Dear Doctor
My best friend is a cancer survivor (her father had died of the same cancer a few years back and she had then wished that she had died not him, and got the cancer within a year). She is 40 (my age), successful and has her own posh house, full time maid and lives alone. I stay over at her house very often at her behest (she gets very upset when I go back to my house for a day or two) so have observed the following symptoms up close:
• Tension, inability to control anger, lack of life satisfaction
• Sleep problems
• Headache, chronic pain and migraine
• Low and depressed mood, frequent crying spells, tearfulness, increase fatigability, negative thinking, ideas of self harm (increased at PMS)
• Suspiciousness, unusual and odd thinking, irritability, self absorbed behavior with family members
• Overspending in bouts (typically clothes, later doesn’t wear purchases), increase energy at times – goes for tennis or jogging at 5 am or late evening (constantly told by mother that she is unattractive and over weight, that she is a failure in relationships that is why men leave her)
• Ideas of increased self importance due to owning her own posh house and having a full time maid at one’s beck and call: yells if any command is not obeyed instantly – thus expects implicit “obedience” from everyone around her, even strangers e.g. mall/restaurant service/etc.
1st Major problem with ex-boyfriend: not letting go of “abusive relationship”
She was dating a guy Amitav 4 years ago who got engaged to her without telling his parents, then she got cancer so was in touch with an old boyfriend (now married) which led to various issues. Amitav has not held a job since then, was sponging off her constantly as she paid for all their holidays, meals, bought him expensive gifts. I finally got her to leave him a few months back (lived with her for a full month to support her), but he kept chasing her and has now got very increasingly abusive in his emails and sms to her (calls her whore etc). He abuses her so badly that she falls sick and her periods get either infrequent or happen too often. One day I came home and she had actually invited him over, saying never mind I love him it’s ok. She talks about him every day under some excuse or the other, despite my telling her that she needs to put him in the past. Finally he has stopped but now she misses his attention. Yesterday she screamed at the maid because she was late coming back from her first visit to family, called her a bloody bitch and then was screaming her head off full day at home. At night she knocked on my door at 2 am, dissolved into tears and requested me to sleep next to her as she was missing Amitav very badly.
2nd Major problem with family/maid: unreasonable and short tempered
She is very short tempered and abusive with her close family, and snaps at the tiniest opportunity, and flares up when they say anything to her (wanted to borrow ragged jacket for US trip from niece, sister said it would not suit her so she lost her temper and bought/carried 4 jackets with her on trip). She screams at her full time maid for no reason and flies off the handle. I find it very difficult to witness her temper and she gets angry that I am not supporting her as she feels she is justified as the maid or family members who are the one misbehaving. She keeps citing examples where she has done a lot for the family and feels that they constantly misbehave with her. They are fed up with her short temperedness.
3rd issue: Now facing problems at work: dark mood swings/suicidal thoughts
She has now started facing problems at work as the top management does not like her interference and she is getting suicidal. She gets black moods lying in bed crying her eyes out saying she doesn’t want to live, made worse by her infrequent spotting period. She screams so badly that I find it very difficult as I don't like people screaming but I don't want to leave her as she has become emotionally dependent on me. She keeps crying for her old ex even though he is abusive with her as she feels he loved her and she will not get anyone else. She is exhibiting clear addiction to him. Yesterday she confided at night that she kept calling and smsing him as she was feeling lonely, thankfully he hadn’t responded. Please suggest further course of action.