace."

My question for MetaFilter is: How do I help a brand new friend with paranoid delusional psychosis? (I researched it, and she does seem to be a textbook case: socially isolated, high functioning in all areas except the focus of her persecutory delusion, and paranoid in the total absence of evidence that she is being harmed.) I feel horribly sad for her, and I'm also a little afraid of dealing with her at all anymore, to be honest. But my conscience would bother me if I just cut her off altogether. She doesn't seem to have other friends. Her family is on the other side of the country. Should I contact her parents anonymously? I feel they must not know about their daughter's need of medical attention or else they'd make her come home or something.... She's basically all alone out here, having moved across the country a couple of years ago after attending grad school near her parents.

To clarify: I am seeing her again this weekend and will try to confirm my suspicions before taking any action. And I understand that confronting her directly probably isn't the way to go. Or is it?
posted by Guinevere to Human Relations (46 answers total) 8 users marked this as a favorite
With all compassion--you cannot fix this person nor can you rescue her. I think this is a case where "no good deed goes unpunished"--if you know other people who have known her longer, you could mention your impressions to them. My guess is that this is a pattern with her, and if you try to intercede, you will find yourself to be a target--this is why she doesn't have friends. I would not contact her parents anonymously. If you feel you must do something, perhaps you could encourage her to get a general medical checkup--tell her you're concerned that the job drama is making her run-down. But I wouldn't engage much after that.
posted by Ideefixe at 9:45 AM on April 21, 2015 [15 favorites]

Do you have a pattern of being the one that points these types of things out, meeting people that desperately need your help, or finding yourself to be the one that feels they need to point certain things out, (i.e. they dont have any other friends) otherwise said person will self-destruct or fall off a cliff?

I recommend not taking any action. You don't know this person all that well, her problems do not sound acute, and it might be leading with the chin by making a comment this early in the relationship. Not to mention your advice might be wrong and take her down a bad path. Wait 30 days and see if you are still friends, and if she's still having problems and getting progressively worse, make a suggestion or help her seek professional help. Also, make sure you are taking care of yourself first. These situations are not without danger.
posted by phaedon at 9:50 AM on April 21, 2015

Response by poster: Thanks for the comments. No, I don't have a history of befriending mentally ill people! This would be my first. Ha. But I am definitely the rescuer type, the den mother, the one who "befriends" that shy or uncool person who nobody else wants to hang out with.... And I really genuinely LIKED this girl. If there were no harm to myself, I wouldn't think twice about remaining her friend and getting to know her better. But I am also the queen of risk aversion and don't want to end up being pushed in front of an oncoming train or knifed in the back.

I'm leaning toward just doing nothing, even though I hate myself for not "helping."
posted by Guinevere at 9:57 AM on April 21, 2015

But I am also the queen of risk aversion and don't want to end up being pushed in front of an oncoming train or knifed in the back.
In reviewing the research on violence and mental illness, the Institute of Medicine concluded, “Although studies suggest a link between mental illnesses and violence, the contribution of people with mental illnesses to overall rates of violence is small,” and further, “the magnitude of the relationship is greatly exaggerated in the minds of the general population” (Institute of Medicine, 2006). For people with mental illnesses, violent behavior appears to be more common when there’s also the presence of other risk factors. These include substance abuse or dependence; a history of violence, juvenile detention, or physical abuse; and recent stressors such as being a crime victim, getting divorced, or losing a job (Elbogen and Johnson, 2009).

... People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime (Appleby, et al., 2001). Researchers at North Carolina State University and Duke University found that people with severe mental illnesses—schizophrenia, bipolar disorder or psychosis—are 2 ½ times more likely to be attacked, raped or mugged than the general population (Hiday, et al., 1999).
It may be helpful to gently point out that your friend's fears seem really high and maybe it would be helpful for her to talk to a therapist or her family about her stress. I wouldn't push it much past that, because it's not your job, but I also wouldn't cut her out of your life due to stereotypes about people with mental illness.
posted by jaguar at 10:02 AM on April 21, 2015 [33 favorites]

Should I contact her parents anonymously?

Oh Good Lord, no. If you really think she's paranoid a new-found friend going behind her back to tell her parents things about her is not the way to go. Whatever she's going through, she's an adult. Please respect that.

I don't think you should do anything except be a friend to her. If she is experiencing some kind of paranoid delusions they are very real to her. Listen, empathise, don't undermine her. If you get to a point of trust you could gently suggest she gets a check up or something, but right now you don't know her well enough to rush in and rescue her from a mental health situation you've diagnosed yourself. Your intentions are good but you need to calm down and take a step back from Rescuer mode. Just hang out with her if you want and see what happens. If you think she's a danger to herself maybe get some advice then, but in the meantime try and be her friend and not her psychiatrist.
posted by billiebee at 10:03 AM on April 21, 2015 [7 favorites]

How do I help a brand new friend with paranoid delusional psychosis?

First and foremost, unless you are a mental health professional, do not diagnose your friend and you do not treat her as if she is a textbook case of whatever it is you researched wherever it was you researched it. You do have neither the education nor expertise to make that call unless, again, you're a professional in the field. You don't have a way of confirming your suspicions because your suspicions are potentially harmful speculation based on casual observation of someone and some casual reading. That's not how diagnosis works. I know you want to help, but trying to help in a way in which you are not trained or qualified can be potentially harmful to who knows what extent.

If you find yourself in a situation where it would be okay to suggest to any other person that they might want to see a health professional (i.e. she tells you she is frequently feeling poorly physically or emotionally) you can support her or give her a hand with finding someone but do not mention terms like "paranoid delusional psychosis" or "persecutory delusion" or "paranoid. "Respect her opinion if she does not want to see anyone if you end up suggesting it, and don't try to convince her of anything. At worst you risk exacerbating whatever is going on with her and at best you risk alienating the hell out of your friend.
posted by griphus at 10:08 AM on April 21, 2015 [23 favorites]

I agree that it's probably a terrible idea to try and help her getting mental health help, since getting help would mean confronting the fact that she has delusions. Evidence shows that trying to counter delusional thoughts with "truth" doesn't seem to work. People who suffer from delusions feel isolated because others try to talk them out of them. You can express your sympathy without playing into them. You can listen to how she feels to let her know that you care, and that you understand she feels threatened. But don't ask her to develop or feed into the delusions.

You might also want to talk to her about strategies of coping as as though what she is saying is true. Ie, she cannot control her coworker, only her own behavior, so what strategies can she find to help keep her focused and happy, and to develop healthy relationships with her other coworkers. Help her to think of ways to keep motivated and productive at work despite this coworker (which is the advice you would give to someone who *really has* an evil conniving coworker).
posted by microcarpetus at 10:08 AM on April 21, 2015 [6 favorites]

I think the key here is "new friend". The level of intervention you're talking about here would be a big overstep in my opinion unless you were someone very close to her. I get it that you're saying she's cut off and there may be no one else to help, and it sounds like she's taking some rather dramatic changes that may be unwarranted. But I think you have to let this one go. I think you have to let her live her life just like every other person on the planet, any of whom may or may not have a mental problem developing but will have to steer their own life regardless. It may mean she has to endure some unpleasant things, but that's her row to hoe. Additionally, people with distorted reality don't typically receive it well when told they have a distorted reality. They can't see it. All they see is the only reality they can see. So if you want to stay friends, a subtler approach would probably be more effective.

If you continue to be friends with her, I think a good thing that friends do is to act as a mirror. So if you reflect back at her some of the things she's saying and gently encourage her, as you've already done, to ask herself whether she's really got support for any given suspicion or claim, that'll be about as much as you can/should do unless you get a lot closer or unless she goes full blown bonkers and appears to be in imminent danger. That's what therapists do. People state some kind of assumption and they'll ask you to back it up. And if you can't back it up, they'll ask you to acknowledge that it's not reality, shouldn't be the basis of your feelings, and to replace it with something supportable and see how that feels.

It's clear that you care, so I say just use some restraint as you continue to show care. It's an awkward situation, but I think it's premature and inappropriate for someone in your position to "take action" based on your assumptions.
posted by Askr at 10:18 AM on April 21, 2015 [1 favorite]

I think that the absolute most you can do would be to say, "hey, it sounds like all of this is really stressful for you. Have you ever considered talking to a counselor to figure out how to deal with the stress of it all?" And then accept whatever her answer is. And also accept that no matter how delicately you phrase it, it may end the friendship if she feels like you're calling her crazy.
posted by decathecting at 10:19 AM on April 21, 2015 [37 favorites]

I think the best you can do is come at it from a very oblique angle, otherwise just be there for her. When I'm skeptical of what someone tells me but I don't think calling it out will work, I basically ignore whether what they say is true and respond as if it were a hypothetical that applied to me:
"Those doormen must be idiots if a total stranger is able to convince them to turn against you."
"If someone I didn't know came to me to badmouth someone I knew, I'd take that with a huge grain of salt. I judge people I know based on what I see not on what other people tell me. If she ever comes to me I'll give her a piece of my mind and tell you all about it."
"If a coworker were out to get me I'd try being the coolest, calmest person in the room, because I think most times people can figure out who the reasonable one is, unless the workplace is seriously screwed up."
"I think if I were as stressed as you I'd be looking up therapists! I'm not able to make the best decisions when I'm under fire like you are."

That kind of thing. You can't tell her what to do, but you can tell her what you'd do without it being exactly advise or explicitly agreeing with her version of events.
posted by Green With You at 10:31 AM on April 21, 2015 [2 favorites]

She is not going to realize she has mental issues if her confrontation with the doormen didn't make her realize how off base she was. Maybe you can be supportive and try to urge her to talk to a counselor or therapy -- simply because of how difficult everything is, and not because you think she is crazy. Then, hopefully, her counselor would pick up on her delusions and treat her as appropriate.

Personally, I wouldn't be comfortable being friends with a person who has this type of mental illness. Not because I would think she would murder me or something, but because it's hard to deal with someone who is not understanding reality and having to manage that. Plus, what if she had delusions about me or one of our friends? I don't think you need to feel bad if you fade away after encouraging her to see someone to deal with her stress. It wouldn't make you a bad person.
posted by AppleTurnover at 10:31 AM on April 21, 2015 [1 favorite]

If you bring this up, the next chapter in her story is perhaps how she met this nice woman Guinevere, but her evil coworker somehow got to this new friend and turned you against her, too. That's not to say you should never suggest her seeing a therapist, but that she may be in a place that this would be grounds for her terminating the friendship. (In my opinion, if questioning her point of view is a dealbreaker for her, then so be it, let her go. But maybe you have more tolerance than I do.)
posted by aimedwander at 10:32 AM on April 21, 2015 [3 favorites]

Suggest to her that as she is under a lot of stress at the moment, that she go see a *Doctor* that she trusts, and looks at going on an antianxiolytic. Yes it sounds like she needs an antipsychotic, but she would be more likely to go for the former, and it may build a relationship of trust, and a mental health history with her doctor.
Counsellors can't prescribe meds, so a Doctor being familiar with her situation would be more helpful.
posted by Elysum at 10:50 AM on April 21, 2015 [3 favorites]

Don't know if this is helpful but I just happen to be in the middle of reading The Exception by Christian Jungersen and it is about exactly this sort of situation. Don't know how it turns out though. From this and his latest book he seems to be trying to get the portrayal of mental illness accurately.
posted by canoehead at 10:55 AM on April 21, 2015 [1 favorite]

Thanks for the comments. No, I don't have a history of befriending mentally ill people! This would be my first. Ha. But I am definitely the rescuer type, the den mother, the one who "befriends" that shy or uncool person who nobody else wants to hang out with.

Yeah, I think you might be experiencing some overlap here; I didn't mean to imply otherwise. Watch out for some symptoms of codependency, for example, attempting to convince people what to do or feel, believing people are incapable of taking care of themselves, gravitating towards people that are unavailable or unhealthy (for example, sitting around for long periods of time trying to figure out how to fix their problems), and using a superficial understanding of psychiatry to control peoples behavior (i.e. call parents, get her to keep apartment and not leave job).

I'm leaning toward just doing nothing, even though I hate myself for not "helping."

By the way, none of this is don't be her friend. Be her friend. Do friend things. Maybe this helps - there's a difference between caring and caretaking.
posted by phaedon at 11:00 AM on April 21, 2015 [5 favorites]

I don't have much to add that the previous posters haven't already (very well) said, but please do not refer to the (supposedly) mentally ill as ''a few ants short of a picnic''. It's pretty offensive.
posted by hasna at 11:11 AM on April 21, 2015 [27 favorites]

Other than suggesting the Doctor, there isn't much that can be done unless she seems like she is in danger of harming herself or others, in which case it is involuntary committal, then meds.
When someone is at that 'in between' stage of paranoia or psychosis, there isn't much to be done.

If you persist in a relationship, treat her with compassion, but don't 'jokingly' agree with delusions, or pretend to. You can say I wouldn't know etc, but sometimes you have to straight out say I don't have that opinion, or, for example "You won't see me tomorrow, I am going to be assassinated tonight", "Well, I don't think that is going to happen. And I'm coming to visit you at 2pm tomorrow, and I will call if I can't make it". These are scary thoughts. From talking about that very conversation, I have been told it can sometimes help to know that someone else doesn't believe in their power (after days of that same discussion, I finally got the response "I believe you", which was one of the happiest bawling with tears moments of my life).
posted by Elysum at 11:25 AM on April 21, 2015 [2 favorites]

First thing first, please don't 'diagnose' people with things like this.

For your own risk aversion purposes, feel free to evaluate whether you think some specific behavior is likely to be dangerous to you, but you're not qualified to diagnose her, so please don't do that.

Whether you want to stay friends with her or not, don't contact her parents or anyone else about her unless you see real, immediate danger. Even if she does have a serious mental illness, she is an adult and her parents couldn't 'make' her do anything, anyway.

Personally, I'd go ahead and stay friends with someone whose friendship I valued, whether they have a mental illness (or are having an 'episode') or not. But I'm not very risk averse in that sense. I have a few friends with mental illnesses whose friendship I really value. And I have never known anyone, ever, who didn't talk crazy sometimes, diagnosable mental illness or not. It can be scary when someone's reality seems so different from yours, but it's perfectly normal to care about and be friends with someone who is different from you. Paranoia is a totally normal thing that everyone experiences from time to time, and pathology is a matter of degree, not type. She's constructing a narrative in her mind that you believe is over the line into something pathological, and you could even be right, but you're constructing a narrative in your mind right now too. People with mental illnesses aren't monsters or aliens. They're human beings just like everyone else, and they deserve the same acceptance and respect that anyone else does.

If there were a point where you had good reason to believe that she was a danger to herself or others, then would be a time to involve some type of authority, but not before.
posted by ernielundquist at 11:25 AM on April 21, 2015 [5 favorites]

She may be partially accurate about her suspicions, perhaps this co-worker has been spreading rumors about her. Granted, it's not likely that it's at the scale she thinks it is, but nevertheless, presume she has some legitimate worries and respond in a manner befitting a good friend: listen.
posted by waving at 11:39 AM on April 21, 2015 [7 favorites]

I actually just went through this with a friend/neighbor. You can Memail because I am not comfortable going into detail here.

Either your friend is already under treatment and her family knows, or this is the first onset of a mental illness.

You can and should call the national chapter helpline at NAMI for really really great insight and advice.
posted by jbenben at 11:45 AM on April 21, 2015 [4 favorites]

I'm leaning toward just doing nothing, even though I hate myself for not "helping."

Oh god please just butt out of this and have nothing to do with it ever again. PLEASE.

You're making a gigantic level of assumptions here. Internet diagnosis and just... NO. The way this is written displays your view/paternalistic opinion of the situation, and the angle you'd be getting involved in from. Just. No.

I've been on the receiving end of this sort of thing, and i've seen people get involved this way more than once. I've also BEEN the rescuer kind of person who thought they just had to help.

Please just don't. The best thing you can do is forget this ever happened or you ever met her.
posted by emptythought at 1:01 PM on April 21, 2015 [6 favorites]

she seems totally normal and together, despite never mentioning any other friends or having any photos of herself with others in her Facebook profile.

I am going to suggest that you have rather poor boundaries, are jumping to some REALLY BIG conclusions about someone you barely know, and you should drop both your assumption that she is mentally ill and your assumption that YOU are the person who "should" help her. Not having photos of yourself with other people on your Facebook profile is not some kind of evidence of mental illness or "abnormality." She's an introvert. Introverts frequently don't have lots of pics of themselves with other people. It isn't some sort of mental defect to be introverted. Just because her behavior is not YOUR normal does not mean it is ABnormal. Geez.

Ernest Hemingway was thought to be suffering paranoid delusions because he thought the government was out to get him. Well after his death, it came out that, no, he wasn't crazy. The government really was dogging his steps: Fresh claim over role the FBI played in suicide of Ernest Hemingway

Furthermore, when she says "She sees it in their faces," that is not necessarily crazy talk. Reading facial expressions and body language is a legitimate thing. People often can tell when someone is flat out lying to them.

If she really has crossed tracks with someone very grudging, her story may well be true -- or at least most of it, even if stress is causing her to exaggerate some things and infer some things that aren't entirely accurate. If you like this young woman so much, then try to be a real friend to her. I will suggest that real friends don't go jumping to really extreme conclusions about how seriously mentally ill you are because you vented about a stressful situation in a way they don't entirely understand or agree with or something.

It sounds to me like you are basically looking for drama because you like to be helpful and if she is as seriously mentally ill as you would like to think she is and you "save" her, that does something for you. As others have said above, don't go around "diagnosing" people as having some specific serious mental illness. Just don't.

If her behavior concerns you so much that you are genuinely afraid that she will stick a knife in you, I suggest you just walk away from this.
posted by Michele in California at 2:11 PM on April 21, 2015 [20 favorites]

Oh god please just butt out of this and have nothing to do with it ever again. PLEASE.

Seconding that. You've known her for 6 weeks, and any 'intervention' you may be planning will backfire badly. Just don't. And "a few ants short of a picnic"? How very offensive and demeaning. Your 'den mother' delusion is terribly misplaced.
posted by derbs at 2:13 PM on April 21, 2015 [12 favorites]

Non-intervention is a very good call. I get feeling sad, scared and guilty and wanting to help her. But oh man that particular emotional trifecta was not leading you into good decisions. Sometimes doing nothing is the most helpful thing to do.

The Internet make us all believe we know more about everything than we really do. Mental health is no different than law or medicine: dabble when there are no real stakes for anyone, see a pro when there are real stakes.

Even with a confirmed diagnosis the Internet cannot tell you how to be a friend to someone with a mental illness in a way that is safe, respectful and helpful to that person. What you were proposing was not safe, not respectful and potentially quite harmful to her.

The most you can do to help that's within the limits of friendship is encourage her see a therapist for guidance on maneuvering toxic work environments. Maybe get some names to pass on. She's invited you into her workplace problem, it's okay to make suggestions on that that problem.
posted by space_cookie at 2:27 PM on April 21, 2015 [5 favorites]

Look, I'm sorry to say this, but unless you're a psychiatrist or psychotherapist or psychiatric advanced practice nurse, you need to mind your own business. Also, if you don't have experience with anti-psychotics or aren't trained in the mental health field, this kind of armchair diagnosis is plain offensive and not funny at all. Calling someone you don't know very well "few ants short of a picnic" is not okay.

I think you need to step away from her. No more "observing" or whatever you're doing. It's not okay, it's not right, don't insert yourself in her life under the guise of compassion.

Let me be fair, I've worked with a lot of people who are obsessed with office politics, etc. They tire me out too.

I actually would suggest you stop "observing" her. Yes, if you tell her,"Your life and work seem so stressful. Do you think you might want to talk to a professional?" that's helpful. All this description and language you are using describing her---sorry, but you can't treat people you know like case studies in a subject you're interested in.

And I apologize if you a doctor or a well-trained psychotherapist or pharmacist or psychiatric nurse, but if you're not, this is incredibly offensive and it's not okay of you to diagnose her and "observe" her, especially if you haven't known her for a long time. I know it's fun for some people to dabble with learning about mental illness and talk about anti-psychotics, etc., but seriously, either just nonchalantly ask if she thinks about seeing a therapist because she sounds stressed or stay out of it.
posted by discopolo at 3:17 PM on April 21, 2015 [9 favorites]

Best answer: From an anonymous commenter:
Not a mental-health professional here, but I have a really close friend who had a doctor-diagnosed psychotic break. If she mentions specific plans to hurt herself or other people, then yeah, that's the point where you can and should get professionals involved. But otherwise, honestly, the conclusion I've come to is that if you think someone you know is having a psychotic break, one of the best things you can do for them, as a non-mental-health professional, is to just listen non-judgmentally and be there for them as a friend. In this case that doesn't mean either "going along with" the delusions or trying to combat them, just validating her emotions (e.g. "wow, I can see why you'd be stressed out by that") and then continuing to hang out with her and do fun stuff together, like it sounds like you would like to anyway. I think the prognosis for people with all kinds of mental illness has been shown to be much better for people with social support networks than for people who are very isolated. And as a bonus, being supportive and friendly is helpful to people going through stressful situations regardless of how much their beliefs are based in real events vs. over-interpretation.
posted by restless_nomad at 4:45 PM on April 21, 2015 [7 favorites]

If she's in a super competitive field and she has an office rival, she may be exaggerating only slightly. People can be vicious and a nasty rumor delivered by a well-dressed professional woman about a withdrawn quiet tenant would carry weight ("oh I work with Anne, I'm dropping these documents off because she had to leave early - she got a secretary fired because she didn't get Anne's coffee order right and HR asked me to deliver this paperwork. Another harassment seminar, maybe it'll work this time. Can you please make sure she gets them - and don't tell her who delivered them, I really don't want her to be angry at me too.")

You don't have enough info or history with this woman to know what's really happening. Just enjoy her company, be friendly and don't try to fix things.
posted by dorothyisunderwood at 5:56 PM on April 21, 2015 [4 favorites]

I'm sorry but I have to chime in.

I had a really good friend growing up. Probably my best friend from middle school through high-school. He was incredibly bright: regularly got better grades than me in school, was an avid reader, and was way better than me at our chosen passions (video games, music, and skateboarding). People liked him; I was an introvert. He was athletic and proficient with music. I really admired him.

I left the state for university, he stayed behind for state school (he couldn't afford to leave). When I got back, he began to confide in me about people being out to get him. It started with an innocuous story about reconnecting with high-school acquaintances, and them being disingenuous at a social event. Hallucinogenics were involved so I thought maybe he was being a bit foolish in public, and wrote it off. However the stories started to get more and more elaborate, where students and professors at his university were "in" on it. Then the police were a part of the conspiracy. People on the train. When I confronted him with logical questions about this, he rebuked it, eventually idly speculating if I was a part of it. "Why are you laughing at me?" he would say. I wasn't laughing. I was listening and trying to help.

Eventually he had an incident involving a car accident and police. He pleaded for help, as he was going to hurt himself.

After a couple years in a mental hospital he was released. I was happy to try and reconnect with him as we'd grown apart. I asked him to join me for dinner. Everything was going great. He seemed to have less energy (assumed it was the meds) but otherwise well adjusted. After dinner, the stories re-emerged. I again questioned him on this. He threatened me with violence, accused me of being "a part" of the whole thing, and then told me he'd kill me. I haven't seen him since... over ten years ago.

I warn you, as you're very early in your relationship with her. You are not equipped for this. You ARE NOT equipped for a mentally unstable person. It doesn't matter what you think you can handle. Mentally unstable people need a special kind of help from educated professionals that understand these situations. More importantly, there needs to be an authority figure with agency over the person to actually be able to help them. If you can sit and listen to crazy, then by all means, entertain their ideas. But I couldn't just listen... I have to offer advice. Because that's what I do.

Please keep your distance. There's some really good advice in this thread that I'd wished I'd had when I was younger. Maybe I could've been a better... listener? But it was really painful to hear this person that I cared about dig himself into a hole. In retrospect I handled it poorly. But you have no idea what you're in for. And you're not in a position to truly help this person. I relate to you in the sense that I always try to help people. I "adopt" people... which is frankly something I'm trying to change because I put them ahead of me. And it's unhealthy. My friend was my wake up call to this. He's cared for by his family and others. I was not equipped for this, and failed.

I don't know... that's my 2 cents. I wish you luck. I truly hope the best for this co-worker. But be very careful.
posted by teabag at 6:34 PM on April 21, 2015 [5 favorites]

Best answer: I answered a very similar question here recently. I think you should contact her family. Please, please read my response to that previous question here.
posted by MexicanYenta at 7:37 PM on April 21, 2015 [1 favorite]

I realize I'm double posting here, but ESPECIALLY dont contact her family. PLEASE.

I know people who really have been harassed by coworkers or friends or exes, and very often they had nosy, insufferable, and even borderline abusive parents with huge issues of their own who would love an opportunity to just swoop in and try and impress their will on the "situation". Many people with real mental issues seem to have gotten it familialy, and their parents have it too. Many people who struggle with weird abusive or stalkers shit in their lives dealt with it at home, and basically find themselves in those situations again out of familiarity or through no fault of their own.

I've said this a lot on ask, but never contact someone's parents unless you know their parents if they're an adult. Just don't do it. It's just as likely they'd show up and fuck everything up and make it worse as that they'd help. Leave that shit to the professionals.
posted by emptythought at 7:56 PM on April 21, 2015 [9 favorites]

MexicanYenta, a landlord is going to have more contact and situational awareness of someone than a new friend who has known someone for all of six weeks and is preparing to disrupt their life. I've had social acquaintances decide they would help mend rifts by contacting my family members, because they had no idea I was estranged for damn good reasons, and as they weren't close friends with long history, I didn't share those private reasons until after I got guilt-tripped and harassed by relatives. It was really intrusive and arrogant of them.

Guinevere, please talk to other people in this woman's life before you stage any kind of intervention. Arrange to have lunch with her near her office, plan a social group activity with her, but for heaven's sake, a six week friendship which is just meeting up occasionally rather than being stranded on an island 24/7 in contact - you barely know her.
posted by dorothyisunderwood at 2:56 AM on April 22, 2015 [3 favorites]

will try to confirm my suspicions before taking any action

How are you going to do this? Unless you're planning on becoming a fully qualified mental health professional in the next few days, you don't really have a way of confirming your suspicions.

Making statements like "a few ants short of a picnic" and "don't want to end up being pushed in front of an oncoming train or knifed in the back" is a really shitty thing to do. The attitude you're displaying with the comments you made shows that you're not going to be a helpful person in this instance. You sound codependent and like you're looking for ways that she's not conforming to the pattern you think she should so that you can swoop in and play at being rescuer and prove to yourself that you're a good person. See what I did there?

You deciding to involve yourself in this could backfire spectacularly, and you have the luxury of just walking away because you don't want to get hurt. A person's family are often the worst group of people to approach, because they make things much worse for the individual concerned. If you really want to help, direct the person to mental health resources in their area, such as actual qualified professionals who are able to decide whether or not this person needs assistance. If you're not qualified, then you're not in a position to do very much.
posted by Solomon at 3:27 AM on April 22, 2015 [6 favorites]

I agree with the people who don't understand your "diagnosis" of someone you met six weeks ago, and that you don't see every single day since you don't work together. Solomon's "what I did there?" Comment has a point -- I imagined what I would say hearing this question from her perspective -- " I just met a new friend six weeks ago. That friend tracked down my parents, found their contact info online even though they've never met, and tried to anonymously leave them a message saying I was delusional" -- I mean, yikes.

If you boil your question down to its essence, "I have a friend who might need serious help - how should I help her?" , the answer is never "anonymously contacting her parents", it's listening, not judging, treating her like an adult and kindly engaging in conversation that presents your perspective of her situation, and getting her to an ER/calling the police if she IS threatening to harm herself or others.

Anther observation to consider: Facebook is the most notorious of inaccurate life representations -- maybe she doesn't maintain her account or like social media, since she is heavily invested in her work?
posted by NikitaNikita at 4:16 AM on April 22, 2015 [2 favorites]

As much criticism as 'a few ants short of a picnic' is getting, I do have some sympathy for the poster.

Metaphors of 'missing-ness' (analogous to the 'missing stair' used to describe acceptance of dangers in social groups, and gaps in information conveyed about those dangers), are used, repeatedly, over and over in different contexts, because the experience of talking to someone in the midst of even a mild psychotic episode, is often frighteningly, viscerally, like they are functioning on many levels, but some aspects are straight out missing.
Missing stairs, missing biscuits, missing ants. It's never just a delusional belief, but some aspect of cognition, logic or pattern recognition that just isn't working.
Depending how smart someone is, or severe the dysfunction, I've seen people cover for normal during an extended conversation, or even lie through their teeth (Yes, of course I've slept [at all!] in the last 3 days...) in a manner that at least indicates the capacity to do so and keep their story straight, before suddenly struggling on a question a 5 year old would be able to answer easily, not just struggling, but unable to get to despite 15 minutes of hinting.

A better metaphor could have been used, but I'm pretty sure metaphors for a 'missing' quality will continue to be used until or unless a *better*, acceptable metaphor becomes standardised for this experience, in regards to specific mental illnesses.

The context of the post is overall one of compassion. Most peoples response to suspected mental illness is to immediately distance themselves, so, while you need to consider your own well being, social isolation only compounds the stress of mental illness. Old, close friends and family would be better for this, but if she doesn't have any...

Oh, and has anyone mentioned that if this *is* mental illness (which can often just be triggered by stress then spiral, but go away in the absence of excessive stress), then her workmates and door staff are probably the people who encounter her often enough that they would be most likely to suspect there is something wrong, and may well be treating her distantly or 'strangely'?

This is a really common feedback cycle for paranoia.
E.g. Anyone who treats you like you are paranoid, is obviously one of the people out to get you, etc.
posted by Elysum at 7:57 AM on April 22, 2015 [4 favorites]

Good grief. I shudder to think how you would diagnose me if we met. I'm an introvert who you'd probably consider "high-functioning" and I'm always presentable and punctual for work and the few social events I attend. I'm exceedingly cynical about the rest of the world, have a poor opinion of nearly everyone and, worst of all, don't even have a Facebook account. (I think the whole mess is incredibly pervasive and intrusive so I'm probably paranoid in your book, too.)

I was hopeful when I saw the first comment you marked best answer "be a compassionate listener" but then saw that you also selected the "contact her parents". If a good idea in your world is her parents "making" her come home, then you have no business trying to deal with this situation - whatever it might be.

And just for the record, it's entirely possible that what she tells you is true. There are some incredibly mentally ill people in the world. It's entirely possible that her co-worker is the one who is ill and aggressive and is actually doing these things. If you read Ask A Manager for any length of time, you'll know that there are way weirder workplaces out there. So don't write her experiences off as paranoid delusion just because you've never experienced what she has.

Stick with your original best answer - listen, be sympathetic, be a friend. Or don't. It's not your job - or your right - to take care of everyone. If you aren't comfortable with the friendship for any reason, you can bail. That doesn't mean you are abandoning her. That doesn't mean you are judging her to be a bad person. It just means you two shouldn't be friends. That's okay. You don't have to like everyone.

And as an aside, lay the hell off the rescuing of shy people. As an introvert, I don't need any help. I don't need to be fixed. I'm not lonely. I sincerely enjoy my peace and quiet and solitude. I don't need to be drawn out because I can't make friends on my own. I'm not so awful that no one wants to be friends with me. I have a co-worker who is like you. She just thinks that people like me are shy and just need a little extra help making friends. It is incredibly disrespectful of my boundaries. She thinks she knows what I need better than I do - and she's only worked there for about six months. And we don't even know each other well. Please learn to respect people's boundaries and autonomy.
posted by Beti at 9:08 AM on April 22, 2015 [4 favorites]

Response by poster: 1. She wants to be friends with me. I'm seeing her again at the end of this week, and she's looking forward to it. She has eagerly accepted every single one of my invitations. She has joined a small social club I'm a part of. At this point, I couldn't disengage if I wanted to!

2. I believed her 100% until she mentioned that all her doormen had been turned against her, and the only evidence was something she "saw" in their faces. I think she is severely ill. I don't think any compassionate person would simply keep walking and ignore after seeing someone who is ill and is not getting medical attention. Yes, contacting a parent may be overstepping - so I will take the advice of those who said to gently suggest see she a therapist to alleviate her stress.
posted by Guinevere at 9:21 AM on April 22, 2015

If you thought she had a drinking problem, would you contact her parents?
If you noticed she was severely obese, would you contact her parents?
If she had a questionable-looking mole on her neck and she brushed off suggestions that she should get it checked out, would you contact her parents?

It's very possible that she has paranoid thoughts about the world. Unless you think she's an immediate danger to herself, it's probably not a time to take action. Even if you were to act, there is not necessarily a clear, easy answer. Who knows what unintended chain of events you might set in motion.

Not every strangely-thinking person needs to be fixed. And for things like this, the fixes available are fairly imperfect, blunt tools that come along with their own issues. I know a two people who started taking Abilify after severe bipolar drove them to a suicidal state. Now on medication, they're no longer suicidal, but they've both gained almost double their original body weight and one lost her sense of humor completely. Is it worth it? The pros and cons must be weighed.

Basically -- new friend, paranoid thoughts but not terribly distressed -- don't get worked up about it. Get to know her. Be her friend. If things take a more obviously bad turn in the future, you can be there for her then, like you would for any other friend.
posted by the jam at 10:37 AM on April 22, 2015 [2 favorites]

At this point, I couldn't disengage if I wanted to!

I wanted to add that you seem stuck on a choice that from an outsider's perspective sounds like "diagnose/engage/assist/take dramatic action" or "run/cut off completely." I just wanted to raise the possibility that you can disengage completely AND attend events with her, be great friends with her, get to know her better, etc. Intervention does not have to take place during a manic episode or a period of high drama.

People have accused you - it should be said, patronizingly - of being patronizing. You seem to have highlighted the few answers that suit you. This is kind of like the rules of how people work. So gentle is always good. I just wanted to add that I know you have good intentions and I think AskMe sometimes tends to dump on OP's.
posted by phaedon at 11:45 AM on April 22, 2015 [1 favorite]

I don't think any compassionate person would simply keep walking and ignore after seeing someone who is ill and is not getting medical attention.

You are seriously overconfident in your ability "diagnose" this person.

I have a serious, complicated, life-threatening medical condition. I routinely wave people off with "I'm fine." or "I'm okay" even when I am not. In fact, I just did that this morning, a morning where I have thrown up five times already. I do it because I don't need the so-called "help" of people who have no fucking clue what I am dealing with but who are willing to screw with my life so THEY can FEEL helpful.

I'm a compassionate person. With age and experience, I have learned to keep my hands to myself until I am clear what is going on and then gently make suggestions if that seems like an okay thing to do. I am not a doctor or other professional, but I have learned a helluva lot in the school of hard knocks. Sometimes that information is useful to other people. But it is never okay to basically randomly fuck with someone because you are bored and think you are smarter than everyone else and know more about their lives than you really do.

I stopped just short in my previous reply of saying that, actually, given your fears she will knife you or push you in front of a train, it sounds to me like you are the one suffering paranoid delusions. It also sounds to me like you are in no way, shape or form qualified to diagnose anything, much less help a mentally ill person.

You can, in fact, walk away from this. Or at least minimize your contact. And you can absolutely, without any doubt, choose to butt out of things you are not qualified to deal with.

First, do no harm. If you aren't prepared to live by that, then trying to "help" because you see yourself as a compassionate person amounts to fucking with people. And it never ends well.
posted by Michele in California at 12:57 PM on April 22, 2015 [9 favorites]

Some other possibilities:

- Your friend actually does have a workplace stalker who is trying to undermine and eliminate her and who may have visited her home. The paranoia about her doorman seems over the top to you, but anyone who has ever been seriously stalked can relate to that "Oh my god, did she come to my HOUSE? Did she talk to my landlord???" state of terror. Wasn't there just a fpp on the blue about an author who dug up the personal information of a woman who left a negative review of her book on goodreads, and was phoning her work and driving to her house to look in her windows? This kind of behavior is fucked up but it does happen in the real world, not just the imaginations of people with paranoid delusions.

- The "lies" the evil coworker is spreading about your friend, including to her doorman, are something like, "I think my friend has stopped taking her medication and I am deeply concerned about her."

Whatever the reality, your new friend's dilemma is something long-term and complicated, and you do not seem qualified to help her. You seem very perky and eager --the ignorant "knifed in the back" comments and "I couldn't disengage if I tried!"-- to escalate a situation that is going to be nightmarish and traumatic at best. You say you want to get your friend "medical help," but how much do you know about the process of getting adults onto an antipsychotic regimen? Given that she is admittedly the first person you've ever known with a mental illness, I doubt you're particularly well informed. This isn't like getting someone with a cut to go get stitches; it's a process that takes years to get right, and can involve all kinds of traumatic institutional (hospital, police) intervention. Are you planning to call in the cops to arrest your friend and put her in an involuntary mental hold if she doesn't agree that she needs to see a psychiatrist who will put her on heavy medication? Are you hoping her family will petition for a legal conservatorship of her, ie full control of her assets and ability to have her medically detained? Do you know her family well enough to trust them not to abuse that kind of extreme power over her? Do you in fact know that she is psychotic at all?

If your friend is really the first (potentially) mentally ill person you have ever been close to, you would benefit from professional guidance from a place like the NAMI Helpline before trying to "help".
posted by moonlight on vermont at 2:29 PM on April 22, 2015 [8 favorites]

I know you are disinclined to listen to folks like me who are cautioning you that you do not have enough information or experience to judge her or help her if she really is mentally ill. I will suggest that your comment that "I couldn't disengage if I wanted to" indicates that you really aren't very socially savvy. Someone socially savvy absolutely knows how to disengage, certainly if they have only known someone six weeks. She obviously has a big problem. Whether that big problem is mental illness of whether it is a bona fide stalker, someone who cannot imagine disengaging after a mere six weeks is completely unqualified to deal with either situation.

I am pretty well convinced that you are more self-centered than you think you are. I do not think you are acting out of compassion. I think you are acting out of some thrill-seeking, arrogant impetus. So I really am not surprised that admonitions to please not fuck with this person's life are falling on deaf ears. But I thought I would post one more time and suggest that if you are wrong and she really, truly has a stalker, inserting yourself into this situation is potentially dangerous for YOU.

I really do not think the young woman you describe is a danger to you. Having thought more about this, your description of her -- as someone who is rearranging their entire life to avoid someone causing them enormous problems -- and your fear that she could do you harm are very much at odds. Someone rearranging their life to avoid trouble is very unlikely to knife someone or otherwise be aggressive. So I really don't think you are anywhere near as socially savvy as you think you are. And I really don't think this young woman is very likely to be a danger to you, though anyone can be a danger if they are pushed far enough. But the possibility that she truly has a stalker is one I think you are vastly underestimating, both in terms of likelihood and in terms of what that means with regards to real world consequences.

I have had several people who had an unhealthy degree of interest in me and trouble letting go of it. I have a long track record of resolving such situations with minimal drama. So I think I know whereof I speak when I say you are very much in over your head here: Stalkers get possessive of their object of interest and they will go after interlopers, sometimes more viciously than they go after their object of interest (because they often desire something FROM their object of interest, whereas they often want other people simply out of their way, whatever that means).

So please, out of interest for your own safety, consider the possibility that you are wrong, she really has a stalker, and you are in potential danger here if you don't back off.
posted by Michele in California at 11:05 AM on April 23, 2015 [4 favorites]

Response by poster: For what it's worth, I called the NAMI Helpline. They told me to contact her family.
posted by Guinevere at 12:46 PM on April 23, 2015

If you are determined to contact her family (which I feel strongly you should not do based on such a short relationship with her, and no relationship with them, but which I can't stop you from doing) could I at least make a suggestion? In one area of my work I have a confidentiality agreement with people and when I am explaining that I may have to break this confidentiality if they are a danger to themselves or others, I let them know that I will inform them before I take this step. It's important not to go behind the back of someone who trusts you, as this woman does (or else she wouldn't have taken you into her confidence).

I would strongly suggest that if you feel you must tell her parents that you tell her this. You could say something like "I am concerned that you may be struggling with some stresses because of your belief that your colleague is turning people against you. I feel that I need to let your parents know because I am worried about you and they may be able to help, but I don't want to do this without your knowledge." Or something. At that point she might tell you exactly why she is geographically distant from them. If you still think your conscience compells you to tell them then at least she is prepared for hearing from them and won't have a nasty shock, which may greatly add to her current stress. Again I personally would advise against this (like, I'm having a hard time keeping this calm in tone) but if you really must then please involve her in it and don't spring it on her.
posted by billiebee at 1:16 PM on April 23, 2015 [1 favorite]

Response by poster: Sorry to threadsit, but.... Yeah, I have no immediate plans to go behind her back and do anything, let alone something as extreme as contacting her parents without ever having met them. (She did mention being close to her family, and we've talked about our families at length in the past, but for all I know she was painting a rosy picture and her family is actually super toxic and she deliberately moved as far from them as she could. As you've said, I barely know her.)

My plan at this point is just to observe and get to know her better. A close friend of mine who met her for the first time recently and drew similar conclusions is going to do the same when we hang out with her again very soon.
posted by Guinevere at 1:32 PM on April 23, 2015 [1 favorite]

You and your friend both barely know her and are going to hang out with her for observational purposes? That's really inappropriate and not helpful at all. At the very least this person, who is going through a rough time of some kind, whether from her own mental thought process, reality, or a combination of both (and as others have said, we can't know) should not have people in her life who can't relate to her as just friends and feel some need to watch and report.
posted by sweetkid at 1:43 PM on April 23, 2015 [1 favorite]

have no immediate plans to go behind her back and do anything

A close friend of mine who met her for the first time recently and drew similar conclusions is going to do the same when we hang out with her again very soon.

You are already going behind her back. A close friend of yours who met her for the first time and drew similar conclusions is not any better positioned to decide anything about this person's life at all than you are and you discussing your new friend with a more established friend is you going behind her back and making plans about her life.

Your last two updates are basically justifying what you already concluded and what you already planned to do. This does not bode well. It is really normal for people to engage in confirmation bias -- to look for evidence that supports the conclusion they want to believe and to ignore or dismiss anything that doesn't agree with what they want to hear. Confirmation bias tends to lead to incorrect conclusions and poor decision-making. It is a bad human habit that much of scientific method is intended to guard against.

It is not a good means to intercede constructively in someone's life, especially not when it is clear something serious is going on but you honestly don't know what that serious thing is. You just want to believe she is mentally ill and you don't want anyone else suggesting your "brilliant" insight is incorrect. Whether she is mentally ill or not, what you are doing (with regards to confirmation bias and justifying your plans to screw with her life) tends to lead to really negative outcomes -- and some of those may well be negative outcomes for you, not just her. Even accusing someone of having a serious mental health issue can cause big problems in their lives. You throw that out there real casually, like you just don't understand the ramifications of what you are saying, nor actually care.
posted by Michele in California at 2:37 PM on April 23, 2015 [3 favorites]

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