My suicidal friend
June 27, 2011 12:51 PM   Subscribe

This is a follow-up question to this question about my suicidal friend.

I ended up suggesting to my friend that he return to his meds just as an experiment, to see if they made things seem better.

He did so about a week ago, and has since been in a happier mood. However, he said he feels inauthentic because he doesn't get upset over things that should upset him. The things he has mentioned are very trivial and would not upset a stable person.

He also told me that he had a long talk with his mom to "prepare" her for his death. Today he was talking about his mental state, and doing a lot of beanplating about it.

This convo took place over IM, and I told him I wanted to hang out and talk in person.

There are so many things I'd like to say to him but I know him well enough to predict how he'd respond. I need help figuring out how best to talk to him about this without alienating him.

Examples: "You mean so much to me, your family, and your friends" would probably result in him accusing me of a guilt trip.

"You have so much to contribute to the world" would probably be met with scorn about how the world doesn't deserve it and/or he can't help anyway.

My friend is bipolar, and has extremely individualistic beliefs about the nature of reality and the afterlife that underlie his suicidal ideation. He cannot be swayed from this. He's incredibly intelligent and justifies his belief system with that fact.

Everything I can think of to say to him will sound like a platitude. He respects me because I listen to him and I engage him in philosophical discussions about reality.

I don't feel I'd be a true friend if I didn't try to help. I'm just not sure how.
posted by sucky_poppet to Human Relations (27 answers total) 6 users marked this as a favorite
Have you considered calling a suicide hotline to discuss this with someone who is trained in suicide prevention? That is a short term answer for some conversation topics, and responses that you can have in your pocket for when your friend accuses you of being manipulative.

It might also be a good idea for you to seek therapy for yourself in the long term. Feeling like someone's only support can be very draining.

My advice is to ask him questions about what he is enjoying about his current state of mind, but that might not go well.

Big hugs to you. Keep taking care of yourself.
posted by bilabial at 12:55 PM on June 27, 2011 [2 favorites]

Seconding calling a hotline on this. And fwiw if you know who his doc is I would call the doc and report the kinds of things he is saying.

Better you piss off your friend than you having to go to a funeral.
posted by St. Alia of the Bunnies at 1:00 PM on June 27, 2011 [2 favorites]

But, in the spirit of the rest of your question, you might want to tell him that if he offs himself that means the disease won, and does he really want to let that bastard disease win?
posted by St. Alia of the Bunnies at 1:01 PM on June 27, 2011 [2 favorites]

To echo bilabial, do try talking to a suicide hotline. Not sure where you live, but in the US there is a national suicide prevention line - 1-800-273-Talk to help you. Otherwise, check your local phone book for the one nearest you.

I work for a crisis line organization in Canada, and calls from people in your situation are not uncommon - we specifically train our volunteers to talk with friends/family members/others who know someone who is thinking about suicide. It is something organizations like this can help you with.

Good luck, and thanks for caring enough for your friend to do this.
posted by never used baby shoes at 1:04 PM on June 27, 2011 [1 favorite]

My friend is bipolar, and has extremely individualistic beliefs about the nature of reality and the afterlife that underlie his suicidal ideation. He cannot be swayed from this. He's incredibly intelligent and justifies his belief system with that fact.

Is there someone who shares some of his belief system but would disagree with his conclusions? Does he believe in reincarnation or rebirth, and therefore this life doesn't matter much, he can get a "do-over"? A Buddhist or Hindu will tell him it don't work that way.
posted by desjardins at 1:14 PM on June 27, 2011

You cannot save him. You really can't. The only person who can save him is him. I know that sounds harsh, but you might one day have to deal with the consequences of his actions and it will be better for you to be ready for that. It takes an awful lot of training to help someone with a condition like this. Chances are, you aren't ready to do/capable of doing what you feel like you ought.

At this point, you need to start looking out for yourself. I'm not suggesting you turn your back on your friend, but it might be helpful for you to talk to someone who has some experience in helping people in your situation. Also, read up about the stages of grief. You'll need them at some point in life, even if it's not now.
posted by Solomon at 1:31 PM on June 27, 2011 [5 favorites]

As someone who has attempted suicide, I greatly appreciate the lengths you are going to for your friend. When I was at that rock bottom place, pretty much nothing anyone said was going to help me. That was why I was suicidal -- it felt like there were no solutions and the only way out of the trap was to end it.

You should know that a lot of what your friend says and thinks is irrational, and that it's probably pretty hard for him to respond to rational ideas in a rational way. Depression is not something that you can talk yourself out of very easily. Don't compare him to a "stable person." He's in a really weird place and will take months to make sense of himself. The difficulties you have in cheering him up or convincing him that life is worth living are difficulties he faces internally all the time: he's at the end of his rope because nothing is able to cheer him up anymore.

This is not a hopeless situation. With medicine, professional help, and lots of support he can pull through. But you should know that it is not within your power to make things ok, and that trying to make things ok is not your job (it may well make things worse). If you can just be there, and let your friend know that you will be there even when he's feeling shitty and that you don't have any expectations for him to not feel shitty, then you will be a tremendous help. If you can help him feel normal, even when he is in the worst pain, then he might start to think that this is not some totally intolerable pain. When everyone around you is telling you to cheer up, and you have a bunch of support and help and you're telling yourself that you want to cheer up -- and for no apparent reason you cannot feel happier -- then you feel trapped. But when you are in pain, and the people around you let you know that they are willing to share your pain and that it is OK for you to be in pain, then you can start to pay attention to that pain instead of running away from it.

This is not to say that you should normalize his suicidal thoughts -- that stuff is not ok, that stuff is part of running away and feeling trapped. You can tolerate and normalize the feelings he is having while also making it clear that you need him to be alive and to start getting the treatment he needs to stay that way.

Things you can do: Be as present, as stable, and as non-judgmental as you can be with him. Help him pay attention to things -- notice how much he's sleeping, eating, going out, spending time alone, taking medicine, enjoying something even for a few seconds, feeling shitty (in all of its many forms) -- and pay attention along with him. Point out choices you see him making, but don't be so quick to offer what he ought to be doing. Be with him when you can, and help him be with himself.

Finally - take care of yourself. This is a burden for you if you choose to take it on. Pay attention to the amount of support you are able to give, and don't try to give more than that. You can't solve this problem by yourself, but you can be helpful and you can try to connect your friend to support that you cannot give yourself.
posted by cubby at 1:42 PM on June 27, 2011 [9 favorites]

Just want to come back and say that yes, I did call the national suicide hotline and they made the suggestion about the meds.

As I mentioned, my friend is extremely smart, with an IQ of 170+. He hasn't encountered many people he believes are his intellectual equal, and that's why he scorns psychiatrists. Are there any psychiatrists who specialize in treating the extremely gifted that I could suggest to him?

I am also in therapy, and this is something I've discussed with my counselor, about how to prepare myself to lose him.

Others in the last thread said to run, and that's not off the table, but helping is first.
posted by sucky_poppet at 1:57 PM on June 27, 2011

If you're in MA, this service is a fantastic resource -- you can specify all kinds of things you want in a therapist (experience working with the gifted, LGBTQ friendly, location, insurance carriers, etc) and get a range of options. There may be similar services elsewhere.
posted by cubby at 2:01 PM on June 27, 2011

Solomon speaks the truth.

I wish you could see this from a completely objective standpoint, because you see so deep into this, your caring is preventing you from seeing the dynamic here.

- You are not a doctor, yet by sharing this info with you and NOT a doctor...your friend avoids treatment AND gets heaps of attention from you.

- Ditto by "preparing" his mother. How do you think that conversation really went between them? I'm sure she's a wreck now and willing to do just about anything to save her son.

If your friend really cared about you or his mother, he'd seek treatment, not attention.

I'm willing to believe mental illness is keeping your friend from seeking treatment.

I'm not willing to believe he doesn't know exactly what he is doing by trying to "prepare" his loved ones.

This is attention seeking behavior at it's worst and most insidious.

Call a hotline for help figuring out how to extricate yourself from this mess. You are not helping your friend by continuing to participate in this little drama.

His experimentations with medication needs to be handled by a doctor, not you.

Get yourself help to create distance. You shouldn't be involved in this situation.

Don't continue to be a victim of this person's illness because that doesn't help him.
posted by jbenben at 2:01 PM on June 27, 2011 [6 favorites]

I agree with the advice that you cannot be your friend's doctor -- but please stick to your conviction to be his friend. Find a safe way to be there for him and do what you can. He needs more than just doctors; he needs to know that the people around him can still be around him (even in some limited capacity) when he is in the worst pain.
posted by cubby at 2:05 PM on June 27, 2011

I'm not willing to believe he doesn't know exactly what he is doing by trying to "prepare" his loved ones.

This is may not be true. If you don't value your own life, it can be very difficult to understand why anyone else would be upset if it ended. If you are so deep in pain that life is unbearable, you tend to view suicide as something that would ease that pain, and because you can't see any other way out of the pain, assume that others see the same limited options.
posted by No1UKnow at 3:29 PM on June 27, 2011 [1 favorite]

Please read How Not to Commit Suicide. Give it to your friend. Ask your friend to consider that his death will be devastating to many people, that he can choose to live an authentic life, and be of value to himself and the community. I don't consider my meds to make me inauthentic. My meds make it possible for me to get through the day. Good luck.
posted by theora55 at 3:36 PM on June 27, 2011 [3 favorites]

Seconding "How Not to Commit suicide". It's the thing that clicked- basically the logical realization that living through my depression was slightly less of a bother than trying to leap through the hoops involved with self termination (Leap off buildings? I can't even dive! Ligature? Do I really want -more- brain damage on top of whatever the @%$^ing depression is doing? Pills? My liver!!!)

Saved by laziness. Worked better than love and guilt, both of which don't work for everyone, no matter how much functional value I may have to other humans.

Practically, do local doctors know he's a suicide risk? if he's an immediate risk can you contact an emergency line for his area? This is a job for the professionals.
posted by Phalene at 3:50 PM on June 27, 2011 [1 favorite]

"If you don't value your own life, it can be very difficult to understand why anyone else would be upset if it ended."

In this case, the OP states his friend has an IQ of 170+. Even if the friend can not emotionally empathize with the feelings of those around him, he surely knows intellectually (strategically?) precisely the effect of his disclosures.

I'm not saying that the OP's friend is not mentally I'll, not worthy of help, or not observably in real pain.

I am saying the OP is in WAY over their head trying to solve this on their own, or even over a hotline. The OP describes a collection of symptoms best treated by true medical professionals who have studied and trained to deal with these types of illnesses.

The friend's illness is having it's way with the friend, but also, the illness is having it's way with the OP.
posted by jbenben at 4:40 PM on June 27, 2011

I am saying the OP is in WAY over their head trying to solve this on their own, or even over a hotline. The OP describes a collection of symptoms best treated by true medical professionals who have studied and trained to deal with these types of illnesses.

I emphatically second this, and also: your friend is not behaving rationally. He's saying he's going to do something to himself in a few years, or whatever timetable, but he could do something tomorrow, a month from now, at the appointed time, or never. That's what you're dealing with. All this other stuff, the IQ, individualism, whatever, it's all a red herring because this person is ill and you can't rationalize with that.
posted by sweetkid at 5:59 PM on June 27, 2011

Set specific goals and times for him. Hammer home that you're going to see each other tomorrow or next week, and he can't go until you do that.
posted by Lovecraft In Brooklyn at 6:39 PM on June 27, 2011

One thing you do have to know is that if he does attempt or complete suicide, it is NOT YOUR FAULT.

You really need to settle that for yourself now. Your impulse to help is good and worthy, and I understand that on some level you need to do this, for you as well as for your friend, but do not, do not DO NOT internalize any responsibility for keeping him alive. This is not something you have control over, ultimately.

Having said that, yes, do contact authorities if you think he is in immediate danger, and do say what you need to say to him, but ultimately, he has to be responsible for his own life. It sucks but it is what it is.
posted by St. Alia of the Bunnies at 6:54 PM on June 27, 2011 [1 favorite]

There are so many things I'd like to say to him but I know him well enough to predict how he'd respond. I need help figuring out how best to talk to him about this without alienating him.

I seriously doubt he has an IQ of 170+. That would mean there are only about 459 people as smart as him or smarter in the U.S. 10,714 in the world.

H_0: he's really that smart

H_A: he's deluding himself

Any reasonable person would have to reject the null hypotheses in favor of the alternative, that he's deluding himself. Is it possible–just possible?–that there are other things he's misjudged about himself.

… not that any of that would change his mind.
posted by cupcake1337 at 7:43 PM on June 27, 2011

jbenben: " This is attention seeking behavior at it's worst and most insidious."

Yeah? When I was suicidal, I honestly did not believe that life could get better, and it was the overriding feeling guiding my whole life. I could not begin to comprehend *anyone* else's emotions relating to my actions; I was too overwhelmed by my own mess. No matter how intelligent you are, emotions can wipe out rational thought.

Also, if anyone had even whispered "attention seeking" in my presence, I'd have been dead the next day, or at least hospitalized. I struggled with the overwhelming, irrational feelings for months before I took any action (and when I did, obviously, my attempt failed), trying to find something else that seemed like a way out besides the permanent one. But if someone had told me they thought my feelings were not legitimate, it would have removed any barrier I felt to making the attempt.

I can't tell you what someone else is thinking, but I can tell you that my experience suggests that once you hit "suicidal" you really, really have no clue what others are thinking or feeling. There just isn't room in the brain.
posted by galadriel at 7:49 PM on June 27, 2011 [2 favorites]

galadriel, I think jbenben is referring to attention-seeking in the sense of this person's specific behavior, in which they're "preparing" people for their death, talking about their high IQ, etc. Not all suicidal behavior is attention seeking, but this does seem like it is. At any rate, it's not something the OP should feel at all equipped to handle, because OP is not equipped.
posted by sweetkid at 8:09 PM on June 27, 2011

Attention seeking and honestly not believing that life could get better are not mutually exclusive things. He may not be aware that what he's doing is seeking attention.
posted by cupcake1337 at 8:22 PM on June 27, 2011 [3 favorites]

Medication for mental illness isn't something that you can just experiment with when you feel like it. It doesn't work that way. It takes time to build up, and even if it does work well, if the person stops taking it (say, they feel so good they don't think they need it anymore), it may not work as well if they start taking it again.

He may be very intelligent, but that doesn't mean he's in touch with reality. Mental illness often works to perpetuate itself- it doesn't want to be healed. If he does commit suicide, you'll feel guilty, you'll wonder what you could've done to keep him from doing it: the answer is "nothing."

The only thing that'll get him out of this pattern is to get on and stay on medicine that works for him and keeps his brain from going back into its spiral. You can't reason with a chemical imbalance. I could be wrong, but even if you were to find him a psychiatrist who specializes in "really smart people," he'd realize that and see his/her methods as just that, phony, dishonest, beneath him.
posted by wondermouse at 9:41 PM on June 27, 2011 [1 favorite]

Both sweetkid and cupcake1337 nailed it.

I meant no disrespect, galadriel. None at all.

I'm worried the OP is caught up and can't see how wanting to help in the way they (think?) they've chosen (bargaining, hand holding, reaching out on friend's behalf) is allowing the friend's disease to be in control of the entire situation. In fact, I feel very comfortable pointing out that what the friend has been communicating to the OP is a manipulative facet of the disease the friend is struggling with. Playing the game by the illness' rules will not result in helping the situation.

I don't know what the answer is, but I do know there are trained medical professionals who have a much much better chance of getting the friend stable than his friends or family on their own.

OP can't be a primary care provider here. Trained medical professionals need to play that role.

Hope that cleared it up.
posted by jbenben at 9:49 PM on June 27, 2011 [3 favorites]

The kinds of help that the OP can offer are not about being a primary care provider. But I do think it's possible and fully appropriate for a friend to be involved in the life of a person with depression and suicidal thoughts. This conversation is starting to sound like the choices are either jump in and be the doctor or cut your losses and distance yourself. There's a middle ground here -- being present, being stable, being OK with your friend's pain, and reminding your friend of the support that is available from doctors and professionals.

As a friend in this situation your biggest job is to notice things that your depressed friend can't see. Like galadriel says - once you're that far gone into pain its almost impossible to recognize your own emotions, let alone anyone elses. When I was there, I had great friends who helped me get better at seeing my behavior (just by saying stuff like "you seem really anxious right now", and I did, but I didn't know it, and they were nice enough to also mean "it's ok that youre anxious, I'm not going anywhere and I'm not asking you to calm down or anything," which was exactly what I needed to know to help me calm down).

Depression is a very isolating disease. To fight it you need support from lots of people. I am really saddened by the attitude in this thread that seems to say that only doctors are qualified to help. Everyone is qualified to help someone with depression. Each person needs to pay a lot of attention to their own feelings and set the limits that they need to protect themselves, but that does not need to mean checking out of your friend's life until he gets better or dies. (You may realize that this is, in fact what you need to do for yourself, and that is also a totally acceptable thing to do - there is no requirement in this situation other than to keep yourself healthy)
posted by cubby at 6:11 AM on June 28, 2011 [2 favorites]

I agree that depression requires a lot of people's help -- but the suffering person does need to be in the care of a competent therapist and/or psychiatrist -- in this case, the OP's friend is putting too much responsibility in the hands of their loved ones. The OP's friend needs a therapist to cut through all the noise of "high IQ," "rational choice of suicide in the next few years" and get to the heart of what the issues are. Also with bipolar, of course, a steady medication regimen is almost always necessary.

I think friends and family are extremely important, but it's not healthy for anyone if the person is not in treatment with a professional.
posted by sweetkid at 8:37 AM on June 28, 2011

jbenben: " OP can't be a primary care provider here. Trained medical professionals need to play that role."

I agree with you wholeheartedly there. Someone who is suicidal is likely not thinking rationally, no matter how smart he thinks he is. Someone who isn't a professional can't talk them out of it with logical arguments--because logic has taken second place to emotion--nor make them see how they're affecting others. In that sort of state they really can't see, and don't even really care.

It *seems* like a good idea, in that kind of state, to try to cushion the upcoming loss; you think you're going to go through with it no matter what, because you can't see any other option, and surely it'd be kinder not to have it be a total shock. (I certainly would have, but I knew that I'd get involuntarily committed, and they would have prevented me from trying.) What someone in that state needs is a professional who has experience helping people see that there ARE other options, that they are THERE, that you CAN get over that abyssal quagmire... really, a friend can't do this, no matter how much they care.

Among other things, the suicidal person is going to dismiss a friend's arguments as wishful thinking: you want to keep your friend, so you argue that the friend's life will get better. But the suicidal person thinks he knows better, and things will never improve. A friend can be supportive, but doesn't have the skills and experience to do what a suicidal person REALLY needs.
posted by galadriel at 3:34 PM on June 28, 2011

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