Counselling for PA..advice anyone? - Pernicious Anaemi...

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Counselling for PA..advice anyone?


Hi guys, I hope you are all well as can be. I was wondering whether anyone has tried counselling to help with PA?

I've talked to my friend who suffers from it and I also think it has led to depression. I've spoken about it and was told that he will think about it.

So I've gone ahead and booked him a session 1-1. I'm mentally and physically exhausted in trying to be there and support him as all I get is cold harsh treatment :(

He doesn't seem to happy about it. I don't know if I've done the right thing but I know he would never have booked it himself. I refer to it as tough love. Any advice anyone?

I've backed off and want the professionals to support him now. I feel my support was not valued and neither am I as a friend and it's so hurtful but I have no choice but to accept that I can't take him out of this dark place. My friendship means nothing and neither does my support. Any advice from anyone who has been in a similar situation?..

Thanks in advance x

26 Replies

This is just my opinion as a B12Deficiency/ PA sufferer.

Don't take it personally - when I'm short of B12 I get snappy or cry - depression is a symptom cured by sufficient B12 treatment not anti depressants. Keep being his friend, he will appreciate it when he feels better.

If one is starving, food is the cure, counselling would not help.

Just my opinion.

Raven321 in reply to beginner1

Thank you so much. I just thought it may help him with how to cope. He does take b12 shots but isn't really helping much :(

beginner1 in reply to Raven321

Perhaps there is something else wrong as well, or he is not getting enough B12 shots.

Are you in the UK or somewhere else.

B12 treatment in the UK is very often inadequate and I've heard, sometimes, no better in the USA.


Raven321 in reply to Raven321

He takes shots every day! Or every other day and changes then regularly too.

Just because he has B12d which is being treated doesn’t mean that your friend can’t have depression due to either the B12d or any other reason. It certainly sounds like it’s time for some professional help with that depression.

All professional counsellors and Samaritans have counselling themselves to help them deal with helping those in need. Depression is terribly selfish and can drain the person trying to help. As you say, you’re mentally and physically exhausted so I think that you are right to try and hand over to the professionals and look after yourself.

Perhaps you can let your friend know that you have really tried your best to help and that you are there for them. However, it is time for professional help as you don’t feel you’ve been able to help them sufficiently to turn the corner.

Good luck!

Gambit62Administrator in reply to JanD236

JanD - I don't think I can agree with you that depression is terribly selfish if you mean that the person with depression is selfish. Depression and anxiety are both very difficult conditions to live with both for the sufferer and for those around them.

JanD236 in reply to Gambit62

No I mean the depression itself is selfish. Maybe I would have been better saying all consuming, leaving no room for thoughts of others.

Gambit62Administrator in reply to JanD236

JanD thanks for clarifying

JanD236 in reply to Gambit62

No prob. Apologies it wasn’t clear. I was trying to get over what you said about the first rule for a carer is to look after oneself......

Please dont take his rudeness personally. I know this can be difficult. As a sufferer of b12 deficiency i know i was super irritated and downright rude because not only did i not feel well but my ability to concentrate and to remember anything was aweful. I felt i had lost 50 points if IQ.

I tell you this to hopefully convey how, when deficient, it is difficult if not flat out impossible to help yourself. I didnt need a list if things to do to help myself, additional stress, worry and internal guilt, i needed someone to do them for me.

I can understand the desire to help your friend by setting up therapy but therapy wont help if there is a physical issue going on.

Has your friend's gp tested for root causes of b12 deficiency? H pylori being my issue but others include chrohns, celliac, thyroid,, ect. Injecting b12 everyday doesnt fix any other deficiencies.

Give yourself a break and make choices for yourself that include maintaining your own sanity and then get back in there and fight for your friend. He will appreciate it when he is well.


The first rule for any carer is that you have to take care of yourself first.

Its possible that the counselling may identify some coping strategies that your friend may be able to use whilst recovering but I have to admit that if someone had arranged counselling for me without consulting me I probably would have bitten their head off and not gone.

I found meditation much more useful in learning strategies for coping with stress - and still do.

Thanks guys for all your advice. I did speak to him about it before hand and he said he will consider it. But I know with him it's an ego thing and he will feel less of a man for going or booking himself. I only did it because I know he would never. I've also started the therapy myself and he knows that. Through counselling I am learning how to cope and how to deal with such behaviour when you care for someone. I also thought he will not feel singled out. I've done my best. I seriously can't do anymore. You can only help someone who wants to feel better or get well :(

If he doesn't decide to go then Thats his choice then I guess.

clivealiveForum Support

Hi Raven321

Life with Pernicious Anaemia can become an unbearable problem unless it is treated correctly and maybe more than counseling your friend needs to ensure that he is getting the right treatment.

That's brilliant Clive. Problem solved. Hmmm!

Sadly, as so many on here will vouchsafe, there is a great lack of knowledge within the medical community about what is the "correct treatment".

How often does your friend have his B12 injections?

Has his Folate level been checked? He may need to supplement.

Does he suffer with painful neurological symptoms which may well be the cause of his depression and curmudgeonliness?

The "brain fogs" and "forgetfulness" can add to his confusion leading him to "lash out" in frustration.

He may even be suffering from dementia leading to disorientation.

These are not "excuses" but reasons for his behaviour which are probably beyond his control.

P.A. is known as a "silent killer". It doesn't manifest itself so that everyone can physically see it. I have had it for 46 years and I look relatively healthy standing at six feet four but I've been down to the depths of depression on three or four occasions and not even realised at the times that the cause was probably the P.A.

I feel a brain fog coming down so I'd best say goodnight.

And on the other hand...

I - and thousands of other B12d sufferers - would give anything to have someone try to help and care like you! You are brilliant for trying and it gives me a boost just knowing that you are out there.

So many people with B12D get abuse from friends and family as well as medics who don't understand the condition.

I have learned that only perpetrators condone abuse. Being abusive is a choice - we can all be abusive but some of us learn not to be and choose not to be, no matter what the circumstances.

I hear what is being said and know first hand that the symptoms of B12d and other depressions make you feel terrible and hideous and cranky but even at my worst I was never abusive to anyone but myself. If I couldn't be kind to someone I would just withdraw and we all can do that if we choose.

Abuse, no matter how subtle, is never acceptable or justifiable.

You are being and feeling hurt and it is pulling you down towards depression but are you then being abusive to your friend because you now "have a good excuse"? I think not. I expect you are actively seeking ways to solve the problems, despite feeling crushed and helpless.

Abuse is just a behaviour pattern like steeling (and in a way they are steeling the self esteem of the person they are victimising). We are all taught it is wrong to steel and most people don't, no matter how much temptation is put in their way. Others make grey borders and may take stuff occasionally depending on the circumstances. A few deliberately steel to further themselves compared to others and some get kind of addicted to it. I just wish society was as adverse to abuse as it is to steeling!!

You can only put in clear boundaries of the behaviour that you do and don't want to cope with and be prepared to put distance between you if your boundaries are not respected. Do not soften on those boundaries for anything or your cause will be lost. When your friend knows you are serious and that those boundaries are sacrosanct, then, if he wants to be closer to you, he will respect them and moderate his behaviour. If not then you need to increase your times apart and fill that time with good things for you to rebuild yourself.

For the victim, abuse is like B12d - you need lots of the good stuff to get over the bad bits!

All that said... With frequent jabs your friend will need supporting supplements to make the extra B12 work and he will probably benefit from a broad spectrum multivitamin and mineral supplement, plus extra folate, potassium, magnesium and maybe iron.

These all help to control depression and anxiety, particularly the folate and potassium. I used to feel like I was being sucked in to a "black hole" if I was short of either of these.

And if you ever want to care for someone with B12d who will appreciate your efforts, there's plenty of us out there! x

So well put Denise - thank you.......

Hi Raven,

I’ve had clinical depression and I’ll try and explain my experience of it in the hope it helps you get a clearer picture of why your friend is behaving as he is. Please keep in mind, though, that depression is a very personal experience and I am not medically qualified in any way.

For the sufferer, depression is a dark, terrifying hole without light or hope. A complete and utter absence of hope. I felt utterly lost, I wanted to be free of the awful place I found myself in but couldn’t find a way out. I was desperate for a guide to take me by the hand and lead me back to a place of safety, normality and light. I had a guide who stuck by me through it all, my wife, but I was so lost I couldn’t see her as such at the time.

Looking back at that time now, I can no longer really understand the mental turmoil I was in. It’s like a very dim and distant memory. I remember the fear though.

Depression brings with it many things but I think the one which most people find difficult to talk about is the over-riding fear, fear well beyond what others describe as anxiety. It’s a fear of everything and nothing, that something awful is about to happen to a loved one or family member. An utterly irrational fear that the sufferer is powerless to control.

In addition to the fear there is an extremely high level of constant anxiety. It may well be with the sufferer every second he or she is awake. It dominates every thought and action.

While all of the above is going on the sufferer presents a smiling mask to the world that all is well. For a time anyway. They’re in total denial because they feel this desperate need to hide their illness, to pretend they’re ‘normal’. The stress this causes is indescribable, unbearable.

I was cold and hurtful to my wife, this was my cry for a help. A very negative way of appealing for help. I eventually grasped I had to find a positive way of asking for help, a positive way of dealing with my emotions. I also realised I needed professional help.

I’m bringing this to a close because although I haven’t even scratched the surface, it’s very long. Show this to your friend, if you wish, I guarantee at least a little of the above will resonate with him.

He is not alone.

As you’ve discovered, helping someone with depression is physically, mentally and emotionally exhausting. You must put your own needs first. You have to set limits and boundaries in order to protect your own wellbeing.

Speaking as a counsellor who has had to stop practicing because of B12 deficiency, i’d agree with previous answers that if your friend is having frequent B12 shots, there is either something else going on physically, or his depression is caused by psychological factors rather than physical ones. A good counsellor will want him to be in close contact with a GP to check out any physical causes. However we all know what a minefield that can be!!

From what you say of your friend, I agree that counselling would be a good option. He can learn coping strategies, if his depression is caused by a physical condition, or hopefully get to the bottom of a psychological one.

Counselling only works when the person wants to be there, so the hope is that the counsellor will be able to do enough in the first session to make your friend want to return. However, it is worth sticking with the process as the first few sessions are usually taken up with history taking & assessments etc before any real therapeutic work begins.

You have obviously been a good friend & I agree with you & others who have said you need to look after yourself within the relationship. However, if your friend does decide to commit to counselling, your support will be invaluable as the counselling process can be a gruelling, if enlightening process. It is worth bearing in mind that we tend to take our mood out on the people we feel safest with, so my guess would be that your friend does value you. However, you need healthy boundaries in place to keep you from buckling under the pressure.

I wish you and your friend all the very best.

Thank you so much your advice is invaluable xxxxx

I booked the session. He text me and said why did I do it when he hasn't said he is ready. So I assured him it was only because I wanted to help. I haven't heard anything since. And we text daily. He also said he has no feelings for anyone other then himself. I think that is the most hurtful thing to read off a best friend when you have been there for them for so long. That's why for the first time i have stopped contact and finally have accepted that my support is not needed, valued or accepted.

Thank you all you guys really help me so much else I would have given up ages ago. The medical professionals do NOT have a clue. I only get info off this website, it's a god send :) xx

Marz in reply to Raven321

Has your friend been tested for his thyroid ? B12 Deficiency can go hand in hand with low thyroid and Low mood. There are more receptors in the brain for the Active hormone T3 - than in any other part of the body. T3 hormone is often given to people with drug resistant depression and was well used in the 50's and 60's. It's popularity faded as it became misused when patients realised they could lose weight and so it was abused ....

Is he taking a Good B complex with the B12 injections - this keeps all the B Vits in balance. Also has he had Folate - Ferritin and VitD tested ?

The above website covers all things thyroid and may be helpful if you click onto the Signs and Symptoms page. There are over 300 symptoms linked to Low thyroid ....

Raven321...I do sympathise with you. I feel sorry for your friend too. I know that the PA made my depression worse and in fact I am wondering now if it was caused by the PA. Last week I used the B12 patches for the first time and it definitely lifted most of the depression I was trying to deal with. Hopefully you will see your friend getting whatever help he needs. Wish you all the best

Thank you xx

Hi Raven 321

You have my sympathy as I know from long personal experience how very difficult it can be to have to try to support loved ones through a deep depression. It was what forced me to grow up quickly at 13 when my father went through it and mother was recovering from a late in life birth. There never seems to be anything you can do to help as no sooner do you think you have solved one problem for them another pops up to take it's place. After 2 years of trying we were fortunate enough to get him in the care of a wonderful group of counselors and into a hospital where his problems were sorted out.

With that experience and a couple of others over the past 60 years I am convinced such problems are either solved very quickly or only with experienced professional help. Having watched father and later a sister-in-law I was able to recognise my own tendencies and how to deal with them until that is something I couldn't deal with hit me and that was solved for me by a clever psychiatrist - in just 30 cathartic minutes. I have found people, including myself, are not very tolerant of other people's attempts to help - space is better then closeness.

I try to help but recognise the need when to back off. I had a recent problem following a blood test with potentially nasty results which put me into a real downer for 3 weeks. I couldn't tell anyone around me as I didn't want to risk them being upset. I was preparing myself for the worst and how to deal with it and waiting for the mental sword hovering over my head to fall. Stopping people making firm plans and commitments was the worst as they all thought I was being plain mean. The cloud went away. The results improved so it was something else, uncomfortable, a nuisance, but nothing life changing or limiting. There was just one person who knew what I was going through and he wouldn't say anything to anyone. It could be possible your friend has something like that and doesn't want to share it with anyone yet.

Best of luck, sometime being a good friend is so difficult.

I work with disengaged teenagers, many of whom have signs of depression, but they are not in a good place to be able to talk about their feelings. One of the things I do sometimes is to show them this great little film called The Black Dog

I find having a film describe depression is much easier for them to hear than listening to a professional. There is no personal baggage attached. It is is also a help to those of us who witnesses to the pain they feel, to see why they snap at us or reject us.

Maybe you could find a way of showing this to your friend?

Thank you x

Are you sure your friendship and support do not mean anything? Remember you are his sounding board and his friend, you see him at his most vunerable, men do not like to be seen as weak and fragile something that we get lambasted with our whole lives.

He maybe pushing you away as a protection response.

He may be reading into his diagnosis and coming up with a multitude of wrong answers and to save his friends feelings he is pushing you away.

Men don't talk about their thoughts they bury them.

Unfortunately with not getting the right vitamins, the brain is not responding efficiently. The pineal gland is struggling and serotonin and melatonin is not being produced properly.

Dont give up on him

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