Expert: Libby Bonner - 8/12/2007

Question
my best friend moved away when i was in the sixth grade and we
promised to stay in touch forever. i am now in the 10th grade and she
has gotton more distant and is hardly talking to me anymore and is
tottaly changing who she is and everything. yesterday, i was talking to
her and she told me that she was diagnosed with bo-polar and
depression. she told me that she gets suicidal thoughts and cuts herself.
i was in shock and i think that she was too because it was the same day
that she was diagnosed. i told her what i thought i should tell her. like,
"im always here for you and you can call me whenever. i really care about
you and that if you ever need anything at anytime im here." but it didnt
hit me till later that day what it actualy is and im really scared for her.
she lives in toronto and i live in vancouver and i want to be there for her
cause im scared shes gonna hurt herself or worse commit suicide or
something. and im so scared, and its not fair for her cause she was
already a lucemia patient for three years about 7 years ago and its like
nothing ever works out for her. i was wondering what i can do to help
her and if i can get some more information on the disorder to help. i just
care about her so much that i cant lose her. shes a very strong person
because of the cancer history than i know that she is able to pull through
it, im just worried that she doesnt know that.

Answer
I'm terribly sorry to hear about your friend.  It will take both of you awhile to adjust to this news.  I thought your immediate repsonse was a good one.

And it may take several weeks or months to find exactly the right mix of medicines that will help her the most. But current medicines work very well and I hope, when she has the right ones [takes trial and error to find them], that she will begin to feel better most of the time - IF she takes the meds.  This is a touchy area with patients.  Don't let your concern taking or not taking them lead you into nagging her.

During the time that she and her doctor are working to find the right meds, she may seem different nearly every time you call.  And there may be times when she would rather not talk.  This is normal.

Your best role as her supporter is to believe in her future and to NOT express over-concern about particular changes in her.  Calm and low-key would help her most.  You probably need to be in charge, sometimes, about how long you talk w/her - if she seems to be having a bad day, or too wierd or excited, it might be best to switch to a neutral topic, if possible and then end the call.

And please try not to "wring your hands" when talking to her.  She does need low-key reactions from you, and brief expressions that you are sorry that today is awful [if it is], and your belief that she will get better.  On the other hand, don't try to persuade her that she will get better if she feels otherwise...just listion.

There is a wonderful Canadian organization that has many free pamphlets.  Many will be of help to you and perhaps to your friend's family.  I think you should not supply direct illness information to her: that is entirely the job of her doctor and her family, since they will know daily details of her progress and what might help/hurt her in the way of information.

Despite its name, this group DOES cover all mental illnesses.  World Fellowship for Schizophrenia and Allied Disorders, Toronto, 1-416-961-2855.  
www.world-schizophrenia.org

Here is a critical question to ask her: does her doctor or her parents or any other adult know she has suicidal thoughts?  If she says No, then you , or one of your parents, MUST let one of her parents know EXACTLY what she has said to you, the exact words. This is a DUTY; it is not the releasing of a secret or the breaking of a promise.  

Be more concerned, right now, about her safety, than about secrets/promises.  If she has been told she is bipolar, her parents also surely know she is and probably are already concerned about suicide.  This would NOT be a good secret to keep.  -- I do remember quite clearly being in the 10th grade, and I remember all of us feeling that our parents just couldn't handle some of our secrets.  Trust me: parents are tough, and they can handle anything.  [This includes your parents, in case you are concerned that they couldn't handle it, would interfere w/ your contintuing relationship w/ her, etc.]  IF you have excellent reasons to believe that hers are parents who could NOT handle the suicide information, then you or one of your parents MUST tell some adult in Toronto, who knows the family, about it.

ABSOLUTELY promise me, also, that you will not set up secret plans to rescue her, or whatever, if you should get wild, desperate calls from her.  Her control over her own mind is not the best right now [that is what all mental illnesses have in common] and so you will have to be calm and assume that the very wildest, crazy talk just means she is sicker at the moment and that she will not continue to think that way.  

Don't buy into the wildest stories.  Some things may even be entirely untrue, and her mind has only imagined them.

I will hope for good steady improvement for your friend.  Pls send me progress reports from time to time, if you wish.