How to deal with a depressed person who thinks people are uniting against her?

Question

Let's call this person Alice.

Alice is currently in therapy and taking drugs to treat a long lasting depression. Alice is also quite egocentric i.e. likes to be in everybody's focus and tries to get attention / confirmation from the group. Alice does that by posting lots of pictures of her dog, telling everybody repeatedly about the food she brought to a social gathering (bought, not self-made) and generally likes to talk about much of her own achievements.

In small dosages I think this is fine behavior but she's very much overdoing it. Furthermore she seems to interpret the absence of such affirmation actions from our side as the presence of hostile feelings. There are times, when the group is not in agreement with her, i.e. a political discussion. While everybody else experiences this as an objective and rational discussion, she gets personal after a while and leaves the discussion because "we united against her". This is objectively false but it's the way she perceives it. From a closer friend I've been told, that Alice has a really hard time after this. I presume because she feels unfairly treated.

Under normal circumstances I would just ignore this person and move on. However, there were times where she was much easier and less prone to be hurt and I enjoyed her being around. Given her condition I also feel bad if we would cease social contact with her. However, given the reoccurring nature of these events that she manages to explode a situation after which everybody feels pissed off, I fear that her own actions might eventually lead to the scenario that she very much fears - being excluded for good. I've had a good deal of patience but recently I notice that I'm feeling fed up with the situation. Still, I suppose this is due to her sickness (depression) so ceasing contact with her would feel unfair.

Given that she already is on medication and professional treatment (therapy), how can I make Alice understand that she sometimes behaves inappropriately with us and that it puts a drain on our relationship?

Answer 1

I do not want to imply you are treating Alice unfairly or have no reason to be angered by her behavior, but I'm not really sure why you seem to have a negative reaction about her since none of what you related seems disrespectful. You could ask her to correct things with specific examples and making her a clear request, but right now, it doesn't seem like you have one. You mostly want to change her in areas she will either likely find offensive (not talking so much about her dog or achievements) or have no power on (feeling different about group being united against her).

Side note, as a person with mental disorder, I don't see a problem with ignoring attention requests you don't find appropriate. I would however not accept to have "pity friends" that only stay because they empathize with my situation. So if Alice's presence is unwanted, it's possible you'd be making her a favor by excluding her.

In case that you would want to pursue friendship with her, and help her, I happen to have experience speaking online to, in their own words, depressed people. They have in common very low self-esteem, and I believe that negative self-judgement is the root cause of many of their social problems. It's possible that what you identify as ego-centrism is only a way for her to cope with her insecurities, as depressive behavior can take many forms (see bold statements).

I usually have very heart-warming responses to denying the negative judgement people inflict themselves and reassuring them about their worth. I would suspect that spotting and denying these negative judgements, either coming from herself or your friends, could help disarm a few dramas.

An example of things you could do is to acknowledge that political discussions carry a lot of subjective values and express your opinions as such. Being less assertive (e.g. not claiming being objective and rational) could help a dissident opinion to coexist with yours without her fragile ego to feel endangered (not implying her as nonobjective and irrational).

Answer 2

By way of a disclaimer, I do just want to say that this is, of course, an interpersonal skills site, not a mental health site, but as the two are linked in your question it is difficult to talk about one without the other.

I'm not a mental health expert, but from your description of Alice, she seems to be exhibiting mild paranoia (she thinks people are "uniting against her") and attention-seeking behaviour (egocentric, constantly posting on social media). These aren't normally symptoms of depression, so my first thought is: is Alice on the correct medication? Or, another possibility: has Alice been completely truthful with you about her condition and treatment?

Of course, there are millions of attention seekers on social media, and they don't all need medication, but the fact that you defend your loyalty to Alice by saying that she wasn't always like this does suggest that all these behaviours are not part of her normal persona and are perhaps part of a condition.

All this considered, I have to answer that the most appropriate way to deal with her is to continue to support her, and, if it is in your power to do so, encourage her talk to her healthcare professional about all these feelings.

I had a friend many years ago who displayed all kinds of erratic behaviours and could be very difficult to be around at times, yet nobody - not even myself - attributed them to any kind of mental health issue, probably because none of the individual behaviours were so severe in isolation. We lost touch (he wasn't such a great friend for the reasons stated) but I was recently told by a family member of his that he was eventually diagnosed as having Bipolar disorder, and now he has the correct medication is "a different person".