I don't remember many details about the first time my best friend told me she wanted to kill herself. She told me as we were sitting in my car, parked in her driveway, staring out my windshield at the dull white of her garage door. She said that she had almost done it a week earlier. After she told me, I started saying a lot of words that I knew wouldn't make any difference. I kept repeating, "You can't. You can't. You can't," until she finally looked back at me and wiped a tear from her own face.
Ever since that night, I think about her multiple times each day. I wonder when I'm going to get a call from her mother and hear a choked up voice on the other end struggling to get the words out. I panic when she goes days without answering my texts. I check her Instagram to see if she's posted anything. I go on her Tumblr. I look to see if she's reactivated her Facebook.
Seven months after that night in her driveway, she spoke to me on the phone from a psychiatric hospital, the same one she had checked into after she first told me she was suicidal. She told me this time her mother tricked her into being re-admitted. She was sobbing, taking deep breaths in between words, and she told me that the moment her mom dies, she's done. I told her not to say that. She said that's always been the plan, that even her mom knows that. I could feel myself getting frustrated. "That's not normal," I said. I wasn't sure if this was bad to say. I wasn't sure if I should try to be reassuring and tell her that it was OK for her to have these feelings, or if I could tell her how I really felt, which was that this was not OK.
When I first asked my friend what she thought of me writing this article, she didn't respond for a day. I was worried she was going to ask me not to write it, or worse, be angry at me for being so insensitive that I would even think of it as a possibility. But when she did eventually respond, she told that she was finally ready to get it out in the open, and started to tell me the details of the illness, the drugs, and the thoughts that have haunted her for years.
As of now, she has been diagnosed with major depressive disorder, one of the most common mental disorders in the United States. According to the World Health Organization, major depression also bears the heaviest burden of disability among mental and behavioral disorders.
It's possible that she could suffer from bipolar II disorder and schizoaffective disorder. However, these disorders are challenging to diagnose when patients are young, since it's difficult to separate the symptoms from normal youth angst. On average, it takes ten years for bipolar patients to be properly diagnosed and treated. Until then, it's basically just trial-and-error.
I am forever watching from the side, grasping at her whenever I can, trying to pull her back in.
Wendy Parker, a registered nurse clinical specialist who specializes in prescribing medication for children and teens, told me doctors often experiment with medication to see what works before they diagnose young people with things like bipolar disorder. "If you give her a medication like Prozac, you watch quickly to see if she responds to it," said Parker. "If she doesn't, and the mood starts to swing from depression to giddy, silly, happy, or from depression to fiercely angry," then doctors have to try a new diagnosis or a new drug.
A few years ago, my friend was prescribed 20 mg of Prozac. Then it was increased to 40 mg, and then to 60 mg, and then they added on 250 mg of the mood stabler Seroquel. She's told me again and again that the medication isn't working. This past December, she decided to stop taking everything altogether. Since then she's dropped out of college and relocated to the other side of the country for an indefinite amount of time. She says she doesn't know where she will be in a month which frightens me. She is always moving, uprooting herself in a merry-go-round of life-changing decisions. And I am forever watching from the side, grasping at her whenever I can, trying to pull her back in.
Two summers ago, when we were both living in New York City, she called me from her apartment on the other edge of Manhattan. She was alternating between laughing and whispering, asking me if I remembered the sneakers looped over the electric wires outside her window. I told her I did. "What if there's a camera in them?" she asked me, suspiciously. At the time, I assumed she'd just smoked a bowl and was high, paranoid—but I remember putting down the phone at the end of the conversation, laying back in my bed, unable to fall asleep, imagining her staring out the window into darkness with wide eyes.
Most of the time, the frustration that accompanies being friends with someone with mental illness has nothing to do with the friend herself. I am frustrated that this has happened to her. I am frustrated that the drugs don't work. I am frustrated that drugs seem to be her only option. I am frustrated that we don't have a better solution. I am frustrated that I can't do one fucking thing to help her.
"There are many people with bipolar disorder who live pretty good lives," Parker told me. "You learn to live with it and take care of yourself. But when you're young, it's really hard. People who deal with it have to come to accept the fact that as a person, they're OK, but their brain is doing this terrible thing that makes life very, very hard."
I asked Parker if there was anything I could do for my friend. She told me to always approach her from a place of understanding; that even if I don't understand, I can try, and that is what makes the difference. She told me when I get annoyed by the things she does to remember to separate my friend from the disorder. "Some of it is her and some of it is the illness," she said.
I'm frustrated that the drugs don't work. I am frustrated that drugs seem to be her only option.
There are the rare times when my friend opens up about what is going on inside her head and I don't know what to say. She mentions the suicide notes she's already written or her plan to kill herself once her mother is dead. In moments like these, when I don't know what the right words are, desperate to say something that will matter to her, and scared that what I say will do more harm than good, Parker told me it's best to keep it simple and honest.
"That would be a place for a friend to say 'Life is important. Your life is important.' It helps," she said.
And I can't give up on her until she understands that. I let her ignore my texts for days, without ever expressing my frustration. I don't complain that she keeps secrets from me and doesn't tell me about her life. I ignore the fact that we speak only when she decides she wants to. Our relationship is one entirely on her terms, and that's the way I imagine it will stay until she gets better. I don't pretend that maintaining our friendship is number one on her priority list. I wouldn't want it to be. Because each time I feel slighted by her, or ignored, or hurt in some way, I automatically forgive her the second after it happens. And I'm going to continue doing that.
If you are struggling with depression or suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255.
Follow Catherine Pears on Twitter.