Ask The Therapist: “I have a friend who has ADHD and has recently been suicidal…it’s scaring all of us, but we don’t know what to do…”

T/W: suicide, depression

In 2016, the number of people estimated to be suffering from mental health issues like depression and anxiety amounted to roughly 1.1 billion. Since then, numbers have likely continued to rise. Moreover, studies have also shown women especially on average are a) more likely to suffer from mental health issues, and b) less likely to talk about them. The taboo in Pakistan surrounding depression and anxiety disorders only serve to aggravate the individuals suffering even more. For the women who cannot seek out full time therapy, we’ve enlisted the help of a trained therapist. You sent us in your questions – here are the answers!

“I have a friend who has ADHD and is 3 years behind in school. Recently, he has been severely depressed and suicidal. We’ve all tried to talk to him, but he doesn’t talk to anyone about anything. He has an entire plan laid out to commit suicide as well and it’s scaring all of us, but we don’t know what to do. His parents are very conservative in their mindset about such things and are not receptive to conversation around mental health. I am scared that if I reach out to them, they’ll scold him and he will cut us all out. What can I do?”

Shahrukh’s Response:

Dear Anon,

That sounds like an incredibly difficult situation to be in. I can only imagine how scared you must feel right now. When it comes to dealing with mental health in Pakistan, especially in more conservative households, I know that there is still a stigma and a lack of dialogue that is still pretty prevalent. At this moment in time, the one question you need to ask yourself is: what is the best move for my friend’s safety

Separating Your Needs From Your Friend’s Needs

This is often a really challenging decision to make, because there is fear that your friend might be upset, or that they may not speak to you again, and I know that this can be a really scary thought, yet at the end you are doing what you can to keep them safe, and sometimes that involves putting our fears and needs aside. This is about their safety. So, how does one know what action to take?

What Can I Do To Help?

Normally in places that are more developed, there are several resources and protocols in place for suicide. Unfortunately, there aren’t any such protocols here, and the options we have are quite limited. It’s important to assess certain risk factors and then see what action to take. Check in and ask them where their mind is at. It’s okay to ask if they are thinking about suicide. If they say yes and give you details about how they intend to do it, it might be time to take some action.

As stated before, the number of options is limited and is based primarily on your own judgement and understanding of the situation. Sometimes you can try interventions like listening or speaking to them, while others may require you to contact others. Some options to consider are:

  • Stay as calm as possible: I know that it can be quite overwhelming to hold space for someone who is feeling suicidal, and it’s important to acknowledge that you are doing your level best to be there for them. So, while you’re there, just keep yourself as grounded and calm as possible and hold space for them as best as you can. The more supported they feel, the better. 
  • Listen to them openly: you may be tempted to advise them on how they can fix what they’re going through. This might not be the best approach if a person is in this state – they are not in a place to really listen to rationale. The best thing you can do for them is listen, validate how they’re feeling and tell them to keep talking and that you’re there to listen to them for however long they need, while reassuring them that you’re there and that they are safe.
  • Going to them physically: if possible, try not to leave a person at risk of suicide alone. Stay by their side, support them and comfort them in whatever you can. The most important thing is for the person to know that you are there for them, and that you are not judging them in any way. You are there because you care about them and you want to help them.
  • Speaking to a family member: if you feel that the parents are not the best option, then perhaps another family member or someone close to the family? A sibling? An aunt? A family friend? The idea to speak to someone who can intervene physically and emotionally. The former being a priority in the worst-case scenario. 

Talking To Them About Seeking Help

Once you have gotten your friend into a more grounded state, it would now be time to perhaps speak to them about taking care of themselves. ADHD is a mental health condition that can be challenging, especially one that’s left untreated. Learning disabilities, depression, anxiety, OCD, sleeping disorders and mood disorders are fairly common in people suffering from ADHD. Some options they can explore are therapy as well a psychiatric consult (if medication is an option they are willing to explore) – the former will help your friend come up with behavioural changes along with emotional and would help him manage his symptoms through psychopharmacological interventions.

Anon, as said before, it can be challenging to help space for someone who is struggling. Remember, that while you are taking care of those around you, don’t forget to look after yourself whenever you need to, it’s equally if not more important. I hope that this article was able to provide you with the answers and clarity that you were looking for. I wish you all the best with your friend. I hope they are able to get to a more grounded space. Best of luck and take care of yourself!

The above article is written by Shahrukh Shahbaz Malik who is trained in humanistic integrative counselling at CPDD in the UK and currently has her own private practice in Karachi. The views expressed in this article are those of one expert. They do not necessarily represent the views of Mashion, nor do they represent the complete picture of the topic at hand. This article is for informational purposes only and is not a substitute for medical diagnosis or treatment.

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