QUESTION:

I have a good friend who became severely depressed after she had mono in college. She's had many problems this last year (too many to go into now), but her parent's won't take her seriously (which means she has no means of paying for treatment) and all her other friends have abandoned her because she drags everyone down and it's really frustrating not being able to help, so here I am basically trying to deal with her myself...... I’m only 18, but I do not give up easily. Lately she has been extremely suicidal. She has not said specifically at any time that she was going to kill her self, just that she has had "suicidal feelings" and has an extreme fondness for razors......... Finally, yesterday, she did mention that she was thinking of checking herself into a mental institution. I do think she needs help, but my concern is that if she goes someplace like that, will she really get the help she needs or will they just heavily sedate her and lock her in a padded room instead of talking her and trying to deal with the causes behind her illness the way a therapist would? I know she is really scared about the thought of going, but she needs to do something. Can you please tell me what to expect and what more I can do to help?

DR. HELLER'S ANSWER:

Preventing suicide is the first goal, so an admission may be necessary. Psychiatric institutions vary in their quality. Some are superb, some become the object of media outrage. If she's in high school, talking with the guidance counselor may be a good start. Many states have a statute that threatening suicide can result in a hospitalization whether or not the individual has insurance or money. You'll need to check on your own state's rules.

If the BPD seems likely, showing her this website, particularly the front cover of my first book "Life at the Border" may be helpful - hope is a very powerful tool. The screening test I use for my patients is available for free at my website, and that symptom list may help her to look for diagnoses and effective answers.

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