Friendship Advice: My Friend Won't Leave Her House!

I have no idea how to approach her about this without sounding like I am accusing her of some deliberate dishonesty or undermining the validity of her claims to physical illness.
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QUESTION

Hi Irene,

A dear friend of mine seems to be in denial of certain mental issues and I don't know how to proceed. None of her other friends do, either, and a lot of people have just given up on her. She is one of the sweetest and most gentle people I have ever met, and I just cannot bring myself to abandon her.

I have been racking my brain trying to think of ways to help her, and I have initiated a number of great conversations to express everything I'm feeling and she seems to understand. But afterwards she always continues repeating the same behavior and its really scary.

We have been close for over three years and the entire time she has had a long series of medical excuses that keep her bedridden or in her house. She has been to hospitals and doctors and clinics across the state trying to get her symptoms diagnosed and there never turns out to be anything actually wrong with her. It is my theory that she does not want to leave her house but is also incapable of being honest with herself and others about this fact, so she makes herself physically sick in order to have an excuse to stay in.

It seems she would rather everyone think of her as a medical science anomaly. She has been treated for panic disorder and depression in the past, and currently takes meds for both. It seems in line with what I have read that she has become agoraphobic, but I have never seen someone in such deep denial about mental problems before.

I have no idea how to approach her about this without sounding like I am accusing her of some deliberate dishonesty or undermining the validity of her claims to physical illness. Yet I also cannot bring myself to just give up on her, because I see all the greatness in her and I want so badly for her to reach her potential.

Any advice on how to proceed would be greatly appreciated, because I am heartbroken.

Signed,

Lindsay

ANSWER

Hi Lindsay,

Your friend is fortunate to have you as her friend. You seem kind, caring, and compassionate -- and it's great that you have tried to educate yourself about mental illness to better understand what she is going through.

It's quite possible that your friend isn't knowingly deceiving you or herself. She may actually believe there is some yet-to-be-discovered physical basis for her problems.

Getting past someone's denial is one of the most difficult quandaries faced by families and friends of people with mental health or substance abuse disorders. It requires a great deal of patience and sometimes progress is made in very small steps.

I can see no benefit in confronting your friend or questioning her honesty outright although she needs to be evaluated by a mental health professional. Two thoughts:

  • You could suggest that your friend speak to her therapist to get a "second opinion" about her physical problems. Sometimes clinicians who are knowledgeable about agoraphobia and other anxiety disorders may even be willing to make a house call if a patient is unable to leave home. Another alternative would be to have her speak to her therapist over the telephone or Skype.
  • Is there someone, perhaps a parent or sibling, who is providing for her basic needs (food, shelter, etc.)? You might speak to one of her immediate family members or consult her physician to express your concerns about her emotional state.
  • Unfortunately, your friend may not seek out help until she is in an acute crisis. The kindest thing you can do is to continue to offer her your friendship and support until she is able to accept help.

    My best,

    Irene

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