Helping a Friend With Anxiety; Involving Her Parents is Out of the Question

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Reader’s Question

My friend has a problem. She says she has a chemical imbalance in her brain, and from everything I’ve talked about with her, I don’t doubt it. She has extreme OCD and a pretty negative self-image, all of which gather together into a huge…something like a ball of stress and pain that is ruining her life.

She’s pretty much given up, but I’m trying to help her. Unfortunately, she’s still in high school. The problem with this is that her parents are really terrible people and think she is an idiot and that she lies about all of this. So she is extremely limited in what she can do. She’s been to a therapist before, who thrust medication in her direction and was no help. (She had Zoloft, which has had little or no effect for her.)

I really want to help her out because I see how much this hurts her, and it hurts me in turn. What paths could she take to get help? Anything involving her parents is out of the question — I’ve recommended this many times already and it’s failed. In my research to try and find some way to help her, I’ve come across Cognitive Behavioral Therapy. If this is a possible solution, how would she go about getting such help without her parents being involved?

Psychologist’s Reply

It sounds like your friend has a very challenging home life but I wouldn’t be so quick to assume that her parents will not help her at all. They did take her to see a therapist at least once, so maybe they would be willing to do that again.

This time I recommend that your friend request a counselor who is willing to work with her on more than just medication. Many counselors work in conjunction with psychiatrists and family physicians so that people get both the medication and the counseling they need. Although medication may not be the right choice for your friend, just because Zoloft didn’t work out for her doesn’t mean that other medications won’t either. A good counselor can help your friend with these decisions as well as providing useful skills that can help her work toward alleviating her pain.

If you are correct that her parents will not help though, there are other avenues for help. Most high schools have counselors who assist students either individually or in groups. They can also intervene with parents so that students get the help they need. I recommend that your friend start there. She can at least talk to her school counselor and see what assistance is available.

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Another avenue for help is through reading books about anxiety, depression and self-esteem. In addition to descriptions of those conditions (geared toward helping her understand why she is feeling the way she does), there are many workbooks that provide exercises your friend could do herself.

You are correct that Cognitive Behavioral Therapy is a possible solution. CBT helps people see the dysfunctional thoughts, behaviors and emotions that are causing such harm, and then works to correct them through a variety of techniques. It is one of the most thoroughly researched and empirically validated therapies used today, so it may be a good choice for your friend.

Another option to consider is Acceptance and Commitment Therapy. ACT helps people accept painful situations, assess their own values and then commit to acting on them so that their lives will be more fulfilling. Many people who don’t find CBT to be helpful do well with ACT, or sometimes they use both approaches together.

It’s clear that you are a very caring person and that your friend is lucky to have you in her corner. Just make certain that you maintain appropriate boundaries and don’t let her burdens overwhelm you. Sometimes it can be a challenge to enjoy our own lives when someone we care about is suffering. Do what you can to help and then let the rest be up to her.

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