Q. My girlfriend (29) suffers from frequent rages over trivial incidents. She is paranoid about the intentions of friends and complains about having no friends or lasting relationships. Often she cannot recall significant conversations or events and suffers from migraines. She has admitted to having a past drinking problem, which seems to be under control. One time she was intoxicated and could not remember calling me in the middle of the night. Her grandmother was diagnosed with Bi-polar. Her mother has a history of alcoholism and infidelity. She knows there is a "problem" but refuses to seek therapy. Her only sense of constant obligation is towards her pets (horses). She says she was shy as a child and horses were her only companions. She can be social but has alienated many people.

I am growing weary and depressed. What is going on?

A. Thank you for your inquiry. From your account, it sounds as if mental illness and alcoholism may be a part of your friends genetic history. This increases her likelihood of developing these types of problems throughout her life (and especially during times of significant change and emotional distress). Unfortunately, the symptoms you described may be part of many disorders/syndromes so I'm not able to tell you anything more defined. However, in terms of helping, it sounds as if you may be the one constant source of support for her at this time. You may want to discuss your concerns for her, for her moods, for her relationship problems, etc.. and ask her whether she wants to work together with you to improve those things. She may have interpersonal needs and emotional needs that she has a hard time verbalizing to others. With increased trust and confidence in you she may begin to share these feelings with you. When the time is right, discuss her feelings about seeking therapy and what would need to be different for her to feel confident and trusting enough to get involved with a qualified therapist. Best wishes.

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