Ask Amy Amy Dickinson, Ask Amy

Amy Dickinson is a general advice columnist.

DEAR AMY: I have a lifelong friend who, in my opinion, is probably within the bipolar spectrum. There have been very worrying episodes during the past 15 years or so, and they seem to be happening more often. My friend does see doctors, including psychiatrists, but has not had a steady one (I have no idea what information she gives her doctors). She has been on different medications, but to my knowledge she has never been diagnosed as bipolar (it runs in her family). She is very intelligent and manipulative. She is divorced, and her adult children live far away. No one else seems as concerned as I am, or is willing to confront her, as that would most likely be pointless and would cause a major rift. I have been so worried about her. I have tried to be supportive, and have helped her during these crises, but after the last episode, I am feeling completely burned out. I need to protect my own peace of mind but I don’t know how to do that and also maintain contact at this point. She is like family to me, but I feel helpless. Is there a way forward?

Worried

DEAR WORRIED: You seem to have anchored to the idea that your friend has bipolar disorder. If you know a little bit about various mental health challenges and illnesses, it is tempting to diagnose people, but the fact is that you probably don’t know the full story of what your friend is dealing with.

You are not a clinician (nor am I). The best thing you can do is to urge your friend to continue on with treatment and remind her of how important it is to communicate fully with her health care team.

You should encourage her to talk with her children. If you are truly alarmed you could reach out to family members to alert them, especially if you think she is a danger to herself or someone else.

Your first duty is to your own health and well-being.

This may require that you distance yourself to some extent and detach from your friend’s problems.

Detachment might sound like this: “I’m sorry you are struggling. I care about you. I worry about you. I hope you’ll get the right kind of help.” That’s it. You don’t leap in, and you learn to say “no” when she tries to pull you in. Anchor to her qualities, not her illness.

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She is an adult. She can choose to pursue or reject friendship, advice or treatment, and you need to be strong enough to let her lead her own life.

DEAR AMY: A few months ago I broke up with my girlfriend, because she moved to Texas and I am going to school in Florida. We have remained friends since the breakup. I thought I was over her until I recently learned that she is dating again. I’m not so bothered that she is dating someone else, but I am bothered by the fact that he lives in the same place I live in. She told me she couldn’t handle the long-distance relationship between us, which is why I broke it off. How I should approach this? I feel like she hasn’t been honest with me, but I value our friendship and don’t want to lose it. Any advice for me?

Upset

DEAR UPSET: You say that you broke up with her. If this is true, then you don’t really have much of a say in how she chooses to conduct her next relationship.

Everyone is different. She may not have been able to handle a long-distance relationship with you, but is willing to have a long-distance relationship with someone else. If she is from Florida and only recently moved to Texas, then it would make sense that many of the people she knows would be also from Florida.

Sometimes it is simply not possible to maintain a friendship after a breakup. If you truly want to be friends, then you will have to accept her various romantic choices, just as she will accept yours.

DEAR AMY: I disagree with your advice to “Stuck,” who broke up with her fiance but continued to live with him because she “couldn’t afford to move out.” If she left the relationship, she should leave the household. She might have to stay in a shelter while she gets on her feet, but moving out is the right thing to do.

Disappointed

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DEAR DISAPPOINTED: Thank you for offering your perspective.