It is so interesting how a constellation of physical symptoms may actually be manifestations of a serious mental health disorder.

I came across this picture on Facebook and it gave me food for thought. In the past year, I have lost a very dear friend because I did not realize that she was as ill as she was , with a mood disorder. Our relationship changed as she decompensated into a serious depression manifesting physically along with distorted thinking that became obvious over time. Typical of so many of our loved ones, she had no insight into her state of being and turned outward towards me, making me the villain. She took no responsibility for herself, and how undependable she had become.

One lesson for me is a reminder to rule out the physical causes of symptoms and then explore the psychiatric. Since this dear friend had a history of serious depression, it is certainly “on the table” as a cause for her physical symptoms. She had been in remission for over 20 years, during the entire time of our friendship, I had no idea what she looked like when symptomatic. Sadly, now I do. As is typical when our loved ones are not accountable for their actions, separations tend to occur.

How could any relationship resolve differences when one party refuses to examine her behavior and apologize for the hurt she’s caused?

For example, this dear friend had blind-sided me with a litany of complaints about me in the beginning of the year. I was stunned speechless. It felt to me just like when other loved ones (with serious mental illness) behaved like this towards me. I said so, too. That was our red flag. I had nothing more to say and would have been content to take a break, however she persisted. This is a long term relationship, like family, and like family, the capacity for hurting one another is great indeed. Reflecting back, it would have been prudent for me to stay with my first impression, that she was just like other family members when symptomatic, and give her the time and space to meet her illness head on. Instead, we dragged it out for a few more months and it blew up around us as our patience ran out.

So I have learned, and I share with you, as loved ones, we need to trust ourselves when it comes to identifying and dealing with symptoms. By doing so, we can reduce our own anger and hurt, and make healthier decisions for all concerned.