You Need Help: Your Friend Needs a Therapist, You Don’t Want It to Be You

Q: Even though I know it’s hideous of me, I’m really angry with my friend of a couple years for not getting treatment for her mental illness. One of the last times we hung out just the two of us, I spent hours trying to convince her to go to therapy — which is available for free in our town. I even offered to go with her if that made it easier. She’s refusing on the grounds that she isn’t worth helping (and I know this is a symptom of her mental illness).

Since then, luckily for me, travel for both of us has led to less time together, but I’m realizing that this stuff has changed our relationship more than I thought it did. She wants to hang out one-on-one but I really, really don’t want that to happen. She keeps saying she misses me (we see each other during group hangs). I don’t want to go back to the close friendship we had before because I’m afraid I’ll end up being her rescuer or therapist again and I’m working really hard on my own depression and transition right now. And again, even though I know it isn’t fair to her, I have a lot of anger. I’m positive she’s noticed something’s up with me by now.

I don’t know if or how to talk to her about any of this. Most importantly, I don’t know how to gently lower her expectations about our friendship! Any advice, or even an “I’ve been there” from anyone, would be wonderful.


A: You sound very stressed out and frustrated about this! Before we move forward and talk about that, though, I need us to be on the same page about something: when you wrote in with this question you titled it “she needs help,” but in fact the one in need of help is you! I am feeling some lack of clarity in your question around what it is exactly you’re trying to accomplish, whether you’re trying to get your friend to seek treatment or whether you’re trying to renegotiate your relationship with her. To be clear, only the latter is realistic and healthy for you to pursue!

We can’t get other people to do things in their own lives that they haven’t chosen to do, even when we (think we) know it’s what’s best for them. We just can’t! It’s one of the difficult facts of being a person that we’re all signed up to learn over and over again endlessly for our whole lives. We can’t control the actions or reactions of others; only our own. When we ask “how can I get this person to do what they need to do,” the real question is “how do I figure out how to live with the fact that they might not?”

Now that we have that out of the way, and we’re committed to focusing on your goals and options here, let’s look at what you said about yourself. Here I made a little poem out of it:

I’m really angry with my friend
I’m realizing that this stuff has changed our relationship
I have a lot of anger
I really, really don’t want [hanging out] to happen
I’m afraid I’ll end up being her rescuer or therapist again
I don’t want to go back to the close friendship we had before

It sounds like you’re actually pretty clear on where you stand! So that’s a good place to start. What I’m hearing you say is that you’re angry and being around your friend is upsetting to you — it’s not totally clear to me whether it’s because she’s actively asking you to process this stuff with her or because it’s difficult for you to be around someone you know isn’t seeking treatment full stop. Honestly, I’m not sure it matters much which it is at this point; the fact that you’re feeling so uncomfortable and resentful is a sign that whatever boundaries are in place right now, if any, aren’t working for you and you need different ones.

Based on what you’ve described here, I’m guessing that all of your thinking about needs and wants in this friendship has been about what you think your friend needs, and how much you think she needs it. Have you thought about what, in an ideal world, you actually want to provide? What kinds of support are you best equipped to provide people in your life, and what do you get the most satisfaction out of? Are you feeling ready to drive people to appointments, to listen over the phone, to be somebody who provides distraction and relief with memes and Netflix binges? Friendship — or any relationship — doesn’t have to be this thing where you pour everything into someone until you start to resent them, at which point you pull back so hard you end up kind of ghosting them. There’s another way! And it starts with knowing what you’re willing to do and what you’re not. For your own self!

After thinking through that, the next step is articulating these things to your friend. You said you don’t know how to gently lower her expectations about your friendship — you do it by talking to her. It sounds like from your question she knows you’re kind of avoiding her, and may well be relieved to have any kind of explanation for the status of your friendship at all. Having answers and information usually feels better than being in the dark, even if you’re worried that what you want to tell her isn’t what she wants to hear.

What should you tell her, exactly? It doesn’t have to be complicated; I think you’ve already said a lot of it right here.

{Maybe you’ve noticed I haven’t been as present lately;} I’m working really hard on my own depression and transition right now. {I know you’ve been going through a lot and I’ve wanted to be there for you; at the same time,} this stuff has changed our relationship more than I thought it did. {I’m feeling burned out and need to take care of myself; I’m happy to provide [type of support] but I know that right now I can’t do [other type of support]}. Thanks for understanding!

It’s scary, I know! Both because articulating needs and boundaries (I have this feeling based on your question that you maybe don’t do that often) is scary and because relationship talks about our wants and needs aren’t as normalized in friendships as they are in romantic relationships, even in queer circles. Maybe your fears will be justified! Maybe this person will freak out that you’re setting boundaries! I don’t know the particulars of their mental health situation but if you’re worried that their reaction could spiral or include self-harm or something along those lines then it might be good to have a backup plan in place, someone to call or have in the wings to step up and support them without putting you in the position of having to immediately backtrack on the boundary you just set.

Maybe, however, you will be pleasantly surprised! Maybe this friend, or other friends, will be able to show up for you in ways you hadn’t anticipated once the paradigm of you both having needs rather than just one of you has been established. Maybe you’ll find that you can envision a future of enjoying this friend’s company again — it sounds like your resentment over this situation has ballooned such that even more casual interaction with them is irritating to you, and it’s not inconceivable that that could change. Even if this relationship has become imbalanced past true repair, the muscles you’re exercising of being clear about what you are and aren’t willing to do and be for the people in your life will end up improving your other relationships. More than that, I think you’ll be happier with yourself. This isn’t just about asking your friend to be accountable for herself and her wellness; setting boundaries and enforcing them is also a way of being accountable for yourself and your own happiness, and making the decision to start doing that can change your life in ways that you may not be able to anticipate right now. Be honest with yourself and others, be loving to your friends and to you, and good luck!


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Rachel is Autostraddle's Managing Editor and the editor who presides over news & politics coverage. Originally from Boston, MA, Rachel now lives in the Midwest. Topics dear to her heart include bisexuality, The X-Files and tacos. Her favorite Ciara video is probably "Ride," but if you're only going to watch one, she recommends "Like A Boy."

Rachel has written 1017 articles for us.

14 Comments

  1. I’ve been both the therapist and the friend that NEEDS to get a therapist. It’s so hard either way. I hope you find some clarity and peace within this friendship and that both of you learn to grow and be friends at a healthy distance. 🙂

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  2. “Friendship — or any relationship — doesn’t have to be this thing where you pour everything into someone until you start to resent them.” RACHEL! What a truth bomb. It took me YEARS to be able to recognize this, and even longer to start actively doing something about it.

    TL;DR I thoroughly endorse this sage advice.

  3. I have absolutely been in this situation and I wish I had this advice then!

    Being transparent with your friends about how mental illness stuff or lack of emotional energy is affecting your ability to show up/do a thing/provide support (instead of deflecting or making excuses) is a real game changer.

  4. I wish I had this advice a year ago, maybe so much would be different today. I have been struggling to find a way to forgive someone who once meant the world to me for how much she had put on me that she would turn around and punish me for in her attempt to deal with her own emotions. It got to the point where I felt like I was trying to hold her whole world together, and I had to let it go or let it break me. I let it go, and saved myself in the process.

  5. Oh, buddy, this is why therapists are NOT supposed to have personal relationships with their patients. Both of you need boundaries, stat.

    She needs to stop dumping shit on you, like, yesterday. That’s not fair to you. You’ve got your own stuff to deal with, and this isn’t your job. It sounds like you feel like you’re in over your head. But also: man, I could’ve written the counterpoint to this letter when I was younger. (“How do I get my friends to stop armchair diagnosing me with random shit?” Later, when things were worse, “how do I get my friends to stop yelling at me for still being sick?”)

    If she’s gonna get therapy it’s gonna have to be a thing she does for herself. You can tell her that. But yeah, you guys need a break.

  6. I was in an extreme form of this situation a couple of years ago. Two things I want to add to Rachel’s excellent advice:

    1. Be prepared for you friend to react negatively when you set boundaries (because it will probably feel like a rejection to her), but STICK TO YOUR GUNS. Taking care of yourself and your own mental health absolutely must come first, and it does not mean you’re selfish or a bad friend.

    2. If their reaction does spiral into self-harm or worse, this is absolutely 1000% NOT YOUR FAULT. You are not a mental health professional, you are not responsible for any other person’s mental well-being, and trying to be so is unsustainable and will eventually result in both of you tanking. Your friend may even be less motivated to seek out the professional help they need if they think they can continue to have their emotional needs met (or partially met) by you.

  7. I had this problem with an ex. I wanted so badly to help them out of their depression, and hoped so much that the work I had done for myself could be a stepping stone for them to get out of that situation. It wasn’t. I helped them find a counselor and had my own sessions along with them, found them a doctor to help with their medical issues, and gave resource after resource and spent countless nights playing the therapist and philanthropist, hoping that maybe with enough time and patience they would come around and view themselves as I saw them. I tried to be as supportive as possible, to give them what I had needed during my darkest times.
    You know that phrase “you can lead a horse to water but you can’t make it drink”? You can give someone all the resources and chances and all your love and time, but if they aren’t willing to make those efforts for themselves and put in the work, nothing you do will make much difference. You can’t passively beat depression. It has to be an active choice in which you hold yourself accountable. While medications and coping mechanisms and community support help treat it, it’s not something other people can do for you. That work has to be done yourself.

    As hard as it is, it’s okay to take a step back and tell someone “I can’t do this any more.” You cannot help others effectively if you aren’t taking care of yourself, and you shouldn’t risk relapsing at the expense of others.

  8. Thank you.

    I did this for a friend, for about 9-10 years and then, I pulled back completely because I realised every call was causing me pain. It was not just that I listened to her, and she didn’t want to listen to me when I talked (which I agree was mostly boring history or philosophy) and also–I was more comfortable with writing and very bad with phones or even F2F talking* (though we used to spend a lot of time together initially until I had to move away for work), and she thought my mails were pretty much to be ignored unless it concerned her.

    I think we had a very big communication gap, and I was pretty bad at it, so mostly my fault; except she did keep making fun of me for everything I did or do as a sign of friendship.

    So, well, I wrote to her explaining everything (which she didn’t understand) and broke up.

    She has a lot of issues with her family, so I worry about her from time to time; but I don’t think contacting her to check on her will help since she seems to think me calling her is me not considering her needs but only mine.

    So… I have completely let it go for now.

    *I realise this makes me pretty bad friendship material. But, I get to thaw out in around 2 years, if you don’t turn a deaf ear to me over that duration (which, unfortunately, she did). 🙁

  9. I think the advice here is spot on. I was in a similar situation with a friend, who was actually getting therapy, but who also turned every single time we hung out into a therapy session for her and texted me constantly every single day as well. I repeatedly tried to set boundaries, and she overstepped them, and I was trying to set those boundaries so I could help her better – so instead of texting me multiple times a day and getting anxious and angry at me when I didn’t reply until the end of the workday, I suggested putting all her thoughts into an email that I would respond to at the end of the day. She agreed that would be a good idea, but didn’t even try to do it.

    Eventually she got very hurtful towards me (she got resentful towards me for not being able to deal with her emotional needs while I was grieving for a friend who killed himself) and we officially fell out. When I tried to offer a way for us to continue the friendship by saying I was happy to hang out with her in a group but didn’t want to continue seeing her one-on-one, that was the end of it. She tried to badmouth me to other people, but everyone knew how it had actually gone down.

    Basically, a real friend will respect your need to set boundaries like that, because they also care about you. If your friend gets mad about you trying to step back, then that’s probably a sign that this isn’t a good friendship.

  10. As someone who has been on both sides of this – oh boy howdy do you not deserve to feel as such. Supporting someone is not the same as taking everything on for them, and it’s totally unfair. The absolute best thing any of my friends or partners have done is stand up for their boundaries.

  11. Yup. Only realized this one after doing therapy myself. I think what gets normalized is this idea that emotional intimacy is the same thing as a therapeutic relationship, then everyone gets caught up in blaming themselves when emotional intimacy runs out.

    Like, acknowledging your own shortcomings or contributions to maintaining shitty shitty relationship dynamics doesn’t make the other person justified for overstepping boundaries. Even when we have a hard time articulating boundaries, there are still people who would rather ask for forgiveness than consent and that is not our fault.

    Love to everyone.

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