Double Take: My friend is contemplating suicide — how should I respond?

Dear Dr. Wes and Gabe: My friend is talking a lot about suicide. I don’t want to break her confidences, but I don’t want my friend to be hurt or worse. My parents wanted me to write and ask your opinion.

Wes: Here is the short version: You need to tell someone who has the power to do something about this. In my experience the most likely helper in these situations is a school counselor or social worker. Having made this pitch to a number of young people over the years, I understand that you don’t typically think of those folks as mental health resources, and they are limited in the real clinical services they can offer. But I’ve had good luck over the years with starting there. Do this today. Don’t even wait until tomorrow.

Double Take columnists Gabe Magee and Dr. Wes Crenshaw

Now for the slightly longer but still hopelessly over simplistic version: Way back in 1970, a book came out with the worlds most self-explanatory title, “The Unresponsive Bystander: Why Doesn’t He Help?” The authors found several answers. Time and again, I’ve found they apply to teens struggling with the choice you’re facing now.

  1. Ambiguity, meaning you’re not exactly sure what’s going to happen or what to do. Teens often talk about suicide but, thankfully, they’re among the lowest risk age groups to successfully commit. You may feel uncertain about the actual risk to your friend and certain about the risk to the friendship if you tell. So you wait and see what happens, hoping for the best.

  2. Cohesiveness, meaning you go along with the group. So, if all your friends agree to tell, it’s likely you’ll gladly join up. More often for teens, however, telling on someone is considered a huge breech of social etiquette and frowned upon, even in serious situations like this. Often friend groups attempt to solve the problem by keeping the suicidal teen occupied or trying to cheer them up. That’s nice, but it’s not a long-term solution.

  3. Diffusion of responsibility, meaning you think someone else is going to act. I’ve seen entire friend groups who knew about one member’s suicidal thoughts and basically stood around waiting to see who would tell, hoping it would be someone else.

If your friend has a therapist — and many kids do now — you could ask to go to a session and then spring your concern in the safety of the clinical office where your friend can get some professional help. No matter what you do, she’ll be angry with you for outing her, but you’ll have peace of mind that you did what you could.

I’ve worked many cases in which the unresponsive bystanders — and even some pretty responsive ones — lost friends and were very frustrated with themselves for not acting more fully on their friend’s behalf.

So, run and tell.

Gabe: Wes is right. It’s vital that you get your friend help as soon as possible.

Depression is a disease. If you thought your friend were in danger from any other illness, would you get them help? As a society, we give more credence to physical diseases than mental ones because we usually can see the former.

By definition suicidal people care little for their own well being, and often will not seek help. Sometimes they will tell close friends of their troubles, just as yours did. Yes, there’s a small chance that your friend is either not being serious or exaggerating her condition. If so, I understand why telling someone could shatter her trust. But you shouldn’t mess around with something as serious as suicide.

Even if you break her trust, telling someone in authority or seeking medical help is crucial. She may hate you for it, but eventually she may forgive you and realize what a great friend you were. Even if she doesn’t, the alternative — doing nothing while your friend is on the brink of leaving the world forever — is something that I personally could not accept for myself.

First-aid for life-threatening lacerations is easy to learn: Apply a bandage and pressure. First-aid for depression is just as important and something we should each learn to administer.

— Wes Crenshaw, Ph.D., ABPP, is author of “I Always Want to Be Where I’m Not: Successful Living with ADD & ADHD.” Learn about his writing and practice at Gabe Magee is a Bishop Seabury Academy senior. Send your confidential 200-word question to Double Take opinions and advice are not a substitute for psychological services.