Friend with mental illness?

[pinkgraffitirat]

Hello,

I'm really struggling to know how best to support a friend who I think is severely mentally unwell without hurting myself.

I've known Rachel through a choir for a few years and she's always been spacy, but we've become close friends over the past year and I believe she may have schizophrenia. However she won't seek help as she believes she's completely lucid and all these things are real.

She regularly has hallucinations and believes God speaks to her and orders her to do things. These are sometimes dangerous things (mainly around men and sex) or she'll become confused as to what the voices want her to do and pull everyone into that decision. For example more than once she's purchased tickets to shows then stood in the lobby for 30 minutes agonising over whether it's where she was supposed to be that evening, with all the event staff clustered around her trying to tell her that she either needed to take her seat or leave. And her most desperate wish is to work in those venues, and she doesn't understand that this makes her unhireable.

She has very chaotic thought processes, can't understand information (for example we tried to arrange a meal but she got so confused at being told "we could go to this restaurant at 7pm or this other restaurant at 7.30" she couldn't make a decision as she just couldn't understand) and no concept of time at all. She's routinely hours late for things and literally never does anything that has to be pre-planned, everything is spur of the moment.

The other week we were hanging out and she suddenly starts panicking because her flight was due to leave in half an hour. What flight? Turns out she met a strange man and slept with him and he sent her plane tickets to come visit him, and then just forgot.

She has no impulse control and will just get distracted and wander off, or a voice in her head will tell her she needs to go somewhere (like walk to the middle of Hampstead Heath at 3am, or take a three-hour taxi ride at midnight to go see a guy). She recently hired some people to do a project that would require her full attention and presence, we were waiting for them, then she noticed a tourist activity starting and thought it looked cool so wandered off to try to join it (without tickets) and I had to run after her going "where are you going, the people you hired are upstairs waiting for you?" Stuff like this happens a lot.

She routinely panics about not having her own income (her family are very wealthy and bought her a house) and will rent out her house, then forget, then panic when they arrive and have to ring all her friends to find somewhere to sleep.

She's can be very sweet and understanding and she tries to do nice things but without thinking them through. For example she regularly buys me tickets on the spur of the moment but gets angry when I can't drop everything to race to the venue, or doesn't understand that I can't get into central London in 20 minutes, or that I'm not willing to arrive halfway through a play.

And I'd be understanding of all of this except she can be very entitled and gets angry when people won't give her what she wants. Like she'll miss every single choir practice then be angry the performance went ahead without her.

I don't want to lose her as a friend because there are ways that I definitely benefit from her friendship, and I do like her. But I worry about her so much, and sometimes her behaviour negatively impacts me. I have no idea what to do.

Sorry this is so long.

I think the only people who can possibly encourage her to seek help are her parents or other family - do you know them?

Or maybe a vicar/priest, if she attends church?

Crikey, that sounds like an enormous mental load to have on your part!
It sounds quite callous, but in my current circumstances I really couldn't maintain that friendship - I'd make sure people close to them knew they needed help, then I'd have to distance myself.

That's a lot of effort.

Her family are unfortunately all abroad. She's not religious. I don't think she really has anyone in her life except for casual friends and other people like me.

I think if she wasn't so wealthy things would have come to a head before now, but she's able to just about cope in a way someone else wouldn't be able to cope, so she's been able to not have any contact with authorities like doctors or benefits people who might flag it.

I know I do need to pull back. But I do genuinely really benefit from certain aspects of her friendship (not financially, in other ways) and I don't want to lose the good parts.

I don’t understand if she’s not religious then why does she think God is speaking to her? Surely that would involve being religious in some way.
how does her being from a wealthy family mean she bypasses ever seeing a doctor?
Even private doctors have a duty of care.

What do you gain from the friendship?

I think that for me the threshold would be if she was putting herself in danger (or if she was in significant distress).

If she was, I might screw up me courage and introduce the subect of mental health concerns, if you haven;t already. If she was open to the conversation I might ask her whether her family or anyone else are providing her with support in relation to her mental health.

Do you, or any of your mutual friends, know any psychiatrists? If you do you could start telling her how marvellous he/she is and how they've done wonders for you/them. Sometimes people will want to follow the herd even if they don't believe they're not well.

That's a good question, actually. I hadn't thought about that. I would assume she's one of those people who consider themselves spiritual rather than religious, ie believes in some kind of God(s) but doesn't have anything to do with organised religion.

In terms of doctors I assume she does go to the doctor when she has a physical ailment (though she's generally very healthy, physically), I meant more that the fact she doesn't need money means she's never had to have a medical assessment for benefits or for work. She comes across very intelligence and rational - maybe just a bit kooky or away with the fairies - so I don't think a doctor would necessarily notice anything amiss if she came in for tonsillitis or something. Even stuff like deciding to sleep on Hampstead Heath - if police went up to her (which obviously they do for people who appear to be rough sleepers) they'd quickly realise that she's not a rough sleeper and I think would brush it off as "rich girl decided to do something silly" and just tell her to go home, rather than reporting her to adult social services.

In terms of what I get out of it. She's very understanding about my own mental health problems. She's not judgemental at all. She's the one friend who's always available to hang out on short notice, and I really struggle with loneliness because all my other friends are starting to get married and have kids, or leave London, and hanging out becomes a "once every two months scheduled weeks in advance" thing.

The other thing is that she's super extroverted and talks to everyone. Like, put her on a tube or a bus, she'll have made friends with a stranger by the end of the journey. My work requires me to attend a lot of parties and social events where I'm expected to talk to people but I'm extremely introverted and just find it painful to go up to someone and start a conversation. I can literally just point out the person I need to talk to, go get a drink, and by the time I get back Rachel will be chatting to that person like she's their oldest and dearest friend and it's easy for me to join that conversation. And just generally having an extroverted friend around makes what are normally excruciating events really fun.

I also do feel sorry for her, because I know none of it is intentional, and that she suffers a lot, and doesn't understand why she can't find work or lasting friends or relationships. I don't want to be another person who abandons her for having an illness.

I have bluntly told her I think she needs to talk to a psychiatrist before and she will say I'm right, but it just doesn't happen. I think googling for one and having to make an appointment ahead of time and stick to it might not be doable.

There isn't much you can do. I had a friend who went completely off the rails. I called social services as she talked about killing herself. They said she was known to them and that was that. She was committed in the end (she overdosed) but was in and out of residential care several times. And still she was not sound. She had a partner and daughter and in the end they moved and she followed them.
I'd write to her family if you know their address. But unless she actually harms herself or has an accident I don't think anything will happen unless she actions it.

If she's reliant on family money, she must still have some kind of contact with them even if they are abroad. Can you find them on social media and send them a message expressing your concerns? I suggest social media because it's unlikely your friend will give you their address or phone number. Perhaps contact her GP or social services and explain you're worried about her. They may not act on it but it's worth a try. Other than that, there's nothing you can do.

Oh, how about the person who runs the choir group? They will have some kind of safeguarding policy so they might be able to report their concerns.

This sounds like your friend is having a possible manic episode. This sex with strangers, possible psychosis, very extroverted and talking to people, sudden anger, buying you things etc? How long has she been like this? Is she always like this or is it on and off? How long have you known her?