One of my best friends is very depressed. The reasons for the depression are understandable: she is recently unemployed; her husband, with whom she does not get along at all, recently took a new job without consulting her and the salary is barely enough to pay for his commuting; they have no savings; and so she is worried about going bankrupt or becoming homeless. As far as I can tell, I’m her only close (in relationship, not in distance) friend. She does have a therapist. She sends me several emails every day. I try to respond to most of them. I try to not say anything that I think might make her feel worse. I give her money when I can (I offered to pay for her to travel to see her daughter who attends college out of state; she accepted). I send her job ads.
Last night, she sent a few messages in which she expressed feelings of extreme unworthiness and said things that made me think I should ask her if she has considered suicide. I said that if she has, I think she should remove all means of causing harm from her home and should promise herself that she will call someone (me, her daughters, health-care provider) if she feels like harming herself.
I don’t know what else to do, both to support her and to keep myself from feeling overwhelmed by what’s going on. Any tips? Thank you.
How can you tell? Do you think it would be reasonable to say, “[Friend], I’m really concerned about you. I’m going to call [X].”
And if I were to tell someone, which relative? She has two brothers, but only one would be appropriate to contact, and two adult daughters. She is, believe it or not, an intensely private person. I think it’s possible she tells me more than she tells her therapist. (Part of the problem is right there, I know.)
Of the two brothers and two adult daughters, is there one which would be more equipped to handle this situation? Immediately jump into action, find the resources necessary to make sure her mother is safe, pick her mother up and bring her home with her? Is a sister-in-law an option if the brothers aren’t? If you aren’t sure which, contact the daughters. If someone is emailing you multiple times a day and is now saying they feel worthless, get them some help sooner rather than later. If you can’t find a relative to take on this situation, offer to go with her to the therapist and lay it all out on the table.
I just emailed her and said that I’m very concerned, asked if she has a therapy appointment scheduled, and suggested that if she doesn’t, she should get one, this week, and talk to her therapist about her suicide thoughts.
We had a 60’s male friend who was very depressed and refused medication because ‘they make people suicidal’. When Robin Williams took his life I used that as an opening to our friend and asked if suicide was something he considered. He said that is something he would never do. His family all knew he was depressed and offered help. A year later he did take his life and I still wonder what any of us could have done differently.
All that said, I would definitely ask your friend if suicide is something she considers.
Here is a radical idea. Call her husband and see if knowing that she is on the verge of a suicide is going to startle him. They may have gone apart but if they cared for each other at some point and have children together than it may be of concern for him.
If you ever suspect that she might make an attempt soon, call the police department in her town.
I wish someone had suspected that my nephew was on the verge before he took his life. Having been through that nightmare, I would do everything in my power to help ANYONE, friend or enemy, I was afraid might be seriously suicidal.
Thank you for all the comments. I appreciate being able to share this dilemma with people who I trust, even though I don’t know who you are (exactly). My friend responded to my email; she said she does have a therapy appointment this week and she isn’t actively contemplating suicide.
Her husband is the biggest part of her problems. A month or so ago, he walked out on her while she was having a breakdown and begging him to stay and help her. He’s awful.
If you know who the therapist is, I’d let that person know what she said to you. The therapist doesn’t have to respond – that would be a HIPAA violation – but you can certainly notify the therapist.
For a friend of mine who was depressed (having suicidal thoughts but strongly NOT wanting to act on them) and was actively working with a therapist, his friends took turns calling him 2x a day. We didn’t work on ‘talking’ but just doing the following:
Making sure he got out of bed and got dressed.
Reviewing a realistic plan for the day. Really low bar but laying in bed all day was not it.
Checking in at night
Morning conversations sometimes went like this. ‘I don’t want to get out of bed. I don’t know what to do with my life. What am I going to do with my life.’ ‘Let’s not talk until you are dressed and out of bed. Sit up.’ ‘ok’, ‘Get out of bed’. ‘ok, I’m out of bed.’ ‘5 jumping-jacks’. ‘What?’ ‘Now.’ ‘ok I did that.’ ‘Jog up and down your stairs 5x until you have a sweat going. Can you do that?’ ‘Yes.’ ‘Ok, I’ll call back in 10min.’ 10min later. ‘Did you do it?’ ‘Yes’ ‘Can you take a shower and get dressed?’ ‘Yeah, I feel better I can do that.’ ‘Ok, I’ll call back in 10 min.’
3 of us took turns with this basic check in and inquired re if apts with therapist were being kept. We also set up a physical activity schedule: taking turns doing something physical outside each day. We did ask if he was having suicidal thoughts and if so, what he was feeling about this (aka was his response, ‘it feels like a good idea’ or was it ‘I don’t like these thoughts; I don’t want to do this.’) but our focus was helping him with mental self-care.
It took drugs and a month before he ‘unfogged’. When he was depressed, it was really noticeable when having a conversation that he wasn’t ‘all there’. Kind of twitchy and unable to maintain normal eye contact. Once he got mentally stable, he worked on reducing the stress in his life. He recovered well but did make some life changes (no alcohol, more focus on a less stressful lifestyle).
Psychiatric help can be frustratingly difficult to access on short notice. Every hospital ER is prepared to accept and evaluate someone in crisis. They may need to wait hours, but eventually a social worker will interview them and make a decision, in consultation with a psychiatrist, whether the person poses a risk to themself. If warranted they will be sent to a psychiatric hospital where they will be monitored, evaluated by a psychiatrist, and participate in therapy every day- essentially the things liska21 did for their friend. Upon discharge they often have an opportunity for intensive outpatient treatment. Someone who is not deemed an imminent threat to themself may be able to voluntarily enroll in the intensive outpatient treatment and the hospital social worker can help arrange that. Insurance coverage varies, but most plans should cover a treatment. Your friend is very lucky to have your help.
@rosered55 , I have been your friend. I lost my mother to depression and suicide 35 years ago.
Depression is a horrible disease that often runs in families.
Unlike your friend, I have a stable marriage and network of close friends, and a longtime therapist and appropriate meds. But as I’ve aged, the challenges of life and work are more difficult for me and there have been times of suicidal thoughts. I’m thankful for my family and support people to reel me back in.
Don’t hesitate to say something to your friends family. It could save her life. And you will know you’ve done all you can do.
How lucky your friend is to have you!
Confidentiality and privilege unfortunately prevents a mental health professional to even acknowledge to some stranger on the phone if someone is even a patient in their office, so if the patient has not given permission for their treating doctor/therapist to talk to this person, it can unfortunately put them in a difficult position. Its a double edged sword that can be a challenge for the doctor/patient relationship. If you have concern that your friend is acutely at risk to themselves or others, you should either take them to an emergency receiving facility or contact the sheriff/police. DIfferent states have different rules about this. In my state, the treating MH professional must have seen the patient within 48 hrs in order to sign a form for involuntary commitment (if this is deemed necessary). So, if you are worried about your friend’s safety, you can encourage them to see if they can get an emergency appointment with their treating therapist and see if they will let you accompany them, or take her to the ER. Good luck!