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Many Questions About What’s Wrong

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi I have been having intuitions and seeing things as long as I can remember. Mostly gods I am a hindu in our family it was considered good to see these things and have intuitions. It was a sign of spritual maturity. My cousin on my mothers side suffers from paranoid scrizophrenia. But some how or other I was not diagnosed and not taken to dr. I finally suffered complete breakdown and was admitted to institution after being treated as out pt. I have been taking medicines regularly for 6 years now. I am well in a way and am a ok husband, father and have 3 children. Right now I am on trifluoperazine 5 mg and trihexiphenidyl 2 mg twice a day. I have been given medicines for paranoid scrizophrenia, bipolar disorder, sedatives for sleep, ocd and stress. I have been to therapist for 4 yrs. Now my problem is following:

1. My sex drive is too much according to my psychiatrist. I need to have sex atleast 5-7 times of week. We have sex almost everyday except when my wife is in her periods.We have been married for 14 yrs and still cant get enough of her. I tried to reduce my drive but I ended up seeing things and hearing voices once again. I used to be frustrated thru out day and lost my temper often. What do I do and is my sex drive ok. My wife seems ok with twice a week but does it more often because I ask her to.

2. I cant seem to enjoy life and I am always looking at negative things in life.

3. I have a cycle of temper. I start getting stressed on thursday evening and it increases till saturday when I loose my temper. And by sunday I am ok. I usually loose my temper on my wife. My dr has given me medicine for that loranzopam 2 mg but it doesnt work. What else can I do?

4. I need to educate my family and myself about the course of my disease I read “surviving schizophrenia” but it was too depressing and all I learnt how much better off I am. Can you suggest anything?

5. I have this need to talk and expess myself but cant seem to make any friends. I just have my relatives and wife to talk to. Is this normal?

6. I smoke about 15 cigarettes a day. I have this unknown fear that if I give up smoking something will go wrong. What do I do/ My wife is pushing me to give up but I am scared like hell. Thanks.

Thank you for writing to Psych Central with your questions. I will address each of them below:

  1. Sex drive: the desire to have sex once a day is not abnormal. Inequality in sexual desire is also common in relationships. It’s only a problem if one person in the relationship considers it to be a problem. You desire to have sex more often than your wife does but she may be all right with this in an effort to help you meet your needs. A couple has to agree on a level of frequency that is comfortable and acceptable to them.

    Some medications can affect sex drive. I would suggest speaking to your psychiatrist about this possibility. Your psychiatrist may be able to make modifications to your medication regimen. He also may not be willing to adjust your medication, fearing that it might endanger your psychological well-being.

  2. Negative thoughts: I would suggest talk therapy to help with your negative thoughts. Medication can be helpful for treating psychotic events but it may not be effective for negative thinking. Talking to a therapist can help you learn how to find happiness. Finding happiness is a journey and everyone needs to find what makes them happy in life. If you continue to struggle with negative thinking, consider talk therapy in addition to medication management with your psychiatrist.
  3. Anger issues: Talk therapy could also help with anger management. Anger management techniques can be very effective. Your anger issues may have nothing to do with your psychotic disorders. I would highly recommend talk therapy for this issue.
  4. Books: There are many books about schizophrenia that you may find very helpful. I would also recommend books about bipolar disorder or other serious mental illnesses. Below are six books that are highly rated:
    • Schizophrenia For Dummies by Jerome Levine and Irene S. Levine
    • An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison
    • Welcome, Silence by Carol North
    • Five Lost Years: A Personal Exploration of Schizophrenia by Christina Alexandra
    • The Soloist: A Lost Dream, an Unlikely Friendship, and the Redemptive Power of Music by Steve Lopez
    • A Beautiful Mind: The Life of Mathematical Genius and Nobel Laureate John Nash by Sylvia Nasar
  5. Social interaction: A therapist can help to determine whether or not there’s a problem with your social interaction. He or she could point out social mistakes and help you to correct them in an effective way.
  6. Smoking cigarettes: I do not believe that you should attempt to stop smoking without the assistance of your psychiatrist or other mental health professional. Your fear that you may relapse if you quit smoking may not be unfounded. It’s not that smoking cessation could cause a psychotic relapse per se. It may be that it could elevate your stress level which might in turn increase the likelihood of an illness relapse. Should you decide to quit smoking, there are medications that your psychiatrist could prescribe that can assist you in this process. A therapist can also help monitor your mood and behavior. Both your psychiatrist and therapist would monitor changes in behavior, changes in thinking, or any other affective changes that may occur during the smoking cessation process.

I also want to add that you seem to have a great level of insight. In addition, you’re open to correcting problematic behaviors, you consistently take your medication and seem dedicated to treatment. All of these factors can help you remain psychologically stable and prevent psychotic relapses.

I hope that I’ve adequately answered your questions. Good luck and please do not hesitate to write back if you have any additional questions. Please take care.

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Early Signs of Schizophrenia?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Please help me: I realize that these questions must become particularly redundant and for that I apologize. Instead of giving you a laundry list of assumptions, I will just explain how I feel and let you tell me the rest. The most noticable thing is that I often find it hard to put what I am feeling or thinking into words. I also tend to feel slightly reclusive and can never seem to socialize as I used to. I often find myself lost in thought and have tried add medicines without results. I find myself believing that my life has no meaning and no matter how well I fulfill my dreams and aspirations I will only be forgotten with time. I act out violently and do so consciously. At the time, my decisions feel like the right thing to do and I always seem to blame the bad outcome on others for not understanding me and being ignorant and/or arrogant. Even my parents just scold me and they’re supposed to be the ones who understand and know what I’m going through. I feel as if everyone functions differently than I do mentally. As if they do not realize things that I do and it always seems as if everyone is against me. whenever I notice people laughing or giggling or even just talking in soft tones,I always feel like they’re laughing at or talking about me. Always in a negative way. Due to this I have developed a particularly low self-esteem. I often feel stressed out and as though nobody else understands what that stress is like. I’m usually humbled, but my brains have always been the one thing that I can be proud of and now its as if theyre fading. I’ve been undermotivated as if nothing matters because no matter what after I die, within years I will no longer be even a memory. I always have a sense of isolation, wherever I go. If whats wrong with me isn’t schizophrenia, then what is it and how can I fix it.

You are in obvious pain. That is exactly why you should seek treatment. It could help you to feel better.

You asked whether or not you have schizophrenia. I cannot determine a diagnosis online. That is another reason why it is important to see a mental health professional. He or she can determine if you meet the criteria for any mental health disorders.

In addition, I need more detailed information from you. For instance, you mentioned that you have tried medications without results. Are you referring to psychiatric medications? Are you seeing a psychiatrist? A family doctor? More information about what you meant by the expression “have tried [to] add medications” would have helped me to help you.

You also mentioned that you act out violently. It would’ve been helpful to have an example of what you consider “acting out violently.”

Generally speaking, schizophrenia is a relatively rare disorder. It is even more rare among individuals under the age of 18. Don’t assume the worst case scenario. You may be experiencing an adjustment period in your life. Depression might also be a possibility.

The teenage years can be volatile. Individuals are beginning to explore who they are. It can be and often is a confusing and tumultuous time in an individual’s life. P. J. Ekerrett of the Harvard Mental Health Letter recently described changes in the adolescent brain as being “colossal.” In all likelihood, those changes affect how one feels on a day-to-day basis. The neurological changes in the brain add to the already challenging time of being an adolescent.

Please speak to your parents about this problem. Ask them to have you evaluated by a mental health professional. Clicking on the find help tab, at the top this page, can help you and your parents locate a mental health professional in your community.

Dr. Kristina Randle
@DrKRandle

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Relapsing and Scared

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I am hearing voices telling me that I am part of the murder club. They tell me that I am causing a hurricane soon and that it would be best if I cleansed the poison in my body out by taking all my medicines at once.

I know that I shouldn’t listen to the voices and I am trying not to, but I am also scared to tell my mom or my therapist just how much I’m struggling. I don’t want to disappoint them because I’ve been doing so well up until now.

Do you think I will be able to get through this on my own, or what else should I do. I am really scared right now.

Pete Earley, best-selling author of the book Crazy, A Father’s Search Through America’s Mental Health Madness, recently profiled the death of a much-loved mental health advocate named Glenn Koons. The story of Mr. Koons is a tragic one. He was a peer-to-peer advocate who worked with groups such as the National Alliance on Mental Illness. He was recently invited to the White House by President Barack Obama to celebrate the 20th anniversary of the Americans with Disabilities Act.

Mr. Koons had gone missing and was recently found dead by a utility worker in a small Pennsylvania town. Some believe that he stopped taking his medication, had a relapse and may have been too ashamed and embarrassed to seek help because of his high-profile status as an individual who had recovered from a mental illness.

The tragic story of Mr. Koons’s death underscores the importance of seeking help. It also highlights the reality that there is no shame in seeking help. No one is certain what happened to Mr. Koons but it is possible that his death could have been prevented. No one knows with certainty what Mr. Koons was thinking and the speculation could be completely inaccurate; however, for many people it is the fear of failure and embarrassment that stops them from getting life-saving help. This should not be the case.

Would you feel embarrassed about seeking help for a broken leg or a bleeding ulcer? I highly doubt it. The same logic should apply when seeking help for a mental illness. There is a stubborn and inaccurate belief in our society that asking for help for a psychological problem equates to being weak or to not having the willpower to handle your own problems. Nothing could be further from the truth.

Each of us faces a series of problems throughout our lives. The nature and severity of those problems varies to one degree or another but problems are a part of daily life. They are a part of human existence. Relapses do happen. You have nothing to be ashamed of. Feeling ashamed is tantamount to blaming yourself for hearing voices. The fact that you hear voices is not your fault. If your loved one were suffering in a similar manner, you would hope and expect that they would come to you for help. It sounds as though you have a supportive mother who loves you. You also have access to a therapist. Please utilize the resources that you have available to you.

Treatments are available that can decrease or eliminate your unpleasant symptoms. Get help as soon as possible. It is the only correct way to handle this situation. I wish you the best luck. Please take care.

Dr. Kristina Randle
@DrKRandle

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Forgetfulness, Daydreaming and Difficulty Concentrating

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi..I am an undergraduate student in the last year of my studies. I am an external student doign independent study. I have gone through a lot of emotional turmoil in the last few years. My fiance cheated on me with another girl which led me to depression. This year I broke out with my best friend and have intense feelings of guilt. Also since the last 2 years I was physically unwell diagnosed with unrine infections and was constantly on medicines. I always had a weak memory and needed to revise my studies frequently. But recently since 2010 I have been having severe forgetfulness isues. I just keep daydreaming all the time and sometimes I feel like my head is going to explod with the multitude of thoughts inside it. I keep forgetting my course work even after revising them so many times. I also find it very difficult to concentrate the moment i look at my book after 5 minutes i get up and start using the Internet or start calling someone. Its like I am just trying to occupy myself so i dont have to go back to work. I force my self to concentrate then my head pains so much. Sometimes I feel there is a huge basketball inside my head bouncing up and down. But i dont feel like that when i am reading a novel or simply relaxing. Since I am doing independent study I am most of the time at home.my parents wanted me to finish my education and regain my health back.I am often very lonely. I want to study but I cant concentrate my head pains and i daydream like crazy. I feel so lazy and lethargic. And often I feel depressed because of all these various thoughts that keep running in my mind. I also cant stop talking…If I dont talk I sing to myself.I feel like a volcano waiting to blow up. I also have a very short temper and snap at people. I get upset at very minor issues and end up crying which seems an outlet to my tense feelings. The only time I feel at peace is when I sleep. Do i need to visit a Psychiatrist? Or is it just me being lazy and not wanting to work? Please help me…I am desperate.

You seem to be exhibiting the signs of depression including: difficulty concentrating, inability to focus, memory problems, irritability, emotional dysregulation, and lethargy. Depression makes sense in the context of losing both your best friend and fiancé. You have endured two major life losses. Your reaction is understandable.

You have asked two questions, one of which is “are you being lazy and simply not wanting to work?” In light of your recent losses I highly doubt these explanations would be accurate. Depression seems like the more logical explanation.

Your second question is related to whether you should visit a psychiatrist. Yes, you should see a psychiatrist and a therapist. A psychiatrist can evaluate your mental health condition and determine whether psychiatric medication would be an appropriate form of treatment. A therapist could help by engaging you in talk therapy. Both could benefit you greatly.

You also mentioned that you have several ongoing medical problems. These should be evaluated by a medical doctor. Don’t neglect these problems. They may be contributing to your recent difficulties.

Receiving professional mental health treatment would be the most efficient way to deal with these issues. I’m sorry but I am not familiar with the mental health resources in your country. Hopefully there is an easy way to access these services. Please take care.

Dr. Kristina Randle

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Don’t Know What I’m Dealing With Crying

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have never seen a psychologist or a anything: I have been recently dealing with weird behavior. I have been starting fights with the people I love the most to get them mad at me and then make them say something to hurt me and then I cry, but when I cry it makes me feel better or I have to cry in order to not be mad anymore. I have also been getting angry over small issues that should have little effect on me….but lately its been having huge effects on me. I get irritated by the smallest things..and if I don’t get my way I take it out on someone else. It may sound like I’m a brat,but I feel that’s not the case because i have never experienced feelings and behaviors like this. Could it be the birth control I started about 6 or 7 months ago? I don’t know why i am acting this way all of a sudden.

Birth control medication may explain your change in mood but there may be other reasons. If I were interviewing you in person, I would explore other areas of your life to determine a possible cause. For instance, has there been a recent significant event or change in your life? Have you recently experienced a loss? Did you recently start a new job? Do you use drugs or alcohol? Are you taking any other prescription medication? Have your sleeping patterns changed? Try to think about and perhaps make a list of any changes in your life in the past several months, no matter how insignificant they may seem. Creating this list may help you uncover a possible explanation.

Journaling about your mood swings may also help. Document each time a mood change occurs. Think about what happened prior to and after the event. Write down every detail. Over time, a pattern may emerge. For instance, you might notice that after each incident you feel exhausted because you hadn’t slept well the night prior. In such a case, sleep deprivation may be part of the problem.

Most birth control medicines consist of two main hormones, estrogen and progestin, but there are many variations. Many women have less-than-ideal reactions to the introduction of hormone changes in the body. It is common for birth control medication to be adjusted, in some cases multiple times. I would suggest speaking to your doctor about your concerns. He or she may be able to make adjustments to the medication which could serve to improve your mood. In addition, it’s always important to report new changes or possible side effects about a medication to your prescribing physician.

I would also urge you to educate yourself about other types of birth control. Medications affect individuals differently. There’s a great deal of literature available about this topic and I would encourage you to read as much as you can.

I wish you the best. Please take care.

Dr. Kristina Randle

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Family hates me and treats me badly

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

I’ve been depressed since I was 9. I’m 13 now. I’ve always had real bad health problems. And my family has always treated me like a piece of crap. But recently it’s gotten worse. My grandma’s friend told my grandma a lie about me claiming I said ‘I’d cut off girls’ fingers if they came into my room! now this is a total lie. I would actually like it if a girl came into my room xD.

My grandma believed this and convinced my entire family that this was true. Then my grandma listened to another lie that my great uncle told her. He claimed that ‘I said I was going to blow my mom up’ I never said such thing. And of course my grandma believed it and convinced my family of it also. My family now thinks I’m a devil child. My grandma thinks I’m going to be a serial killer. My mom thinks I deserve to die. My dads still cool. And the rest of my family treat me like I should have never been born.

But I can’t tell my family I’m depressed cause they think that anyone who doesn’t think life is always perfect should go to hell. I’ve told a few friends about my depression and they’ve helped me a Lot. But then this happened and I just don’t know what to do anymore

It sounds like you’ve already had more to handle than someone who is only 13 should. You didn’t mention the kind of health problems you’ve had. Chronic or serious illness is enough to get anyone down. Sometimes too there are long term effects of the medicines or anesthesia (if you had to have surgery) that look and feel like depression. If that weren’t enough, for reasons neither you nor I understand, the very people who should be a source of warmth and comfort are instead blaming you and labeling you in negative ways. It must hurt terribly.

I don’t know what’s going on with the family. I do know you can’t manage this on your own. You need someone who can help your family hear you. Ideally, you would all get into family therapy. But if the family is the kind that would never consider it, do at least enlist your school guidance counselor or a trusted teacher or some other adult who is willing to help sort things out. You could also ask your doctor for a few minutes in private to explain what is going on and to ask for some help.

Meanwhile, develop an active life with supportive friends outside the family. If you feel good about yourself, the accusations and criticisms won’t hurt quite so much. You will know that you’re okay even if you don’t get the support and validation you should be getting from the family. Join a team or club. Eat right, get at least 8 hours of sleep a night, and make sure you get some exercise every day to combat the depression. Turn yourself into the kind of guy that other kids respect. Good friends are the best medicine for a disappointing family.

I wish you well.
Dr. Marie
.

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Was This Marriage Necessary?

by Diane Walcutt, Ph.D.
written by Diane Walcutt, Ph.D.

Please I need a professional reply in this matter. I am married for 2 years.I have a 14 month old baby. This marriage was settled by my parents. They chose the girl and I agreed. Before marriage I had some psychological problems. I was studying Masters in IT in Dhaka, Bangladesh in 2007.

Both my parents were abroad in Saudi Arabia. I was in dhaka with my younger brother. There was a lot of pressure of courses. There was also the challenge of making a good result set by my father. I also felt loneliness. I could not handle the pressure. I was partly responsible since I was irregular in my studies and wasted my time in games etc.

During my exam in february,2007 I became arrogant, misbehaving, used to break things out of anger,used to brag and give foul lectures, became proudy and felt all knowing. I hardly slept 3 to 4 hours a day and took food irregularly. There was also a feeling that everyone around is observing me and criticising me. My friends noticed the change and took me to a psychologist.

I failed in two subjects. In disgrace and humiliation my condition deteriorated. I had palpitition and could not sleep at night. My mother returned in March. She took me to the same psychologist. He prescribed some medicines for three months and suggested my mother to arrange a marriage for me. He also asked to put me in complete relaxation. He told that if I get a friend such as a wife my condition will improve.

In the next two months, my condition improved. I was married in June, 2007 with the expense of my father.
Both I and my wife were unaware at that time that the intention of my parents was to improve my mental health. Although I told my wife that I was mentally sick before marriage, she took me as a normal person as my condition was lot better. By the end of July, I became completely well. I love my wife and she loves me dearly and she is happy with me.

I am also happy but still there is a feeling that disturbs me that I don’t worth all of these. Once my father was angry with me for a certain matter and told me that I don’t worth any girl, had they not arranged the marriage for me I could not marry anyone by myself. This came as a shock for me. Ever since I cannot comfortably enjoy my family life. My father holds me responsible for the mental illness I suffered.

I have all the rights but I feel them granted, like I don’t deserve them! I am in debt for all of these to my parents! All my pleasures of my family life are permitted, not personal!

I make love with my wife, I adore my kids, still I feel the lack of personal freedom and right in it. Was a marriage absolutely necessary for my cure of mental illness? Could it be healed through medicines and other therapy? How much responsible was I for my mental illness?

Hello and thank you for your question:

I must confess, I don’t know a lot about your culture, only what my patients from your country have told me. I do know that mental health is looked upon as a weakness, but here in America, we have done a lot of research that has proven that it is NOT a weakness, but a real chemical problem.

It is NOT true that you don’t deserve your wife and children. It is also NOT true that your illness is your fault. However, it could be true that you were very stressed and staying up too many hours studying that you became exhausted. If you were drinking a lot of coffee and playing video games as well, that will make you lose sleep, become agitated and very difficult to live with. You can have a physical collapse, which will affect your mental health.

Your doctor may have been right in recommending that you get married. It may not have “cured” your mental illness, but you certainly did get a lot better, didn’t you? It would seem that not only did you get your health back, but got a wonderful family in the process. 

Be thankful for your loving family. Your parents obviously wanted what was best for you.

Was the marriage necessary? Maybe not, but with all honesty, there is no reason for you to feel guilty about how your life changed for the better.  Be happy with what you have been blessed with. You are a fortunate man.

I hope this helps,

Dr. Diana Walcutt

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Sister Have Schizophrenia?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

My younger unmarried sister thought that she is married with an unseen person and she feels and talks him mostly. I m here for my sister’s problem. Don’t understand what kind of problem she had and what sort of treatment should given to her. Some says that she has schizophrenia and some says that it is schizotypal. Actually we have no reliable doctor here and also our family not support us, some members are not trying to understand that she has any problem. They thought that she is acting or something like that for some unknown reason. Some of the immediate family members thought that this mental stage will recover itself as time passes.

She is an educated montessori teacher for 6 years, unmarried having no other emotional relation. Suddenly left her job 2 months before with the reason that everybody of my co workers were against me and don’t want me to job there. Now her condition is that she thought herself married with somebody which cannot be seen by any one. He give her commands in her mind how to live and she left the job because he ordered her. One day she told me that i m 2 months pregnant having 8 kids without the person who married me touched me. She feel her all the time that he is with her, she is talking him most of the time while watching any wall.

We talk to a psychiatrist and he advised to give her medicines for about one year and she should be admit in the hospital for early treatment. Now nobody in our family want to give her any kind of drug for such a long time and me myself against to admit her in hospital. Kindly advise me what to do? Is this schizophrenia or schizotypal? what kind of treatment she needs? and most important is this thing curable?? I will be very thankful to u please help us. kindly tell me what is the criteria to know is the doctor reliable or not? she saw the same person (now she thought married with) since an year, when an year back she told me about it that i saw him somewhere in the market or in any public transport i said that its all ur illusions but now she saw or feel him in her home, as she said. The other problem is that if some doctor suggests any medicines then how to make her agree to take the meds, i tried to give her some sleeping pills and she refused. She thought herself perfectly well. Also want to know that is the situation needs hospitalization??

You are dealing with a challenging though very common situation. You sister may have schizophrenia. She is clearly delusional. She has imagined that she is married to a person who no one can see. She apparently is aware of his presence and claims to be able to see him. She also takes commands from him about how she should behave.

I do not know whether she has schizophrenia or schizotypal personality disorder because I do not have enough information to offer a diagnosis. A doctor who met with her in person would be better able to judge what she may be suffering from. What is clear is that she is delusional and is refusing help because she does not believe anything is wrong. It’s very common for people with schizophrenia and other psychotic-based disorders to not be aware that they’re experiencing symptoms. Their lack of awareness can make it very difficult to convince them to seek help. Why would they seek help if they believe nothing is wrong?

You sister could benefit from antipsychotic medication. This type of medication can stop her from believing in things and people that are not real. It can stop her delusions and can help restore her to her “old self.” Antipsychotic medication may not “cure” her but it has the potential to greatly improve her life. Psychiatrists prescribe these types of medications. This is the kind of doctor she needs to see.

My suggestion is that you do what you can to get her into treatment and to take medication. Is there a way you can convince her to get help? Could your family convince her? Is there anyone in the family who could persuade her to see a psychiatrist for an evaluation? This is what she needs. Otherwise, if she is experiencing psychosis related to schizophrenia or another similar psychotic disorder, her symptoms may only intensify. She may even become so delusional or paranoid that she becomes a danger to herself or others.

Tell her that the medications can help her feel better. Explain to her that you are worried for her safety and you are trying to do what you can to make sure she is safe and well. Express to her your concern for her well-being and that medication and treatment by a mental health professional is a way for her to feel “normal” again. Utilize the help of your family or friends if you believe it will convince her to attend treatment. As I mentioned above, your situation is challenging but with your help and continued attempts to get her into treatment there is good chance she can stabilize. Please write again if you have any additional questions.

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