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I'm looking for some advice to help a friend of mine. I wasn't sure where to look until I googled a few things and found this place.

I'll apologise in advance for the lengthy first post. I really have no idea how to start this out so if I seem as though I am rambling I really do apologise it will make sense somewhere in the mix of things.

I'm trying to help my friend out but am having a hard time getting him to try new things which is a large part of the problem. We've spoken about it together and have come to some sort of conclusion that it may be something to do with social anxiety and depression or something similar.

As of now he hates being around people in any way. Most of the time he refuses to go where there will be people e.g. stores, family parties, school (he dropped out after 10th grade because of this), outings with just myself, pretty much anywhere except for his bedroom. He also refuses to talk on the telephone with people he doesn't know well which limits it to about 5 people who he will talk to on the phone. Calling up a phone company to ask for bill information is pretty much impossible for him.

He has trouble holding a conversation with people because he just does not know what to say. He says that he is scared of being around people but is not sure why I think it's more of an anxious thing as he describes being nauseous, nervous and sweaty around other people. Because of this he doesn't want to get a job for fear of having to be around people. He knows that he needs a job it's just that he cannot get passed the initial feeling he has when being around people. I've suggested doing an online degree or something so that he could get into a job that he will need little contact with people and can continue to work on the underlying problem but he doesn't really take to that idea.(if anyone has suggestions of jobs that have minimal contact with people please share!! Especially ones he could start right away)

Also he has problems sleeping. He just cannot fall asleep too easily and when he does he wakes up several times during the night. The most sleep he gets a night is around 3-5 hours of broken sleep.

He did smoke marijuana and said that when he smoked it made him feel motivated and he wanted to do things such as getting a job. However, we recently came to an agreement for him to quit to see whether or not it would help any. There have been a few times when I have convinced him to take a two week or longer break from it and on those times it really didn't make things any better.

I've tried convincing him to see a doctor but it's someone he would have to talk to and he's very apprehensive about it. He thinks he would get nothing out of a doctor, that they would either tell him what he already knows or put him on meds. However, I think he could at least get somewhat of a definite diagnosis rather than guessing at it.

I've suggested alternative medications and treatments but again they are things he is apprehensive about.

Does anyone have any ideas on how I can help or how he can help himself because he really does want to get over this it just seems as though it is too much for him.

Thanks in advance I know it's long but I am just really looking for some help here.

David Baxter PhD

Late Founder
Re: Looking to help a friend. Possible SA??

There are several things he can do that would benefit him a great deal more than smoking weed - that may well make him feel more relaxed temporarily but in fact exacerbates the problem over the long run.

One of the SSRI medications would be much more helpful. Often, with anxioety disorders, the patient does quite well on a lower dose than is usual for depression, which means many of the possibloe side-effects can be avoided. Any family doctor should be able to prescribe and monitor these medications.

Perhaps printing out this thread would be reassuring to him.


I have had social anxiety related problems similar too, but not quite as extreme, and much more so when I was younger.

Just want to say that in my experience, smoking marijauna made things worse for me. It made me more isolated and paranoid of peoples motives. Thats why I quit smoking it a long time ago. In my experience I think it does not help at all.
But, it may have different effects on different people.

Daniel E.

The socialization approach to hikikomori ["acute social withdrawal"] treatment views the problem as one of socialization rather than mental illness. Instead of clinical treatment in a hospital, the hikikomori is removed from the original environment of the home into a shared living environment and encouraged to reintegrate into social groups through daily activities with other hikikomori who are already in various states of recovery; this approach shows the person that they are not alone in their condition and appears to be successful for most cases.

Some ideas regarding treatment that come to mind after reading the above quote:

- Group therapy in addition to individual therapy
- Living with roommates rather than living alone or with parents
- Going to college in person even if on a part-time basis or supplemented with distance learning.
- If he lives in the US: going to a GED-prep class if he hasn't taken the GED exam already as a substitute for high-school graduation

Regarding more general feelings of anxiety and depression he may have, exercise can be very helpful and can help with sleep. The same is true of antidepressants, of course, and, music can help, too, though usually not as much as therapy, medications, and exercise. It seems these more general feelings of despair, hopelessness, etc. may need to be addressed before he feels hopeful enough to work on socializing.
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