How do I help from a distance?

By Dr. Marie Hartwell-Walker

10 years ago my best friend since 7th grade was diagnosed with schizoaffective disorder. I have since moved out of state and have try to maintain a relationship over the phone.

She seems to be getting worse and I don’t know what to do. She dominates our hour conversations about religion and her delusions. She is now getting aggressive and accusatory. I can not say anything right, even if I agree with her. I asked for a break from talking for a week and she left voice mails of scriptures.

I don’t want to throw away a 16 year friendship, but I don’t know if I am emotionally stable enough to handle it. What am I suppose to do? How can I talk to her?

A: As much as you love your friend and as much as you want to help, you are at the limit of what you can do from a distance. It sounds to me like she is decompensating. She needs to be evaluated by a professional and offered treatment. I suspect she won’t tolerate hearing a direct suggestion from you that she see her doctor. It’s still worth a try. You didn’t mention whether she has a partner or a family or a mutual friend who lives near her. If so, the most helpful thing you can do is let that person know that your friend is in trouble and see if that person is willing to take her to be seen by a crisis team or her psychiatrist.

If you are truly the only person she talks to, you have a difficult decision to make: Do you go for a visit and see if you can get her the help she needs? Or do you continue to offer what support you can over the phone and then hope for the best? Please do factor in the realities of your finances, your time, and your emotional reserve for taking on more. In the meantime, your loyalty and caring are probably having more positive impact than you know or that she can appreciate in her current state. She’s lucky to have you for a friend.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 14 Jul 2011

APA Reference
Hartwell-Walker, D. (2011). How do I help from a distance?. Psych Central. Retrieved on December 18, 2014, from http://psychcentral.com/ask-the-therapist/2011/07/14/how-do-i-help-from-a-distance/

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