earlier today my girlfriend messaged me saying this: “I haven’t been feeling like myself and this week isn’t the first time I’ve felt like this. I don’t feel like my body belongs to me like it belongs to someone else and it’s scary. I tried talking to my mother about it but that didn’t work out- as usual. The more days go by, the less I feel like me. My depression is also taking over, I’m also acting up more than usual” I wasn’t sure how to answer her because I was confused. She said she didn’t know how to describe it any further but she is scared because it’s getting worse. A few things to mention is that she has Anxiety, Depression, and BPD. Were both pretty young me being 19 her being 18, so I are seeking help for her. I would bring her to a psychiatrist but our relation is long distance, being 3-4 hours away from each other. I can’t afford to drive that far and I don’t think my car could handle that. Please just give me a word of advice to help her out, anything. something that she can do to calm down and stabilize, to something that I can tell her and somewhat diagnose her.

Encourage her to seek treatment. As you said, you would take her if you could but you can’t because of the distance. That’s okay. Supporting and encouraging her from a distance is a perfectly fine approach.

I would specifically recommend that she consult with a mental health professional such as a therapist and a psychiatrist. Therapists evaluate an individual’s condition, diagnose it and treat emotional problems with counseling. Many therapists specialize in specific types of counseling. You mentioned that your girlfriend has BPD but I don’t know if you meant borderline personality disorder or bipolar disorder. Individuals with borderline personality disorder often benefit from a psychotherapeutic treatment called dialectical behavioral therapy (DBT). Individuals with bipolar disorder often benefit from a psychotherapeutic treatment called cognitive behavioral therapy (CBT). CBT is also highly effective for both anxiety and depression.

Encourage her to contact 4 or 5 therapists and to interview them over the phone. This allows her to evaluate whether or not she feels comfortable with any of them over the phone. At that point, she should choose the one with whom she felt the most comfortable. In our pandemic environment, the next step in the process would likely involve her beginning treatment via Skype or a related technology. She may prefer to attend in person, and that might be an option, depending on where she lives and what services are available.

As for meeting with a psychiatrist, she might start by contacting her primary care physician (PCP) and asking for a referral. She should report her symptoms to her PCP which would assist them in making their referral. Psychiatrists mainly focus on providing medication for psychiatric conditions. They don’t typically provide talk therapy or counseling as a therapist would. That is why she may need both a therapist and a psychiatrist. What works the best for her will depend upon her needs.

The idea that she doesn’t feel as though her body belongs to her may be a sign of depersonalization/derealization disorder. Depersonalization is the feeling of being detached from one’s thoughts, feelings, and body. Derealization is the feeling of being disconnected from one surrounding environment. The symptoms of depersonalization and/or derealization are associated with dissociative disorders and trauma histories. The symptoms are also associated with seizure disorders and certain brain disorders. Thus, she should seek the expertise of mental health professionals who can evaluate her condition, rule out possible medical problems, and develop an action plan for treatment.

You can’t treat her symptoms because you are not a mental health professional and it would be ill-advised to attempt to do so. You can be most helpful by encouraging her to undergo mental health treatment. The more encouragement and support you provide, the greater the likelihood that she will get the help she needs. Good luck and please take care.

Dr. Kristina Randle