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Dear Dr Duffy,

i was hoping if you would be able to advise me about a friend that i have who seems to be lying about things. i believe that he has a mental problem and that i believe that he does not realise what he is saying. i have known him for 3 years, and he has lied with alot of confidence for example lying about countries that he has visited, when he obvious has not, jobs he has had, etc. i just want to be sure that if whether this is true or not. should i ask him further questions about the lies that he has told me, without me mentioning to him that i know he is lying. and if i do this i hope it does not make his mental state worse. what should i do? i look forward to hear from you.

Answer:

It is hard to answer this without seeing your friend. If she has no other symptoms of psychiatric illness  this is probably not about a major mental illness. This type of lying can be a part of a mental illness but goes along with other symptoms ( rapid speech, lack of sleep, irritability, false beliefs).

Look up Bipolar Disorder ( you can find it on my site) and see if she has other signs of this disorder. If so he needs to be seen by a mental health professional.

On the other hand, sometime people with severe low self esteem make up these kinds of things to make themselves  feel better.

If you really care about your friend,  gently let him know you are concerned and do not see how these things cannot be true. But be prepared for his anger.  Going along with the lies as if you believe them is not helpful to him or your relationship.

Good luck

Dr. Duffy

I am worried my brother has some kind of paranoia disorder.  He believes people are following him, listening and watching him through radio transmissions, etc.  He is not to the point where he’s totally disfunctional but he lost her job because of it and  family relations are seriously strained.  His family and  work have tried to get him to seek psychological counseling but he refuses.  What can I do to help him when he doesn’t think there’s anything wrong with him?

Thank you,
Joe

Joe,
This is always a difficult situation, trying to get help for someone who needs it but is unwilling. This happens frequently. Families often become so frustrated in situations like this because they love the person who is clearly in desperate need of treatment and feel helpless to make it happen..

 In your case, your  brother sounds like he  has some serious psychotic symptoms. That means he cannot differentiate them from reality. Psychotic symptoms can be seen in acute drug use and a number of mental  illnesses such as schizophrenia, Bipolar I disorder and others. He  clearly needs evaluation and probably medications.

Here is what I suggest. You need to use “tough love”. That is not an easy thing to do. I suggest a family meeting with your brother with one person speaking for the family. You must be together on this and speak clearly.  He should be told that he needs help and if he refuses you will no longer support him in some way. (ie money, visits etc). Try to be gentle but FIRM and stick to it. Offer to go with him to an appointment, and support him as much as you can and remind him that you love him. When you do this things might actually get worse at first but that may be necessary to force the issue. Sometimes the  situation needs to turn into a crisis for something to happen.

 At any point if your brother does anything unsafe or threatening to herself or others call the police immediately. They will make a mental hygiene arrest and take him to the nearest hospital for a psychiatric evaluation.  Remember these actions may seem drastic and harsh and your brother may get angry but in the long run they may save him from a much worse situation.

One other thing, I suggest you make an appointment with a psychiatrist or a psychiatric nurse practitioner. If you cant do that speak with his primary care provider and see if she is willing to see him and prescribe if necessary (PCP do not specialize in mental illness and often prefer not to treat them). Do not see a counselor as they will only refer him somewhere else and that will mean another appointment.

Please also remember to take care of yourself.

Good luck
Dr. Duffy.

Dear Dr. Duffy,

Sometimes you think you know someone— and you really don’t know them at all.  I thought I knew my sister- I thought her selfishness was harmless-  I had no idea that there was nothing she would not do to get her way or get what she wanted.
My sister Mary and my brother Joe were fighting twenty years ago- it was horrible.  My Father went by to check on my sister- she was screaming about our brother Joe- our Father went home and went to bed and died – right then- it was too much for him! He told our Mother that he could do something with the children when they were little- but now there was nothing- nothing he could do– I was talking to my Mother on the phone when he had the heart attack- he said her name– I was trying to get her to make him go to the hospital- he wouldn’t.
Now 20 years later- here we are again….about 2 yrs ago our Mother discovered breast cancer- had the removal and went on trying to save herself, survive.  I stayed at the hospital with her and our roles sort of changed – I  just did my best to take care of her and knew our days were limited– as we they all are, but there is something about this- it is an unbelievable reality.  The thing that happened was that my siblings did not have the same mind set– my little brother did- Bill  was the baby and they just became closer.  I think I just realized that she was my Mother – the only one I would ever have and I was going to try my best to make the rest of her days as pleasant as possible- spend time with her- I called her every morning and every night— I never was ever jealous of any time any of the others spent with her- actually I was relieved because I really worried about her.

However Mary was still up to her bad behavior. She had married an older man who  had children  she did not care for- my sister was in huge fear that her husband would die and she would have to split their belongings with his adult  children- so my sister talked my brother and law into signing a quit claim on their house.  My sister promised she would always take care of my brother in law- which did not happen- she then starting picking on him and being mean to him.  One night she even called the police to have him removed from the house.  The police said they could not do this- because they were married– so you guessed it- she started divorcing him. She ended up getting most of his money.
 I did witness all of this- and so did our Mother– it was horrible.  Then my sister started in on me- same thing – picking on me- talking bad to me– My sister called and said horrible things to me– on and on– I did not listen to anything she said- by then- I had thought she had just lost it!
Then she started picking on our Mother– yes our Mother – who by now had had cancer my Mother was devastated – so disappointed and angry at my sister— I actually said to my Mother- I will say anything you want me to – to Mary to make her leave you alone— my Mother said,”don’t you dare” my Mother said to tell my sister when she was gone- that my sister was no longer her daughter.
Recently my Mother was so upset- so I grabbed my daughter and we ran to spend the night with her.  When we got there it was 90 degrees in my Mother’s house- she thought the AC was broken- I messed with it- it was just frozen up–got it back on – turned on some fans- tried to calm my Mother- there was no calming her.  Our Mother was sick with the stress from my sister- my sister had been calling our Mother and saying horrible things to her– my sister actually told my Mother she was never going to speak to her again– My Mother told her you will probably get your wish- because I am in stage 4 cancer. Of course pneumonia set in– my Mother went to the hospital- she had lost her will to live…. our Mother died shortly after.

I was with her when she died and I am still sad- I don’t think I will ever really get over this.
Oh but now my sister is trying to steal my part of what I was supposed to inherit— it is awful…..

Thank you for listening,

Sharon
 

Dr Duffy’s Answer

Dear Sharon,

This is all very upsetting. We often have ideas and beliefs (understandably so) about what we want and should have in a family and end up being very disappointed and angry.

Your sister has been behaving badly for many years, this will probably not change. It sounds like both your parents could not give up on her (this is not unusual for parents). You however need to let her go. She will only cause you more grief.

Sounds like you did your best for your parents and it was a good thing your mom had you!

What you probably need to do now is cut off ties with your sister, as letting her abuse you more would just make things worse for you. Let yourself get angry, it is important not to let yourself be in the victim role! I suggest you find a good counselor to talk with to try to come to terms with your feelings and the things that have happened in your family.

You need to let a lawyer deal with the financial end of things and fight for your rights. You then can focus on taking care of yourself personally. You do not deserve to let your pain and anger effect the rest of your life. She shouldn’t have that much power over you!

Wishing you the best.

Dr. Duffy

Response from Sharon

Thank you very much- you are very right.  my sister keeps pulling our chain – I think because it is all she now has left of the family.
we are taking the house to a judge this week to try to force it to sell.  so we can be away from her-
she lies to people – so there is no telling what she is making up—
it is exhausting to have a toxic sister like this- I appreciate you and I know you are right on target!

Thanks again

Sharon

  I read your bah humbug blog about Valentines Day and must admit that if I were single, I’d definitely do a few of those!!
But I am not single and my husband of almost 40 years forgot last year to get me anything and said “it’s just another day.   what about me?”  this year he has been ill and not able to get out but I still feel he could do SOMETHING, like maybe just tell me something extra nice.�
  Anyway, any ideas on how to soothe myself about this? 

Thanks,

 A Reader

Hi Reader,

Thanks for your response. You know sometimes men need to be told what they should do (:. Women hate to do this as they often feel the man should think of it on their own.  When  they don’t (which is frequent)  we just get more angry and hurt. So I suggest you take the bull by the horns and tell him directly you would like to do something romantic on Valentines day and you can have a discussion about what might be good for both of you. The discussion itself may make you feel better and maybe you can come up with an idea that will please you both, think out of the box.

Happy V Day

Dr. Duffy
 

 Hi Dr. Duffy

Yes! and it worked.  thanks much!

Regards,
A reader

 Dear Dr Duffy,

Where do I begin? First, a little background: I am a 23 year-old female. I have been married for 4 years to a man that is 20 years older than I. We have had two children age 3 and a newborn. We plan to have more children. They are a wonderful family.

For several years I have felt frustrated and disappointed with life, although I realize that I am extremely fortunate and very blessed. There is an emptiness inside that seems to echo louder with time and yet I cannot put a finger on what is eating away at me.

 Earlier attempts at communicating with my husband regarding these issues have left me feeling weak, unimportant and angry. He doesn’t seem to hear me in anything that I say, so anymore I don’t say anything other than superficial conversing. While I am constantly surrounded by my immediate family I feel extremely alone.

 I have never been a morning person, however, I sleep in as long as my children will allow me and I dread the new day for the tireless effort that will be required. I love the evenings because the day is finally over and sleep offers one slight reprieve of the emptiness. Even simple tasks seem dreadfully difficult.

 I work at home but I avoid my duties and responsibilities as long as possible. The house is often in disarray and I can’t get my work done. It seems that most things that I start I cannot finish.

 One of the only things that gets me through the day is the thought of alcohol at the end of the day, after the boys are in bed. I can easily drink 20-30 ounces of wine in an evening and be able to function quite well.

My biggest regret is that I am breastfeeding, and while I try to time things in the evening so that he doesn’t nurse until the early morning hours, occasionally he wakes up before then and needs to feed. Each morning I resolve to stop drinking but the strong desire to slip into oblivion at the end of the day is too much to resist, and so the cycle continues.

 I used to create fantasy stories that I would live out in detail in order to escape the reality of this life. In a way I used it to cope with reality, and have always enjoyed the stories. However, since I have married and have children I have little to no time to engage in my fantasy worlds.

 When I do things I enjoy my husband gets angry because I am neglecting my other duties and shoots down the small enjoyment I had, so I am back to simply mulling through life and feeling miserable.

 I don’t feel that I can trust my husband with my inner feelings. I feel myself withdrawing from him. I avoid physical intimacy and have a strong desire (sometimes an uncontrollable urge) to pull back from his advances. Why do I avoid him; what is wrong with me?

•  How can I engage in life with joy and enthusiasm?
•  How can I rekindle my relationship with my husband?
•  How can I stop drinking and find something else to take its place?

 I do not want to live like this… and I pray that the Lord will help me through. If you have any suggestions, I would be very grateful.

 -Alone and desperate

Answer From Dr. Duffy 

Dear Alone,

 There are a number of things about your letter that I would like to respond to.

 First I believe you may be depressed. This could be postpartum depression or may have been present before as some of your comments suggest. Here are some things you said that make me concerned about depression.

• “Emptiness inside”
• “I used to create fantasy stories that I would live out in detail in order to escape the reality of this life”
• “The house is often in disarray and I can’t get my work done.”
• “It seems that most things that I start I cannot finish”
• “…sleep in as long as my children will allow me”
• “I dread the new day for the tireless effort that will be required”
• “I love the evenings because the day is finally over and sleep offers one slight reprieve of the emptiness.”
• “Even simple tasks seem dreadfully difficult.”

 Of course I cannot make this diagnosis over the internet, I encourage you to be evaluated by a mental health professional. You may need an antidepressant but it will not help much if you continue with the alcohol.

  Second: Your relationship with your husband. Although you start off saying what a wonderful family you have, you quickly talk about how unsatisfying your marriage is. It is certainly not the situation where you should have more children.

 My suggestion is that you tell your husband that you are very unhappy and the situation must be taken seriously or it most likely will get worse. Be honest about your feelings and worries. Couple therapy may be necessary. If he refuses to go you need to find a professional to talk to for yourself. This will help you to figure out what to do next and help you to answer your final questions.

 Third: Your alcohol intake. It sounds like you have a serious problem because you cannot stop despite multiple attempts and worries about breastfeeding. Many experts feel 2 drinks will not hurt the infant but anything over that may. (you are way over this limit!)

 The other issue is alcohol makes depression worse!  It is hard to know what comes first the alcohol or the depression. My suggestion would be to get some help to stop drinking first. This can be done through many programs and AA. You must do this and it sounds as if you cannot do it alone.

 Please get some help, for your own sake and for the sake of your children, and your marriage. I am truly concerned about you, and send you my best.

From a Reader named “Mary”

Please help me! I have been in a relationship with my live in boyfriend about 3 yrs. He is like having another child around. He does not help with things and expects me to take care of everything. He has a bad temper and although he has never hit me when he gets angry he breaks things. I want to end this relationship but when I tell him that he says he can’t live without me and will kill himself if I go. I’m scared! I don’t know what to do. I cry all the time and can’t sleep well at night.

Dr. Duffy’s response.

Mary, this is a tough situation and I can under why you feel scared. First let me tell you that unfortunately this situation is not that uncommon. Men who act like your boyfriend are often very dependent on the women they are with! They try to get what they want and need with threats of all kinds. Threatening to kill himself in order to keep you is emotional blackmail! So what to do…….

First and most important: you must be very sure you want to end this relationship. The worse thing you can do is make threats to leave in hopes that he will change his behavior. When you do this it only teaches him that you do not mean what you say. If these threats do get him to change, it is usually only for a very brief time and then the behavior starts again. So you must so some serious soul searching and make sure this is what you really want. Make sure you are really ready. Once you have done this you must put a plan in place to leave. Try not to do it on the spur of the moment or during a crisis unless you are being physically threatened!

Second: Make a plan: You must decide when you want to leave and where you will go. Many women want the man to leave the home. This is much harder to make happen (although not impossible) and the easier and safer thing to do would be to leave temporarily with the expectation that living arrangements will be settled later. Certainly who leaves the home may be dependent on who ownership. Leaving may also have some legal complications for those who are married and the advice of an attorney should be sought. If there are children involved it is more difficult but that is also all the more reason to go ahead with such a plan.

If you have already discussed your desire to leave you do not need to tell him that you are leaving until you are ready to go. In the process of leaving however YOU CANNOT COUNT ON HIM TO BE REASONABLE. Once the crisis is over and he is certain this is really the end, he may become more reasonable and able to negotiate things. Mediators are available in most areas to help separating people with just this type of issue.

Third: get the help of others. Many women are embarrassed by this type of situation and try to manage it alone. This is a mistake! Secrecy is one of the things that make blackmail effective! You must let people you trust know what is going on. Tell a friend, family members, your boyfriend’s family (he needs support too) and perhaps a professional. You do not need to reveal all the details just make sure they realize you are planning to leave and he is making threats to kill himself. A strategy that often works is to have someone he trusts with him when you actually leave. If you leave and he makes threats you may need to notify the police to check on him.

Fourth: take care of yourself. This is critical. I have a few questions here. Are you depressed? You mention crying and trouble sleeping. Now a certain amount of this is to be expected in this situation, but are you seriously depressed? This is an important distinction to make. Do you have trouble with concentration and memory? Are you anxious and feeling overwhelmed by the situation? Are you feeling hopeless, helpless and immobilized? Are you having trouble machine decisions? Are you eating? Is your energy level where it should be? Do you have a history of depression? These are some questions that might help you decide the level of your depression. Please review the symptoms of depression on the following page to help you decide if you are clinically depressed. If you are significantly depressed you may find it much harder if not impossible to leave while you feel this way. If you think this is the case you should consider having an evaluation by a mental health professional. If you are depressed there are medications and some herbs that may be of help to you. Once you feel better you will be more able to deal with this situation.

The other question I would have in this area is IS THIS A PATTERN FOR YOU? Do you have a history of getting involved in the same type of relationships? Do you seem to attract needy people (men and friends.)? Do you try and take care of everyone. Do you take care of yourself? Do you feel good about yourself? These are important questions to answer for your own emotional well being and to help with future choices.

You must remember no one is responsible for the life of another person. We all must take responsibility for our own lives. Just as you cannot cause someone to take their own life if they wish to live, you also cannot prevent it if they are determined to die. Suicide is not usually the result of a single loss, but the end of a long history of depression , problems and pain. Persons like this are in desperate need of professional help and sometimes staying with them to try and help may actually prevent them from getting the professional help they really need. GOOD LUCK!

�

About once a week I will be choosing a question from my readers to answer on this blog.

I will try to answer those that I believe will interest the most people. Send your questions to me at Dr.Duffy@PsychSense.com

Here is the first question/ Answer. Let me know your comments, follow up questions.

I was hospitalized under the Mental Health Act in 2003. Where are Mental Health records kept and by whom, for how long, and who can access them? Are records accessible by Companies, as I am concerned about my career prospects in the future?

Hi,
Mental Health records are kept by the hospital, and outpatient providers. They should only be released with your permission EXCEPT to certain places/people such as: Other medical providers involved in your care, insurance companies and perhaps law enforcement agencies.

You do not have to put any information about your mental health on employment applications if you do not wish.
Check the HIPPA laws for more information then you want on patient privacy. The hospital you were in should have a copy of their privacy policy.

By the way discrimination is illegal if you can do your job.

Good luck, Dr. Duffy