Dear Prudence,
One of my best friends of over a decade, “Grace, ” has long struggled with very specific mental health issues. I’m not a professional and I generally have no interest in diagnosing people, but it’s so clear to me that her behavior aligns with OCD. For example, she’ll obsessively check the stove and door locks, catastrophize over very small issues, and exhibit magical thinking about how her personal good or bad behavior can influence how long her loved ones stay alive. She recently called me in tears because she sent a mildly passive-aggressive email to a colleague and she was imagining it going viral online for some reason and destroying her career. We talked about it for over an hour. I’m still haunted by the time I stayed with her because she had thoughts of hurting herself when she got COVID—she both felt like it was cosmic retribution for some terrible evil she had committed and also spiraled out about possibly killing the mail carrier she’d just said hello to from 30 feet away.
She knows the way she feels isn’t typical, but I think she lacks the perspective of how deeply this is affecting her life. I’ve watched her self-sabotage her career and relationships again and again, turning to pop remedies like weighted blankets, herbal tinctures, and unlicensed healers instead of therapy. I believe in the concept of self-care and nontraditional modalities, but you just can’t self-care your way out of such a profound struggle.
Here’s the problem: Grace’s mom is a jerk, and uses Grace’s symptoms as the scapegoat to cover up her unkindness. Basically, “You’re crazy and just need to be medicated. The way I’ve behaved is totally reasonable.” So the idea of seeking a diagnosis and getting medication help has been weaponized against her. Her narrative now is, “My mom is an asshole and everything she has to say is incorrect and mean-spirited,” which isn’t untrue—but as someone who loves her, I also really want her to seek professional help and consider medication. Is it reasonable for me to sit her down and explain that from my perspective she truly needs professional help? Obviously, I don’t want to alienate Grace and lose her trust, but at this point, the situation is dire enough that I think it’s worth the risk. How should I go about this?
—No One Wants to Hear Their Mom Is Right