and Addressing Sudden Behavioral Changes in Friends

Mental disorders

Hello doctor, my friend used to be very normal and got along well with us until he started working part-time.
After that, he seemed to be affected by some stressors and began experiencing extreme mood swings, alternating between crying and laughing.
Eventually, he started to harass girls, such as asking our female classmates to help him with procreation, and even asked strangers to do things for him.
He also makes strange and nonsensical statements, considering himself a deity or claiming to see Jesus.
It seems that his family is unwilling to address the situation.
What symptoms might this be, and how should we handle it?

Niming, 20~29 year old female. Ask Date: 2022/11/18

Dr. Li Guanying reply Psychiatry

From your letter, it is clear that you are experiencing discomfort and distress due to concerns about your friend and the pressure of mental health symptoms.

1.
Facing an uncertain future, psychosomatic disorders are common in modern individuals.
This is a chronic condition that requires long-term treatment for recovery.

2.
Psychosomatic disorders are chronic illnesses that have periods of exacerbation, remission, recovery, and relapse.
More than half of the patients may experience a recurrence even after symptom relief.
Due to individual differences in constitution, your friend's situation requires medical attention, and the appropriate medication will take time to determine.

3.
In terms of pharmacological treatment, each primary medication requires 4 to 6 weeks to assess its efficacy.
It is advisable for you to note the duration and frequency of any discomfort symptoms you experience.

4.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, anesthesia-free, highly safe treatment option that does not require hospitalization and can improve anxiety and depression issues.
Your friend should discuss the psychosomatic aspects thoroughly with their physician during follow-up visits.

Our clinic has outpatient services available from Monday to Friday, both in the morning and afternoon.
I recommend considering a visit to the clinic for a personal assessment of your symptoms, allowing for a collaborative discussion to determine the best course of action for you.

Wishing you mental well-being,
Dr.
Li Guanying, Psychiatry

Reply Date: 2022/11/18

More Info

The sudden behavioral changes you are observing in your friend could be indicative of several underlying issues, including psychological stress, possible substance abuse, or the onset of a mental health disorder. It is important to approach this situation with sensitivity and understanding, as your friend may be experiencing significant distress.

Firstly, the erratic emotional fluctuations—such as alternating between crying and laughing—can be a sign of mood disorders, including bipolar disorder or major depressive disorder with mixed features. These conditions can lead to unpredictable emotional responses and behaviors that may seem out of character for the individual. Additionally, the inappropriate comments and actions, such as making sexual advances towards female classmates or claiming to have divine experiences, could suggest a disconnection from reality, which may be associated with psychotic disorders or severe anxiety.

The fact that your friend is exhibiting behaviors such as demanding help from strangers and expressing grandiose beliefs (e.g., seeing himself as a deity) raises concerns about possible psychosis. This could be a symptom of a serious mental health condition, such as schizophrenia or schizoaffective disorder, particularly if these beliefs are persistent and not situationally appropriate.

Given that his family seems unwilling to address the situation, it may be challenging for him to receive the help he needs. However, as a friend, there are several steps you can take to support him:
1. Open Communication: Approach your friend in a non-confrontational manner. Express your concern for his well-being and let him know that you are there to listen. Sometimes, individuals in distress may not recognize the severity of their situation, and having a supportive friend can encourage them to seek help.

2. Encourage Professional Help: Gently suggest that he speak with a mental health professional. You might offer to help him find resources or accompany him to an appointment if he feels comfortable. Emphasize that seeking help is a sign of strength, not weakness.

3. Set Boundaries: While it’s important to be supportive, it’s equally crucial to protect your own mental health. If his behavior becomes too overwhelming or harmful, it’s okay to set boundaries. Let him know that certain behaviors are unacceptable and that you care about him, but you also need to take care of yourself.

4. Involve Others: If you feel that his behavior poses a risk to himself or others, it may be necessary to involve other friends or family members who can help intervene. Sometimes, a collective approach can be more effective in encouraging someone to seek help.

5. Educate Yourself: Understanding mental health issues can help you better support your friend. Familiarize yourself with common symptoms and treatments for mental health disorders. This knowledge can empower you to have informed discussions with him and others about his behavior.

6. Be Patient: Recovery from mental health issues can be a long process. Your friend may not respond immediately to your concerns or suggestions. It’s important to remain patient and continue to offer support without judgment.

In conclusion, the behaviors you are witnessing in your friend are concerning and warrant attention. While you can provide support, professional intervention is crucial for addressing potential mental health issues. Encourage your friend to seek help, and be there for him as he navigates this challenging time. Remember, mental health is a complex field, and it’s essential to approach these situations with compassion and understanding.

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