I have no professional qualifications. I’m sharing what I wish someone had told me.

Your friend is cutting herself and maybe doing some other self destructive things.

1. Don’t freak out. It’s a big deal and it’s not a big deal. It’s really, really common. The odds are that, believe it or not, everything will be fine, eventually.

2. Is she bleeding right now? She probably doesn’t need stitches. I’ve taken people to the ER for all sorts of horrific looking things that made me feel faint and no one ever got stitches. Butterfly bandages and superglue do wonders.

3. You’re feeling a lot of things and that’s fine. What are you feeling? Angry? Panicked? Sad? Frustrated? Helpless? Why do you feel that way? Probably because you care about her and hate to see her suffer and know this is not something you can fix. Let her know the why part.

4. This is probably not an emergency. Some people cut once, some people cut for decades. This doesn’t need a solution tonight. Thankfully, since there’s no simple solution.

5. Cutting is a coping mechanism. It’s not the real problem. There’s no treatment for cutting. People who cut can address whatever they are trying to cope with, find alternative ways to cope, or both. Coping mechanisms that help someone regain control are a great help.

6. Give her the space to talk. Don’t confront her. Don’t arrange an intervention. Watch some movies. Go for a walk. Be around. Invite her to open up by letting her know you care and are trustworthy.

7. Let her know what resources are there. There’s not a lot in the US, but there are some. Maybe you’re students and have access to counselors. Maybe there’s a great sliding scale mental health clinic. Some people swear by CBT, DBT, and mindfulness. Maybe there’s something you can help her with to deal with the underlying problem.

8. You can’t force her to accept help or address the pain. It’s her choice. You can decide that you can’t handle listening to her problems is she chooses to stay in an unhealthy or dangerous situation. It will harm you to watch people who decide to stay in pain and not try to change that. It’s okay to protect yourself.

9. If they want to stop, help them. Distract them when they get upset. Suggest other ways to cope when things are overwhelming. Encourage them when they succeed. Comfort them when they don’t. There’s no deadline to change. Not everyone wants to stop and trying to force them to will only make it worse.

10. People who are desperate are very good at manipulation. They’re probably not trying to manipulate or take advantage of you, but they’re too absorbed in their own pain to think about the cost of their actions on anyone else. They will explode your life if you let them. Decide where your boundaries are and maintain them, even though it’s so, so hard.

11. There will be more. The more you accept people who are in too much pain to reciprocate friendship, the more you will surround yourself with people who are in pain. One day you will walk away from most of them. Not out of anger, just by deciding this is not what you want your life to look like.