Ask Dr. Vail: "From A Concerned Friend"

Dear Dr. Vail,

 A good friend recently has been acting quite differently. Three months ago, they experienced a breakup with their long-term partner and lost their job. Since then, he has been withdrawing from social activities, appears to be drinking alone, and seems to be losing interest in activities he previously really enjoyed. I don't know what to do. I am afraid to ask if he is suicidal because I don't want to offend him and have him feel I think he is crazy. However, I am so scared that if I don't do something, he might hurt himself as he has said that he feels hopeless and does not think anything will ever get better.

— Signed a concerned friend

Dear Concerned,

Thank you for writing to ask how to help your friend. Depression often feels overwhelming and confusing for both the people experiencing depression and for those who care about them.

Regarding your friend, I suggest that you directly ask him if he is thinking about hurting himself. Most people have had thoughts of suicide at some point in their life, yet less than 2% of deaths are from suicide. Many people assume that if they ask if someone is suicidal, they might plant a new and terrible idea in someone's mind. However, information about suicide is all over the media, so it is not likely to be a new idea, especially if your friend has mentioned believing that nothing will ever get better.

Suicide prevention should not be a last-minute thought for anyone. If you are worried, act quickly. Ask your friend specifically, what he is thinking, and if you are afraid he is suicidal, be direct. Do your best to determine if your friend's suicidal thoughts are new or if he has been struggling with these thoughts for a while. Ask the hard questions. For example, does he have a plan or a timeline for how he would commit suicide? If he answers yes, or has an intention to hurt himself, ask him to give you what he is planning to use to commit suicide.

If you determine that he is at high risk of hurting himself,  do not leave your friend alone. If possible, tell other people who care about this person and establish a support network for him. Quite often, a suicidal person will beg you to keep this information a secret. PLEASE, please do not hold this information secret. Look for a local suicide prevention hotline. If they have a doctor, make an appointment for them, or give them the names of mental health therapists in their community.  If possible,  go with them to their meeting.  If your friend resists this intervention, keep trying. Taking steps to get help is often very difficult when people are depressed and weary. It is often tough for people struggling with depression to make an effort to get help for themselves. Keep telling your friend you care about and want to help him. This concern goes a long way towards helping someone believe that life may get better. Sometimes, knowing that one person cares about them gives people hope that life might get better and helps them find the strength to keep living.