I have bipolar depression and for the past few years (they are adding up), it has taken over my life.  When I was in the middle of a very serious depression person after person rejected me.  I have found that most people simply do not believe that depression is a real illness.  It is!  Before I Became so seriously depressed, I kept all my problems to myself for years but it got to the point where I could not anymore.  My experience of reaching out did not work out and people, by in large, were not very nice.  I do not know how good of a friend you are to this person but to him/her what he/she is saying is real to them.  It can become very difficult for you, as a friend, to hang in there but if you care about this person, I urge you to try.  Read as much as you are willing to about this illness and you may get some understanding.  If your friend is not taking his/her meds urge her/him to and if they are not working urge her to go to a GOOD doctor and work on getting on a medication that will work.  It is my opinion that good medication and the support of a good counselor and good family and friends helps people who suffer from mental illness.  I hope this helps and thank you for being such a caring friend that you would write in to ask the question.........Pam

Be very direct.  This is serious.  Ask him directly, "Are you thinking about hurting yourself?"  This might open him up and help you to help him get help.  Maybe no one has ever asked him directly because people are afraid.  I have been a therapist for many years and know this is the best way to start.