Not Sure How To Handle Sucidial Texts From A Friend With Ptsd

[Justmehere]

I have a friend I met in treatment years ago. She recently went through her second breakup with a guy who had a history of emotional abuse and rape of her.

I'm proud of her for breaking up with him and working so hard to break the trauma bond with him.

She told me that one of the biggest reason she didn't want to break up with him is because of how he would support her when she was extremely dissociative or flashbacky... and yet what she deemed as support seemed very appalling to me from the outside, and it made me even more concerned with how badly she is struggling with her symptoms and so deeply alone, that what he would do is something she would feel is the best support she has - and it just might be.

She is in treatment though with a therapist and she is a generally very open and honest person, and she says she has been telling her therapist everything. Because of this (and many other reasons) I have not pushed as much as maybe I would have otherwise that it's time to get some more support - but we have talked about it a few times.

Since the breakup, she has been texting me every couple of days and consistently telling me she wants to die. I have been validating how bad her pain is and otherwise listening and telling her I'm here and to please keep reaching out. I asked today if she is thinking of any "ways to die" and she texted back. "every day." I suggested as gently and as clearly as I could that it's time to get more support...

She feels like she can't find any more support. I believe that right now her depression is telling her to give up, and I'm so frekaing proud of her for ensuring so long.

I also know that there are more options and I'm not the only one that thinks it's time to pursue those options, even though they are not easy options.

A few months ago she told me of her therapist and her arguing over doing a PTSD focused inpatient hospitalization program - better than even an acute inpatient unit.

She refused back then, and decided to try to finish school right now. I probably would have done the same. Now it's mid-semester and she is crashing and I'm very worried. She sounds like crap on the phone.

We live states away, and I know really well that I can't save her or keep her from ending her life.

But what can I do? At what point do I call someone else in her area for help?

I asked her if she has told her therapist about how bad things are. She didn't answer. Do I ask again? I have asked how I can support her through this time? No response to that question, but she did keep responding. I did suggest this site, but she poo pooed that and I can totally respect that.

Any suggestions on what I can do or say? I'm so close to her that I'm sure I'm not seeing the situation objectively myself. I have survived my own suicidie attempt and lost a roommate to suicidie. I don't want to lose my friend.

And I don't know how to respond when she texts, "I'm in pain. I want to die" and nothing else.

Help. Any input would be much appreciated.

 

[joeylittle]

I asked her if she has told her therapist about how bad things are. She didn't answer. Do I ask again? I have asked how I can support her through this time? No response to that question, but she did keep responding.

You can try and draw her out about what she is afraid of, in re: telling her therapist how bad things are. Asking it like, 'what are you afraid that your therapist would say, if you told them'?, followed by, 'has your therapist ever talked about having you admitted against your will'? (that's just the most likely fear)....conversations like this are easier if you assume going into them that you aren't going to change her mind, you just want to understand her thinking better. But, you may end up helping her change her own mind in the process.

It's good that she keeps responding, even though she's avoiding the questions she has no answers to. Believe it or not, just being there as a person she can express these thoughts to is a very helpful thing. Right now, it's keeping her from believing that she is totally alone with her thoughts.

The problem is, it's a lot of pressure for you to carry, to be the only person who is hearing 'I'm in pain, I want to die'.

How are you doing with that? It's going to affect you, and clearly is - but do you feel like you need it to stop?

 

[Casey_03]

You obviously know her better than I do, but my first impression about her saying "I want to die" is not that she is actively suicidal, but that she is being open about how she feels -- which is a good thing. It seems like a good sign that she responds to you and is open about her emotions; that to me means she hasn't actually given up and isn't planning to kill herself. I can say that I personally have said "I want to die" before when I was depressed but i never meant it and I said it only to a friend who i knew would understand I didn't really mean it in a suicidal way. That said, I don't know all the context, nor do I know your friend and you would know better about whether or not this type of statement from her is cause for alarm. I think she definitely needs more intensive therapy, regardless of whether or not she's suicidal, and inpatient might be the best bet. And I agree with @joeylittle that it's unfair for you to have to worry about whether or not she's suicidal -- especially if you've already lost someone to suicide. She might just not be thinking clearly and making the connection about this, but you could bring it up, gently, and just tell her how much it hurts you to hear her say that, and how much you worry when she does. I also hope that she's not bringing up suicide in any emotional blackmail type way? You know, like if you're not there for her when she needs you, she says "i'm going to kill myself right now if you don't pick up." That's not happening, is it? I had a friend do that to me before and it was incredibly awful. It also might be good to encourage her to start being creative in some way to express these dark thoughts .... drawing or painting or something. That can be immensely helpful as an outlet for really dark feelings, and at least that way it's slightly productive ...

 

[The Albatross]

Sure, yeah I'd ask again. You can also choose to notify local law enforcement and ask them to do a "wellness check" based on the texts you've received... of course that is fraught with potential consequences as well. Me? I'd rather try to do something than nothing though.

 

[EveHarrington]

Went through something similar and it dragged me so far down that I couldnt remember having an episode like this before----I felt like I was drowning only this term does the whole experience injustice.

I have no real advice for you other than to seek out professional help. You can't bear this burden on your own and if you do nothing-----not talking about suicide, but you could be left knowing nothing, which is a hell all of its own.

 

[Justmehere]

Opps, I am sorry, I posted before I had written out my full response. My computer is acting up. My apologies.

Asking it like, 'what are you afraid that your therapist would say, if you told them'?, followed by, 'has your therapist ever talked about having you admitted against your will'? (that's just the most likely fear)....

This is a really great idea to see if I can draw her out a little. At least she will know someone is listening.

you aren't going to change her mind... But, you may end up helping her change her own mind in the process.

@joeylittle, This is probably just what I needed to read in this moment.

How are you doing with that? It's going to affect you, and clearly is - but do you feel like you need it to stop?

I'm struggling with it today. Before, it didn't get to me, but now it is starting to hit me differently. This is part of what prompted me to post today. "I am in pain, I want to die." - this is a hard text to get in the middle of work. If she was more willing to engage more help from others, I think I would not feel so hard for me to handle. I am focusing on my feelings, but I guess they are not inconsequential.

I've been in her shoes, and I struggled to reach out. I don't want to discourage her from reaching out, but I kind of feel lost on how to respond.

I think part of me got a little mad at her today. Ending her life is end to our friendship. Let me be selfish for a moment, I would so freaking miss her if she died. "I want to die" feels hard to read when I want her to live, even for the selfish reason that I like our friendship and I really care about her. I have no grand delusions that our friendship can make life worth living against the backdrop of her pain, and she absolutely has to find what will make life worth it for her own self, and I want her to be able to feel like she can talk about what she is feeling... I know she is not thinking about how it is an end to our friendship, but that she is simply so desperate for an escape and a solution to her overwhelming pain, that death feels like a good idea. I get it. But I also know there is hope out there. I had to do intensive PTSD work and I hated it, but I did it to live. To be honest, I'm a little mad she isn't willing. But would rather abandon life itself. So yeah, it's getting to me a little today, and I need to really carefully consider that as we move forward.

I did lose a roommate to suicide - so I also own that some of my reaction may also be about that death.

You obviously know her better than I do, but my first impression about her saying "I want to die" is not that she is actively suicidal, but that she is being open about how she feels -- which is a good thing.

@Casey_03 - Yeah, this has been my impression up until this point. Now, I am not as sure. It is good that her therapist at least knew in the past she has struggled this deeply....

I also hope that she's not bringing up suicide in any emotional blackmail type way? You know, like if you're not there for her when she needs you, she says "i'm going to kill myself right now if you don't pick up." That's not happening, is it?

No, it's not. She is actually very respectful of any boundaries I state, and has never done this. If she did, my first call would be for a welfare check. Period. I don't do emotional blackmail.... And my roommate did this to other people - not me, but others, and they didn't take it seriously and he did end his life. With my friend now, it seems more like a desperate venting. She doesn't even ask for anything in return.

Oh dear, I really don't want to lose her. I've lost too many people.

It also might be good to encourage her to start being creative in some way to express these dark thoughts .... drawing or painting or something. That can be immensely helpful as an outlet for really dark feelings, and at least that way it's slightly productive ...

This is a great idea! Thanks!

I'd rather try to do something than nothing though.

@The Albatross - Yeah, this is what I tend to default to as well.

She took today off from work because of her anxiety is super high. I gave her a call this afternoon. She didn't pick up. I asked that she just check in with me within an hour, and I was honest that it was so that I knew she was still fighting to live and that I was here for her... I didn't tell her this next part yet, but if I don't hear back, then I will call the suicide crisis folks in her area and tell them what's up and let them decide if a welfare check is warranted. Maybe it's too much, maybe she would be pissed, but her life is worth more to me than even our friendship. No one believed my roommate, and they figured he was just venting too... and he's dead now. So yeah, that does play a role into this now with her.

I hate PTSD and I hate depression and the lives it takes.

 

[Justmehere]

I have no real advice for you other than to seek out professional help. You can't bear this burden on your own and if you do nothing-----not talking about suicide, but you could be left knowing nothing, which is a hell all of its own.

Yeah, this is a good point. I may end up reaching out to the suicide crisis team in her area either way, even as just support for myself.

 

[joeylittle]

my first impression about her saying "I want to die" is not that she is actively suicidal,

This is usually the case. However, it takes a full assessment to actually know what danger someone is in (I'm not correcting you specifically, @Casey_03 -I'm only adding information).

@Justmehere, you probably don't want to get into assessment-type questions, especially at this point, given your own feelings that are starting to emerge. My strong advice would be that you lean into talking with her about the pros and cons of her sharing more of this with her therapist.

I gave her a call this afternoon. She didn't pick up. I asked that she just check in with me within an hour, and I was honest that it was so that I knew she was still fighting to live and that I was here for her

Make sure that you follow up with a text. Also, a stronger technique is actually to not leave a message more than ' trying to reach you', at the most. Then, call back about every 10 minutes, no message needed. An hour is a tight timeline if she's sleeping or avoiding, but repeated calls - so long as they don't stress YOU out - will keep trying to get her attention. It usually works, even though it can take awhile. If you know she's at her phone, somehow, you can call repeatedly. That's definitely useful if you are in the middle of talking with someone in crisis and they either hang up on you or 'lose the connection' (passive hanging up). Just keep ringing them, no message. They will pick up the vast majority of the time. You can call local crisis in-between those calls.

If the opportunity presents itself, you can find out if she has a date or method or means. Just asking flat out can be upsetting, though - not for her, for you. A good way in, for you as a friend, is something like 'I am so sorry you are in this much pain. I've been in a similar place before, myself. Can I ask you a more specific question?' And then, assuming she says yes, ask 'Have you been having thoughts about how you might kill yourself?'

She might know where you are heading by the first bit, and answer the second bit without a prompt. The prompt is specifically worded to make it as easy as possible for someone to answer it. 'been having thoughts about' keeps it safely as thoughts, not plans, and 'how you might' leaves it also as thoughts, and as an open-ended query. Then, just wait. What you are hoping for is something like, 'well, I don't know, really', and then ideas. Or, 'I have these pills, I guess I would take them', or "I think about (fill in the blank)'. A 'maybe' kind of answer doesn't mean the person is safe, but it means they are safe at the moment - that's all. That can give you some relief to hear, though. Any answer that starts directly with 'I would' or 'I will' is reason enough for a non-clinician to advance the conversation up to someone trained in crisis assessment.

I have no idea if that helps or just makes you more upset, @Justmehere - and really, it's so important that you are listening to your own feelings during this, and it's great to hear that you have steps in place for what you can do to move this off of your 'plate', so to speak. I very much hope that your friend decides to open up to her therapist. And, I just want to validate that you can call a crisis line at any time in order to get help with this. There are no bonus-points for helping her keep it quiet (I know you know this, just affirming it).

 

[Kailani]

You are a great friend to have her call on her support systems and reach out to you! It may be a hard time she is going through and just how she is feeling but not acting on. May be a coping mechanism and it may not. Is there a suicide hotline you can give her? A PTSD hotline number? It is so... Hard to help a far away friend! She trusts you and sounds like she values you. Circumstances can change for her for the better. Maybe she can plan for future treatment at the PTSD place; that might give her hope. Maybe there is an outpatient option locally. My fear would be being admitted against my will as joeylittle said. Love the creative release suggestion! Self care behaviors; a movie, a bath, hot tea and warm blankets, animals.... Breakups aren't ever easy but she has been through it before successfully. Hope it helps and sorry if I reiterated others cuz I haven't had a chance to read all the posts!

 

[Justmehere]

you probably don't want to get into assessment-type questions, especially at this point, given your own feelings that are starting to emerge. My strong advice would be that you lean into talking with her about the pros and cons of her sharing more of this with her therapist.

Thanks for this suggestion. I know I can't objectively evaluate the risk - I don't have the training, I'm too close, and I have my own stuff and history and emotions... I think that talking to her about her therapist is a great subject - and one that isn't too triggering for me.

I followed up my voicemail message with a text... no response yet. It is fairly possible she could be sleeping or avoiding. Goodness knows I have done it. But at the same time, it's not my role to guess what's going on. I have to also take her at her word.

If the opportunity presents itself, you can find out if she has a date or method or means. Just asking flat out can be upsetting, though - not for her, for you. A good way in, for you as a friend, is something like 'I am so sorry you are in this much pain. I've been in a similar place before, myself. Can I ask you a more specific question?' And then, assuming she says yes, ask 'Have you been having thoughts about how you might kill yourself?'

This is so reassuring to read. I said some of this on text earlier, almost word for word, and felt like maybe I said completely the wrong thing. Thanks for the good advice on how to further follow up if she responds.

I have no idea if that helps or just makes you more upset

Actually, your feedback has been very reassuring and helpful - thank you.

Thanks @Kailani for the encouragement! I almost sent her links to a crisis line, but she has had crap experiences with them and hospitals, so I am just so reluctant to push any of that. She's got a therapist she likes so I hope she can trust to reach out at least there. I would have the same fear of being committed against my will too. My hope is that she will respond and maybe we can talk about her talking to her therapist about treatment options she can choose... We almost were talking about it...

I started to think of when the police were looking for my roommate after his first attempt. I remember letting the police come in and search for any clues of where he might be. They caught him in time and got him to a hospital. Through it all, he told me that our talks after he was in the hospital were the best. I did nothing but listen... It broke my heart to hear that "just listening" meant so much to him.

In the end, he lost his battle against depression and I am really not over losing him, am I? :( How could I be? He was a great guy.

I don't want my friend to lose her battle too.

But damn, I can't be even slightly objective about this. :/ I noticed she deleted all her recent posts off Facebook. It was another unusual thing for her to do. I went ahead and called the local crisis unit in her area. They reassured me that I'm not overreacting. Frankly, I made it sound like a really low key situation, because... well, I want them to handle it as low key as possible. They are headed out to check on where she lives now. I gave them her campus address, and figured if it's serious enough to warrant more help, they will track her down at home too.

If they find her and admit her, she may hate me... At least she will be alive to hate me.

 

[Justmehere]

Well, the welfare check folks couldn't find her... But she texted me. It was the simple "please let me know how you are doing" that got her attention. She said she is now with a friend... She said thanks for caring and checking up on me.

I texted back, "I'm glad you have someone there with you and I hope you are able to get some sleep tonight. I'll check in with you tomorrow" and I signed off with our typical sign off to send love her way.

I didn't quite know what else to say. I hope that maybe she knows I'm here and I do care. And yeah, I'll call out the freaking calvary to save her life if needed...

I dunno what else to think. I'll reach out to her tomorrow and see how this goes. Suicidality usually sticks around for a little while, and she's forthright enough that if she wants me to bug off, she'll hopefully tell me.

Thanks all for the support as I sorted out how to respond. It means a lot to me.