The place she was referred to (the clinic my therapist recommended) had an online appointment system. She says she tried calling at her appointment time and it went to a voicemail. After they she distrusted everything. She desperately needs help. She seems clearer of thought early part of days and then struggles as the day goes on. She totally believes we love her and want to help and then later in the day thinks it’s all bullshit. Her roommate Rob is helping the best he can. I kinda feel like we’re all she’s got right now; Rob, you, me, Beth. We had a long talk yesterday followed by lunch and more long talk. She wants to run and she wants to end things but she also thinks that’s weak and wants to fight. I believe a big part of her imbalance is depression. She really thinks she’s no good and doesn’t believe anyone would want to help her. She’s also afraid if she’s too honest with a friends or a therapist, she end up in an institution or some other lock down she doesn’t want to be in. Okay that’s it for now. The goal has to be to get her to be evaluated by a professional
This is really scary. I wish I wasn’t out of the country.
This seems like even more of a red flag for potential substance abuse. I’m not aware of any psychiatric conditions, aside from substance use and dementia (re: “sundowning”), that has the pattern of gradually worsening symptoms as the day progresses.
Although I’m looking at this based on 3rd or 4th hand information, I would place money that this is more of an addiction issue than a psychiatric issue–which is actually good news for her, if she’s willing to be honest and get help.
P.S. Although she could genuinely be afraid of being a psychiatric inpatient, it’s also possible that she knows that a hospital stay means a forced break from her substance use.
I don’t think it’s addiction to any kind of hard drugs. Maybe she is drinking a lot. My friend has been in contact with her throughout the day and didn’t mention anything like her being drunk at night. And as far as I know she’s never been a big alone drinker.
But yeah this day pattern thing is really weird. She has really been struggling with menopause for years now. She’s talked about severe mood swings and alluded to stuff like this before. But I never realized how serious it could get.
Without meeting her it’s really difficult to know what’s going on. Is she even willing to just have a full medical workup to rule out some unusual/bizarre medical condition?
However, unless someone can convince her to be honest with herself about the help she needs (and her need to temporarily cease all substance use), she’ll have to get a lot worse before treatment/hospitalization can be forced upon her.
Hope you don’t mind that I asked my gf, a therapist. She recommended that you tell your therapist exactly this, and ask if it makes sense to go half as often (e.g. every other week if you’re going weekly)
She apparently feels she’s living in some kind of simulation or Truman Show put on by a bunch of puppet masters. She sees coincidences and connections in stuff people say to her, then she sees the same word on TV, and then a sign or passing car, etc.
She’s also described it as like a never ending acid trip, in so many words. She’s always been into astrology and all that new agey stuff, so this feels kind of a hardcore manifestation of that to me. I know she was “microdosing” acid and probably other things, which me and her other friends think was a contributing factor. We’re not confident she’s stopped doing it, even though she says she stopped.
When she’s feeling up, she said she laughs at the ingenuity of the puppet masters. When she’s feeling down, things turn dark and she thinks everyone is conspiring against her.
She is back on her hormone meds now. She still refuses to talk about anti-depressants. She’s supposedly going to see a therapist when her Obamacare kicks in on 9/1. She had a great job doing public art installations that ended, which I think is a contributing factor in all this.
I’ve known her for almost 30 years, and she’s always been one of my most solid friends. She’s super smart, type A, generally keeps things very upbeat. She’s the opposite of any kind of histrionic. She rose pretty fast to director at a major company, then left and has done various interesting jobs since.
Other than a few paranoia-type incidents in the past that I mentioned, and some abandonment and fear of commitment issues, she’s never been remotely unstable like this. She’s the one of the last people I would expect this to happen to. It’s spooky to think that one of the most solid people you know can suddenly fall into such a major mental health crisis.
The feeling that reality is not real has a name, “derealization”, which might be useful in talking to her about this as it’s much less stigma-laden than other appropriate words like paranoia and delusion.
There could be a lot of possible reasons for this, she needs to see a psych, so if you can make it seem like a standard symptom maybe that will be helpful.
I looked into derealization. She definitely has some of these symptoms. But it doesn’t mesh entirely, and the article says it almost always comes on in teens or early adulthood.
What meshes 100% is this:
She’s on a camping trip right now with some other old friends that she should trust as much as anyone in her life. Here’s a text from my friend who’s been most involved with her:
Hi Guys. M is texting me right now stating T is having a meltdown up at the cabin at Mono. She says R is at a nearby campground and asked me to try to reach her for help. I have called and text R but straight to voicemail and text bubble is green…ironically just like when tommi disappeared. Apparently T got word her uncle died and somehow she now thinks both M and H are part of the grand bullshit production. Anyway, nothing we can do except maybe try to call T. M even sent me some short recordings and she mentioned the Truman Show and T said her dad said the same thing.
Even in her good times lately she still thinks she’s in a Truman show, but she sees the beauty and humor in it. When things go bad she gets paranoid. She’s also said a bunch of times that it’s like an acid trip that never ends.
She’s still mostly resistant to getting help. But some inroads are happening.
I don’t know why they thought a camping trip was a good idea. She’s always had a tendency to feel trapped and want to just bug out at the first sign of stress even in the best of times. Something like a camping trip where she can’t just leave easily runs a risk of triggering that.
If she believes in the simulation, it’s psychosis; if she knows it isn’t real, just the brain misfiring, it’s derealization/depersonalization. Psychosis is probably easier to treat.
She needs inpatient care. From experience, it is nearly impossible to make that happen involuntarily. Our system is flat out terrible for situations like this.
Yeah derealization is a feeling, not a belief. IANAD but this does sound psychotic. I hope you can get her some help.
At least for late onset schizophrenia (which I’m not saying this is, as a prominent symptom of that is usually visual/auditory hallucinations) I’m pretty sure high levels of occupational functioning positively correlate. Generally speaking psychosis is associated with excessive dopaminergic activity and antipsychotics are dopamine antagonists, so the association with highly-motivated people makes sense.
I saw my friend last night in person for the first time since all this went down. We drove an hour in the car together each way to a friend’s house to watch the (crappy) Chiefs game. Then my friend put on a comedy special by Matt Rife where he talks about dating red flags and he mentioned some club in Miami called e11even a lot. Everything seemed perfectly fine until this morning, when around 8am me and the friend both got texts from her:
To me:
Dammit. I keep trusting you guys and believing your stories and my eyes. What’s the point of the alternate reality, humiliation TV? We’ve established I’m gullible. It’s like shooting fish in a barrel.
To my friend:
I keep falling for the stupid setups. Fake Chiefs games. Red flag comedy. Eleven11. Barbie chic in audience. I don’t know how to be myself in this world without feeling like a gullible jackass. I want to travel with you and see Beth but not if I’m questioning the point.
They’re supposed to travel together to see our other old friend Beth. Beth knows what she’s getting into and is up for the trip possibly being rocky. I’ve seen Beth coach people down off bad trips multiple times, so if any layperson can handle this it’s probably her.
So anyway, I don’t expect anyone to know what to do here. It just helps me to write it down. This is legit psychosis and all I know is me and her friends are in way over our heads. But as long as our friend is resistant to seeing a real doctor and going on medication, I don’t think there’s much else we can do. It feels like we’re waiting for something drastic to happen.
So just got back from a 10 day rugby trip to the Philippines and Thailand.
Did pretty much everything I know not to do. Drank too much, not enough sleep, irregular sleep, a bunch of different party drugs, and a fair bit of weed (legal in Thailand… I didn’t know!)
Add in the usual jet lag which always messes with me.
Hoo boy. Hitting me today, suspect this may not be fun.
So you got a bunch of CBD shit or you were breaking the law.
People have the same thoughts about Czech Republic. That’s why shops are everywhere in Old Town selling dumb tourists what they think is actual weed when it’s CBD shit.
