I have a friend who I have known since college (it’s been 4 or 5 years now) and we were very close at one point. He has struggled with severe anxiety and depression since I’ve known him and people who also knew him before that confirm that it has been a very, very long-term thing for him. Now we live in different states but we still talk every once in a while. His patterns are very consistent- the only thing that ever makes him happy is a new relationship.

As a result , he obsesses all the time about finding intimate relationships, regardless of whether they are casual or long-term. He relies on them to validate him and when he can’t find anyone, he falls into a continuous spiral of feeling worthless, unattractive, unsuccessful, etc. This has been his pattern for years and it is hard to watch. He continuously says that women don’t want him because he’s not tall/rich/attractive/muscular/charismatic enough but really I think his social issues are largely due to his mental illness. I think he understands this logically but can not shake his feelings about himself.

I know he has reached out to professionals before but he says it’s been a long time since any therapists have actually helped him. He did see a specialist a little while ago and they confirmed via CATscan that he had chemical balances in his brain. Still, he says nothing has really changed since that treatment started and he just gets more and more frustrated with how helpless he feels.

In the last year he’s had a pretty bad breakup. He also lost his job due to allegations of him harassing some of the female staff. One of his ex girlfriends also claimed that he got violent during their breakup a few years ago. I never personally knew him to get violent, even though I was also romantically involved with him for a short time a while back (we are both very comfortable as friends now and he never does or says anything to suggest otherwise), and even during times when I told him things he might not like to hear, I never personally saw him demonstrate any of this behavior. So I really don’t know how much is true.

He’s generally not a healthy person. Irregular sleep schedule, some drug use, and frequent drinking are all long-term behaviors of his. He did get sober for a couple months and I was really proud of him but I think he started drinking again. He has said some bizarre things before, like that he wishes he was born before the 50’s because then the common gender expectations and norms would make it easier to find a wife.

Lately I feel that he has reached a new low. It seems like he’s tried everything, but still now constantly posting things about wanting to die on social media. I can not possibly intervene every single time he has this thought running through his head. He now seems disinterested hobbies that he used to at least be somewhat consistent in.

Every time he talks to me the conversation is the same. He tells me his thoughts. I just try to encourage him to see himself more positively, highlight that he has a lot to offer as a person, that he should keep trying and getting better is hard work, that he has to choose for himself, etc. but he always goes back to the same place.

What I really want is to break this cycle and for him to be able to just go on with his life. I am afraid that one day I will hear that he is gone. All of our other mutual friends seem to have given up on him, likely because of some similar fears. I just don’t know what to do.