Friend/coworker struggling with depression and suicidal ideation
October 25, 2022 4:00 PM Subscribe
I have a friend/coworker who has a long history of depression and anxiety. He has been on and off of SSRIs (and the like) in the past and usually his bad episodes are provoked by a specific stressor and are self-limited. Now, he is in the midst of a very bad period that doesn’t seem to have had any particular cause, and he’s having suicidal thoughts. I want to know what kind of role I can play when he already has a robust support structure, medical care, etc. More below.
3 months ago, he began having terrific insomnia, sleeping 1-2 hours per night. He began taking some sleep aids, and this has helped, but this seemed to provoke a depressive episode (or maybe the insomnia was the first presenting symptom of the episode). Ever since, he has had feelings of hopelessness, malaise, and depressed mood. He is seeing a psychiatrist, who has had him increase his Zoloft and who is considering adding an atypical antipsychotic. He is seeing a therapist once a week. He has a very supporting and understanding wife and has been very open about his feelings and what he is going through with me, his business partner and friend of 10 years.
Today, he let me know that he has been having near-constant thoughts of suicide. This is not new for him, but the thoughts are more intrusive. He does not have a plan. He does not have firearms in the house. His psychiatrist and therapist and PCP are all aware, as is his wife. But obviously, I’m very concerned that he could follow through. His medical professionals do not seem to be ready to have him go in for inpatient treatment. He is doing great at work and seems to be happiest at work, where he feels productive and is distracted.
I’m torn up about the situation and, specifically, about how I can best help. I want to do everything that I can for him and he knows that he can call me 24/7. But is there a more specific way I can be available or helpful? We don’t hang out much socially, but I would be happy to, and I’ve considered inviting him over or to play tennis or hike. He does seem to have a close group of friends who are all in the loop, too.
I’m not even sure what I hope to get out of posting this. If I could snap my fingers and change something, it would be for him to realize that there truly is hope of getting out of this hole and that he has barely scratched the surface of treatment options. I’ve told him that, but I’m not sure it sinks in.
3 months ago, he began having terrific insomnia, sleeping 1-2 hours per night. He began taking some sleep aids, and this has helped, but this seemed to provoke a depressive episode (or maybe the insomnia was the first presenting symptom of the episode). Ever since, he has had feelings of hopelessness, malaise, and depressed mood. He is seeing a psychiatrist, who has had him increase his Zoloft and who is considering adding an atypical antipsychotic. He is seeing a therapist once a week. He has a very supporting and understanding wife and has been very open about his feelings and what he is going through with me, his business partner and friend of 10 years.
Today, he let me know that he has been having near-constant thoughts of suicide. This is not new for him, but the thoughts are more intrusive. He does not have a plan. He does not have firearms in the house. His psychiatrist and therapist and PCP are all aware, as is his wife. But obviously, I’m very concerned that he could follow through. His medical professionals do not seem to be ready to have him go in for inpatient treatment. He is doing great at work and seems to be happiest at work, where he feels productive and is distracted.
I’m torn up about the situation and, specifically, about how I can best help. I want to do everything that I can for him and he knows that he can call me 24/7. But is there a more specific way I can be available or helpful? We don’t hang out much socially, but I would be happy to, and I’ve considered inviting him over or to play tennis or hike. He does seem to have a close group of friends who are all in the loop, too.
I’m not even sure what I hope to get out of posting this. If I could snap my fingers and change something, it would be for him to realize that there truly is hope of getting out of this hole and that he has barely scratched the surface of treatment options. I’ve told him that, but I’m not sure it sinks in.
Thank him for looping you in, and tell him you would miss him if he wasn't around anymore. Insomnia is terrible. Does the office set-up / general schedule (if he's telecommuting) allow for a nap? You could ask if a sleep/rest break splitting his helpfully productive and distracting workday into sections would make a positive difference. Today in related FPPs.
posted by Iris Gambol at 5:18 PM on October 25, 2022
posted by Iris Gambol at 5:18 PM on October 25, 2022
You have to ask him.
He's still an adult who gets to decide what he needs and you need consent from him to do anything more than general kindness, for one thing. For another, nobody here knows what he needs. I can't tell you what I would need here and have that be useful for him.
You just have to talk to him and say hey, how I can best support you here? Only he can tell you. It may be super specific to him and you and work. It may be nothing, in which case just be nice and say hello regularly but let him work.
posted by Lyn Never at 6:37 PM on October 25, 2022 [1 favorite]
He's still an adult who gets to decide what he needs and you need consent from him to do anything more than general kindness, for one thing. For another, nobody here knows what he needs. I can't tell you what I would need here and have that be useful for him.
You just have to talk to him and say hey, how I can best support you here? Only he can tell you. It may be super specific to him and you and work. It may be nothing, in which case just be nice and say hello regularly but let him work.
posted by Lyn Never at 6:37 PM on October 25, 2022 [1 favorite]
Yes, please do ask him. And if he's being open with you, then just generally checking in once in a while with genuine care is usually appreciated -- not in a panicky "Are you in danger???" way but just in a "I care about you and actually want to hear how you're doing, even if you're struggling" way. (Caveat would be to make sure you're not trying to "fix" him in these conversations.)
posted by lapis at 7:59 AM on October 26, 2022
posted by lapis at 7:59 AM on October 26, 2022
Ask him.
If he’s happiest being productive at work, he might enjoy doing productive/active things for fun. The tennis and hiking ideas sound good to me.
I’m super depressed and don’t have the network I wish I had, and I’d appreciate it if someone invited me to go hiking. Even if I feel cranky and sad the whole time, it’s better to be around friends than not.
posted by bunderful at 12:46 PM on October 26, 2022
If he’s happiest being productive at work, he might enjoy doing productive/active things for fun. The tennis and hiking ideas sound good to me.
I’m super depressed and don’t have the network I wish I had, and I’d appreciate it if someone invited me to go hiking. Even if I feel cranky and sad the whole time, it’s better to be around friends than not.
posted by bunderful at 12:46 PM on October 26, 2022
Can you suggest ketamine therapy? There are clinics all over now.
posted by waving at 2:24 PM on October 26, 2022
posted by waving at 2:24 PM on October 26, 2022
This thread is closed to new comments.
As someone who, like you, cares deeply and, perhaps like you, who takes on people's stuff too easily, I suggest you step back your involvement emotionally and logistically. He doesn't want to hang out outside of work; frankly he may not see your relationship the same way you do, which is fine, but a reason not to push. He's got lots of people to handle the social stuff. It makes me so happy hearing how satisfied and productive he seems to feel at work. You are helping provide him with a relief, even temporarily, and treating him like the business partner he is surely makes him feel good. He's probably tired of being constantly monitored because, even if depression can make us incredibly self-focused unintentionally, there are moments of clarity when we feel our current level of need is kind of embarrassing. (We shouldn't have to feel this way but it is what it is!) You could do little things to help make the work day nice for you both (and any employees you may have) like flowers for everyone's desk or a favorite coffee. Or a compliment and thank you on something well-done. I think you have a really unique and cool way to support him, and I hope that makes you both feel good.
posted by smorgasbord at 4:46 PM on October 25, 2022 [4 favorites]