I am 27 i have a friend who is 18, allow me to call her Mary, just graduated from high school, she is a wonderful young lady. I am concerned for her safety. I lost touch with her family for about 8 years, I have recently found them again. Mary is now very depressed, threatens suicide, tells everyone they would be better off without her and she cuts herself. I do not know what to do. She has asked me to try and help her figure this out, as I admitted to her that when I was younger I, too, had some of these same issues. She has said she will only talk to me if one, I promise not to tell a soul and two, only when she feels she can trust me 100 percent. In the mean time she continues to cut–it is killing me inside to see this wonderful little girl hurting herself all the time. Is there something I could possibly do to help her without betraying her trust? I am truly worried about her, I want her to talk to someone, anyone who may be able to help her, but I know she will not accept professional help. I want to do whatever I can to help, but I am only a friend, not a doctor. She needs help and quick! It tears me up to see her this way, all the cuts and scars-remnants of what she has done to herself, please give me some information to point me in the right direction to help her!
- Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
- Dr. Dombeck intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
- Questions submitted to this column are not guaranteed to receive responses.
- No correspondence takes place.
- No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Dombeck to people submitting questions.
- Dr. Dombeck, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Dombeck and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
- Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Your sense of urgency is well placed. Your friend sounds fairly suicidal and really would benefit from professional help as soon as possible so as to stabilize her condition. Untreated depression and suicidal ideation are sometimes a lethal combination. The good news is that depression is a treatable condition. Medicine and psychotherapy would very likely help her to calm down.
There are several things you can do to help move your friend towards the help she needs without violating her trust. You can educate her about depression, emphasizing that it is a treatable disease that interferes with proper judgment (so that people who are depressed lose the judgment to see that they have a treatable condition). You can educate her about the different treatments for depression and suicidal ideation – emphasizing that they are very safe and painless (involving psychotherapy and medication) and, although not perfect, helpful. No one gets locked up in a hospital for years anymore and no one gets a lobotomy. Educate her that suicide is a permanent solution to what is almost always a temporary problem (but suicidal people have difficulty seeing this because their judgment is off due to their depression). Provide her contact information for doctors who could help. Offer to make an appointment for her, and offer to accompany her to the doctor’s appointment. Teach her about depression and suicide support groups (based in the community, available on the telephone (such as Samaritans), and online where she can talk with people who either are experiencing or have experienced similar states of mind and who know about treatments. In general, work on her until she softens up and becomes willing to get help.
p> All of the above advice assumes that while your friend is depressed and suicidal, she is not acutely suicidal (ready with a plan to kill herself tonight). If your friend becomes acutely suicidal, it’s time to call in the police and the doctors so as to preserve her safety. After all, what is the bigger betrayal; Letting someone die of a problem that could be solved? Or forcing them against their will to get help that will avert a lethal crisis? Just in case it isn’t clear: letting someone die by lack of action that could save them is a far bigger betrayal than getting someone temporarily hospitalized. Because this is true, it’s not a good idea to promise your friend that you’ll never under any circumstances call the health professionals on her.