Hi! I have a friend that even though he does not present with MDD, has some traits that worry me. From an outsider's perspective he is a very shiny dude. In fact, he is really enthusiastic in what he does. He is an extremely quick and deep learner. Additionally, he also had such a diverse amount of experiences through his life... like sometimes it seems really unbeliavable. Lol. But the amazing thing is that it's the truth. Well, a great and interesting person to hang out with, but also a super great Friend and an amazing person in general. 

In all of this, you would ask yourself what is the issue. Well, the problem is that since he was around 12 years old, he began having sort of "ticks" in which his brain was just misfiring self-mutilation or even suicidal thoughts. The recurrence of the episodes apparently was following a wavy pattern of peaks and throughs but over time the peaks became more frequent than the throughs. These compulsive and almost obsessive thoughts, are really causing so much pain in him although he really manages to mask it up extremely well.  

I suggested him to go to a psychiatrist that could prescribe him some drugs and to follow some CBT. The main problem is that he has no time for these things. We are both students, and our course is really, really demanding therefore we have almost no social life outside our 4 friends group. Theoretically we would be able to make friends, go to parties or visit cities, but literally, we have zero time. Nada. 

Because I am younger than him and went to a demanding course straight after highschool, I never experienced what a easy uni life was. On the other hand though, as mentioned before, this guy had the opportunity to experience so many different things in the years post-highschool and especially pre-Covid. Right now, a normal day for him (and us) is waking up at 8, following lectures until 5, going to the library, coming home at 8, eating something,  quizzing, sleep and repeat. 

Of course such an alienating life style, curved on a desk and staring at a screen for hours on end, is not the greatest thing for our mental health. The problem though is that he began mentioning those annoying thoughts after some months I got to know him. Now 3 years have passed since I met him and I noticed that the frequency of lower moods and these "tick-like thoughts" increased and decreased respectively. The fact that he started more often struggling sleeping, has mood changes, problems with gf and being demotivated worries me. 

How does someone get rid of these malicious thoughts? Imagine waking up almost every day for years and thinking about obnoxious self-inflictive things. He luckily does not do that because he is strong and rational enough to resist the urge of these thoughts. I really hope that somehow this trend can be stopped. Do you think that the best decision is to act ASAP and trying some CBT accompanied by some pharmacological help as I suggested? The only problem though is the time. Therefore I am wondering if it is worth doing some intensive CBT during the summer break and the continue it less intensively once the courses restart.

Best of luck to everyone that suffers from a depressive condition or any depressive disorder. It is such a horrible thing and people should be more aware of it, that is why I am asking if someone knows a suggestion for my friend. I feel like the people around that know him relatively superficially do not have idea how hard it must be.