The following issue is all too easy to ridicule, flame, or misconstrue; I hope someone out there will take it seriously.
I have a close friend in his late 30’s who seems to have become “job-phobic.” That’s my term for it, and it’s not a very good one. He’s not exactly afraid to work. In a way he “hates” work: but what that amounts to is that he can’t find an occupation that keeps his juices flowing. Typically he will work for a few weeks at some low-level job (which is all he really applied for, though he has a much higher background in terms of training), quit, and then spend months on unemploment, or collecting disability (for diagnosed depression), or getting financial help from his family. He’s unmarried. He’s been on various combinations of prescription anti-depressants (zoloft, prozak, depakote, about a dozen others all told) over the last five years. He can’t afford any kind of long-term talking-therapy (ie, a psychologist), and so has to make do with county psychiatric support–a seven minute visit once a month. He’s usually amiable, but over time has started speaking very slowly and deliberately: even feeding himself seems laborious. He sometimes has anxiety attacks; mostly he just sleeps 10-12 hours a day in widely varying cycles. Since moving into a poorer urban area, he has been drifting into recreational drug use (mostly painkillers): he says it’s the only way he can feel good for any span of time at all. His libido is near-zero.
I’m not asking here for a “diagnosis.” Obviously this is some sort of depression. In some (not all) ways, it suggests Chronic Fatigue Syndrome. He experiences any restriction upon his time as invasive, and most work-related tasts as unbearably boring. I’m convinced that he has a problem that is at least partly, maybe primarily, physical in nature–a physical illness. What HAPPENS to people with illnesses like this “in the long run”? Is he likely to wind up on the street? In jail? A suicide?
I wonder how many of our street people and other “unworthies” are like this? Telling such a person to "buck up, “try harder,” “develop a better attitude,” blah blah blah is about as effective as telling someone with a shattered leg to stand up and walk.
Is there such a thing as career counseling for a person with this kind of impairment? Is there a way to find real psychologists who do “pro bono” work on occasion? (I would never recommend a case of this severity to a community-center MFCC or LCSW type therapist.) Anything out there?
Preface: I am not a psychologist. But I fraternize with wannabes.
I don’t think your friend has a job phobia. A phobia, basically, is a fear of a thing or situation so great it interferes with a person’s ability to live a normal life. Your friend has no fear of being employed; he’s just reluctant, almost unwilling, to be employed. I would also say that he lacks knowledge of what he really wants to do, and that he lacks motivation, proper attitude, and a sense of responsibility.
Of course, that only would apply if his only problem was his employment pattern. But there’s a lot more to your friend than that, and I think you know it.
The changes in his eating and sleeping patterns, sluggishness, and unhappiness-- these are classic depression symptoms. The recreational drug use can’t be good for him, either.
I know you said you didn’t want a diagnosis, but, frankly, I don’t think this fellow’s employment prospects can improve until the possiblity of him having depression is addressed. He needs to seek treatment for that, and for his drug addiction. Right now, whether he can get and hold down a job is the least of his worries.
You can help your friend by looking into treatment for him. I’m not positive, but I would think that there are places that can and will concurrently treat depression and substance abuse problems.
Tell your friend there is no shame in needing the kind of help he (IMO) obviously needs.
They don’t make a big deal about it, but most Catholic hospitals will write off any portion of a treatment bill that the patient cannot afford to pay. By far the most of this is done with drug/alcohol counseling (which is probably NOT where to start) but they would also have inpatient and partial-day services where they would work with your friend on a number of levels. He really has to want to get well, and have some faith that other people want to help him. If he doesn’t have both, its not worth wasting anyone’s time with right now.
One thing that definitely helps is to find some interactive activity that allows for a progression (that is, you get better at it) that the subject can involve themself in. Even if it is a stupid waste of time, as long as they can care about it enough it will help focus their nervous energy while the recovery process happens. Don’t try to confuse this with job training or anything useful at all, or he may resent it just for being such a thing.
I slowly climbed out of a year-long depression while I played a MUD. Whatever works.
I should have made clear that I have been trying to help my friend for several years now as these symptoms worsened: I’m the one that hooked him up with the county psychiatric system, which has at least provided him with medications that seem to have kept him from totally bottoming out. He says he recognizes that he has problems, that he wants to get better, to feel good, etc; and that his drug use is some part of the problem.
It’s my impression–maybe just a notion–that he needs a year or so of weekly psychotherapy by a real professional before he can move forward in his life. As he has only disability income right now, and his family is tapped out, and I’m trying not to be either a “rescuer” or “enabler” (it’s a weakness of mine)…finding a (let’s be blunt) free psychologist with a specialization in issues of depression looks like the only answer. So do Catholic hospitals usually offer psychologists? (He’s Catholic, by the way.)
Plus his Driver’s License can’t be renewed due to outstanding tickets. Plus, plus, plus-- Some of you know what it’s like. Do they ever get better??
Just passed my 1 yr employment anniversary (not at the same job unfortunately) but before that I had a good solid 2 yrs of unemployment. Dropped out of college, moved around alot, your basic avoiding anything resembling a healthy life.
My thoughts are these. His situation is extremely unstable, the long sleep times and different schedules are the dead giveaway. Guessing he probably doesn’t get out much, and when he does its not for long. this kinda thing from my experience either gets better or gets worse, no real in-between.
As far as helping him, no easy answer here. Firstly, on some level he needs to want to get better, without that I don’t think anything else will work. The second thing I would say is for him to have a long-term goal. Doesn’t have to be big and fancy, or even job-related, for me it was that I could go back to college…haven’t actually done that yet, but that thought, that hope is what really gave me a future.
Third is structure. The sleep schedule has to stop, its extremely destructive. pick a schedule, preferably early and stick to it, extremely important IMO, a wierd sleep schedule just destroys any opportunity for success.
Lastly is the hard part. getting and holding a job won’t be easy for him, like I said above I spent 2 yrs w/o any income supported by family before I STARTED getting better. My thoughts are with you.
I have a little experince with this as I went through a long and really devistating<SP?> bout with severe clinical depression.
#1. Finding the right meds is a hard thing. I took alot of stuff and after 2 years found the meds that work for me.
#2. Getting the person to get outside and do anything is really important. It may sound trivial but accomplishing any task, such as just checking the mail or going to the store, will help. It sounds stupid but I felt so much better when I accomplished paying my bills on time.
#3. Related to #2, schedule stuff with this person and make him stick to it. This maybe hard but do it. When I was really bad all I wanted to do was hide from everyone. It is a common symptom of depression.
#4. Depression can take years to get really bad. It took me somehing like 10 years to get really bad. The longer he goes without effective help the worse the chances. I realize he’s gone through alot of shrinks but I went through 5 before I found the right Doc.
#5. The more people involved in trying to help him the better. At the same time make sure everone involved understands that this is an illness. As someone else said, telling a depressed person to pull it together or just work through it doesn’t work. In fact it makes the person worse because it lowers their self-esteem.
Hope this helps. I will think about your friend (I’d pray but I am an Atheist). If you have any questions feel free to email me.
If he’s suffering chronic fatigue, depression and other symptoms that suggestion Chronic Fatigue and Immune Deficiency Syndrome (CFIDS), then he may be incapable of working. It comes in varying degrees of severity, and some are unable to live a normal life while others manage to keep working and don’t seem as affected.
If he’s got all the symptoms of CFIDS, but is also suffering pain, I’d suggest he ask his doctor about Fibromyalgia Syndrome (FMS). To treat him, they’ll stick him on Zoloft, so not a lot is going to change but it might help to give his condition a name.
If he was depressed before he started getting fatigue, etc, then I’d say it’s caused by the depression. Treating the depression will treat the other problems.
There are a bunch of links on the FMS Support Group website at http://www.mbtree.com/fms - you might be able to find some useful information on CFIDS, FMS and depression.
Thanks all. Prayers count whether you believe in (a) God or not.
He does have a smallish degree of pain as one of his many symptoms. Though that may have to do with a lot of time in the prone position.
I suppose I was hoping somebody had a referral to “your local Association of Depression-Psychologists doing Pro-Bono Work.” Maybe a little unrealistic. Just a tad.
I’ll keep checking this topic until it has faded irrevocably into deep background.