Worried my friend is going off the rails - advice needed on depression and drugs!

[Indiestarr]

I'm worried about a good friend of mine. She has a history of antidepressants, and also a history of drugs, but about 18mos ago she seemed to have put both behind her. However, about a year ago she was consumed by depression, like a bolt from the blue, and had little choice but to go back on the tablets. She insisted there was no external reason for depression - her work was picking up, she had a great marital relationship, no-one had abused her etc etc - and she scoffed at the docs attempt to make her have counselling. Instead she insisted she'd addled her brain through too many drugs at uni and this chemical imbalance made her prone to depression, and she'd just have to take pills for good.

However, since then she's becoming more and more wild. She always drank a lot but lately it's increased, her behaviour has become reckless and she's started to do a lot of Ketamine. When I reminded her of her delicate mental state which she'd previously blamed on drugs she practically bit my head off saying 'look I know I said that but it's not down to drugs, the depression's genetic' . A couple of times I've been surprised when we've gone out for an ordinary night - not a party or club - and she admits she's on Ketamine. Surely this is very unwise if you have to take antidepressants to function?

On the reckless front she'll leave the house in the middle of the night intoxicated, pick up strange men and bring them home. She was attacked on one such occasion. A mutual friend confided in me the other day that she's equally worried and is beginning to feel uncomfortable going out with her because of her behaviour. On this particular occasion she'd done ketamine, got off with a girl and brought several strange men back to the house, despite her husband being there (he's too mild and hippyish to say anything). None of her friends behave like this, but we do know people who do and she used to scorn them!

I'm no expert on depression but I was always pretty sceptical of her diagnosis, and her increasing irresponsibilty makes me think there ARE external reasons for her depressive state. She's in her 30s, not keen on the idea of kids, works freelance, seemingly happily married. Does it ring any bells with anyone? I'm looking for advice because I know she will argue down my attempts to counsel her!

[madmouse]

Now I'm no expert on this and there is no such thing as diagnosing someone over the internet, but I'm wondering if she could be bipolar - both the out of the blue depression and the reckless behaviour make me think that. Maybe one of the people who know a lot more about this will see this thread.

There are also other reasons for depression and reckless behaviour - a history of child abuse for example.

There is not a lot you can do if she refuses treatment. If you think she is a danger to herself and/or others you may need to talk to her dh about getting in touch with her doctor about that.

Support her where you can, as she does need you! But protect your own boundaries too.

[Thingumy]

It could be her medication mixed with drugs.

I went through a very self destructive episode when I started mixing alcohol with my antidepressants,much the same as your friend.I turned into a totally reckless person (buggered off in pubs and gone missing for hours,been arrested etc).Majority of those dark times,I was in blackout mode-sounds like you friend is the same.

Mixing drugs,alcohol and prescribed AD's is a recipe for disaster or death to put it bluntly.

I was on meds for 17 years and looked 'ok' but if I stopped them,my depression and anxiety would creep back in so I don't think you should doubt her reasons for 'needing' her medication.

I think she needs to admit thats she's abusing alcohol and illegal drugs and also her husband really needs to step up the mark here,does he want his wife to die from drug abuse or even worse,murdered or killed whilst heavily intoxicated?

[Thingumy]

It would be interesting to know if she is a long term Seroxat taker (AD's)

[Indiestarr]

Thanks Thingumy, very sound advice. As you say, mixing all those brain-altering chemicals is bound to lead to disaster. I'll have to ask her what tablets she's on.

When I said I was skeptical of her diagnosis I didn't mean of being depressed - I'm sure she is - I just meant of it being caused either by youthful drug excesses or genetics. I wonder if she may be in denial about things being wrong. But I don't know enough about depression - maybe you CAN be completely happy and still be depressed. Or maybe madmouse is right about bipolar disorder, which perhaps is something different? I just don't know enough about it.....

[PlentyOfPrimroses]

I wouldn't say I'm an expert but I have a fair amount of experience of depression and also of working in mental health.

Your friend probably has no idea what causes her depression and her GP probably has no idea either. After rather a lot of therapy I still don't know why I get depressed, it just happens from time to time and I doubt I'll ever really put it behind me for good. I think this is the case for a lot of people. The best I can do is look after myself physically (eat proper meals even when I don't feel like it, go to bed at sensible times, get enough exercise and daylight etc.) and keep a sharp eye on myself for signs I might be slipping. The five ways to wellbeing are a good resource for staying well and helping recovery.

In terms of how you as a friend can help, it doesn't really make much difference what her exact diagnosis is, what the causes are or what medication she's on. Just be there with a friendly, non-judgmental ear when she needs it. Let her know you are worried about her but try not to give her advice (beyond encouraging her to go back to the dr's or seek other help) or try to 'fix' her problems. If you know her DH well enough you could have a chat with him and find out his take on it - sounds a bit weird that he's watching his DW behave in a self-destructive way and not even saying anything.

Look after yourself - don't take on too much and, as madmouse says, protect your boundaries. It might not be the best thing to meet her in pubs for now - what about going out for some walks while the weather is good, or having a meal out or at your place?

A good place for info and advice is the Mind website

I hope your friend feels better soon.

[Indiestarr]

Thanks for such a helpful, constructive post Plenty. Although I just want to help I could see myself wading in and damaging our friendship in the process. It really helps to get some perspective. I love the idea of walks instead of the pub. I spoke to our other friend who's worried about her today and we were really unclear what to do so this will be a big help, thanks again.