When Someone You Love Spirals Out of Control, When Do You Stay and When Do You Go?

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Both former NBA star Lamar Odom and USC football coach Steve Sarkisian allegedly suffered substance-abuse-related breakdowns this week. Odom is now fighting for his life, and Sarkisian has lost his job. (Photos: Getty Images)

On Tuesday night, news broke that former NBA star Lamar Odom was found unconscious at a Nevada brothel, seemingly of a drug or alcohol overdose. Though the two are still legally married, Khloe Kardashian left the basketball star after five years together in 2013, reportedly over his struggle with substance abuse and, primarily, his addiction to cocaine.

Odom remains in critical condition, still unconscious, with Kardashian by his side after she rushed to Las Vegas upon hearing the news.

Earlier this week, University of Southern California football coach Steve Sarkisian was fired, allegedly as a result of his own struggle with alcoholism and his violation of the school’s zero-tolerance policy regarding alcohol use. He was on his way to a treatment facility when USC’s athletic director attempted to inform him of his firing for cause.

Sarkisian, who is in the middle of a divorce, is reportedly struggling to cope with it. The 41-year-old has three children with his estranged wife.

Also this week, reality TV star Scott Disick, the former boyfriend of Kourtney Kardashian and father of her children, checked into rehab to get help for his addiction problems. His struggle with alcohol was a frequent theme in Keeping Up With the Kardashians.

We can’t pretend to know the inside details of the lives of these stars. But their situation is one we can relate to. Many of us have someone in our lives who has gone off the deep end because of substance abuse, mental illness, or other circumstances.

Your relationship changes. One of you grows distant. The other does not know whether to stay and attempt to protect, or leave to preserve his or her own sanity. If you stay, you may be miserable, but if you go, they’re on their own and you’ll never forgive yourself if anything happens to them.

And while we can only speculate about the current involvement of loved ones in Odom’s, Sarkisian’s, and Disick’s lives, we can use this moment to explore how friends and family can best support a loved one struggling with addiction — and when it is best, for their own sanity and safety, to walk away.

When Can You Tell They’re on the Brink of Breakdown?

“Frankly, it’s usually not that secret,” Gail Saltz, MD, a psychiatrist, tells Yahoo Health. “A one-time thing is a one-time thing,” Saltz explains, whereas “repeated behavior that results in harm to the person in some way, and that the person is usually defensive about” is typically an indication of addiction.

Addicts, and others with self-destructive behavior, will “say their behavior is someone else’s fault, not theirs, or say they just had bad luck. They will externalize the problem and tell you that it’s coming from sources outside and not inside of them,” says Saltz, noting that addicts will often just “straight up lie” about what happened, continually changing a story to distance themselves from any personal responsibility for their behavior.

What’s the Best Way to Help — Without Enabling?

“The thing is to be supportive by telling that person that there is a problem, that you think that there is something going on that they need to seek help for,” says Saltz. “Support can come from offering to help them find that help, to take them to that help, to discuss with them what that help might look like.”

And yet, she explains, loved ones still must be cautious of not enabling self-destructive behavior in their attempt to provide support.

Related: As Lamar Odom Remains in Critical Condition, a Look at the Dangers of Taking Herbal Viagra

“People often feel seduced into not wanting to upset the person who doesn’t want to change, seduced into doing what that other person is telling them,” she says, noting that those with self-destructive tendencies might tell loved ones that the support being offered isn’t helpful. “They’ll often say, ‘Pretend! Ignore! Look past! Believe the externalization I have created about the problem!’”

However, she says, if the person shows an interest in making a change and getting help, “you want to stay and be helpful.” It is also often worth trying to help a person with whom you have shared relationships — like children — if you feel that the hurt caused by their leaving might be greater than the self-destructive behavior itself.

“Sometimes someone who is repeatedly doing self-destructive behavior, especially when it comes to substance abuse, really [has] to hit rock bottom before making any change, if they even are going to make a change,” Saltz adds, which is why loved ones must be especially careful that their help in a difficult time is not, in fact, supporting the behavior that is causing the difficulty.

She recommends, for example, telling a loved one that you will fund their treatment but won’t fund their addiction. Let them know, “I will help you help yourself, but I will not help you otherwise.”

Most important, she explains, is being clear about how much care and love you have for the person in need, while also remaining objective and not providing that love if the person struggling is not trying to change.

“That’s not constructive for them or you,” she says.

Need help with a substance abuse problem? Call the Substance Abuse and Mental Health Services Administration hotline at 1-800-662-HELP (4357).

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