Friend With Mental Health Issues Asked Me For Help - But I am Clueless What To Do

[MiNombreEsFicticious]

On 3/13/2019 at 6:58 PM, RuamRudy said:

I checked on Mental Health resources and there are actually several free or very low cost counseling services in Manila, but he told me that he had already tried some of them and they were no use to him. The counselor he saw is the brother of one of his clients, and he said that the session he attended helped him think more clearly about his issues, but despite my gently nagging, he has not booked a follow up appointment. It is almost like an intense ennui has a grip of him.

 

To be honest, he is both proud and stubborn, which I think is part of the problem - reaching out to me was clearly a huge thing for him as he had been struggling with this almost alone for over a year. 

My mother killed herself. My uncle killed himself. I speak from experience. Your friend needs medical help, every other kind of help is secondary and doesn't work without medical intervention. And your friend needs to want to be helped. If he already seen a therapist, that's a good sign, he is open to getting help. You might try calling the US embassy in Manila and ask them what to do, since your friend is American. I'm sure they have experience dealing with this kind of situation and can at least point you in the right direction. 

 

Your friend is lucky to have you, but remember, you can only help someone who wants to be helped. If your friend is unwilling, you have to step back. My mom had severe depression but found a great medication that saved her for several years... and then she thought she could handle things without the medication. A few weeks later she was dead. 

[Bang Bang]

On 3/13/2019 at 6:49 PM, RuamRudy said:

For most of the time in Manila he has been living with his Filipino girlfriend and I think his social life pretty much revolved around hers, but his erratic behavior and their shared money problems has led her to leave him last month, seemingly for good.

Is there a way to get his gf back in the picture? From what you say she was for a while the center of his life, or at least anchor. Her leaving was probably a  punch in the gut of someone already down.

 

Maybe you might have a chat with her and see if she's willing to come back and try to drag him out of this. If she still cares for him she might. (But no one could blame if she said no.)

[Katia]

17 hours ago, johnnybangkok said:

I think most of the people on this thread have given you a the best advice which is to seek professional help asap but I will add another point which is to not give up on him.

A close friend of mine suffered from depression and over many, many years he lied, cheated and generally buggered up his life to the point where most of his friends and family had given up on him. A couple of us stuck with him though until it got so bad that even we thought a bit of 'tough love' might do the trick; so we cut all communications with him 'for his own good'.

Two weeks later he killed himself.

I live with that awful decision every day and the guilt is unbearable at times. If I could go back and change that decision I would in a heartbeat, but I can't and it's done now.  

You sound like a really nice guy and you've already done so much for him and I know this sounds unfair considering he's not even a really close friend of yours but he cannot be left to his own devises. Get in contact with the family and try and get him home (this sounds to me like the best plan) or if that fails get him to a proper psychiatrist who can judge whether he really is a threat to himself. He can then judge whether he needs to be sectioned for his own good (I'm really not sure you would have the authority for this as it's usually only family that can do this but it's worth a shot) or maybe he will refer him to the US embassy. All of this would be made a lot easier if he was back home.

I'm sorry you have to take on this burden but I can assure you whatever guilt you may feel about walking away from the situation is a mere drop in the ocean compared to the guilt you will feel if it all goes really badly.    

The problem is that it is not your fault.  You are and were not responsible for keeping him alive, especially not since it sounds like you would have had to take a lot of abuse to do so (lying and cheating is not a "normal" part of depression, and while depression is a terrible disease, it does not absolve someone of taking advantage of others).  In the end, we cannot be responsible for other people.  If he was standing there with a gun to his head and you said "Oh, that's too bad but they're having a sale on Chang over at Cheap Charlie's, bye" and walked out; if you handed him a bottle of pills and said "have fun"; if you said "yeah, world would probably be better off without you"; that would be one thing, but no, it is not your fault that you could not and did not babysit another person 24/7 (especially since doing so would have been to your own detriment) for fear of what might happen, and there is nothing wrong with protecting yourself against someone abusive.  Do not feel guilty.  You did what you could, and even hung on longer than family... in the end, you could not work miracles.  There is no guilt in that.