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Question:

A childhood friend and I have reconnected over the past few years. A few years ago she told me about some hallucinations she’s had. When I suggested that she get mental help, she shied away from me a bit and did not open up about some of her issues for a while. Recently though, she’s started communicating her “deeper” issues again, and I am sincerely concerned.

She’s had hallucinations of experiencing things that don’t really happen (think aliens, demons, fairies), but she’s also having delusions that she IS someone else. She honestly believes she is a fictional character in her spirit, but trapped in her body. Recently more “personalities” like that have started speaking to her as well- she can sometimes hear their voices.

She has confided these things to her other family members as well, and she is very upset that no one believes her. I know she has been treated by a doctor for depression because she has a lot of self-loathing, no motivation, fatigue, physical difficulties, dark moods and thoughts of suicide. But her mother and I don’t think that she’s spoken to a doctor about the other stuff, her “beliefs” and hearing voices. She keeps saying she doesn’t want people to think that she’s crazy (and most of the time she seems normal until she goes off the deep end and explains how she is someone else or that a demon spoke to her).

Her family members and I don’t think she’s “crazy,” but we know she needs help because some of the things she’s explaining to us are not normal. Her physical and mental problems have made it difficult for her to hold down a job, so she’s dependant on many other people. She doesn’t really have the money for extensive treatment or medications, and so we’re afraid that she will refuse to seek help simply because she cannot afford it. She has a great home support system, but this isn’t enough as she clearly needs medication and therapy.

Where should we turn?? Are there public services that can help her?

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Answer:

Your friend is very ashamed of her symptoms. As you point out, she fears that others will think of her as “crazy.” I would guess that she fears this also. However, there are many things that can cause her symptoms and that is why she needs to be honest with her medical doctor.

Some  examples of causes of her symptoms are medications she may need to take, Post Traumatic Stress Disorder, having been abused, physically or sexually during childhood, and these can be symptoms of Bipolar Disorder which is very treatable. Physical abuse can result in what is called a “dissociative disorder.” That may explain why she sometimes seems like different people.

In any case, I agree that she needs to be seen by a psychiatrist so that these problems can be sorted out and that she get the correct treatment. If her symptoms are a result of a chemical imbalance in her brain then medication could resolve these things and without her needing extensive psychotherapy because it can be expensive.

The problem is not the expense of treatment but her resistance to getting help. Obviously, she is resistant because she fears being judged as crazy. She needs to be encouraged to accept her symptoms, admit to them and see a psychiatrist. Her family needs to understand that she tells them are symptomatic of serious problems.

There are places where low cost psychiatry and psychotherapy are available. Mental health clinics are a good place to start. Places such as Jewish Family Service, Catholic Charities, and out patient clinics that are part of a  hospital are excellent types of places. These are just a few examples. My suggestion is that she own up to her problems, tell her doctor and ask him or her where she can go for help. She needs to know that she can be helped to feel much better.

By the way, once her doctor knows this he may order a complete physical exam on the theory that there is a medical disorder behind all of this. Additionally, if her symptoms prevent her from working, she may qualify for social security disability and that would provide her with medicare. Her doctor would have to submit the justification for qualifying for disability.

Finally, if she feels suicidal she should be taken to the emergency room. Suicidal thoughts are dangerous.

Best of Luck

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