[bloudermilk]

I'm very sorry to hear that your friend is experiencing this crisis and the distress it's causing you. I've been through similar episodes before, first with an immediate family member who experienced a months-long manic episode that was later diagnosed as manic bipolar disorder, then a close friend who experienced a drug-induced psychosis which evolved into long-term schizophrenia. I know how hard it is to watch someone you love behave erratically and how powerless it can feel to try and fail to help. Here's what I learned...

The most important thing you can do is take care of yourself. Your own physical and mental health are prerequisites to caring for anyone else and being a part of extreme psychological distress of someone you love takes a huge toll. Lean on whatever practices you already have to stay healthy and content. Remember that what you're witnessing is not your fault and not in your control.

The best way I've found to be supportive are to be present as much or little as I can without compromising my own being. Intervening, escalating, and trying to reason with people in this state seldom has the intended effect and often has the inverse effect. As much as you're able, accept your friend for who they are in this state, listen without judgement, and validate their experience without cosigning it. Stay in touch with their family and close friends and work together to seek medical intervention if they risk the well-being of themself or others.

I'm here if you want to talk about it on a call or over email. Same handle at gmail. Be well and keep reaching out for support.

[qnleigh]

I would add to this trying to find other people who know your friend and can help. Ideally local, but if he has friends who he trusts that he can talk to over phone/video that works too. Get their connect information. It sounds like this is beyond what any one person can handle on their own, but you are in a unique position to connect him with further resources, in general and during acute crises should they happen.

Also know that 988 is now the nationwide suicide hotline number (in the US), and that you can also use this resource for yourself to deal with your friend's situation. Look up nearby crisis centers and save their info.

Lastly, for me 'take care of yourself' means talking about the situation with trusted friends and family. There can be a tenancy to treat kinds of things as taboo, but open discussion and outside perspective can be extremely helpful.

[rented_mule]

I like the 988 advice. I'd take it a bit further... consider getting professional help (counselor, therapist, etc.) for yourself as well, at least temporarily.

I see at least two angles where this can be beneficial...

One is getting guidance on how to keep yourself as mentally healthy as possible while going through something so difficult. This is at the heart of the ideas I'm responding to above... you have to stay afloat to have any chance of helping. If you've ever been on a commercial flight, you've heard "Put on your oxygen mask before helping others with their masks." The right professional can be a big help.

Another is that a professional will be able to give you guidance about what you might be able to help your friend with, and things you probably shouldn't try to help with. Professionals have seen a much broader spectrum of situations and have a better idea of where they themselves might be able to help (or not) and where a layperson may be able to help (or not). And they can give you ideas for things to try that might help your friend while exposing you to less risk of harm.

You're taking a smart step by asking for advice. In my experience, a professional often has the best advice.