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My friend/roomate is bipolar and sometimes self mutilates. I want to comfort her and let her know I am disappointed in the situation without making her feel bad or like I am disappointed in her. I just don't have the words. What can I say to let her know it's not okay she cut but it's okay she had a meltdown and we will both try harder to avoid the next time. She is on medication and in therapy once a week but as her support system I feel like I often fail her. I am getting better at reading her moods and doing things to change the direction of the crashes. There are three area's I don't know how to handle yet and one of them is after the cutting.

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Cutting occurs -in generalistic terms- due to a build-up of emotional pain in a person with a mood disorder. It's basically one of the last-ditch efforts they can resort to that will trigger a release of endorphins as a temporary manner to relieve this pain.

 

There is little you can do in the moment. Once a person is depressed to that point there is little that penetrates their mind as it is overwhelmed by an emotional grief that is monstrous, omnipresent and inescapable. It's sad to think about, and scary for those not used to the concept, but how does much of anything outside oneself matter when inside there's so much pain that death itself seems like the only viable alternative? This is a phenomenon that needs treatment in the realm of medications (and healthy lifestyle choices, one must add), and as they're already in the system, cutting is a pretty good indicator that they're not doing enough.

 

Outside of the moment you have to approach the subject based on her mood. If still depressed no good can come. Once in a more decent mood, hit the nail straight-on and tell her both what you're feeling and how much of the dynamics of 'cutting' you understand. You may be able to make some headway, but don't expect much. As I said, it's an occurrence of extremes that results only from mental imbalance in the extremes. Unless you have a magic needle full of Serotonin to shoot into her head every time she hits 'meltdown', you can't stop the momentum she's already gained.

 

Finally, on the subject of the patient's actual moodswings, NEVER forget that the patient is a different person altogether based on his/her mood. Happy me can swear up and down fully intending never to cut again, but as soon as the mood alters that person is gone, and the one standing in their shoes and looking through their eyes sees and feels the world a whole different way.

 

As for your feelings of failure, don't. A support system can not save an unstable person any more than love can battle a cancerous tumor. Life is full of tribulations and hardships: taking those away from a person is to take away their life (Someone please quote that, I'm quite impressed with it ). This girl is in serious need of proper medication. I hope she's still in the process of trying combinations and isn't under the impression that this is as good as it gets, and don't let yourself be deluded as to such, either.

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