Dear Doc: This is kind of an uncomfortable subject, but I'd rather address this before it's too late. Every time something like Suicide Prevention Month comes around, you hear about the list of tell-tale signs of someone who may be thinking about harming themselves: depression, increased drinking, talk of being useless to everyone, giving away their possessions, etc. I never thought I'd be looking at all of these signs face to face, but here I am. The person is a very close friend who, just months ago, was at the gym every day, the "life of the party" any time we went out and just an overall fun, outgoing, pleasant person to be around. I know he had a difficult childhood and he's seen a rough deployment or two. But it never seemed to bother him in the past and he still never talks about it. I honestly don't know what happened. My fear is that he might also think he's too "tough" to get help.
My question is, what should I do? What CAN I do? I want to tread lightly for fear of making his situation any worse than it already is, but I also realize the sooner I or someone else can help him, the better. Where do I go? Where does he go? What can I do personally? How can I convince him that getting help isn't a sign of weakness? Thanks in advance, Doc.
-I've Got a Friend Who I'm Worried About
Dear Friend: Unfortunately, you and your friend are not the first people to experience both sides of this. Fortunately, there are people out there who can help. I spoke to Dr. Tim Hoyt, chief of psychological health promotion and supervisor of the Combat and Operational Stress Control mission at the Psychological Health Center of Excellence. Here's what he said:
Talking about suicide with a friend might feel like a weighty topic. By showing concern and genuine care, having this conversation can be the same as any other time that you might check in with a friend after an accident, medical treatment, or the death of a loved one. As a result of the pandemic and other upheavals during the past two years, it's a safe bet that almost anyone you check in with is going to be struggling in some way.
You can start the conversation by reaching out. Give them a call or send a text message to say, "I wanted to check in and see how you are doing. When can we talk for a few minutes?" They might be busy right now, but set a time to follow up, such as: "I'll call you after work today," or "Let's meet up to grab coffee in the morning."
If they aren't ready to talk, you can still offer support and share resources. This can be a personal offer, such as: "Remember you're not alone with this. I'm available any time to check in." You can also remind them about resources, such as saying, "If you've had a really bad day, just remember that suicide prevention briefing we had last month. You can always call 1-800-273-8255 to reach the Veterans Crisis Line."
If he or she is willing to talk or you have set up a time, be sure to tune in and give your friend undivided attention. Listen, and let your friend do most of the talking. You can use open-ended questions to get the conversation going, such as, "I'm worried about you. What's going on?"
When they open up, express interest and don't judge them: "I'm glad you're talking to me about this and I'm here to support you. How are you coping with this?" Express genuine concern and ask the straightforward question: "I know you've been going through a lot lately. You're my friend and I care about what you're going through. I know it's common to experience depression or thoughts of suicide during times like these. Have you been thinking about killing yourself?" It's important to know that asking a friend about suicide won't cause that friend to attempt suicide.
Whether or not they have been thinking about suicide, you can encourage your friend to seek help during difficult times. Emphasize that experiencing challenges and seeking help are normal. Offer to help them reach out to a professional or make the call with them. If you feel comfortable, share your own experience of a time when you sought help for something. Places to start include the Veterans Crisis Line, Military OneSource (1-800-342-9647), or the inTransition program (1-800-424-7877).
After your conversation, it's important to check in again and follow-up. It will probably take more than one conversation to really help. A few days later, reach out again: "I've been thinking about our chat and wanted to follow up. How are you feeling?" If they decline invitations, keep working to include them, whether for a group activity or just to grab lunch. Feeling connected is important during adversity and can give more opportunities to help when needed.
Even though it may feel awkward, there is no wrong way to start the conversation and let someone know that you care about what they are going through. Just reach out, be genuine, and encourage your friend in any way that you can.
Friend, as Dr. Hoyt said, there are a lot of resources out there. It's a matter of what you feel comfortable with and, likely more important, what your friend feels comfortable with.
Also please remember that if you think your friend is in direct danger or in the midst of harming himself, you should contact your local emergency services or military medical treatment facility immediately.
The underlying fact is that it probably won't be easy for either one of you, but any help you can provide to your friend is better than none. If one of the ways of going about it doesn't work, there's absolutely nothing wrong with trying another.
Whatever you choose to do, please…take care of your friend out there!