CW: Depression, anxiety, suicidal ideation.

I have a dear friend who is struggling with some severe mental health issues right now, and I feel really scared and helpless about it.

We’ve been friends for a few years and almost the whole time I’ve known her, she’s struggled with this, but it’s gotten worse lately in a scary way. She’s been unemployed or underemployed for several years and lost her job more than six months ago after a very stressful experience in a toxic work environment, and has not found a new job since. She’s heavily in debt and has no income and her family isn’t in a good position to support her. Recently, she was diagnosed with bipolar II, which seemed to present a turning point, as it helped to make sense of many of the struggles she’s faced. But her medication does not appear to be working, or might even be making her depressive symptoms worse. I hung out with her a few weeks ago and she seemed to be doing well, but I saw her last night and she was not ok at all. She admitted to me that she doesn’t see any way out of her situation and sometimes she doesn’t want to be alive anymore. She said she’d never actually do anything to hurt herself - and saying you don’t want to be alive is different than saying you want to kill yourself - but it still scared me.

She’s very destabilized right now, both psychologically and in terms of her life circumstances. I know I can’t “fix” the situation or make anything better and there’s nothing I can really do except be there, listen, spend time with her when she needs it, and make sure to check up on her regularly. But I feel so fucking helpless. I tried to talk to her about some possible solutions but she won’t listen. I know that there isn’t a good safety net in place for people with mental health issues and most of the options available to her - like going on disability - are not really good options at all. But even so, her thinking is so distorted right now that she is completely resistant to any ideas, whether they’re realistic or not. She’s deep in the catastrophizing mindset and because she used to work in a legal clinic and has lots of experience with people applying for social assistance, she will shoot down anything I try to say.

I guess I just don’t know how to handle this. She says she won’t hurt herself, but how can I trust that? If she did, and I hadn’t done everything I could, I’d never forgive myself. I know I can’t fix anything but I can’t just sit there and listen to her talk about how her life is an irrevocable mess she can never recover from. I told her that, even though she can’t see a way out now, there is one, with support from her loved ones and mental healthcare providers. I want to make sure to check up on her regularly and I offered to make a plan to hang out once a week -make dinner, go to a yoga class, go for a walk, etc. - and she seemed to like that idea. I also strongly urged her to talk to her doctor as soon as possible about the worsening of her depression and ask that they look at adjusting her medication and dosage, etc. But other than that, I just feel completely helpless. Talking to her is actually a super frustrating experience because she shoots down everything I say and gets angry when I try to suggest coping strategies. I feel helpless and frustrated and hopeless. I feel like I’m just babysitting her to make sure she doesn’t hurt herself - and I’m willing to do it, because I love her, but it doesn’t feel great to know your hands are tied unless she does attempt to harm or kill herself. I can’t get through to her, I can’t help her put a plan together, I can’t make a bit of difference in concretely changing the life circumstances - unemployment, debt, possibly losing her housing, an unsupportive family - that are exacerbating her issues. It feels like just watching someone drown from a distance and not being able to get to them.