Dear Captain Awkward,
One of my friends has mental health issues of severe depression (along with some other stuff) that is being ineffectively treated–a situation that they are trying to change, but solutions are slow going.
The depression brain weasels are causing my friend to regularly assume that everyone they know and care about is actively furious with them. I (and other mutual friends) will regularly check in with our friend only to hear how they were sure we were mad at them for a litany of tiny “infractions” that most of us would never even notice.
I know that my friend can’t help what the depression tells them. But it is also becoming incredibly difficult to spend the first hour of any interaction with this friend repeatedly reassuring them that no, really, I’m honestly not mad. The extended confessions (“I was so sure you were mad at me for the following reasons…”) seem to spin them up into a state of heightened tension and to be causing harm to them in spite of the “forgiveness” afterward. I think the harm is stemming from their viewing the confession as evidence that they are awful and that their forgiveness is predicated on our saintliness, which will surely run out someday.
In short: while I’m not mad at them and I do love them dearly, the weekly confessions are hurting them and are a genuine drain on my own limited spoons for social interactions, causing an avoidance spiral that doesn’t help them believe people aren’t angry with them. Is there a set of scripts you might can recommend for cutting through the litany of specifics each time and reminding them that we’ve done this before and those recurring feels are just the depression speaking?
Much love!
Much love back, because you sound like a great friend and this is very delicate stuff.
Interrupting is rude and we were all raised not to do it, right? But there is a case to be made for it here. Give your friend a short interval, and, when you feel yourself running out of patience, interrupt the flow.
Your friend: “I was sure you were never going to call me again because I am so awful…”
You: “Let me stop you right there. I am not mad at you. In fact, I am calling because I like you and want to talk to you. But I don’t have the energy to hear the Jerkbrain Memo Re: Why You Suck today.”
Them: “You’re so good to me, but I’m sure any day you are going to give up on our friendsh-.”
You: “I am not going to do that, and I don’t like listening to you talk about yourself this way.” + SUBJECT CHANGE.
Ideas for subject changes:
- Ask them about something they are a fan of. “Have you finished The Martian yet? It reminds me of old MacGyver episodes.”
- Ask them about a hobby. “How is the terrarium coming together?”
- Ask them for help figuring something out. “I can’t figure out which pair of glasses looks best on me. Can I text you some photos and get your feedback?”
- Follow up on something you talked about last time. “Any news on your Grandma’s trip around the world?”
You’re not going to suddenly become a shitty friend if you do this. You aren’t going to stop asking “How are you?” and listening and caring about the answer. This interrupting the initial flow of self-hatred and criticism is not about not listening to your friend, or not honoring their pain, or about asking them to pretend that everything is all right for you. It is about interrupting something that has become an automatic, crippling, horrible, spiraling habit. There is a ritual happening here, where they vomit their horrible feelings and you reassure them, but they don’t believe it and they don’t become more reassured. If you give yourself permission to stop completing the ritual, over time ritual may become much shorter or even stop entirely, making room for more intentional conversations.
Be warned: The first couple of times you interrupt it might be even more awful than usual. Your friend might have a shame spiral that is now about how you have to cut them off from talking about their shame (instead of just their normal routine shame-spiral). If you’re not an interrupt-y sort, you will feel mortified and brittle. Keep doing it, though. I predict that if you do it consistently, the habit will change and your friend will catch themselves, with something like, “You don’t want to hear all that.” It might sound passive-aggressive as hell when they say it at first, so don’t protest that you DO in fact want to hear all that, just keep saying gentle things and keep changing the subject. Them catching themselves is good.
Other scripts & strategies:
- “I need to be your Distracting, Talk About Puppies And Rainbows Friend Today.”
- “I can listen to 5 minutes of venting, so make it good. Then you will listen to five minutes of venting from me, and then we will proceed to new business.”
- “That sucks, I am so sorry you are feeling like that.” Sometimes there is nothing TO say. Just empathize and let them get it out.
- “That sounds really difficult/annoying/awful. What do you think you’ll do?” “Solution-oriented” sounds like such a corporate robo-douche term, but asking the person to tell you their plan is another way of breaking up the ritual of negative brain-dumping.
- “I don’t know what I can say to reassure you that I am not mad at you. I am mad at your Jerkbrain right now, because it keeps accusing me of lying about my intentions and feelings. What could I do or say that might make you feel better?” They might not know, but that doesn’t mean you shouldn’t ask.
- Sometimes, but ONLY SOMETIMES AND WITH GREAT CARE AND IF YOU THINK THE PERSON CAN ROLL WITH IT, agree in a joking, hyperbolic way that mimics what the depression is doing. “Yes, you are terrible. That is why I call you every week and why you make me laugh until I literally pee myself and why I love giving you hugs: Your terribleness.” “Yes, I am furious at you. That is why I can’t wait to find out how your job interview went, and to send you 10,000 cute animal gifs.” “You are literally the world’s worst person. That’s why I called, actually, to see if the World’s Worst Person would be interested in having ice cream with Saint Me, the World’s Most Patient and Selfless Person.” One (again, ritualized) thing that happens with these conversations is that they say “I’m terrible,” you say “No you’re not,” and then it becomes Asshole Brain Debate Club where they try to convince you of their terribleness by offering detailed evidence. If they say “I’m terrible” and you say “Sure, ok. Also, your hair looks pretty like that,” it breaks the automatic call-and-response they are used to.
Two related posts are:
Let me add a few things from past posts.
- Routine is important. Having a regular check-in can help your friend predict and count on you and lessen anxiety (somewhat).
- If communication is draining to you, make sure you do this at a time when you have a lot of energy to spare, and when you can relax/treat yourself in some small way. Take care of yourself.
- If you live nearby and can see each other in person, shake up the routine of what you do together. If your normal thing is to stay in and watch TV or movies, try going out and doing something instead, or try coloring books/games/puzzles/knitting/crafting (something participatory). If you always talk on the phone, try using a chat program. If you always chat, try a phone call. Depression likes patterns and settles into them like a pair of comfy old slippers. Change what you do and see if depression lags a bit to catch up.
- If you do invite your friend out (instead of going to see them) or otherwise change things up, make it about your preferences rather than “for their own good.”
“A walk in the park will do you good”==> “I’m in the mood to be outside, care to walk with me for a bit?” - If you don’t have the energy for whatever reason, be (strategically) honest. Your friend may sense that they are being managed and call you out on it. Be honest: “It’s really good to catch up with you, but I am not feeling so awesome today and I need to talk about light subjects.“
- If you have to cancel plans for some reason, reach out the next day with a text to say hello. It’s reassuring.
- Small, frequent doses of company or thoughtfulness might work better for you right now than infrequent, more intense hangouts.
- Get in the habit of treating each new day and interaction like a blank slate. Maybe last time your friend ran themselves down for half an hour before you could interrupt, and you are dreading how it will go today. Do your best to show your friend that you don’t hold onto past irritations and slights. “Yeah, last week was pretty intense, but I’m not upset with you. What’s new today with (safe, interesting subject)?“
Remember: Your friend needs a trained counseling and medical pro to treat their illness and help them feel differently. While it’s good to be gentle with your friend and their feelings, you aren’t responsible for fixing their feelings and even if you were you wouldn’t be able to do that just by being a great friend. You are allowed to try to redirect conversations and set limits on what you can handle. Remember also: Being consistently present and engaged is more important than getting any one interaction perfect. Forgive yourself for mistakes, and for getting impatient or bummed out sometimes.
Readers, if your friends have been especially good at interrupting or getting around your shame spirals when you’re in one, I’d love to hear what worked.
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Best way to get through to me when I’m in a shame spiral is providing me (limited) options. I can’t always figure out or communicate my needs, so my rockstar friends will take on some of this thought burden by offering me suggestions within their control. For example, “Do you want me to come do homework next to you OR do you want me to make you some food OR do you want a hug OR do you want to go for a walk?”. And then I can pick the option that sounds closest to my needs, and we do that thing. I don’t have to worry about resentment for asking too much of them, they don’t have to worry for ages as I desperately try to work out what help looks like and whether I need it.
^^^Yes!!!
My beloved partners, and my awesome adult daughter, do this for me. “You sound like you’re getting into a shame and/or anxiety spiral. Would you like me to bring you some tea / climb into bed and cuddle / put on an exciting show that grabs your attention / spend a little time outside / go out for some kind of food-treat?”
Just listing some options, rather than saying “What do you want me to DOOOO??!?” (which is how I hear it when I’m in a bad headspace), takes away some of the decision-paralysis that I deal with when depression or anxiety is riding my brain with spurs. Even though it’s being asked in a considerate “What do you want me to do to help you?” way, for me, having to come up with an independent answer can be difficult. Giving a short list of 3-5 options is a WONDERFUL kindness!
who the heck are these selfless friends/support you guys have?! seriously.
I’m wondering exactly the same thing. I am most certainly living in a different universe.
I have friends like this (and try to be a friend like this), and I don’t think any of us are particularly selfless. We just get it–most of us have mental illness, anxiety, trauma, abusive families, or some combination therein, as all of the associated brain weasels. So we treat each other with care, knowing we will need that care sometimes as well. And we know what kind of specific care works best for *us* in a shame-spiral, and try to do the same for others (unless they need a different thing).
+1
Options are good.
That is a brilliant idea. When I’m in that sort of place and people ask me what I need or what they should do, I panic and two things happen: 1) I feel this huge burden of responsibility for figuring out what my friend should do when my brain isn’t working well enough to figure it out, and 2) my Jerkbrain goes all “You’re so useless, this person is trying to HELP you and you are making them feel awful by leaving them hanging and refusing to cooperate.” So options YES. As soon as my husband gets back from town I’m going to show him this. Thanks, people!
Coming from where I do, I suspect/agree it might work quite well for the LW as well. Once you’ve interrupted your friend, giving them options should help avoid the awkwardness, if your friend is anything like me. If anyone interrupts my shame spiral, I feel really embarrassed and ashamed for putting them through it in the first place and for being SOOOO AWWWWFUL that they felt the need to forcibly escape the conversation. Interruption + distraction seems like sound advice.
It might help to brainstorm a list of workable options with Friend sometime when the Jerkbrain is quiet, so you have somewhere to go from instead of flailing around trying to come up with something, anything that might help.
As an anxious/depressed person who often goes on “I’m so terrible” shame spirals I want to give a thumbs up to the Captains advice here. I can say that, for me, the hyperbolic teasing works really well. When I fall down the shame-spiral-staircase my boyfriend is uniquely talented at snapping me out of it with a gentle ribbing. And otherwise, being interrupted sucks in the moment, but I usually end up in a better spot than I would have had I continued the spiral.
Good luck!
Same here. If I can laugh at the shame-weasels, it makes them temporarily go away.
Same here! My ex at the time could snap me out of my anxiety spirals by saying something jokingly hyperbolic I knew with certainty to be untrue, so instead of going into that ritualistic back and forth where I needed his reassurance but also didn’t believe he meant it, it made me think about what I could do to reassure myself. Doesn’t work for everyone, but it really helped snap me out of it.
Word on the interruptions. My sweetie asks me (with love) to try to take a deep breath, which when I’m feeling anxious is so hard to do, you know? and since it’s so hard, just to, like, breathe inward, it usually makes me almost-laugh which kind of interrupts the anxiety-spiral.
My BFF used to respond to my shame-spirals with “So you were human.” The ritual response to that was “Sorry for being human.” And we’d laugh and move on.
I have a friend with depression who has been socialised by her family to exist in a permanent state of shame. She has literally apologised for the fact that I walked away from the computer and forgot to mention it, feeling like she should have magically known that I was AFK. I have had a two stage attack on her brain weasels. The first one, that lasted a couple of months, was every time she apologised and for everything she apologised for I just said “I forgive you” + conversation change.
When she started being more comfortable with the idea that I was not going to attack her/let her stay in her spiral and she was having a good day where we could have a serious talk I had a conversation with her about how it was difficult to feel comfortable when she apologised for everything. We have to have that conversation again every now and then but each time it’s easier for her to accept and step out of the spiral.
Sometimes I do have to just say “Stop that” or “Don’t start that” when the weasels are particularly bad but in general she’s started being able to catch herself and change the subject. I don’t know if this would be helpful for most people (my friend is fourteen years younger than me, which seems to give her the idea that I am a Person Who Has Some Kind Of Authority In The World) but when she’s able to identify the weasels, the hamster of anxiety, or the gremlin with a sledgehammer I tell her that I’m proud of her.
I was thinking something similar, in that the depressed friend may not be fully conscious of their pattern, and a, “Do you realize you may be doing this thing?” conversation might be extremely helpful in helping them to identify the pattern and then be able to realize when they’re doing it. I always appreciate that sort of insight when a friend has picked up on a pattern I may not have figured out yet.
As someone who has been the depressed person, you probably can’t reassure your friend you don’t hate them. They live with a monster whispering in their ear 24/7, and you can only be available when your life allows. But what you can do, what it sounds like you’re doing, is being there. Just keep calling and seeing your friend, because if they’re doing therapy they will hopefully learn about putting objective evidence against lying depression monster, and ‘my friend meets me for lunch every week’ is an objective measure against ‘no one cares, everyone hates me.’
Though if you can’t be there for a while, whether it’s your own life or even if their depression makes you not okay to be in their company, be there after. Fuck ‘if you can’t handle me at my worst you don’t deserve me at my best’ – it is bullshit. At my worst I was a horrible person. I’m still grateful for the friends who wanted to spend time as I got better and became more realistic. You legit don’t need to be a saint to still be a good friend.
This. The monstrous chorus singing “You do not deserve love! Your existence is a blight on the universe! You’re evil evil evil, bad bad bad! Better just give in, because your so-called friends are laughing at yooouuu! You suck!”
It is Hell, and reality is just drowned out by the chorus, and yhe light is blacked out by thick black fog. I used to state my sheer awfulness as a way to make my friends realise just how terrible I was, so that they could cut me loose without feeling any sense of guilt, or and social obligation. It was my (now) wife that said to me “Trying to push me away like this is ridiculous, because I know its not you talking. Listening to you constantly putting down the woman I love is hurting me so much. It makes me really upset, so don’t do that”
Hearing her reframe it as “You are criticising the person I love, and that hurts me” was the first time that I’d been stunned into cutting the chorus off. They were making my beloved miserable, which was beyond the pale. Summoning that outrage whenever the chorus started their vile litany really helped me to cut them off, or at least make me too pissed off to listen to them.
The Captain’s scripts sound like they should have a similar script, so LW, I hope they help to still the weasels. You’re a good friend
This approach certainly isn’t for every situation. But I have a very lovely friend who will get into body shaming spirals about ‘how terribly fat’ she is. I will usually listen patiently to each new complaint once or twice, but the next time they come up I will say something along the line of ‘Hold on, we’ve had this conversation before. I understand you are uncomfortable with X part of your body but it is time to either do something about it, or stop complaining & figure out how to accept it.’
It has helped turn the conversation to her new work-out plan, or the fabulous dress that she bought that looks great on her and she is super happy with.
severe depression (along with some other stuff) that is being ineffectively treated–a situation that they are trying to change, but solutions are slow going
I’d like to gently suggest that perhaps the solutions would be a little less slow going if the friend didn’t have LW on call for these tedious conversations. I wonder if the friend feels that maybe it’s not so very, very urgent to find a therapist when LW generously gives an hour or so every week taking in the friend’s feelingsbombs. I wouldn’t be surprised if that even comes up — that is, friend including “I’m a terrible person because I dump my problems on you instead of finding a therapist — in the conversations. And it likely contributes to their spiral of stinkin’ thinkin’.
I really do see this situation, at least in part, as LW being the friend’s ersatz therapist. This is no good at all. Even if LW is actually a therapist, LW is not the friend’s therapist. I think LW should seriously consider extracting her- or himself from these conversations cold turkey or with some really blunt language. I’m very, very sympathetic to the friend, though. I’ve been in that position in the past and I’ve had to be told in no uncertain terms that I was being tedious and needed a real therapist, not someone to call up and recite my problems to.
Maybe LW is afraid of losing the friendship if this conversation (or something like it) happens. I think that’s a risk. But the situation right now sounds pretty untenable. The friend thinks LW is a good friend because LW listens to the feelingsdumps. Is that a solid basis for a friendship? LW thinks the friend is a good friend because . . . why? I see that the friend is using their relationship with LW as a replacement for therapy. This is not being a good friend, whether due to depression or anything else.
It can be really, really hard to get the help you need, though.
Many therapists aren’t taking new patients, some GPs aren’t comfortable prescribing antidepressants or anti-anxiety meds, not everyone can afford to see a psychiatrist or psychologist, maybe the friend is trying meds with a professional but hasn’t had much luck yet . . . etc.
I think that your comment is coming from a good place, and if it’s just that the friend is procrastinating about getting help, I think you’re right.
However, as someone who has watched friends *earnestly trying* to get desperately-needed help, and being told that they can be seen for a new-patient appointment in a month and a half, or nobody local takes their insurance, or they are struggling to get on disability benefits . . . there are a lot of times when it’s difficult or impossible to access care.
I don’t think we can tell either way from the phrasing of the letter, so I wanted to point out that this is an inference, not directly in the text.
Yes!
When I desperately needed help for my anxiety, here was the list of my options:
1) the one local place that took my insurance which could see me in 3 months.
2) the one place way the hell out in the boonies that took my insurance and which could see me in 3 weeks but I had to take a half-day off work to go there because it was so far
3) go cry on the front door of the psychiatric hospital and hope someone took pity on me
I had enough vacation saved up to choose door #2, but if I hadn’t, well…it would have been a very long 3 months, if I’d made it 3 months while remaining functional, which I might not have.
I’m in that boat right now for my depression and it sucks. I waited almost 4 months for a new-patient appointment in July, and the follow-up appointment was scheduled for…..the end of September. Not so helpful.
Wow, I didn’t realize how lucky I am to live in a place with plenty of therapists & quite a few who take my insurance.
When I finally got up the courage to call two different people, both offered me intake appointments within a first week (I think one offered me an appointment for a Monday when I called on Friday). I went to both, and then continued to see the one who I liked best. I recognized that was fast, but what you’ve said gives me a better appreciation of exactly how lucky I am.
In reply to blackcat:
I mean, I’m even better off than many: I’m in a major metropolitan city, and my needs are not life-or-death. But I’m on healthcare benefits right now, and there’s tons of restrictions that come with that. I have to get all my health services at the same clinic, of which there are only 2 in my area. And there’s only one psychologist serving the whole clinic. Apparently they’re in the process of hiring more, but who knows when that will actually happen, or if it will benefit me at all when they do.
Blackcat, it puts my complaints into perspective too. I go to a group practice so while I’ve been annoyed with things like frequent rebookings and changing availability, actually getting an appointment in the first place has never been an issue. Worst case scenario is getting there and hearing “she’s running late, do you want to come back another day or see someone else now?”
I knew it can be hard to find care, but I never gleaned just HOW hard, or how fortunate I am.
Man, can I vent here. Ive got a dear long-distance friend who’s a largely single parent of a teen girl. For the last year, she’s told me of her problems, largely due to her refusal to look for anything but the most menial physical labor work. Lately, a death of a close friend since childhood has pushed her too far. She’s called me, literally screaming. I looked up resources for her and she wont follow up. Shes kept me from dleeping and I’m stressed into the next day with worry. The only rea son I didn’t have her picked up on a psych hold (which I think would get her some resources) was the kid. They’re 1200 miles from me. Now she’s decided her condo is toxic and has moved into sone strangers house. The kid’s dad has appeared but the kid is terrified to leave her mom. The house has a dad eho was kicked out and came back. Now seems like a good time to help the mom, but my friends tell me they think I’m horrible. I dont want the kid to get raped by whatever’s wrong with stranger dad in host house. The woman is angry with me for setting boundaries eith her and has not apologized. When I was similarly ill and roomed with some people, the cops had to help me move as there were guns under the man’s bed.
How is this relevant at all, especially in a comment about how difficult it is to find help? Is this somehow supposed to prove that *some people* actually don’t look for help and how much of a pain that is for others? Because all I got from this is that you had terrible boundaries with this woman, you set better boundaries, but you still want to complain.
As scary and worrying this situation is for you, imagine how terrifying it is for your friend.
Yeeesss…
I live in an area where there’s barely room to turn around without bumping into a medical office of some kind and have awesome insurance. And it *still* means often calling many people to see who’s actually accepting new patients, and whether it’s worth going to the one who seems perfect but doesn’t take my insurance, and then discovering that this therapist is only at the nearby office once a week… And even if the logistical issues worked perfectly, it usually means calling up people you’ve never met, whom you have little or no information about (seriously, why do therapists almost never have websites? It would be nice for regular doctors too, but therapy varies so drastically by style that you really can’t tell anything useful from a basic directory entry.) and telling them extremely personal things. Depression, anxiety, and many other mental illnesses tend to make you specifically bad at doing all these things. It can feel like someone telling you that they would be happy to set that broken leg, just climb those five flights of stairs to the clinic.
Yeah, therapist-hunting is something of a misadventure here, too.
My funniest story about that: putting the criteria for what I wanted into my insurance’s find-a-therapist referral directory (on bus line, has evening hours, works with adults who have ADHD, within X miles of Location), got a match that seemed good, put in Google – and suddenly everything clicked and I realized she would have been perfect except for the part where she was someone I knew personally and it hadn’t registered because in the context I knew her she went by her middle name, but her first and last name were what was listed in the clinical directory.
But I did find a good match for Spouse (after he’d gotten set up with a spectacularly bad referral from the last time he was inpatient) through this contact – she has a friend in the field who is NOT known to me personally and who specializes in the sorts of things he needs and finds helpful. So that’s something, at least.
Ooops. I have friend who’s a therapist in this area, and they also seem like they’d be a really awesome match for me except for the part where I know them and that would be inappropriate.
Seconding the assertion that it can be really difficult to find helpful mental health treatment. It took me seven years going to a few sessions with several dozen psychiatrists and psychologists to find a psychiatrist who could help me at all, and his practice wasn’t even generally open to people in my demographic (I had to get some convoluted personal referrals). The problem is that there is no such thing as “a good therapist”, there are only therapists who are good or bad for any individual person, because one really needs someone who can understand enough of one’s worldview to differentiate between benign variation and pathological issues. Finding a working balance of medication (if medication is actually necessary/helpful) can take years after finding a helpful therapist, too, because we still know almost nothing about the methods of action of our psych drugs. And some of the most helpful drugs for some people aren’t legal everywhere – I settled on a cannabis regimen under the guidance of my psychiatrist that has been working well for years now (cannabis absolutely does cause changes to the brain with regular use, and that can be a very good thing), but it’s still illegal in my state. In my experience, slow progress is the norm.
I once counted the number of therapists, counselors and psychologists I’d been to and could recall thirteen. And there’s been two more since. #13 and #15 were about the only ones that were really helpful, and #15 was at the clinic that lost its funding just after my assessment.
I’m also pretty terrified that my drugs will stop working someday – all my previous ones have, I seem to build up a resistance to a lot of things quite quickly (including sleeping pills, which by the third time I ever took any were down to giving me six hours of sleep), and now I’m on Effexor which is hell to wean off. So fingers crossed that keeps working!
And sometimes even when you have insurance, it’s impossible to cover therapy.
I have insurance through my work. I have a $2000 deductible that starts over every 12 months. I cannot group medical expenses…. so a therapist’s appointment goes into one deductible pot, and the visit to the eye doctor goes into a different deductible pot. Up until the deductible, I pay 100% out of pocket on every single medical expense unless it’s preventive care. Once I hit the deductible, I then have 70/30 co-pay. The biggest advantage of the insurance is that I only have to pay the first $5,000 of the co-pay, so if I have a serious accident, I’m only on the hook for that part. But it makes frequent care, like therapy, pretty much impossible.
I’ve looked into switching insurance, but I make enough money I couldn’t get on any low-income benefit, and since my work offers insurance, I wouldn’t get any kind of tax benefit; I might end up paying even *more* than I currently do ($125 a month through work, as well as whatever I put into an HSA.)
I desperately want to get back to therapy, but without putting myself into deep debt, it feels hopeless.
Speaking as a preventative therapy doc (not a therapist, but sometimes I feel like it…), taking insurance is just not worth it (for me). And the number of docs who feel this way are growing, which can be seen by more practices going cash only.
The insurance companies do not allow for appropriate coverage (limiting the number of yearly visits regardless of condition and medical necessity), so patients end up paying out-of-pocket for services that really should be covered or they discontinue care despite really needing more. And more and more patients have higher and higher deductibles and co-pays every year, so oftentimes you aren’t even close to hitting your deductible unless you are really sick or have to go to the ER. I personally think that if you are pay hundreds (if not over a thousand) each month for your premium and you have a deductible of a couple grand, there should be a significantly better co-insurance than 70/30.
Also, the insurance companies just do not pay the doctors enough. If I took insurance, I would receive 30% less per visit of what I charge cash. I also have to do more work because I need to do more forms for insurance cases. Furthermore, I would have to hire a full-time employee who would do nothing else except deal with the insurance companies to try to get the money earned for services, which is at least $30k/year salary with a living wage. This $30k is something I need to earn ON TOP of what I need in order to pay myself and keep the lights on at the office. Finally, (and this is not an exhaustive list) the insurance companies can arbitrarily decide your notes aren’t “good enough” and the therapy “wasn’t necessary” after reviewing a few cases, and say, “well, 6 out of 10 cases weren’t up to our ~standards~, so we want 60% of the money we paid you back.” It’s complete and utter BS.
What I am trying to say is that the healthcare system in the USA is horribly, horribly broken. No one should have to go into deep debt to take care of themselves.
It makes me so incredibly ANGRY, especially when I read these stories about so many of the commenters struggling to get the care they need so they can function. I know I could help so many more people if I could afford to take insurance, but I just can’t. It’s not worth doing twice the work for half the pay plus the mental-emotional drain and stress of wondering whether or not I am going to get paid and the constant threat of being audited. The best I can offer my patients is to give them a superbill to submit to their insurance if they have out-of-network coverage. I make sure I take rigorous notes so there is no reason on my end for their claims to be denied.
I hope this helps people understand why some docs do not take insurance.
Yeah as someone who’s been through the system a lot it sounded like external problems with getting help to me, though obviously I could be wrong. But eg I got put on a waiting list for the Anxiety Disorders Unit, which is for people with severe anxiety disorders. It took nine months to get an assessment. More recently I moved to a different city and managed to get a referral to an anxiety disorders clinic – the only one in the area. After fighting with social services through paperwork for a while I finally got everything sorted to be able to afford one appointment a fortnight. I had an assessment. Then the clinic lost its funding and had to close. I do have a good GP and I’m lucky that I’ve had doctors who trust me with my medication and self-reporting etc, but this one I very often get the feeling from things he says that the reason he treats me as responsible is because I’m a well-presenting, educated, born upper middle-class white person.
It doesn’t even have to be a matter of no insurance or doctors not taking patients. I have excellent insurance and a great psychiatric NP, and it’s STILL really really hard to get treatment right. You try one drug and the side effects are more unbearable than the depression you’re trying to treat. You try another that works great…for a while. And then it doesn’t. It’s not something that you simply get help for and then you’re done.
It could very well be that, which the LW should be aware of in case that’s what’s going on, but it could also be a whole mess of other things making that solution slow going — insurance not covering the right kinds of medications or giving the LW’s friend refill issues, or an inability to afford therapy/better therapy, or the only therapist who is available (due to distance, cost, etc) is a really bad match and LW’s friend is trying to find an alternative, etc. That kind of thing is depressingly, frustratingly common, too.
Co-signing what the people above me have already said, I think “get to therapy” is not a particularly helpful response in situations like this.
Therapy is not always a thing that is available in people’s circumstances, and losing lots of your Team Me when you’re struggling is (speaking from experience) very difficult and exacerbates the problem. I don’t miss the people who did this in my situation because you do you, but I do think they were shitty friends. The Captain’s advice is much, much better in this way because it sets boundaries around those interactions and redirects them into less unpleasant situations while not ditching your friends because they’re struggling.
People doing this because they assume therapy is both necessarily available and a magical cure is an A++ way of ensuring that people like the LW’s friend *seriously* spiral.
You really didn’t suggest it that gently: you’ve basically gone ahead and accused the friend of being to blame for her own depression, and of being a bad friend– just another day in the mental illness stigma mines, then.
The friend’s panicked fears that she’s infuriating everyone around her aren’t the same as using LW as a therapist. It’s not GOOD, or healthy, and the LW would be right to put a stop to it, but aspersions beyond that are completely unnecessary. And the idea that if the friend just stopped talking to LW the right help for her would magically materialise is laughable. Difficulty finding effective therapy isn’t the exception, it’s the norm.
Seconding all that has been said above and adding, if you don’t have insurance in the first place or have crappy insurance that will only pay for group therapy (which is not useful for everyone/all ailments) finding someone who has a) sliding scale fees and b) availability anytime soon is essentially impossible.
I’ve been the incredibly sad person who thinks that every time someone isn’t smiling, EVERYONE HATES ME OMG OMG.
The problem is…hell, I don’t know a way around it. Because pulling away or setting limits will tell their Jerkbrain that you *do* hate them. And sadly, when someone is depressed, their interactions often *do* run on saintliness that will run out. Every new close friend I’ve had in the past 4-5 years has eventually given up trying to help me after a time, despite me telling them “I break people, you don’t want to get into this” and them denying that it will ever happen. All I can recommend here is swapping out friends and having their Team Me rotate so everyone with low spoons is refreshing while a high-spoons person is helping, and getting them some more effective therapy if it’s at all possible.
For declaring your need for space and sanity, I’d suggest things that don’t target your friend or accuse them. Go heavy on the I-statements. (“I feel x” rather than “You do X.”) Become the master of very plausible and truthful excuses. “I’m super busy, but I’m looking forward to lunch on Tuesday!” or “I’m feeling a bit sick, can we postpone our dinner to Friday? I’ll be fine by then,” is better than “I can’t hear this anymore. I’m going to have to cut back on how often we hang out because I have resources to recover too.” Even if the latter is sensible, depressed people can be extremely sensitive, and especially if your friend is suicidal or self-harms, “tough love” can set off a reaction. While you aren’t responsible for their actions, you can at least help mitigate their Jerkbrain’s response to you in particular.
Also, perhaps it’s possible to have group gatherings? Other friends there will help support a conversation, and that will help redirect subjects away from the Jerkbrain’s complaints and to things that can be a refreshing distraction for all involved. Sometimes, when you’re sad, just sitting there in silence and listening to your friends’ happy voices without having to contribute really does help.
Best I can do. Good luck, LW.
I have a similar background. The best thing anybody said to me was “WOW, your FOO must have been a piece of work, because I keep expecting you to apologize for bleeding on me if you get hurt,” followed later by, “I just want to reach back in time and punch your [emotionally abusive caregiver] in the nose.”
I married him, by the way. I still have depression, but things are better.
Anyway, thinking about the times when I was all “I have failed to fulfill the conditions of friendship and therefore friendship will be replaced by shaming and ostracism” about tiny things, I think that compassion and understanding just put salt on the shame. If somebody had whipped out an empty spray bottle and proceeded to spray all around me while shouting, “Out, brainweasels of shame! Out! Out, I say!” that might have shaken me out of it, because it’s funny.
LW here. 🙂
Thank you so much, Captain Awkward! I think this is really excellent advice, and honestly I just wouldn’t have thought of interrupting. I was raised a Good Southern Girl (TM) where interrupting is just Not Done, and I really do think this will help. I don’t think either of us enjoy the confessional sessions, but have been at a loss to break out.
Re: The “being treated but ineffectually”, I’m not at liberty to disclose someone else’s health details, but they ARE getting treatment, it’s just really slow going for various good reasons. I saw someone ask about that and didn’t want everyone to worry.
I’m glad this was helpful! I think the Captain gave you really good advice here 🙂
And, heh — I was commenting as I was reading along, so I just left a comment about how we shouldn’t assume that your friend wasn’t getting treatment at all. Some treatment just takes a while to work, to find a good mesh with a therapist, or to find the right meds that will actually help.
You are being an awesome and supportive friend, and I hope that you’re able to short-circuit your friend’s shame spirals! ❤
Caveat first: I have never been clinically depressed, so this is not the same thing, but for much of my life I’ve struggled against constant self-blame and putting myself down to others. I did it because I wanted to let them know I was terrible before they started to think that way themselves, or to take blame before anyone else did so no one else would have to be uncomfortable.
What finally broke me out of this was that I stepped in to a minor position of authority at work, and one of the people who was newly reporting to me said these magic words: “I’ve never heard anyone talk badly about your work, except for you.”
That completely floored me, and shocked me into a place where I had to start considering that, just maybe, I wasn’t as terrible as I’d always been saying — and that I was actually doing myself *more harm* by all the negative talk about myself. It was a long road of being really mindful about my words and thinking before I spoke, but after awhile, I stopped *thinking* so negatively when I didn’t *speak* so negatively.
Again, this is not the same situation as someone with a mental health issue who can’t help the negative thoughts, but that sentence from my co-worker was enough to startle me out of an almost life-long spiral and start to do the work I needed to change.
1. “I promise I’ll let you know if I’m ever mad at you, so you can stop worrying about it.”
1.5. Also, in response to glomarization, I wonder how “Hmm. What does your therapist say about that?” would work.
2. Definitely agree with shaking up the routines. Especially get out of the house and do something physical, perhaps in nature.
I’m not saying that everyone’s depression would be cured if they went out and did a brisk walk. But there’s enough evidence that it seems to help in some cases that, barring any other physical problems, it probably can’t hurt. (Is that enough disclaimers? 🙂 )
Besides, like they say with bad acid trips, set and setting. If you can’t change the mindset, change the setting, and sometimes that changes the mindset. I know that when I was depressed, going to the therapist always made me feel better, not because of the therapist herself, but because having the appointment meant I got out of the house and did something. (Yes, I understand, people who are severely depressed can’t do that, but it’s not sounding like that’s the case here. LW isn’t saying depressed friend can’t get out of bed.)
Oh, your #1 is excellent. One of my friends told me that once, and it was super helpful. She said, “I am not the type to sulk in silence. If I’m upset with you, I’ll tell you.” It felt like a weight was lifted from both our shoulders.
As a fellow former depressed person, I third this! You can even say ‘look, sweetie, I promise I’ll tell you but I get that your anxiety is going to make it hard for you to rely on that, so you get to ask me ONCE per visit if we’re ok.’ That might seem like too much work, so maybe it’s not a good suggestion for you, but if you can do it, it’ll help replace the old ritual with a new, quicker one!
Yes to laying it out like that! I have a friend with some anxiety about being overwhelming and I’m an introvert so it’s actually a good possibility that I will be overwhelmed. Things got a lot more relaxed when I told her one day, “I’m not mad at you or upset with you but I’m going downstairs for 10 minutes and you’re staying upstairs so I can take a break.” Break was had and I came back ready for more. Now she knows I’ll take care of my end of things and she doesn’t have to sit there in dread that she’s gone on too long or too much.
Ooof yes! Although having friends say “no” or “I can’t listen to that right now” was painful at the time, it always always built trust for me that they would advocate for their own needs, so I knew in the future that when they said “yes,” they really meant it.
I have used, “Have you ever known me to suffer in silence or not speak my mind?” to great effect. But it only works if you have that reputation
Yes. I have a clinically depressed spouse and a anxiously-inclined best friend and I have gotten both of them out of shame/anxiety spirals wrt to me/our relationship(s) saying something quite similar. It also helps that I am calm, matter of fact, and deliberate when I *do* have a problem. Modeling “good” behavior.
I have a very anxious/avoidant mother and a very psychologically healthy father, and I wonder what I would be like if I hadn’t had his stress/problem-solving/life-issue-tackling modeling.
Yeeeah, unfortunately I DO sometimes need to mull something over before I realise I’m angry about it, having reacted calmly at the time, which is not great for my clinically depressed friend’s brainweasels. Her brain is telling her I do this all the time, when I’ve actually done it to her about twice? But it’s something for the weasels to sink their teeth into.
Actually, the fact that we’ve been through a couple of pretty major fights has probably helped in the long run.
I have a partner with chronic anxiety issues, and often when he’s feeling bad (either because of his anxiety or because of other stuff) he’ll start perceiving upset and anger and tension coming from completely-relaxed-and-comfortable me. We had a few stressful discussions about it early on, and then I stumbled onto Answer #1, and it works wonders.
Since then, I’ve made a very explicit point of doing my best to reply 100% honestly when he asks me if I’m cross at him. Mostly my response will be “not in the slightest; I’m totally fine”, but occasionally it’ll be something more like “well, I was slightly bugged by that thing you said a few minutes ago, but then I decided it was silly for me to be bugged by that and I’m totally over it now.” And (very rarely) it’ll be more like “yeah, I’m a bit peeved about X, and hadn’t yet worked out whether or not to mention it.” The fact that my partner now knows from experience that I *will* say if something’s bugging me in those moments *really* helps him to actually trust me when I say “I’m fine, not cross at all”; and now he finds it much easier to accept that if I say I’m OK, I really am in fact OK (even though his jerkbrain perceptions say otherwise).
As an incredibly anxious person I also find people who do #1 super relaxing-but only once I believe they will really tell me. I relax so much more about people who have straightforwardly said no to me for self-care reasons. I always worry that I’m bothering people with my invitations, so I am so glad for people who say not tonight, I need an introvert netflix night alone, because I know that if they’re comfortable saying no, their yeses are really meant. I believe they are not bothered by me much more because of their occasional no than I would believe any reassurance they could give if I were to ask if I was bothering them.
I think there’s something to be said for exercising a boundary early in a relationship just for this reason. The person exercising the boundary gets confirmation that it will be respected, and the person having the boundary set to has evidence that the other party isn’t just putting up with them to be polite.
“I promise I’ll let you know if I’m ever mad at you, so you can stop worrying about it.”
YES THIS! I am one of those people incapable of holding grudges/stewing on things. A lot of communication work has led to a (I think) fairly healthy system: “If I am upset with you, I will tell you BEFORE it turns into a thing, or when it IS a thing how we can deal with it. If I am happy with you, I will tell you frequently. If I am anxious about something, I might not be able to talk right away, but you can ask yes or no questions and I will nod and then fill you in later.”
With new partners or new friends that struggle with mental illness/emotional processing, it sometimes takes awhile for their brains to relax and believe it. “WHAT IF ITS A TRAP” is a pretty strong Jerkbrain response. What I’ve found helps is a script something like this.
A) “Were you mad about that thing? I was really worried.”
B) “Nope! I promise I wasn’t. If I seemed weird, I might have been at a sad place in my book. If I am upset with you about something I’ll let you know.”
~~time passes~~
~~Person A does something that does upset me a little bit or make me anxious~~
B) “Hey, I just want you to know that when you did X, I felt Y. Next time, can we Z?”
A) OMG Yes! Thank you for telling me!
B) It happens. Now, about video games.
~~The world does not end, I don’t hate them~~
This second part is key. It might take a few rounds of small upsets/actual communication to get through. I’ve found that being really vigilant about YOUR feelings helps the other person be more secure in theirs. I don’t go looking for things to be upset about, but I might find a very small upset that I was thinking about glossing over and use it as a low-stakes practice round.
Yes! And not to encourage intentionally annoying one’s friends or anything, but I find it really does help if someone tells me once or twice when something bothers them. I know my friends are nice people, and therefore the really clever brainweasels will say that *because* they are nice, generous people they must only be hanging out with me out of charity or because they don’t want to hurt my feelings. That particular line doesn’t work nearly so well if I have proof that they really will tell me if I annoy them or if they even just don’t feel like doing X activity.
Oh my. I know a dear lady whose anxiety makes me climb the walls. She knows she has anxiety, and she is aware that some of her behaviors are anxiety driven. I don’t believe she is getting any care at all. Thank you for providing all these ideas. I was on the verge of dropping xanax in her soda when she wasn’t looking.
Yikes. I think you were joking with the xanax comment, but I felt a bit creeped by it. Glad you’re getting some good ideas!
Yes. Maybe rethink how funny a joke “I’m going to secretly drug people to change their behavior” actually is.
LW, you are being a very good friend by wanting to be there for this person while also realizing that the current state of affairs is wholly untenable. The Captain offers you wonderful scripts for stopping the shame spiral, but on a practical note, can you use a timer? Like, at the beginning of the conversation when you can tell your friend is going down the rabbit hole, let them know you care and want to listen, but you also need to put a firm time limit on that particular conversation, so it does not become the totality of your time together. Maybe say something like, “Friend, I want to reassure you that I am not angry or mad at you. It sounds like you really need to vocalize your brain weasels. How about five minutes? I have this awesome chicken kitchen timer that squawks when it dings; so when you hear the squawk, you know the Chicken Has Spoken, and we can move on. You will know, without a doubt at the end of those five minutes, that I am not angry or furious with you in anyway, and then we can talk about how they really need to make another Firefly movie. Okay?” And then, when that chicken squawks, change the subject to whatever is enjoyable for both of you. I hope you can utilize the Captain’s strategies, and best wishes.
I want someone to set the chicken timer so that the Squawk will introduce the awesome!
Caveat: not a doctor or scientist or medical professional of any kind.
I have an anxiety disorder, and it can be very appealing to have someone reassure me when I am anxious. It is also a natural response from them. I just want to reinforce that this, while seemingly helpful, isn’t really good for me (or them!). I’ve read that anxious people can get very stuck on getting the reassurance, which can reinforce the tendency to dwell on it. Anxiety disorders, depression, etc are absolutely not caused by this, but it can be counterproductive to their management.
Also, only if it’s possible, you want to, you have the energy, and your friend would appreciate the help, is there anything you could do to support their treatment? Help them source transportation or payment programs, decide insurance forms, give them a ride?
Decode insurance forms. Stupid autocorrect.
I feel for LW’s friend so much – I have been a chronic shame-spiraller who was convinced my friends hated me or resented me for pretty much everything. The worst part is I KNEW I was annoying them with my constant apologies and asking for reassurance, but I also couldn’t make myself stop. Finally, my therapist managed to break the cycle almost completely with one suggestion: say “thank you” instead of “I’m sorry” whenever I felt myself about to shame-apologize. The substitution turns the conversation from the infinite “I’m sorry for doing X!” “It’s ok!” “I’m sorry for apologizing, is it REALLY OK?” “Yes it’s really ok!” to one that has a clear stopping point. “Thank you for sticking by me even though I did X.” “You’re welcome.” And then it becomes really difficult to drag that conversation out further. It sounds simple, but it completely transformed the depression – friendship – shame interactions in my brain for the better.
Unfortunately I don’t know if it’s possible to suggest this as a friend, rather than a therapist, without it coming out wrong. But I thought I’d throw it out there.
Another good tactic one of my friends had was similar to the hyperbole suggestion: “That horrible terrible thing you did? You can make it up to me by making us tea / petting my cat for me / choosing the movie / some other tiny non-task.” It’s funny, provides a quick subject change, and derails the shame train by highlighting how absurd it is.
I really love that idea about translating the “you’re better than I deserve” shame-spiral to “you’re really generous” gratitude.
Oh wow, I love that.
I love the alternate track to the hyperbole suggestion! Doing small things that make me feel happy and useful is how I get through my day.
The “thank you” idea is brilliant! I shall try to use it myself.
I try and do that with my husband! It really does work. And it makes me feel better because I get to tell him how great he is–which is often what I’d really rather do, more than degrade myself.
He also discovered he could stop my apology chains by just interrupting me with, “I love you,” which was one of the only things that I COULDN’T apologize for.
My boyfriend, when I get into Apology Mode, will gently puncture my extreme thinking. He’ll counter my endless “sorry”s with “I forgive you for being human”, “I forgive you for having feelings”, “why are you apologizing?” or “how is that your fault?” Or, the kickers, “if I did that, would you be mad at me?” or “do you really think that I would want to spend this much time with you if I hated you? Why would I do that?”
It’s very disconcerting to be stuck in “nobody loves me, everybody hates me” mode and have someone ask you to explain your reasoning. Why do I think everyone hates me? Because I SUCK WAHHH. Not exactly logical. But emotions aren’t logical and it’s helped me a lot to have to put my swirling self-hatred into words and discuss them with someone who cares about me.
Big YES to turning things around with “would you be mad at me/hate me if I did that?” I’ve tried that with a friend and it does work. With that particular friend, I can then follow it up with gentle teasing, along the lines of “so do you really think I’m so horrible that I’d hate someone for such a trivial thing?” I wouldn’t necessarily recommend that for anyone else though. My friend just has that sort of sense of humour.
Hah, my bf usually follows it up with “so why do you get held to different standards than the rest of the world?” What’s funny is that he has unreasonable expectations for himself so I’ve turned it around on him once or twice. 😉
Practice! I have a friend who begins every conversation with apologies– for things like not calling sooner or for not talking to me more at the last club meeting we were at together. She’ll also circle back to the apologies when the conversation has moved on to something else and she’s searching for something to say next. She rarely comes out and says what she meant to call about in the first place. I get the idea it’s a nervous tic with her, something she does to fill space while she gathers her thoughts the way other people say um or y’know. If she’s in the habit of apologizing automatically, I’m just as much in the habit of answering with that’s-alright or I-should-have-also. I’ve had to practice changing the subject and not saying that I wasn’t offended every bit as much as I’ve had to practice undoing my other automatic habits like biting my cuticles. When I don’t forgive her or reassure her, I let the sentence hang while I wait for her to get to the point. It’s working– slowly.
I don’t think anyone else has mentioned this yet: LW, it sounds like your friend might have hypervigilance. (The Wikipedia article on it is pretty good if you want to read up on it.) I have this; it’s a response to long-term trauma, and it’s exacerbated by anxiety.
I say this not because it’s your job to manage / think about your friend’s anxiety, but actually for the exact opposite reason — if this is what’s going on, then the best thing you can do for your friend is to continue being yourself even when they start to spiral, and to be honest about how you’re feeling / why your face is doing what it’s doing. For me, this is because my hypervigilance is basically the equivalent of a cat running around a stranger and smelling them while all puffed up: it’s trying to assess whether or not the situation is safe. The best thing my friends can do for Hypervigilance Cat is to remain unruffled, let themselves be sniffed briefly, and then go back to whatever they were doing.
Here are some scripts my friends have used with me (and my inner Hypervigilance Cat) that have worked well:
– “I honestly don’t remember saying [Thing I Worried Meant They Were Mad At Me]. It must not have been very important.” +subject change
– “The expression on my face right now / back then just means I’m listening to you. Is there something else going on that you want to talk about?”
– “I’m not mad, but I am very tired. That doesn’t mean I don’t want to hang around you. It just means I need hanging out to be low-impact today.”
– “I *am* happy to see you! I’m just also very busy this week and don’t have a lot of energy. Can we do [Other Non-Talking Activity] together instead of chatting?”
Also, as noted above, I strongly second the Captain’s recommendation of Subject Change and/or Distracting Activity. Paradoxically, feeling like the focus of the hangout isn’t on my feelings makes it easier for me to deal with my feelings.
I hope this helps, LW! Good luck!
OMG. Thank you, I think you just gave me valuable insight on advising a loved one who isn’t even sure how to seek help, because its so hard to describe the behavior. /end thread hijack
Oh, hooray, I’m so glad this helped! \o/
When I read the post, I immediately thought of relationship object permanence.
(tumblr link because it’s the most succinct and accessible way i’ve seen it described): http://hiccupkin.tumblr.com/post/124184826499/hey-everyone-im-here-to-talk-to-you-a-little
Um, whoa, this may actually have changed my life. Holy crap. Thank you.
One of the things a lot of people don’t know about depression is that it’s often co-morbid with anxiety problems – or in other words, depression and anxiety are the “terrible twins” of mental health. To me, LW, what you’re describing from your friend sounds more like an anxiety issue – they’re getting trapped in this loop of “I’m terrible” and aren’t able to break out of that loop. It’s sort of a less-dramatic version of a panic attack.
The key, as with panic attacks, is interrupting the loop, or short-circuiting it.
To set this up, you need to explain to your friend (preferably on a day where they aren’t doing this particular bit of mental hamster-wheel panic and are able to take new information on board) that if you have any problems with the friendship, you will communicate these. Then when they start apologising and worrying over how terrible they’re being, you ask them one very simple question:
“Did I say I was mad/upset/annoyed/etc?”
Usually the answer will be no.
The next question is “do you trust me to let you know when things are a problem?”
Hopefully the answer here is “yes”, which will mean it’s subject change time, and move on to something which will jolt the mental hamster off the wheel of self-abnegation.
What if the answer is “no”?
What if, as has happened to me, past experience has demonstrated that people say everything is fine until one day they dump everything on you and say they’ve been irritated or angry for a while, and all those times you thought they were mad but they said they were tired, they later revealed that they were actually somewhere between annoyed and angry?
I admit I was shame-spiraling all over them. I had no idea anxiety was a thing that might apply to me, at that time.
I don’t know how to trust that somebody will actually tell me that there’s a problem before it’s irreparable, because I’ve never experienced that in person.
I’ve been in exactly this situation and it sucks and I’m sorry it happened to you. The friend who dumped me listed all the qualities I most hated about myself in her final email, and it devastated me for weeks. Months. It convinced me that all the things I most feared were true, and that all my other friends were just waiting for their chance to dump me too.
Three things, though:
1. The jerkbrain has this uncanny ability to latch on to That One Time The Thing I Most Feared Did Actually Happen and to say “See? See? I’m not being paranoid!” And, like all brainmonsters, it’s trying to help, but it’s putting undue weight on the bad thing and completely ignoring all the good things.
I understand and respect the pain and worry That One (Or However Many) Time(s) caused, but it doesn’t help to keep fixating on it. There’s a point where paranoia isn’t actually keeping you any safer. Like, seeing an axe murderer in the news is scary and it’s good to pay attention, but if you stop going grocery shopping because you start to think EVERYONE might be an axe murderer then you’re not giving the news story the appropriate weight in your life.
I kept bringing up That One Time as “evidence” to my therapist that everyone hated me, and she was like, “okay, that was that friend, but now let’s talk about all these OTHER friends and how likely it is that they’re all lying to you all the time about everything.” And we went through the evidence and it seemed I have great friends who are awesome, and who are still there for me. That One Time is evidence too, yes, and it shouldn’t be discarded entirely, but it’s evidence ABOUT THAT PARTICULAR FRIEND and not about your entire life. Which brings me to,
2. IT IS YOUR FRIEND’S RESPONSIBILITY TO USE HER WORDS. If she is silently resentful but still saying “fine, everything is fine!” then that is ON HER HEAD. You can’t be responsible for things she’s not telling you and feeling in secret all by herself. I know first-hand that that knowledge doesn’t make it hurt any less, and I’ll repeat again how sorry I am that your friend (friends? you use the plural, but my point stands) turned out to be two-faced. In my experience the thing that hurt the most about the betrayal was not even the loss of that friend herself so much as the fact that it poisoned all the rest of my friendships for a long time as I wondered what they were hiding and whether they were also lying to me. But therapy taught me to check in regularly and take my friends at their word, and turns out that most of them aren’t compulsive liars! When they say they’re having fun and we should hang out again, they mean it! We can have honest conversations about lots of things, including mental illness! And the more I think back on the relationship I had with the friend who dumped me, the more I realized that we really didn’t have healthy communication patterns in general — some of this is my fault, I own that — but I can’t tar everyone I know with the same brush.
3. It feels like you’ve learned a lot about yourself since this happened and that’s not nothing. Someone who is unaware of her mental issues is going to be much harder to talk to and much harder to move forward with than someone who is actively working to grow. And I think that will in turn attract a quality of friend who is keen to take that journey with you rather than constantly scanning the exits, y’know? I can’t tell from your message whether this was very rare or a common pattern; if it was so common as to decimate your friends group then yes, you might need to start working on your own communication patterns. But it looks like you’re well on your way already. Good luck. We’re rooting for you.
Well it’s sort of not That One Time. The count is low, but the percentage is high. Also this is entirely about male SOs (I am female). Of the five boyfriends I’ve had ever, one straight up couldn’t keep his hands to himself (hey at least *he* didn’t lie); one I thought respected me and my no until I found out I couldn’t trust to keep his hands to himself… when I was sleeping; one was interested until he “caught” me then his video games reasserted themselves and all those expressions of being interested in the stuff I was interested in were revealed to not actually be true – “yeah let’s go this is great fun!” turned into “nooo, it’s too faaaar, it’s too inconvenient, and I’m not at a good stopping point in this video game” when nothing at all about the event itself had changed; and two said everything was ok when really it wasn’t and dumped me because I was “too broken”. So I am *extremely* suspicious of expressions of interest and courting behaviour and expressions that everything is fine, because my experience has shown that it’s just a performance. And yeah, there’s a chance I contributed to the poisoning in the last one, because at that point I had learned to be suspicious, and was still anxious and didn’t know yet about anxiety. Yeah, bitter and suspicious is poison, that’s why I’m staying single for the foreseeable future. One of the many reasons, anyway.
So it’s not evidence that everybody hates me, it’s more that all the guys who have expressed interest in me aren’t actually interested in me, only in having a girlfriend. Achievement unlocked? And those are few and far between, too; I realized a bit under two years ago that I’d dated every guy who ever asked me. All five of them. (And that’s another reason I’m staying single for a while; I need to practice saying no.)
I should probably stop here; I don’t mean to hijack the discussion.
I don’t have an answer, but I have some random thoughts.
1) You and the LW are coming at this from opposite perspectives. The LW actively WANTS to do the right thing. You’re looking back on friends who didn’t treat you very well, and trying to figure out why. Maybe if your friends had known more about how to deal with these issues, they’d have behaved differently and you’d have had more positive experiences. Most of us don’t get much education in these issues. Or maybe your friends were just jerks. Just because you have anxiety doesn’t mean everyone else was perfect! Maybe you’ll meet nicer people someday.
2) There’s a frustrating sort of cycle where something which really was okay becomes not-okay if someone won’t let go of it. Like, if a friend is late to meet me, that’s fine. Stuff happens, no biggie. If they apologize, that’s fine. If they keep picking at it and picking at it, that’s annoying. If they then start in on how they’re a terrible human being, that’s painful to watch, and it also puts pressure on me to do a big song-and-dance about how wonderful they are… which is annoying. If they accuse me of secretly hating them, that’s actually really offensive. But by then I may feel I can’t get offended, because they need me to be a perfect friend because they’re so stressed, so I have to double down on reassurances, while secretly getting more and more ticked… of course what I’m describing is a shame spiral looks like from the other side. CA’s advice is designed to break up this dynamic.
3) Worse, this cycle of suppressing anger can happen with really major things and not just small ones. Fictional example – your friend steals your car and crashes it, but you feel like you _have_ to forgive lest they kill themselves.
4) Why did other people seem angry so often? Please note, I’m not expecting an answer! What I mean is, there’s a whole range of possibilities. Were these cases where a reasonable person would be angry, because you genuinely behaved badly? Did small things get escalated due to shame spiraling? Or were these cases where you had passive aggressive friends who loved to jerk you around with manipulative BS? (Fictional example: saying they’ll go see any movie you like, then sighing loudly because you picked something they weren’t interested in, because of course they wanted the appearance of generosity while manipulating you into putting their desires first.)
5) This letter and the responses hopefully serve as testimony that people exist who really do want to deal with other people’s anxiety in a kind and honest fashion.
Best wishes for the future.
Yeah. Shame spirals suck for both sides. I get (now) that my shame spirals were too much for them, and are probably caused by anxiety, exacerbated by the gaslighting and self-esteem-stomping of a crappy ex who was one of the guys who said he wasn’t angry or annoyed when he was, then later revealed that he had been angry when he dumped me. (Exacerbated? How about enthusiastically fuelled. He said to me several times that I was bad at people, and what friends I had were just pretending to like me because they were too polite to say otherwise. No evidence but his word, of course, that I was bad at reading people’s interest level and emotions, because silly me to think he was angry, no no, he was just tired.) There’s a good chance that these guys were angry that I couldn’t just stop being anxious (because undiagnosed… well, still undiagnosed, but I now know that it’s a thing and the descriptions and coping strategies I’ve read about seem to be helping) and didn’t know how to cope with it themselves. Fair enough.
But I still don’t know how to trust somebody to let me know if there’s a problem. I’ve never seen it in person.
Anyhow, as above, this isn’t quite on topic for the LW’s letter.
That ex sounds like a real jerk. I hope I won’t hurt your feelings by saying so, if you’re still fond of him. He had no business saying those things, though. From your description, he sounds like the kind of jerk who on some level actually liked that you had anxiety, because it let him control you, so he deliberately did things to make it worse.
Jedi hugs if you want them!
You didn’t hurt my feelings. He’s long gone and I’m glad that’s the case.
I think this comment is very well put.
That trust is something I’ve had to build piece by piece, in both roles of that relationship–I was really negatively affected by “it’sfineit’sfineBOOM” relationships, and tried my best never to be on the giving end of that; that led to years of me trying to be really mindful and explicit about my relationships.
The biggest thing for me is, I don’t actually trust someone not to bottle up until they’ve proven that they can say “No”. If someone always agrees with me I have no idea if they’re actually fine or if they’re building up resentment. So I look for the little moments when they can confidently disagree–say “I don’t like that restaurant, let’s go somewhere else,” or “I know you’re having fun, but I’m bored; can we leave in half an hour?” or “That hurt my feelings.” When we can healthily differ over little things and have small experiences mending a breach or reaffirming our relationship despite differences, then I have more confidence we can handle the big disagreements.
It’s something I look for as well. I once broken up with someone in part because after six months together, we’d never had a disagreement. I would express an opinion or plan or desire, and the person would agree with me. Not that I like arguing all the time, but I know I can be a pushy person, and I chose to be friends with and in relationships with people who I know can stand up to me when they want to. It makes me feel safer from “it’sfineit’sfineBOOM” situations, and also like I am hanging out with fully formed and three dimensional people. Having opinions about things is sexy.
I really like knowing the next time I am going to do something with a friend; it helps me realize they haven’t come to hate me in the last N days. I really like my friends spontaneously expressing that they are having fun / thanking me for doing something fun with me; it helps me realize that they enjoy my company and are not doing things out of pity. I really like it when my friends initiate plans with me; it helps me feel a lot more secure in being able to spend time with them and to feel like they want to spend time with me. I like regular touch and words of care; I trust my friends to not lie to me and touch and words feel unequivocal in a way most things aren’t.
I don’t know if any of those will work for your friend, but they are good for me.
Not actually helpful, but I would be so tempted to start handing out rosaries. “Say five Hail Marys and a Hello Dolly” kind of thing. I mean, if it’s a ritual of confession and absolution they want, might as well, right? (No. Wrong. Do not actually do this thing.)
Although at some point you might be able to fold it into one of the jokes. “Yes, you’re completely horrible. That’s why I want to do things with you. But to make it up to me, come out for ice cream, as penance. My treat.”
If the other person is actually Catholic or formerly Catholic and has a warped sense of humor, I can actually see it working. Very much a “know your audience” thing, but it made me smile (not Catholic, but I do have anxiety disorder and residual ex-Fundamentalist guilt).
“Say five Hail Marys and a Hello Dolly” would totally derail me and get me laughing — if I were the sort to spiral into irrational anxiety about imagined social sins I’d committed, or to apologize repeatedly for saying I’m sorry too much. Which I do, but I’m sorry.
I love the idea of token penance. I think that would often make me feel a lot better. I mean, I would actually say the Hail Mary’s, maybe not what you meant.
Something that really helped me was when I was venting to a friend about something, saying something about how so many people had done XYZ thing to me and I was always afraid they were doing it too. And my friend, my best friend, finally had had enough, I think. My depression was bad at the time and we’d done this song and a dance a few times. She finally just got angry and shouted, “I’M NOT THOSE OTHER PEOPLE. I’M YOUR FRIEND.”
It completely stopped me in my tracks. Yes, this is my friend. My friend loves me and wants me to be happy. My friend will do their best to help me. But as their friend, I need to trust them.
It might help to also say something like, “You are my friend. I am your friend. And I need you to trust me to tell you if you HAVE done something to upset me. I WILL communicate with you because you’re my friend and I care about you and I know this matters to you. From now on, because I know anxiety and depression are a thing for you, let’s limit the question to once an interaction. You get to ask me once in a conversation if I’m angry with you about something since we’ve last spoken. And then you need to trust me and believe me so we can move on and enjoy our time together. Can we try doing that? I think this will help you avoid the shame spiral this seems to give you.”
Any thoughts on breaking the “Jerkbrain dump / reassurance / detailed explanation of why reassurance isn’t true” spiral when it’s coming from a spouse? My husband’s anxiety frequently manifests as him being convinced that he’s terrible at his job (he’s not) and is going to disappoint everyone at work (unlikely). I don’t have the emotional resources to engage in Asshole Brain Debate Club every day, but I feel like I would be an shitty spouse if I asked him to limit his venting or changed the subject.
I’m not married, but as a partnered-person my two-cents is: recognize that your spouse is, at their core, a person. Being a spouse means you don’t automatically break up with them over frequent, exhausting Brain Debates (something that is generally an acceptable automatic-dealbreaker as a non-married person, but I would argue warrants a little more patience as a spouse) but it doesn’t mean you put up with it indefinitely and unconditionally. Setting limits prevents the slow, grinding resentment that has killed more marriages then I’m comfortable observing in my lifetime and helps keep you on your game for debate club when you are scheduled to engage.
You are not a shitty spouse if you limit his venting. Spouse is not the same as therapist. Spouse makes a bad therapist.
I am also married and after several years we have both actually put a line on self-hate diatribes from each other. It is exhausting for both of us. So now we limit it. It is OK to put a limit on these things!
For me I went with ‘I love you, and I understand your fears and your feelings, but it hurts me to listen to you be cruel to yourself like that. In future, I’m going to let you have a few minutes and then I’m going to change the subject, OK?’ And that’s what we do.
Now instead of the spiral we both just say ‘I’m feeling kind of x today’ the other person goes ‘what can I do to help that, what do you want to do?’ and then we try and do that.
Oh, I really like that script, thank you.
A CBT type approach can help. You posit that maybe others think he is doing a good job, and what evidence has he seen to support either position? I will ask him to pass on evidence from his workday, and we will decide together whether it seems people think he’s great or not (spoiler: they do). Then when he inevitably says they’re wrong, I ask him if he respects their judgement in other ways. He usually does. Then we go over the conclusion that he is in fact doing well against the professional standards of his workplace, but he can still make improvements if he wants. Lots of iterations of this conversation later, he’s pretty confident and can get over the occasional work error without wanting to flee to Scotland. And I often tell him how proud of him I am that he goes to work and comes back, even when he does want to flee to Scotland.
I would tend to refer him as often as possible back to whoever’s job it actually is to tell him whether he’s good at his job. It’s certainly not a good idea for him to be asking his supervisor for reassurance every five minutes either, but if he doesn’t have something like this already and his boss isn’t obviously a jerk, it couldn’t hurt to ask for a quick check-in on his performance or more detailed job requirements he can check himself against or things like that.
I’ve been in the position of not being able to tell if I’m letting things slip at work, or just dealing with brainweasels telling me I suck at everything, or struggling because there’s actually something going on at work that is making things objectively more difficult, and it’s usually been really reassuring to go “hey, boss, am I doing ok? Is there anything I should be working on?”. And even if the answer is “actually, you’ve been kind of dropping the ball recently”, then that pops that horrible waiting-for-people-to-notice-I-screwed-up bubble and we can figure out if there’s some tool or support I’m not getting, or if I have too much on my plate, or what.
My husband suffers depression, and paranoia and trust issues to go with his PTSD (yay)! His last, wonderful therapist described his jerkbrain as”Mr Bugger” (he’s English, this works for us). So whenever he went into a self-hatred or anxiety spiral, I would say something like “I don’t listen to Mr Bugger’s bullshit” or “Mr Bugger is not allowed in the bedroom” or even “I didn’t invite Mr Bugger to come shopping with us”. We occasionally physically flicked at his shoulder, as if to remove the little devil.
It was surprisingly effective – much like the Captain’s suggestion of interrupting – it interrupts the thought process and gives my hubby a quick pause where he thinks about where that self-destructive thought it coming from. It’s not from HIM, it’s not from ME, it’s from Mr Bugger/The Jerkbrain/His depression.
Therefore it cannot be trusted.
The instances of him doing this have significantly decreased and now it’s an in-joke for us. It also means my only role in “counselling” him is to remind him that not all his thoughts come from a good place and he should ignore them. And to generally love him for everything else.
YES this. My spouse had an Imaginary Celette who would call him names for things (aka JerkBrain projecting onto me during arguments) and I spent a lot of time saying “No, I did not say that. Imaginary Celette said that and it isn’t very nice.” I can’t really “stop” the spiral, but i can say “Dude, I did not say that, your Anxiety said that and I am not taking responsibility for that”
It’s really important for long-term to have some boundaries. We can’t be their therapists.
Sometimes when a person is in that awful spiral of seeking reassurance, but being unable to believe in it when it’s offered, I’ve found it helpful to point out to them that you seem to notice a thing going on where their insecurity level doesn’t seem to change regardless of what you say. Ask them if they agree with you and listen to what they say. Ask them if they can think of anything you could say which could change their mind about the negative things they’re saying.
In the day to day, I have also found it helpful to completely not engage with the Jerkbrain.
PERSON: God, I don’t know why you hang out with me, I’m so annoying and stupid.
ME: Hmm. (Pause to be clear that I heard what they said, I just don’t have anything to say back.) I was thinking it would be really fun to go take a walk by the waterfront and get some coffee. You wanna do that?
Or you could also try a thing where you register as briefly as possible that you disagree but then you change the topic.
PERSON: God, I don’t know why you like me, I’m such a shitty friend.
ME: Well, I don’t agree. But that’s a really cute sweater you’re wearing, is that new? Where’d you get it?
Good luck. I am sending you good vibes and I hope you can have some good talks soon.
Speaking as someone who’s been the friend in this situation more times than I can count, I can add a tiny bit of advice to the Captain’s excellent scripts here. Silences are really hard for us anxious folks. The vacuum just gets filled up with all kinds of detailed scenarios in which the person is angry or resentful. If I’ve gone out with someone for a fun evening but hear nothing afterward, I worry that they didn’t have as much fun as I did, and then start coming up with reasons they may not have had fun, and the brainweasel magic can soon turn that into “I guess the night was shitty after all, and EXTRA shitty because you ignored what must have been obvious signs of your friend’s misery.” If I send a long thoughtful email and get no response for a few days, then that turns into a certainty that the email was annoying or oversharing and that the person never wants to hear from me again.
So a text saying, “Hey, busy now, but will respond to your email soon!” or “Had a great time last night, let’s do it again!” or “Thinking of you, let’s catch up!” goes a LONG way with me. It doesn’t cure the anxiety, of course, but soothes it all out of proportion to the effort it takes.
YES! Small positive contacts, so good!
I’m a big fan of sarcastic agreement; I especially like the, “Sure, ok. Also, your hair looks pretty like that,” style that doesn’t expound on how ridiculous the claim is and instead simply contrasts your demeanor and behavior with the obvious lie they’re telling themself and asking you to agree with. This avoids the possibility that the person will latch onto the satirical description of how awful they are as actual criticism that can extend the shame spiral, while both your normal, engaged treatment of them and the very fact of your agreement undermine the claim that you actually think they’re awful. You’re basically refusing to engage with the jerkbrain while still acknowledging your friend’s feelings.
Re: the silence thing…My sister does this to me all the time, probably advice from her therapist. Maybe I’m a needy mess, maybe I’m not, but if she weren’t my sister, I would never speak to her again. It is a hateful thing to do to ANYONE. If this is the only way you can deal with a mentally ill person or any person, that person is better off without you.
I have failed in a situation like this as the online friend of a depressed person. It was years ago and I handled it immaturely. I was this person’s major system of social support. They would beg me to say all the things I didn’t like about them. And have meltdowns that I wasn’t responding to their texts, while I was sleeping or at work. They would read things into what I said, and I would reassure them that it wasn’t anything about them. I tried to institute rules like not making assumptions about why I wasn’t responding (even though by that point, I *was* avoiding them sometimes, besides venting about them to other people, and pretending I wasn’t annoyed when I was.) They probably found those rules impossible to follow.
It all ended in almost the worst possible way, when they had some kind of break and began making paranoid accusations of me (e.g., I was spying on them in their house.) I freaked out and told them I couldn’t help them and not to contact me again. I definitely feel that I failed and was unkind to my former friend, even though they were very difficult to deal with. I wish I’d had a resource like this.
You didn’t fail. That was an impossible situation. You were given a problem you couldn’t solve. It sounds like you did your best to make things work with your friend. It isn’t your fault that they were too unwell to treat you appropriately, or that you felt uncomfortable about it.
Please don’t be so hard on yourself – you didn’t fail. I have been in a similar situation where, if I didn’t respond to someone fast enough (someone who already tramped all over any boundaries I tried to set) they would respond with FEELINGSBOMB texts trying to get the answer they wanted, and if I didn’t answer those, they would text me and say we should never speak again because obviously I hated them and they wouldn’t bother me anymore and etc. etc. except maybe I should because of our deep connection? Then throw in a lot of “you’re the best person I’ve ever known” texts in between texts telling how they’d never speak to me again.
I mean, oof. There does indeed come a certain point where you have to be your own life preserver in some relationships. There is nothing wrong with that.
I’ve been both friends in this situation. It’s a really suck place to be.
What I try to do when I’m in LW’s position is be clear and honest about my needs. Like I’ll say, “Please stop apologizing. It’s making me uncomfortable.” Sometimes the friend is okay with this, and sometimes it starts more shame spiraling, but I used to try to just suck it up and be endlessly patient and ignore my own feelings in a relationship because the other person had Issues, and that was a terrible idea.
The old method made me a caretaker instead of a friend. I felt neglected and resentful. And it wasn’t very respectful of my friend either, because I was treating them like they didn’t have anything to give, like I could help them through my goodness or hurt them through my carelessness, but they couldn’t help or hurt me. I was treating them like they were powerless.
Now I try to remember that friendship is mutual, and just because someone is dealing with emotional issues doesn’t mean they’re incompetent. It doesn’t always go smoothly, but it feels more honest than what I used to do.
My jerkbrain tends to be that way sometimes. What would help from a friend is if they hugged me. (WARNING: No surprise hugs EVER. I need to see it coming and be able to refuse – I generally don’t refuse hugs from friends, but need to see I have the option.) I don’t know what the habits between your friend and you are, but if you feel like it (and I guess only if you’re feeling with them), you may ask: “May I hug you?”
On the other hand, one thing that doesn’t help at all is when they stay staring at me with a nervous expression. That triggers spiralling.
One more thought, it may be very counterproductive if you claim that you’re not angry with your friend while being irritated about what they’re saying at the moment. You emotion is showing. “I’m not angry with you for the thing you did last week” will come across as a lie. “I’m not angry with you for the thing you did last week but I am getting pissed off by the littany you’re giving right now” might, actually, be a better option.
And even one more. Once they believe you you’re not angry, they may still need to vent the worrying they’ve had. “I was so sure you were mad at me” doesn’t have to need an answer.
I had a depressed friend who often thought I was angry at her. I didn’t understand that it came from depression at the time, though. She would decide I was mad at her, but instead of going into a shame spiral, she would become angry and defensive, like, “You have NO REASON to be angry at me for that thing! Your behavior is weird! You are not a good friend!” Etc. A refrain was that she couldn’t “live up to my expectations” (I was never sure what those expectations were!). I didn’t want to deny the experience she was having and would try to figure out what I had done. It was really tough managing these interactions and I ended up walking on eggshells most of the time. Is there a term for “I’m angry that you’re angry at me” behavior?
Hmm I can relate to the constant feeling that people don’t like me and overanalyzing my own every move and feeling terrible all the time
But I’m not so severe that I obsessively make it known all the time. Or ever. I tend to just feel bad. Only if people stop talking right after whatever I feel did would I think they might be mad
I do have anxiety though which makes me obsess over other random things not necessarily how I interact with others but.more that my life or my families lives will be ruined by xyz
My friend with the spiralling shame-brain has told me that these things I did helped her. I throw them out here in case anyone wants more optionsvto offer:
1. Cooking a meal in her kitchen while chatting with her. Then we ate, and she got the leftovers and a sense of friendly acceptance in her kitchen in place of her guilt and shame about not keeping it up to her mother’s standards.
2. Bringing over cookie dough or banana bread batter (after mixing up the ingredients at home) and baking the treat in her oven so her place got the cozy scent. (She doesn’t have food restrictions or issues.)
3. Weeding with her in her garden one weekend, and then in my garden the next. It’s easier to visit when we’re working on something mindless together. It also helps materially with the “not up to mother’s standards” shame (which I share) and the “too busy to visit” issue because the kids can be running around while we work and talk.
Just a note in support of the various “Set a time limit” suggestions throughout the comments, and to note that I think both the time and the limit are important. As a former and possibly future shame-spiraling person, I know from experience how important it is to a)feel like you are being heard/not being ignored BUT also b)getting a gentle nudge from the friend to whom you are shame-venting: “I am not going to let you go all the way down this rabbit hole, because I care about both of us and that’s not good for either of us.”
Cutting somebody off the second they open their mouth can be good tough love etc, but to me in the past (especially coming from friends I knew had trouble handling emotional stuff in general — why did I lean so hard on so many of such people, you ask? Good question, I answer) it has signaled “I can’t handle this I can’t handle this please stop please STOP AAAGH.” The problem is that then redoubles the shame: “Oh my God why can’t I get it together, I must be so miserable to be with, my friends can’t even stand to listen to me for 10 seconds, oh my God why do I suck” and so on etc. The reason I like all the Captain’s redirect suggestions so much is because they start out with variations on such a key thing the spiraling person needs to hear: “I acknowledge how you feel even if it’s the Jerkbrain and not real. I don’t agree, but I don’t dismiss, either.” Varying people need varying levels of this, but I know I needed a lot.
The scripts are great and over time, can really become friend-shorthand that is so comforting. One of my closest friends, who had a LOT of trouble handling my emotions when they were at their Jerkbrainiest, has grown to the point where she is a champ — but also hasn’t had to become a touchy-feely person that she simply isn’t. If I’m venting to her and it goes over a line we both sense, all she has to do is gently urge me, “Take care of yourself,” and I know that’s shorthand for “I love you, so no shame spiral today, OK?”
My go to phrase in these situations is “I don’t believe that, but I don’t want to argue with you. Can I get you a cup of tea/find you some videos of cute animals/distract you by rambling about comics/something else that might help?” It took me awhile to learn that, because I knew agreeing with the self-hate would be bad, but arguing with the self-hate seemed to be bad too. I only started doing this once the arguing started to affect my mental health, and I knew I had to take a few steps back. My experience is that this might make them feel just as shitty as the other options, but if so, there was probably nothing I could have said that would have made them feel better.
I also, if I can think of a good way to make this clear without making it sound like I don’t want to talk to them, try to make it clear that if it would help I can also shut up and leave them alone. I haven’t found a good phrasing for that one, but I know sometimes one really does need an “out” of the conversation when they start to spiral.
My only additional advice is regarding someone saying “I will let you know when I’m angry”.
You have to actually do that, if you say you will. Don’t hold it up and bring it up later after reassuring them that everything is ok.
I had a friend who would do this, and it made me unable to trust myself on reading their emotions and feelings.
“Are you ok? I feel like you’re mad”
“no no, I”m not”
later
“Actually yes I was, I was mad the whole time”
“WHAT”
Rawr! I’m short on time so I can’t read all of these amazing-looking comments right now (augh, so amazing, commentariat!) but I wanted to chip in:
My brain interprets lack of contact as “ha, I hate you and/or I have totally forgotten you exist because you are so worthless that I don’t care about you at all.” The most helpful things some of my friends do are:
-if we have plans, they text me the day before or several hours in advance of plans to check in “hey, we’re going to the movie! I’m so excited to see you!” While my FEELINGS of apprehension may or may not be soothed by this, it gives my Logic Brainparts some ammunition in the “hey, would they be excited to see you if they hated you or were secretly mad about your existence?” and starts our interactions out on the note of “yay! Exciting thing has come to pass!” instead of “oh, are they only here because they said they’d be and they’d rather be doing literally anything else?!”
-greeting me in a way that makes me feel loved. Physical closeness is for me the thing that signals to my brain that this person is not just tolerating me, so a warm hug at the beginning of any interaction reassures me, especially if my friend is not in a good mood. Starting off on a loving note lets me relax a little so my brain doesn’t associate any non-positive feelings my friend might be having with => I AM AWFUL AND THE CAUSE!
-sending me texts, notes, or links to things on the internet when they think about me. It’s reassuring to know that people think about me when I’m not there, and I love getting links to things because it reminds me that I am interesting and people care about me enough to learn my preferences so that things they see in the world will make them think “oh! startledoctopus will LOVE this!”
All of these things take energy and effort, so take care of yourself and don’t force yourself to do anything that drains you too much!
I’m really grateful for the opportunity to read this today, because while I don’t subject my friends to hour-long apology/confession rituals, I DO tend to just withdraw entirely after I accidentally allow communication to lapse during a bad depressive episode. Then I feel like they are boilingly furious at me for my abandonment and like it’s not safe to break the silence – which is almost never the case. Reading this, I could HEAR their voices and could identify tools they’ve used to try to reach me through the miasma of my mental illness, and it was so very reassuring. Thank you.