So I guess this might be a bit of a sad/frustrated rant on my part.

I have a friend I have known for almost 10 years. She suffers from mild - moderate depression and has done the entire time I have known her. In the last few years she seeks out ECT and hospital for every single life issue. If she doesnt get ECT when she requests it, she overdoses on medication until the pdoc agrees. Her depression is always triggered and she is very intermittent with therapy although enjoys group/being inpatient and is med compliant.

After her last round of ECT (bilatteral 8+ sessions) she has not been herself. After every round she has she seems to take longer and longer to recover. It has been a few months and there is no sign of the former fun an confident person she was.

She literally sits there and stares at me for hours on end. I suggest what we might do and the answer every single time, without fail, no matter what I ask her is "I dont mind". It drives me batty and we usually end up doing not much except her staring blankly at me while I try to suggest activites or engage her in conversation.

She has been a good friend to me and I am sad to be limiting time with her but I just waste any time I do spend with her because all she does is stare at me and I cant figure out how to bring back my friend.

I've questioned if she is still depressed, she says not at all. And I've questioned if she is overmedicated which she also disagrees with. She does not seem to notice the change in herself at all. She is also extremely clingy, she would rather stare at me all day than be at home alone, so, many days when I say I am not out she takes that as an invite. I would not mind her over a few times a week if she was helpful at all or even a bit of fun.

But its not. Its a chore and I feel like I am babysitting my brain dead friend

Will she ever recover?

I find it interesting that you characterize her depression as mild-to-moderate when everything you describe sounds like quite severe depression. Just because her depression is "triggered" as you put it doesn't make the depression less severe. Anyone who is so unstable that she is intentionally ODing to land herself in the hospital and under psychiatric care is not just dealing with mild-to-moderate symptoms, and it sounds like there is much more going on than depression actually.

This may or may not be the result of ECT. This could be the result of serious depression that has just become so prevalent in her life that she doesn't even see it for depression anymore. Have you talked to her about the changes you have seen in her personality? Have you set healthy boundaries around how often she comes over and how long she stays? Have you encouraged her to seek out regular therapy in order to cope with those changes and her depressive symptoms?

You know enough to know that serious depression is often a life-long diagnosis and struggle for people. It sounds like she is still in the midst of her struggle while you want her to be at the end of it; but she's not there. Are you willing and able to be her friend while she continues to struggle? Are you willing and able to change your own expectations for her in a way that is supportive of her and still nourishing to your relationship?

Lots to think about.

Originally Posted by lolagrace

I find it interesting that you characterize her depression as mild-to-moderate when everything you describe sounds like quite severe depression. Just because her depression is "triggered" as you put it doesn't make the depression less severe. Anyone who is so unstable that she is intentionally ODing to land herself in the hospital and under psychiatric care is not just dealing with mild-to-moderate symptoms, and it sounds like there is much more going on than depression actually.

This may or may not be the result of ECT. This could be the result of serious depression that has just become so prevalent in her life that she doesn't even see it for depression anymore. Have you talked to her about the changes you have seen in her personality? Have you set healthy boundaries around how often she comes over and how long she stays? Have you encouraged her to seek out regular therapy in order to cope with those changes and her depressive symptoms?

You know enough to know that serious depression is often a life-long diagnosis and struggle for people. It sounds like she is still in the midst of her struggle while you want her to be at the end of it; but she's not there. Are you willing and able to be her friend while she continues to struggle? Are you willing and able to change your own expectations for her in a way that is supportive of her and still nourishing to your relationship?

Lots to think about.

I realise triggered makes it no easier, but there are plenty of tools she could try to deal with them as they arise. Shes done the best DBT and CBT courses the state has on offer, CBT more than once, but she wont use the skills because she "doesnt remember cos of ECT" and flat out refuses to even hear reminders. If I use a skill in front of her, to calm myself, I get laughed at. She thinks my craft is childish and real depression cannot be helped by coping strategies.

She "overdoses"on 80mg of zyprexa as her "go to" as it is enough to have her medicated enough that her parents are worried enough to take her to the ER but not enough to die from - she told me this in her words on the phone after she had done it once. Seems I am also the second person she calls. First she tells her parents then she talks to me so she doesnt pass out and die until they can take her to hospital - this has happened more than once, and it is draining on me, perhaps that is selfish of me for such an old friend but it gets hard especially when I had such major depression issues going on myself. And everyone including her T and pdocs were not letting her go inpatient as they said she needed to learn to cope without it. Cue 80mg dose and she was admitted to a public ward... she hated it and discharged then threatened overdose again if she didnt get put in a private hospital... she got her way.

This is the way shes been inpatient and requesting and recieving ECT in the last 14 months. I really believe that these issues were better dealt with in therapy as she has not addressed why she reacts this way. I have tried everything I know to get through to her that she needs to practice these skills to stay stable.

She tells me every time that she loves being in hospital and how its just like a great holiday for her. I dont know why she doesnt go on a real holiday :/ this frustrates me as I feel inpatient is for those that are ill.

I regularly encourage her to continue therapy but she is amendment that ECT fixes her and she doesnt need therapy except while in hospital. I ask why she needs meds if ECT fixes her and she says so she doesnt relapse - but she has had more treatments than I can count now. She says she cant handle even a week of depression and has to get ECT to get out of it as she says nothing else helps (yet will not try anything else...)

She is completely convinced she is totally stable right now, happy even. But she does not appear that way. She is blank and so out of it and you cant even hold a semi decent conversation with her. I have told her 8 times in the last 3 days that I am not available, some days she has asked 3 times over what I am doing and if she can come "hang out" which quite literally means stare at me. I am never invited to her place, she always wants to come to mine and she regularly drinks, smokes and eats junk which she knows I had banned here. Perhaps I can confirm boundaries, so thank you for pointing that out - I am so pleased someone was able to respond and help me with this.

I am trying so super hard to build my life up again after losing my life's work, it seriously frustrates me that she will not even try, nor be more supportive of the changes I want to make. And it is so freaking hard to have a conversation. She has no input when I have some massive things going on. I really miss my friend. I have voiced my concern over the changes in her but she retorts that her family think she is better now.

I've stopped talking about any mental health in front of her now as she also seems to pick up what I am doing. She has tried twice to get me to go inpatient with her (that is why I have been so adamant not to go to hospital perhaps when I should have as she has been there). We met in different circumstances but I stupidly told her it was the best place for treatment so she switched.

I just dont have the energy to baby sit her when I have so much going on but she knows I am home and gets upset, which has resulted in ODs in the past. I dont know what to do about this My friends say she is a pest and to dump her in this life transition.

Thanks for the further information. Yeah, it sounds like she has many issues beyond depression. And honestly, I don't think ECT is really the big issue here. Yes, she may be having some personality changes because of the residual effects of ECT, but there are much larger personality issues going on. I definitely would encourage you to set clear boundaries with her. Remember, you can't fix her, nor can you get someone to fix themselves if they aren't willing to do the work. If she is using ODing as a way to get her way, don't feed into that by giving in to pacify her. That's sounds a bit more like a personality disorder than straight depression, and until the people around her hold some boundaries with her and her behavior, she will probably keep doing what she is doing. It's getting her what she thinks she wants right now unfortunately, and if her parents and doctors can't hold boundaries with her, you probably won't make much headway.

You have to decide if this is truly a friendship that is something you want to work for, or if it is a drain on you personally and you are just being used. And I don't mean she's intentionally and consciously manipulating you, but in essence, that is the reality of what she is doing with everyone from the sounds of it.

If you want to work for it, you are going to have to set very clear boundaries that you aren't going to save her from her own manipulative behaviors. You may have to set a boundary that she cannot call you for help if she OD's like this again, that if she OD's she needs to handle it with her parents and doctors, that you cannot be that person for her. She probably won't react well to you setting boundaries, but try to remember you need to do that for yourself. It is about keeping yourself safe and keeping balance in your own life. Boundaries are really for our own well-being, and other people often don't like it when we change them and hold them, but you have yourself you need to look out for. If she really values the friendship, she is going to have to be willing to meet you halfway there. Setting those boundaries and seeing how she reacts may be very telling as to whether this friendship even salvageable.

[-jimi-]

I don't know if I read in things that are not there, but I have a long long term online friend who was VERY warm, funny, quite smart in his own ways and very self aware. Along the line something inside him that he doesn't even seem aware of, took over. Instead of fighting back the ways he knew it, he has found another way, I will describe it as self hypnosis. I wonder if your friend has a similar mind.

My friend isn't happy or sad anymore, he doesn't battle anything really, he is just "OK" all the time. He as his doctor wrapped around his finger and was progressively prescribed more and more meds until he could enter zombie state. It seems this is even twofold, there is one will to self hypnotize, and something else I don't even know what it is. It is some form of abusing health care to feel taken care of. Which is very far from the strong individual I learned to know.

When I ask him, he denies he even does this. It is like a foreign entity in his brain is doing this for him. Who then hides and refuses to speak.

He does not only self hypnotize with meds, he does it with TV and food too. He can sit and watch his "favorite" TV shows all his waking hours, he can't even watch something different, it has to be sort of the same all the time. He eats the same food almost every day (and it is not good food).

I think maybe things got too bad so that he basically killed himself while still being here in some odd way. He doesn't think anymore, he doesn't remember. It is like talking to a computer that says the same stuff day after day.

I think maybe your friend abuses ETC the same as my friend abuses prescribed med. To help enter the trance like state. Where time just passes by, and there are no emotions and no thoughts.

[pachyderm]

Sounds to me as though there are some doctors and/or mental health specialists who are not helping either...

Thankyou so much for the replies to this, it has helped me think things through. I did have a big answer written but my computer died and I do not have time right now to retype but just wanted to say thankyou for helping me with this.

Jimi I wonder if you are correct as she always tells me how much she loves being given the anesthetic and loves to try and fight it off, she says there is no better feeling in the world.

Pachyderm, I agree. She's been diagnosed BPD in the past but according to her that was a bad doctor and the good doctor says its MDD. Also the "good" pdoc gives her 10mg Zyprexa prn for anxiety at the shops and has not cut off her supply ....

I would usually have her over now.. I feel mean avoiding but it is just so uncomfortable now.

[Nammu]

Actually it sounds like her parents, her doctor and the hospital she chooses are all enabling her. By putting boundaries on her you are probably her best friend and she senses that. But she needs to decide if she's going to grow up or always seek out negative attention as a way to cope with the world. She sounds like an addict desperate to seek oblivion rather than face life.

Sorry if this sounds overly harsh, from what you said that's the way I read it.

Not harsh at all mate, I appriciate the input.

She's been stable since the last round of ect in that she hasn't threatened herself since the last treatments. But she has also been not herself at all. Shes so out of it no wonder she hasn't had any episodes, she's almost oblivious to what happens around her. No longer has an opinion or much to say at all. Occasionally she will blurt out something inappropriate, it is bizarre to be talking about work and she would blurt out how many orgasms she had last night. She usedo be quite reserved with those kinds of things. Then her face goes blank and it is back to staring at me.

Yep boundaries boundaries boundaries for me. Thank you guys, good reason to look over my group work files.

I have questioned her pdocs decisions many a time and she tells me that pdoc didn't make the decision regarding ECT and that she always actively asks and seeks it. I don't think the hospital can do much if the pdoc ok'd the treatment.

I am close to going to her parents with my concerns but she is over 30 years old and i doubt I will get through to them, she calls them mommy and daddy and has no intention of moving out. Nor can she function to look after herself at all. I have had her over a lot and tried to help with life skills, she can't cook at all, not clean to save herself. I tried to teach her how to cook a potato in the microwave about 4 times and she still can't ( or won't) do it. So yes I do agree parents are enabling her. Plus they are wealthy so she doesn't have to work and knows this but is working at the moment with her parents giving an allowance.

Sorry bout posting so much, laptop is not working.

I guess also I am actually really worried about her. I was beating myself up a bit for this thread as it makes her look like a bad person, she was not always this way. She was a wonderful cheerful confident person with an opinion on most things which made our encounters fun.

I worry about her future, what will she do when her parents grow older? I feel for her siblings that will probably end up lumped with her.

Her T has said in the past that many of her issues would resolve with a boyfriend/partner which I thought was weird at the time but now makes sense. She got one and was great while wih him but it started again when they broke up and is now on the hunt for another but I have no idea how she can have a meaningful relationship when she can't hold a conversation with a long term friend.

I am concerned for her, I am sad for our friendship.

[Nammu]

I kind of wonder what she would do if committed to the public hospital. She wouldnt be able to leave ADA, and would have to learn how to deal with things if she wanted to leave, they would not allow her to OD. But it would be a moot point if they also did ECT. But no amount of therapy and meds will help until she decides to get better. Nobody can change anybody else , the person has to decide they want to change. I had a roommate like that once, if she didn't get things her way she would throw a tantrum and then went to the hospital. I moved out and often wonder what happen to her.

I wonder what would happen if you told her she couldn't come around until she was willing to use the DBT and other coping methods. A very good friend of mine did that with me. When my bipolar was flailing up she said she couldn't handle it, to stay away when I was like that. It helped me to identify some of the early signs because she would say to leave. She did it in a nice way, I knew we were still friends, it was the illness she couldn't deal with, not me. Like I said it made me more aware of how others saw me and helped me to take charge of my illness by getting therapy and meds. We had the best relationship because of that. I left the state and we kept I touch for years. We both moved a lot so at some point we lost touch. I should try finding her on the computer.

It sounds like such a hard place to be in. What ing your friend back but no idea what you can do.

She has been in a public hospital twice - both times "voluntarily". The first time she lasted 2 nights before discharging and demanding to see her doctor who was away (she was magically fixed and didn't need to be in hospital, til the day her pdoc got back and she lost the plot and got admitted to the clinic) second time her pdoc would not admit her to the clinic so she oded and she lasted one night, discharged herself and said she would kill herself if she didn't get to go to the private hospital. She has never been held against her will, all of her admissions are because she wanted to be there. I wonder if she would have a different attitude if she didn't have the luxuries of private hospitals or if she had ever been held or threatened with locked wards as I have.

I feel a bit of guilt too as I directed her to the hospital that was to be the downfall her previous hospital did not do ect. ( actually now I think if it the previous hospital was an eating disorder one and she hasnt had any eating disorder tendencies since switching)

Yes thankyou all for pointing out that I cannot help her unless she wants to change, that is something I struggle with. I tend to get mad when people will not even try and frustrated that I know I have the skills to help but cannot. At this stage I am just wondering if she will be able to hold a conversation with me and lead an adult life. I (perhaps selfishly) would like to surround myself with people who can help better me, she is not one at the moment but I dearly miss when she was.

[Bird Feeder]

Your friend sounds very manipulative and I don't think it has anything to do with the ECT. I hope you have clear boundaries for your sake.

Yep I definitely needed a reminder on boundaries. I have put some through to here already as I had more missed calls and messages from Her. Thankyou all for helping me with that. Sometimes it is hard to see when you are in the midst of it. For me it is great to be told straight out, no fluffy bs.

She wasn't like this before her first couple rounds of ECT, that's why I wonder. Could the anaesthetic or anything like that have an impact on personality? I'd argue that is the part she is addicted to.