I would like your advice on a situation regarding helping someone.

[Twoapenny]

Hi everyone,

I've been providing online support for a young lady (15) who has been suffering from depression.  I'm going to be a bit oblique about what exactly her situation is in order to ensure there's no way of identifying her.

She'd posted for general help a couple of times, which people had responded to.  A while after that she posted a very worrying message indicating that she might harm herself.  The forum in question is similar to this one in as much that it is anonymous and members don't generally give identifying information about themselves.  With that in mind, there was no way of alerting anyone else to this young lady's condition and the only way to contact her was through the board.  After receiving no response through the forum I tried private messaging her, which she did respond to.  We've been communicating in that way for about a year now.

She's a lovely girl, very bright and very self aware.  She's had some terrible problems in her life and doesn't appear to get any help or support from her family.  Similarly, she's been/is going to various doctors, therapists, psychiatrists etc, none of whom seem to be able to help her out.  I quite regularly get emails from her in which she says she wants to die or she is researching ways to commit suicide via the internet.  Those episodes can lift again quite quickly and things can seem to level out for a bit.  I've experienced those very intense mood swings myself and know how terribly difficult they are to deal with.

I have sent her numerous links to all sorts of support groups relating to the sorts of problems she's told me about, most of which she hasn't contacted.  I completely understand that; if you're not in the right frame of mind to do these things then they just won't help so I don't mind that she hasn't contacted them, but I am pretty much completely out of ideas now and the situation seems to have got worse.

She is very focused on (and stressed out by) her education and the way she wants her future to go, so I asked her recently what sort of work she wants to do as an adult, as I wondered if there was a way of her getting there without having to take so many exams in such a short space of time.

She told me she wants to be a psychotherapist.  Obviously the route to that is an academic one, you can't start off making the tea and just learn as you go along.  So apart from it meaning there's no way to lift the academic pressure, it also strikes me as a quite unsuitable job for her to be studying towards as her own health problems would prevent her from working in that sort of field if they can't be levelled out in some way and she seems to be pretty impervious to therapy (she's on her fourth therapist in twelve months), she won't take meds and she won't contact any groups for support.

[Twoapenny]

Sorry I've split the post in two as the typing seems to get really slow the further down I get!

In essence, she seems to be avoiding doing everything that a psychotherapist would tell her to do.

I am not in any way criticising her, I have been in these situations myself and I know how hard they can be to deal with and dig yourself out of.  But I feel completely out of my depth now.  I don't want to stop supporting her - she's repeatedly said I'm the only person that listens to her and the only person she feels she can be honest with.  She's a lovely, lovely girl and very intelligent.  But I don't feel that she's getting anything like the help that she needs and I don't feel that there's anything else I can think of to suggest to her with a view to that changing.  I don't know how to respond now the next time she tells me she's suicidal because I've literally not got anything else I feel I can say or suggest in that situation.  It feels really serious and I feel I've got in over my head.

I suppose my thinking now is how do I respond?  It's clear that offering advice isn't really useful but equally feels like it isn't appropriate just to offer platitudes when someone is saying that they want to die.

My instinct with this is that, if she does want to become a therapist then she'll have to start engaging with psych services and doing some of the things she doesn't want to do.  I feel concerned that if I say that it may push her back into feeling suicidal again.  Equally she may take some notice of it as she says she trusts me.  But I know that is a very fragile thing.

So I am stumped.  I genuinely don't know what to do for the best now.  Any thoughts would be appreciated.  Dr G, if you have any thoughts on this I would be very glad to hear them.

[Hopalong]

Oh what a hard one, Tupp. I hope Doc G weighs in, too.

I find the internet frightening in this way...

How wonderful that you've helped her as long as you have.
Nothing you've done or left undone can positively guarantee an outcome.

But this is good, that you're asking Doc G.
I've read some stories about suicides being prevented by people
alerting authorities, who can then trace the poster's location through
their IP, etc. (I don't even know how all that works.)

Perhaps since she's a minor, that could be done to save her?

Hops

[Twoapenny]

Thanks Hopsie.  I didn't know that about tracing IP addresses.  That's useful to know.

I'm worried that I may have hindered her rather than helping, by offering her support that isn't actually enough (ie she really needs to be engaging with services local to her, seeing people face to face, getting proper help through counselling or whatever is most appropriate).  I'm also starting to worry about my own co-dependency issues and whether I'm over stepping boundaries.  I don't, in any way, want to leave her unsupported.  I remember so clearly a complete stranger helping me through my early breakdown.  Never knew her name or where she lived, didn't keep in touch once the crisis passed.  But she got me through some terribly dark moments when I felt so alone and no-one else seemed to want to help.  So I can understand completely where she's coming from and am more than happy to be in contact with her if it is truly helping her.  But I'm starting to worry that it isn't and that it may be stopping her from asking from help in other places now?  I'm not sure.  Am very glad to have this board to ask for help; we've all been on both sides of this sort of situation, I think, which is why I thought I'd talk it over with all of you before I do something else.

Thank you.

[Meh]

I'm rather harsh at this point in life. I think people are on the road of life alone and under random conditions. I would say if she survives then she does and if she doesn't then she doesn't

I don't honesty think there is a lot you can do unless you offer to adopt her, spend a lot of time managing her time and then pay for her to go to college where she is likely to change her mind or even drop out.

I met a prostitute who was studying to be a therapist. There is a cliché saying that people become therapists to work out their own issues.

If it makes you feel any better I have read in more than one source that the majority of people who threaten to commit suicide don't. Though I am not sure how long those people were followed up with.

Who doesn't sometimes think about ending it all?  It's very common thought for people to have.

My advice would be to do things which make you and your son healthy and happy-- and let the rest of the world figure it out for themselves.

There are many people all over the world who have problems. Many people in bad situations.

I think a young person's life has so much to do with their immediate 3-D surroundings. I mean if you like this kind of thing there are those big-sister-big-brother mentor programs but it's in 3-D.

If I were you I would let it go and find something else to focus on.

I lived with a bulimic 24 year old, at one point I started crying just because her situation was so sad. There was nothing I could do, I talked with her but that did not change anything at all. There is not even anything that the social workers/therapist she was seeing could do for her. She would have to be enrolled in some kind of expensive in-patient program that isn't covered by her Medicaid/medicare whatever she has. In the end I think many solutions come down to money and social status. She attended a church they couldn't/wouldn't do anything.

I think life is a selfish experience and all people can hope to do is improve their own plight.

There are many solutions to life's problems. But the solutions are not free and are not accessible to every person. There is competition for solutions. State of the art medical interventions, private schools versus public schools, zip codes. Ethnicity and scholarships.

To be the right person at the right place at the right time requires generations of planning or just dumb luck.

[Twoapenny]

I'm rather harsh at this point in life. I think people are on the road of life alone and under random conditions. I would say if she survives then she does and if she doesn't then she doesn't

I don't honesty think there is a lot you can do unless you offer to adopt her, spend a lot of time managing her time and then pay for her to go to college where she is likely to change her mind or even drop out.

I met a prostitute who was studying to be a therapist. There is a cliché saying that people become therapists to work out their own issues.

If it makes you feel any better I have read in more than one source that the majority of people who threaten to commit suicide don't. Though I am not sure how long those people were followed up with.

Who doesn't sometimes think about ending it all?  It's very common thought for people to have.

My advice would be to do things which make you and your son healthy and happy-- and let the rest of the world figure it out for themselves.

There are many people all over the world who have problems. Many people in bad situations.

I think a young person's life has so much to do with their immediate 3-D surroundings. I mean if you like this kind of thing there are those big-sister-big-brother mentor programs but it's in 3-D.

If I were you I would let it go and find something else to focus on.

I lived with a bulimic 24 year old, at one point I started crying just because her situation was so sad. There was nothing I could do, I talked with her but that did not change anything at all. There is not even anything that the social workers/therapist she was seeing could do for her. She would have to be enrolled in some kind of expensive in-patient program that isn't covered by her Medicaid/medicare whatever she has. In the end I think many solutions come down to money and social status. She attended a church they couldn't/wouldn't do anything.

I think life is a selfish experience and all people can hope to do is improve their own plight.

There are many solutions to life's problems. But the solutions are not free and are not accessible to every person. There is competition for solutions. State of the art medical interventions, private schools versus public schools, zip codes. Ethnicity and scholarships.

To be the right person at the right place at the right time requires generations of planning or just dumb luck.

Yep, there is nothing in there that I disagree with, Green!

I think helping people is part of what makes me happy, though.  I've had a lot of issues with co-dependency, which I'm working on, but I think part of what makes me tick is a desire to give out kindness and help others (although not at the expense of helping myself, as it has been in the past).  And I have a kind of 'pay it forward' way of thinking when it comes to my son.  He'll be reliant on the kindness of others throughout his life and I have a sort of 'treat others as I want him to be treated' thing in my head - again, not at the expense of 'the here and now' but, I don't know, there's something about vulnerable people that does really light my fire.

I think the point I've got to now is wondering whether I should just limit what I do with this young lady to a sort of platitude giving thing (sympathy, cyber hugs but no advice) or to encourage her to seek proper help elsewhere (which may make her feel like I don't want to help her anymore and make her worse, or it maybe that once she gets the right sort of help none of this will be an issue anymore anyway).

The training to be a therapist thing is interesting; it makes me wonder why people want to learn about therapy

[Twoapenny]

Sorry, the screen locked again and I had to post to clear it!

I'm wondering why people want to learn about therapy but don't want to do it themselves?  It seems a funny way of going around things to me.

I'm wondering at this point if I should make one last suggestion, which would be that she starts seeing a psychotherapist in order to clear out the stuff she needs to before she can train to become one.  And from that point offer friendly support but not make any more suggestions?

[BonesMS]

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I can see all kinds of facets with this situation.  What complicates it even more is that, legally, this child is still a minor and her parents have the final say as to what she can be permitted to do.  I've dealt with similar situations as a hotline counselor and have worked with similar situations, face-to-face, as an employee at a residential school for the Deaf.  It is NOT an easy thing to deal with and I HEAR YOU!

I've also been in that child's place, growing up, and have had the experience of one kind woman who took me under her wing when I needed a mother.  We kinda, sort of, adopted each other because she was the kind of mother I needed, BADLY, and I was the child she always wanted.  I was able to benefit from her maternal love from the age of 10 to the age of 14 when she died suddenly.  (Long story.)  Maybe that is what this kid needs....some kind of maternal love that she is clearly NOT getting at home.

I have to think some more before I can find the right words to verbalize what I'm seeing in my mind.

[Twoapenny]

(((((((((((((((((((((Tupp))))))))))))))))))))

I can see all kinds of facets with this situation.  What complicates it even more is that, legally, this child is still a minor and her parents have the final say as to what she can be permitted to do.  I've dealt with similar situations as a hotline counselor and have worked with similar situations, face-to-face, as an employee at a residential school for the Deaf.  It is NOT an easy thing to deal with and I HEAR YOU!

I've also been in that child's place, growing up, and have had the experience of one kind woman who took me under her wing when I needed a mother.  We kinda, sort of, adopted each other because she was the kind of mother I needed, BADLY, and I was the child she always wanted.  I was able to benefit from her maternal love from the age of 10 to the age of 14 when she died suddenly.  (Long story.)  Maybe that is what this kid needs....some kind of maternal love that she is clearly NOT getting at home.

I have to think some more before I can find the right words to verbalize what I'm seeing in my mind.

Yes, this is the thing, I've been on both sides of the situation myself.  She's told me I feel like a surrogate mum to her because her own mum just doesn't care.  I can identify so strongly with that.  But at the same time I've been so careful about what I say because she's technically a child and I am an unknown on the internet.  So trying to balance that line between caring and not over stepping the mark has been hard and I do feel that I'm in over my head now and, for that reason, possibly not actually helping her out.  She's feeling well again at the moment, the awful suicidal episode has passed again.  I know myself that in those well periods I'd convince myself it was all fine, then when those crashes hit there's no plan, no support, nothing's in place because once it lifts you feel like you can cope again and don't make any of the necessary arrangements.

[BonesMS]

I'm hoping Dr. G can weigh in, soon, so we can have his perspective on this as a professional therapist.  You and I have basically functioned as crisis interventionists, which is WAY different from being a professional therapist.

[Meh]

Well Two, I am sure it helps her just to know that somebody cares enough to listen and understand.

I would say just listening is enough.

We don't always know what resource is going to be real help.

She might have an opposition to authority figures. Or if people have never received real help they don't trust in the concept. Or maybe the situation is not what she is describing it to be.

Well since we don't know what her problem is it's hard to start saying if therapy will help. Therapy is more of a support than a cure in most situations in my opinion.

[Twoapenny]

Well Two, I am sure it helps her just to know that somebody cares enough to listen and understand.

I would say just listening is enough.

We don't always know what resource is going to be real help.

She might have an opposition to authority figures. Or if people have never received real help they don't trust in the concept. Or maybe the situation is not what she is describing it to be.

Well since we don't know what her problem is it's hard to start saying if therapy will help. Therapy is more of a support than a cure in most situations in my opinion.

Yes, Green, I think you are right.  I've been thinking about it over night and think perhaps neutral, opinion and suggestion free support is probably best.  I think she needs proper help (and quite a lot of it) but we need to want the help for it to make any difference; I can't do that bit for her.  A listening ear and a cyber pat on the shoulder.

[Twoapenny]

I'm hoping Dr. G can weigh in, soon, so we can have his perspective on this as a professional therapist.  You and I have basically functioned as crisis interventionists, which is WAY different from being a professional therapist.

I did realise last night that one of the volunteers at the sports group we go to is a psychologist so I'll have a chat to him about it.  I suspect the responses (as Green's has been) is to listen and do no more.  I think she needs a lot more help than I can give her and I think I'm in danger of over stepping the mark and need to take a step back and be more objective.

[Twoapenny]

Phew!  I am feeling mightily relieved!  I spoke to the psychologist I know; his feeling is that the young lady in question has trust issues and isn't able to cope with face to face meetings with people or deal with her problems at the minute (which I can relate to enormously!).  His feeling is that anonymous, online support is as much as she can handle and is therefore what she needs, so he thinks if I'm happy to keep being a friendly ear then that's enough.  I'm very relieved, I was worried that I was making things worse but he thinks I'm probably giving her all the help she can actually deal with at the minute so not to worry about it.  His only concern was that I might be taking on too much but he said he's happy for me to chat it through with him every couple of weeks so I'm not dealing with it all on my own.  I feel much better about it all now and the added bonus is that it's one of the few times I've asked for help in the real world and got some!  I usually get knocked back so this has really helped me as well as, hopefully, helping her in some way.  So thank you everyone for all of your advice and input, it's been  a really big help and I feel much better about everything now

[BonesMS]

Phew!  I am feeling mightily relieved!  I spoke to the psychologist I know; his feeling is that the young lady in question has trust issues and isn't able to cope with face to face meetings with people or deal with her problems at the minute (which I can relate to enormously!).  His feeling is that anonymous, online support is as much as she can handle and is therefore what she needs, so he thinks if I'm happy to keep being a friendly ear then that's enough.  I'm very relieved, I was worried that I was making things worse but he thinks I'm probably giving her all the help she can actually deal with at the minute so not to worry about it.  His only concern was that I might be taking on too much but he said he's happy for me to chat it through with him every couple of weeks so I'm not dealing with it all on my own.  I feel much better about it all now and the added bonus is that it's one of the few times I've asked for help in the real world and got some!  I usually get knocked back so this has really helped me as well as, hopefully, helping her in some way.  So thank you everyone for all of your advice and input, it's been  a really big help and I feel much better about everything now

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