Dear Annie: I have a friend, "Marcy," whom I've known for about six years through a mutual group of acquaintances. She was very kind when my mother was alive, often coming over to help, and she has also helped with my kids. Over time we became friends. Marcy is single, on disability and doesn't drive. I'm married and work full time, and I've always tried to be accommodating and to help when I can.

Recently, she has been pressing me to drive her to a specialty clinic out of state for a consultation she scheduled on her own. This isn't a referral from her local doctor. To take her would mean three to four days off work for me and an eight-hour drive each way in the middle of winter.

A few months ago, she went to a similar clinic in another state, and it didn't offer anything more helpful than her local treatment options. She even ended up hospitalized while she was there.

I've given her other transportation ideas, but she says none of them will work. I don't want to be a bad friend or make her feel rejected, but I don't believe this trip will help her — and I simply cannot take a week off work to do it. I also suspect part of this may be mental and/or self-inflicted.

Her medical problems have increased over the past year, especially after "Elaine," the relative she lives with, began treatment for cancer. Over the last two years, Marcy has pushed away nearly everyone in our group except one or two people because they "don't have enough time for her." She nearly ended our friendship over something similar.

When Elaine and Marcy stayed with us for a while so Elaine could regain strength, I noticed a pattern: Whenever stress rose — Elaine needing treatments, plans with other people or someone else going through a hard time — Marcy would retreat to her room and soon afterward end up in the hospital. In the last six months, she's been hospitalized more than Elaine has.

I don't want to confront her harshly, especially since I'm one of the few people she has left, but I'm at a loss. Any advice would help. — Caring but Confused

Dear Caring but Confused: You've been more than a good friend to Marcy; you've been a lifeline. But even the most generous soul has limits, and it sounds like you've reached yours.

An eight-hour winter drive and several days off work for a nonreferral appointment is far beyond what any friend should be expected to provide. You've offered alternatives, and she's rejected them.

The pattern you've noticed — health crises rising with stress — suggests Marcy may need more support than friends can provide. Nudge her gently toward talking with a doctor or counselor about what's been happening. If she reacts badly, remember that a friend who requires you to sacrifice your job and peace of mind is asking too much.

You've carried her as far as you reasonably can. Now give her the chance — and the responsibility — to reach for the kind of help that can truly support her.

"Out of Bounds: Estrangement, Boundaries and the Search for Forgiveness" is out now! Annie Lane's third anthology is for anyone who has lived with anger, estrangement or the deep ache of being wronged — because forgiveness isn't for them. It's for you. Visit http://www.creatorspublishing.com for more information. Follow Annie Lane on Instagram at @dearannieofficial. Send your questions for Annie Lane to [email protected].

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