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A troubled friend

 
 
plank
12:38 / 04.03.02
Ok, so basically a long standing mate of mine came down to London this weekend for a big party that we were having, only to confuse and worry everyone (well, me) by behaving in a very odd way.

For someone who I've always known as lively, sociable and self confidant, he was being: extremely vague, seemed to have difficulty in making any kind of decision (from choosing a drink in the pub to deciding when to cross the road) without prompting from me or other people, responded to my questions with mono-syllabic answers or with peculiar non-verbal facial gestures which I could not make head not tail of, and spent most of the night standing on his own and staring into space. At one point I asked him outright if he was on drugs (which was almost funny considering that I was), because he just looked completely smacked out. In short, he was not on this planet.

Unfortunately, we were not really in the right environment to attempt a major heart to heart conversation. Although I've only seen him about three or four times since October last year, he has deteriated very noicably. I tried to extract some information from him, and got as far as finding out that he hadn't really spoken all during January, and that he considers his ability to now string half a sentence together as an improvement. His parents have told him to see a therapist, but he either does not want to or does not think he needs to.

There is something seriously wrong, and it doesn't take a genius to work it what it is. He spent most of last year doing an internship at an architectural firm in New York. From what I can gather, it sounds like an absolutely incredible experience. He sorted it all out himself, went out there with next to no money, met some amazing people, worked in a bookshop to make ends meet, lived in numerous cupboards in Manhattan, everything. And so it was that in the very final week of what must have been a quite profound year for him personally, that he witnessed the WTC attacks.

Before he left my house yesterday afternoon. I told him he should speak to a professional. He insists he's alright though, even when he quite clearly isn't. I told him to at least go back home and speak to his parents, but he drove back to uni in Manchester.

I can't think what else could be causing his decidely weird behaviour other than some long delayed/repressed trauma stemming from September 11. Does this sound like an accurate assessment? Furthermore, what should I/can I do to help him out? I'm convinced that this is some kind of mental illness that needs to be addressed sooner rather than later, and I'd be really grateful for any advice or thoughts barbeloids could dispense.
 
 
01
15:03 / 04.03.02
I'm no psychologist but it sounds like he has some sort of obsessive compulsive disorder. If it's related to witnessing the WTC disaster I'm not sure, but it could be as it is an anxiety disorder. Maybe he's trapped in some loop of behaviour that in his mind keeps something just as terrible as the WTC bombing from happening. For the same reason that people with obsessive compulsive disorder check their curtains 50 times a night. They feel that if they don't, something horrible will happen to them or a loved one.

[ 04-03-2002: Message edited by: 01 ]
 
 
Ganesh
16:53 / 04.03.02
OCD doesn't usually arise that quickly in someone who's previously been well. I'm guessing depression, quite a severe episode.

Ideally, he should see either his own GP or the student health service doctor in Manchester. Chances are he'll need antidepressant medication in the first instance with either counselling or more formal cognitive behaviour therapy afterwards, depending what's going on.

If he absolutely refuses to see a doctor, you could try suggesting to him that he takes St John's Wort. It's an over-the-counter herbal preparation that basically works the same way as antidepressants but is seen as more 'natural' by many.

If his parents (or Uni colleagues) become seriously worried about him (if he starts talking about suicide, say, or holes up in his room for weeks on end, seeming paranoid), they should discuss him with the student health services. If necessary, a doctor could visit him at home and (worst case scenario here) decide whether he's detainable under the Mental Health Act.
 
 
BioDynamo
17:31 / 04.03.02
Ganesh, I'd like to ask you how you feel about posting replies to questions like this one? I'm sure you've gone it over yourself..
Taking into account that most people on the board feel you are a positive authority on certain issues, how do you feel responding to specific cases with rather limited possibilities to meet the person in question and make a more thorough analysis? How does this situation affect your reply?
Are you afraid of, by answering one question like this, on-line, making people expect answers and being bombarded with questions?
 
 
Ganesh
17:40 / 04.03.02
Worries me slightly, but I guess I know enough about the subject to give answers which are, to me, reasonably generic and 'best guess' (in this case, for example, depression is by far the most likely explanation, followed by undisclosed drug use, and so on). If I were sticking my neck out on 'riskier' subjects (advising on, ooh, cardiac drugs or something) I'd be more circumspect - and, naturally, getting the individual to local medical/psychiatric services for a proper assessment is almost always the best option.

In terms of being bombarded with questions, I generally find this sort of clinical scenario - where I'm offering an opinion on a single situation - easier than the looser 'what is depression' type threads.
 
  
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