My friend is in bad shape, and I want to help
March 19, 2021 5:10 PM   Subscribe

I care about someone whose mental health issues (anxiety/depression) seem to be getting out of control. I'm worried about her. How can I help her?

Let's call her Sue.

Sue has long suffered from anxiety, depression, insomnia, and low self-esteem.

But over the last two years, she's really been through the wringer: a long and acrimonious divorce, a verbally and physically abusive romantic involvement (which has left her with some PTSD), and (of course) a global pandemic.

She's also grappling with a significantly reduced income (due to the divorce and related expenses), a job that she's unhappy with, the imminent loss of that job (because her current employment contract is coming to an end), and co-parenting two adolescent children.

All of this would be incredibly difficult for anyone. So you can imagine how hard it's been for someone who already struggles with anxiety.

The divorce is finally over, and she says she's gradually feeling better – but observing her situation from the outside, it seems like she's dealing with her many stressors by...not dealing with them.

Her anxiety often paralyzes her into inaction – which means that she doesn't do things that she knows she needs to do. The longer she puts off doing things, the bigger the problems become – which causes more anxiety. And being unable to keep up with these responsibilities makes her feel like a loser, which causes even more anxiety. Which makes her feel even more paralyzed and unable to act.

It's a vicious circle. This article about "avoidance coping" sounds a lot like her.

She needs to look for a new job, but she hasn't. She's told me (twice) that she's looked into getting unemployment benefits instead, so she doesn't have to worry about work. (I have clearly discouraged her from this line of thought.)

She works from home in her current job, but she hasn't really been doing anything for several weeks. That makes her feel guilty, which makes her feel like a loser, which makes her feel like she couldn't possibly get another job anyway.

She hasn't taken her recycling out in over a month, and it's piling up. This causes her distress, but she can't seem to it. The more it piles up, the more distress it causes.

She has a heavy marijuana habit. (I have reason to believe that this could threaten her custody of her kids, if she's not more careful. She doesn't partake in front of them or anything, and she is by no means a bad parent – but I think her use is heavier and more obvious than she realizes, and her ex has shown that he's willing to use her substance use against her.) She eats in bed. She often doesn't bathe or get dressed until late in the afternoon.

The says that the insomnia is partly because nighttime is the one time she doesn't feel like she's under a million demands. She just lies awake and enjoys not having any immediate responsibilities to think about.

I know that she was in therapy at one point, but I don't know if that's still the case. She goes for occasional walks, but gets no other exercise. Her diet is not great.

My question: What, if anything, can I do to help Sue pull out of this slump? I'm worried that she's going to end up with an income, or maybe even losing the kids (which would destroy her).

I obviously can't solve her problems for her – like, I can't walk into her house and take her recycling out for her, I can't apply to jobs on her behalf, and I can't physically drag her out of bed in the morning. (And even if I did, who's going to solve the next problem that comes along?)

I try to keep unsolicited advice to a minimum, and I try to deliver it gently when I do offer it. She knows what she needs to do to get her shit together – she just feels unable to actually do it. She already feels awful about that. Pointing out the obvious things that she's not doing will just make her feel like more of a loser.

I try to listen to her problems without judgment, and she has sometimes thanked me for doing so. But I sometimes wonder whether I'm crossing the line into enabling.

Is supportive listening all that I can do? Or are there other steps I should be considering?

Thanks for reading.
posted by anonymous to Human Relations (20 answers total) 6 users marked this as a favorite
I obviously can't solve her problems for her – like, I can't walk into her house and take her recycling out for her

Why not? If she is not coping because she's exhausted, having help with some of the grinding, draining chores could give her the space she needs to recover enough mental energy to start actually working on the other things.
posted by heatherlogan at 5:19 PM on March 19, 2021 [23 favorites]

Once, when I was really going through some things, I presented myself as mostly fine. My super close friends knew something was wrong but were mostly a sympathetic ear and I also didn’t want to burden them with how bad everything was. I finally got my act together after a less close friend said to me, “You might think you’re dealing with it, but you’re not. You’re not okay, and you need to get help.” I needed someone else to tell me how bad it was and none of my close friends wanted to tell me the truth because they were worried they’d upset me. Maybe your friend needs that, too.

But also, yes, I agree with the above. I know it’s the pandemic, but can you plan walks together? Or figure out a safe way to help with chores? Maybe bring boxes outside and just break them down together.
posted by loulou718 at 5:26 PM on March 19, 2021 [3 favorites]

Is it so bad if she takes unemployment for a bit so she can catch her breath a bit? With the federal top up, the financial side shouldn’t be too bad. I have had an okay year overall and am not parenting, and I still do basically nothing at work multiple days a week sometimes because pandemic life is isolating and lacks external accountability. If her contract is ending anyhow, work may be an okay thing for her to suck at right now.

Giving her a heads up that her pot use may be more noticeable than she realizes may be a good idea, especially if you follow up with an appealing alternative coping method you can do with her. Maybe you can ask if she had a therapist and offer to help her find one if not?

She sounds really overwhelmed, and eventually the solution needs to be her getting a break. But mind your boundaries and pull back if you’re starting to feel resentful or like she’s a fixer-upper project.
posted by momus_window at 6:15 PM on March 19, 2021 [13 favorites]

She may not be in any condition to work and therefore unemployment benefits would be appropriate!

I would go over and just literally take out her recycling with zero fanfare, while drinking coffees you’ve brought over and and talking about something unrelated, maybe a problem you’re having so she doesn’t feel like a problem herself.

I’ve been in her state. Exactly as you said, I knew what I “needed” to do and that everything would be cool if I would just do it. Reminders, no matter how gentle, would make me feel incredibly judged. There was a wall of shame around me and anyone who would remind me of shameful things was on the other side of that wall. Personally, I needed a safe person, someone I could open up to in my own time in my own way. That’s not enabling. Enabling implies she’s being bad.

I do want to say that I feel defensive I her behalf just reading this—comments on her diet, unemployment benefits, etc. You almost sound mad at her. It’s okay if you’re not up to being supportive!
posted by kapers at 6:31 PM on March 19, 2021 [28 favorites]

I see nothing wrong with offering to help her with the things she finds overwhelming (taking out recycling, applying for a new job, etc.). I faced a similar situation years ago, with a friend who wanted to apply to graduate school but just couldn't find the wherewithal to write the essays, request the recommendations, order transcripts, and submit the applications. I did much of this work for her. To make a long story short, she got accepted into an excellent school and ended up getting a PhD in biology. Last I heard, she was doing quite well in life.
posted by akk2014 at 7:43 PM on March 19, 2021 [2 favorites]

Yes, when I’ve faced similar problems, the best things my friends did for me were to come over and physically get me out of the house. But that’s just really not practical for a lot of us right now because of the pandemic.

Maybe calling in the morning might give her a reason to get out of bed? Or schedule activities to do together online? I’m just reading poetry over Zoom with some friends next week, and it’s giving me a lot of motivation to get through the days.
posted by The Underpants Monster at 7:53 PM on March 19, 2021

I feel like I've been in about 97% of the places your friend's been, and yes, the pandemic has made all of the struggles some how more unbearable. Your friend has real illnesses: she has anxiety, depression, PTSD (it sounds like?). Pardon the mental illness cliche question: If she were struggling with another visible or recognizable debilitating illness that leaves sufferers unable to work, unable to move around (being confined to a bed because of anxiety/depression can feel like a kind of literal paralysis), seriously disrupted sleep (which alone can cause a whole host of physical and mental ailments and to me is a huge red flag that your friend has some very serious depression going on), and more, would you help her with anything you could? I feel pretty certain that you would. You are searching for how best to help your friend now and I'd recommend trying to reframe how you see her actions/inactions. She is quite ill. Take out the recycling. Help her with the unemployment paperwork. Bring her treats! Wash her dishes. Do a load of laundry when you visit. You get the idea. It's all of those tasks that can make a tough life feel absolutely unbearable and the relief when they are completed is huge!

Last week, I emailed my aging parents from bed because I just needed someone to take a box into the attic, bring me some milk and bread, and fold some laundry. It was hard (I'm an adult!), but I knew they would help--no judgement. No judgement + hanging in there with your friend until she can do more = the excellent friend you are looking to be. Good luck and don't forget to take care of yourself!
posted by Poeia8Kate at 7:57 PM on March 19, 2021 [11 favorites]

Good god, why would you discourage her from getting benefits?? She's disabled. This is like a huge thing she is trying to do for herself.

Look, I'll be honest. The contempt you feel towards her for not just bulldozing her way through life like you are is dripping from the page. She is picking up on that. You think she's a loser. It's really obvious. I would think far fron enabling her, you are actually knocking her down and reinforcing her negative self-judgements. Maybe the best thing you can do for her is to stop talking to her for a while.
posted by PercussivePaul at 8:43 PM on March 19, 2021 [20 favorites]

Enabling is doing for someone what they can do themselves. I'm not sure you're describing someone who can do those things right now.
posted by crunchy potato at 9:12 PM on March 19, 2021 [14 favorites]

Do the things for her. Recently I was in a rough spot, mental health wise. I was fortunate enough to be able to call two friends and say “I need help. Come wash my dishes and go to this appt and mop my floors with me.” That small boost was a boost closer to being out of the whole. It is literally that simple.
posted by Grandysaur at 12:40 AM on March 20, 2021 [6 favorites]

First off, what are you willing to do for her?
If the answer is only listen and that's it, or nothing, then none of the other stuff matters because you aren't willing to do it.

Secondly, depending on the state, marajuana usage is a nonstarter regarding like child protective services. But family court is a entirely different system and varies based on lawyers and judges and a bunch of different things, so I can't give advice there. But unless there is something actively happening at the moment, than its probably not worth talking to her about.

Third, it's okay for her to get unemployment for a bit. Her contracts coming to an end, she needs to look for employment and find a new job.... That's what unemployment benefits are for! And of course she's not doing much for her current job, she's been effectively fired so she's just treading water and that response is perfectly normal and acceptable.

Fourth, if you are willing to help her with some day to day stuff, just do it. Make it short and simple, hey, on Sat I can come by and help you get some stuff done how does that sound? And go for it. Do what you can. Encourage her.
posted by AlexiaSky at 12:48 AM on March 20, 2021 [1 favorite]

Don't have kids nor a pot habit but do have long standing depression. The thing that would have helped me from the suggestions above would be someone bringing over a couple of takeout coffees, a general upbeat chat, and then gathering together and taking out the recycling/ trash. Tidy home tidy mind has some truth, but more importantly it's a quick win that is easy for a non-depressed person to do in 30 minutes but could take a depressed person all day to get round to. Bonus: keeping the home free of fast food containers and the like improves the chances of keeping the place free of vermin, which would be another total pain in the neck and could draw the landlord's attention to other things in the home. Basically I am long term depressed and get disability (not for depression but for bipolar) and I end up using some of that money having someone come over to help with tidying, a friend helping me for free would be a bonus. It may well be this person just isn't up to much work at the moment and should be getting unemployment, but I will caution that once you "fall off the hamster wheel" everything slows down, life without routine can make some mental health things worse, it can be quite hard getting back into work when employers scrutinise employment gaps. If someone is getting therapy or help or doing things that regain their strength to work a break is super helpful, but if they use the break to get high and watch tv all day things get worse not better.

Some help wording or applying for jobs might be a good thing you could do for your friend. In my 20s (many years ago) I was unusual in having my own laptop and printer at a time both were costly. I had a friend who had a degree in accounting but was getting nowhere finding work with his degree and was working in a bar. I got hold of something a bit like a Chamber of Commerce directory and sent loads of speculative letters which eventually led to his start in getting a professional career as an accountant. This was back around 1995 so I am not saying this tactic would work in 2021 but in general there might me some jobhunting tasks you can advise or help with. The lesson from my outdated example was that my friend has just lost confidence from rejections and my little burst of energy as a neutral, non-rejected person helped quite a bit. Just be careful not to get into any sort of dynamic where you become the nagging parent and they become a rebellious teenager. That could be a bit of a minefield though so I think a simple small win is the coffee, windows open to reduce risk, and taking out the recycling. I literally pay for something like this and it does help quite a bit.
posted by AuroraSky at 1:57 AM on March 20, 2021 [6 favorites]

I obviously can't solve her problems for her – like, I can't walk into her house and take her recycling out for her, I can't apply to jobs on her behalf, and I can't physically drag her out of bed in the morning. (And even if I did, who's going to solve the next problem that comes along?)

Yeah, to support what some others have said -- if you're in a place where you can physically come over, and you feel like you can do this without exuding judgment or making her feel bad -- then hell yes, tell her you want to come take out her recycling, clean her kitchen, give her a day's worth of work. She might not be comfortable accepting, but that's what would really help, even if it's for the short term. Because I get in similar situations, and then every time I have to use all my energy to dig myself out of these holes, and then I don't have any left over to actually make any progress on anything else. It's a huge vicious cycle, and helping someone break it is not a waste. (And if you're going to get frustrated if/when it happens to her again -- don't. This is a really hard world to live in even when you're healthy, and she's playing on a much harder mode than most people. You have no idea.)

If you can't get over there yourself, maybe you can send her a cleaning service. That might even be better, since it's impersonal. If you can afford it, a regular service for a set few months would be incredible. Send her some meals, so she doesn't have to cook. And yeah, take her out for walks. Start with that, worry about the rest later.

Sometimes helping people doesn't work. (I wouldn't see it as enabling, personally -- this is a health issue -- but that's up to you.) But sometimes helping people dig themselves out from under insurmountable backlogs, and giving them a cleaner slate to work with, and helping them remember what normal life feels like for a bit, can really make a difference.
posted by trig at 2:23 AM on March 20, 2021 [8 favorites]

You might be reading these suggestions to just go over and do the things and thinking "but that's just treating the symptoms, how does it really HELP"... but remember, people take cough suppressants and decongestants not because they cure colds, but because they help them sleep and thus recover faster. Symptom treatment reduces suffering. Symptom treatment IS help.
posted by inexorably_forward at 3:38 AM on March 20, 2021 [13 favorites]

Nthing go help her. Honestly, that is what she likely needs more than a sympathetic ear. Go take out her recycling, make her some meals she can store in the freezer, offer to take the kids for a day and take them on an outing. Help her get her resume mishap and sit down with her while she applies for some jobs. I would approach this like someone who was recovering from a majory surgery (and a husband--ectomy certainly counts) that had no family nearby. Go over a few times a week if you can, and *do* stuff. If you truly want to help, this is how.
posted by ananci at 9:05 AM on March 20, 2021 [5 favorites]

She's told me (twice) that she's looked into getting unemployment benefits instead, so she doesn't have to worry about work. (I have clearly discouraged her from this line of thought.)

Don't. She should get these benefits if she needs them and it sounds like she does. I get that you are concerned about a number of real things but your friend is in a crisis and probably needs some breathing room to get some stuff done. The pandemic has been really hard, having kids at home all the time is really hard, all the other stuff is really hard. Go get her recycling. Make a regular plan with her that is doing something that is either helpful or social. Stop thinking about things that aren't how you would do them--eating in bed, pot use, bathing at different times--that aren't impacting her immediate ability to run her life and/or take care of her kids. Insomnia can be one of the manifestations of depression even if she's got a reason why she thinks she does it, it may not be the reason. When I was going through a rough patch, a really long time ago, a friend helped me just by coming over, sometimes to chat, sometimes to go on a walk with me, sometimes to keep me company while I did my laundry that had been piling up. We didn't talk about me or what was going on in my life we just... did a few small things, lighte3d my load and eventually it got easier for me to do some of these things myself.
posted by jessamyn at 11:46 AM on March 20, 2021 [9 favorites]

"She's told me (twice) that she's looked into getting unemployment benefits instead, so she doesn't have to worry about work. (I have clearly discouraged her from this line of thought.)"

Quite possibly reverse your opinion on this. The system 'supporting' the country literally just broke, awhile. These benefits may give her the resting times she needs to rejuvenate for herself, and care for her children. With a better safety net, she may be less drawn to cannabis (if that's what she needs), more motivated to care for her space/children, better able to remain rich, real sleep, and more motivated for herself. In all honesty, financial constrain may be a significant cause for her anxiety- with some clarity in this area, she may be able to tend to the others.

It is a genuinely difficult time and those benefits are there, intentionally, to support. The bootstrap days and the days of one upmanship don't need to exist anymore. People need direct and grassroots support, you've been given some wonderful information here.

Good luck, it sounds like she'll pull up the plane.
posted by firstdaffodils at 10:34 PM on March 20, 2021 [2 favorites]

*retain rich sleep. sorry mods.
posted by firstdaffodils at 10:42 PM on March 20, 2021

If you go over and take out her recycling and potter about the house doing whatever cleaning and chores need to be done not quite ignoring her but just being there in the same place as her will go a long way towards making her feel cared for not to mention getting her life a bit more organised.

Treat her like she’s sitting there with two broken legs or she’s a baby you’ve plopped on a rug so you can get the housework done. No expectations but she’s there and you’re there and you’re a kindly calming productive influence.

Depression is all about feeling horrendously low, like no one gives a shit if you live or die and you don’t have the energy to care either way. Being there for someone depressed frightens people, they think they have to say the right thing. But it’s not about saying anything at all, it’s about being physically there, a living connection to the world.
posted by kitten magic at 12:41 AM on March 21, 2021 [3 favorites]

Yeah, I'm not in a position to speak to the child custody or substance issues, but as the Depressed Person more often than not, someone who can come over and in a no-shame, low-drama, kind way, be like, here is coffee, after you drink it you're going to take a shower while I do the dishes, then we're going to gather up all the trash together and take it out, and then we'll get some fresh air and sunshine on a loop around the block while the laundry runs, and then we'll go get groceries together and have a nice lunch....

Like, obviously you are not going to change her brain chemistry, but depression is SO MUCH HARDER to dig out of when you're dirty, your house is dirty, you're not eating right, your bed/clothes are dirty, and you haven't seen sunlight in days. And it's embarrassing, so it's not likely that you're going to want anyone to come over and see this situation. The times that friends came and shoved me in sweats and forced me to brush my hair and go to IHOP after I hadn't left my room in days, or the times my husband has ordered me into the shower while he put the laundry in, and then taken me on a walk around the block, have literally been lifesaving. Obviously I still had a lot to deal with, but everything just seems more manageable if someone is literally willing to do that shame-building stuff. The key is to just be very low-key and chill about it all and have minimal expectations that the person will entertain you or do a lot on their own - just like you would if they had the flu or a new baby or something.

Also, the concept of "body-doubling" - great for people with executive function issues, sometimes you just need someone to hang with you while you do the Thing You Can't Seem To Get Done. But first, basic hygiene and food.
posted by bowtiesarecool at 10:23 AM on March 26, 2021 [2 favorites]

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