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Mark Manley
Mark Manley, Therapist
Category: Mental Health
Satisfied Customers: 402
Experience:  Licensed Marriage and Family Therapist. Over 15 years exp. Married 30 years and happy.
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I need guidance in helping a close friend deal with mental

Customer Question

I need guidance in helping a close friend deal with mental issues and alcohol problem.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Mark Manley replied 5 years ago.
Thanks for using JustAnswer.
Happy to help. What are the details?
Mark Manley
Customer: replied 5 years ago.
Mike is on disability for mental issues. I do not have his official diagnosis but he says serious depression, low self-esteem and lack of motivation. Mike is 24 and was adopted from south america at about 6 months. He knows nothing about his birth parents. He was raised as an only child. I believe he feels his adoptive father did not really want him. He gets along fine with mom. However, he doesnt live at home. It seems the father doesn't want him living there. I believe Mike doesn't really want to live there as well. Mike also has drinking problem. I don't want to label him an alcoholic but he drinks definitely above average. He drinks mostly at his rented room. His parents control his money and pay the rent for him. I have known Mike for over 5 years.
We hang out and communicate quite often. We both could be labeled as bisexual. He is not my boyfriend but we have a relationship that could be taken that way. Obviously, Mike has a limited income and I do help him out. He says I have made a difference in his life and he is thankful to have me in his life. I do not give him cash directly due to him buying alcohol. I care about him and do have feelings for him.
He says the same. He stopped taking his prescribed medicine about 5 months ago. I do not believe he is active with his psychitrist for some time now. Mike is fine most of time but I have noticed some changes in him since mid November. He seems more agitated by small stuff. He also seemed to isolate himself on and off with at least me for several weeks in December. He said it had nothing to do with me and gets like that with everybody. He saw it upset and confused me.
Mike only has a couple other friend. His other friend told me Mike is lonely and manic depressive. I believe the lonely part is most likely
true but I have no idea about manic depressive. Mike calls me his best friend due to amount of time I give him plus helping him by taking him to restaurants, gas, and occasional gifts. Mike is intelligent and off hand does not appear to have problems. Mike also lived with my brother and me for 3 months in early 2011. He moved out claiming my brother got on his nerves. I beleive he imagined this. He put himself in the woods for over a week till he rented where he currently stays. Mike told me he quit drinking but started up again about 3 weeks later. He also started smoking pot with an ex roommate over the summer. I warned him several times this person was trouble and it took him about 2 months to see this. He said he wanted nothing to do with this person anymore but after 3 months hes back on Mike's facebook. I believe he went Friday nite to this mans house for a party. I am concerned about this. Mike mentioned going to AA meetings
not long ago but now says its not really for him. He talked a few days ago about finding a new therapist. I would love to see this.
Do u think I need to encourage him to do this and show my emotions to him? He wants me to sleep close to him fairly often and wants me to hold his hand while hes drivng. We do have a good sexual relationship.
However, I just feel stressed out over his issues lately and I have been concerned about him for a long time now. A major part of me wants
to continue being there but now a small part of me feels like I need to cut back. I know he would be upset by this. When we were not speaking much a few weeks ago he said he had several dreams about me.
He told me had a dream about me the other night when I was with him.
He says he has love for me. I appreciate your guidance.
Expert:  Mark Manley replied 5 years ago.
Thanks for the information. I will be back with you on this later today.
Mark Manley and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Thank You. I want to point out I know they are his issues and not mine.
I just need guidance on how to talk better to him about getting back on treatment. Also, I find it odd he wanted nothing to do with this marijuana individual for 3 months. He even mentioned this individual upset him a good deal like 2 days ago but now he wants to communicate with him. Is this consistent with his illness?
Customer: replied 5 years ago.
I would like to add a little more info. Mike was dating a girl well over a year ago and she broke up with him. He took it hard and ended up in a hospital. He also went to the hospital with a panic attack after his landlord hinted he thought Mike stole something. It turned out the missing item was found at the landlords parent's house. The landlord made a passing remark about mike doing the dishes and mike got angry.
He broke down crying a few minutes later and ran out of the room.
I also recall Mike and I going to the beach and he went all over the beach collecting seashells. I watched how happy he was that day.
I may have a couple small issues myself but I will deal with that later.
I just want to help him now. I look forward to your answer and please take your time. I apologize if this is too long.
Expert:  Mark Manley replied 5 years ago.
Mike is lucky to have a good friend like you.
To give you my best response I need a little more information.
Are you familiar at all with Bipolar Disorder (formally called manic depressive disorder)?
Customer: replied 5 years ago.
He is lucky. I would go with him to get help any day any time.
I am not too familiar with bipolar but I have looked it up in the past.
I do not see some of the signs in him. I asked him if he has bipolar recently and he said no. Please tell me what more info you need.
I will try to give.
Expert:  Mark Manley replied 5 years ago.
This will sound harsh but:
The best way to help Mike is to be firm with him in expecting him to do his part. It is OK to help Mike but everybody needs to be careful to 'help' him vs enable him. 'Helping' him requires him to do his part. Along the lines of , "Mike if you go to treatment and take your meds. as prescribed I will help you temporarily with the some things you are having difficulty with."
For your wellbeing and Mike's I recommend you read the book 'Co-dependent No More'. This is an old classic designed to help the people who are significant in troubled peoples lives. It is addressed to those whose companions are alcoholics and while Mike is not an alcoholic the principles discussed are all applicable.
It is a tricky balance to strike between helping and enabling. It is very difficult to deal with people with a mood disorder like Depression, or Bipolar combined with substance use/abuse.
As you mentioned above if necessary you can offer to accompany him to his mental health appointments and follow up with him on his medication compliance.
Let me know if I can be of additional service.
Mark Manley
Customer: replied 5 years ago.
Please tell me how I should communicate my feelings to him best.
I am thinking of writing a small note and watch him read it or talking directly to him. I am going to try being firm but a little emotional with him. Do you think he could be bipolar?
Expert:  Mark Manley replied 5 years ago.
I am all for direct face to face communication as your first choice and then in writing if you think he is not hearing you or if verbal communication breaks down. Yes I think he could be or he may be what is termed cylothymic described bellow.
As per
By Mayo Clinic staff
Cyclothymia (si-kloh-THIGH-me-uh), also called cyclothymic disorder, is a mild form of bipolar disorder. Like bipolar disorder, cyclothymia is a chronic mood disorder that causes emotional ups and downs.
With cyclothymia, you experience periods when your mood noticeably fluctuates from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.
Compared with bipolar disorder, the highs and lows of cyclothymia are less extreme. Still, it's critical to seek help managing these symptoms because they increase your risk of bipolar disorder. Treatment options for cyclothymia include psychotherapy, medications, and — most important — close, ongoing follow-up with your doctor.
Gentle but firm is the approach. I sense, from what you have shared, you will do a great job.
Mark Manley
Customer: replied 5 years ago.
Thank you. I looked further into this condition and and I think it's possible he has it. I know this is off topic but he says he has dreams about me more than a few times now. What could this mean about our relationship? He says they are dreams of us traveling around,etc.
Expert:  Mark Manley replied 5 years ago.
First it is a good sign he is having dreams . Second it is good that they are positive. Third it is a sign he is feeling positive about your relationship. Obviously you are important to him an he enjoys your companionship. An active positive dream life is an asset to healing.
Customer: replied 5 years ago.
THANKS! Your answer makes me feel even more stronger to support him dealing with his issues. Some have told me to practically cut him off but it would cruel. He is a warm gentle person who shows me affection.
Expert:  Mark Manley replied 5 years ago.
You are welcome.
Customer: replied 5 years ago.
I spoke to Mike. He is unwilling to go seek help. He said he basically has no respect for himself. He said he could understand if I don't want to be involved with him that much anymore. He said he thinks no one has any respect for him and that he doesn't even really respect himself. It seems all he wants to is drink. I told him I need to focus on me more now. After we talked, I sent him a text stating " I am glad I made a difference in your life. I wish I could have done " He has not responded so far. Would it be wrong of me to reduce the amount of attention and help I give him? It's his choice not to change his life but it's also my choice to not deal with him that much. I am hoping he will get help but I am also concerned he will get worse without me around. He also admitted that he notices some changes in a couple other friends towards him. I believe he will start feeling very isolated soon. About 4 years ago, he took some sleeping pills and was rushed to the hospital. I just don't want to listen to him talking about booze and pot every day. I am sick of it.
Customer: replied 5 years ago.
Expert:  Mark Manley replied 5 years ago.
Good for you. No you don't have to choose to spend your time with him. Let him know you love him and that you want the best for him and that you will do anything that is in your power to help him. But stay clear that your power is so very limited because he has to be the one to take responsibility for his health and happiness. Distance under the circumstances is a good idea in my opinion.
Mark Manley
Customer: replied 5 years ago.
Relist: Other.
I am satisfied with this answer but I want a fresh look at this situation. There are new developments and I am willing to pay another fee.
Customer: replied 5 years ago.
About 2 weeks ago, Mike told me he owed his landlord 15 dollars. He asked me to help him. I agreed but I said I would give the landlord personally the cash or he can give the landlord a check. I suspected he was lying due to the fact he was too calm considering the landlord made him mad. I admit I accused him of trying to use the money for something bad. He told me to get of his car. We did not speak for about 8 days.
He texted me monday telling me he loved me. He apologized and admitted he just wanted to buy beer that. He also smokes some type of spice fake pot. He told me he gets wasted a lot. He told he feels guilty about the way he treats me and knowing the affect of his addictions on me. Last nite, we made plans to go to dinner tonite. He never called me so I texted hello. Got no answer. I called an hour later and he kept sending to voicemai. Finally, I sent a text telling him I am tired of his bullshit. He texted me back telling me to never contact him again and that I have serious issues. He claims he will change his phone number. I am concerned for him but I do not know what to do.
I also am unsure if he is serious about cutting me off. It obviously upsets me. He told me last nite he loved me and would be jealous if if another guy showed interest in me. He said not too jealous if a girl but yes another guy. My final text to him was reminding him how he admits he treats me like dirt. He then told me he was done with me.
He told me his car battery died but I asked him why he did not say that from the beginning. He had no answer. He was supposed to have lunch with another friend today. The other friend said Mike cancelled because he got to wasted last night. I know I am not perfect but does it sound like I deserve this?
Customer: replied 5 years ago.
I just submitted it. Please review. Mark Manley reviewed and answered but want a new look with the new info I provided.
Customer: replied 5 years ago.
I know you mentioned before it is quite possible he has some form of bipolar. I have read more about it and seems to sound somewhat familiar. The isolation from everyone sometimes. The feelings of guilt later on. His text reads " well I'm done. don't speak or see me any more. You got serious issues and I always knew it. Dont bother me again" I guarantee he was drinking heavily and smoking some fake pot made of potpourri and not taking his meds. However, he wants to be rid of me due to my so-called issues. His landlord believes he is unstable.