I recently discovered a friend of mine has homicidal fantasies. I assured them I would be a loyal and caring friend and I really mean it but I’m concerned and wish to help. I know this needs to be taken care of by a professional, but I have no idea how to get them help when neither of us have the resources to do so. They tell me that they have had this since they were very young and fantasize about murdering other people they know: family, friends, even strangers repeatedly and all the time. They don’t have an urge to act on these fantasies thankfully but they are a very prominent morbid obsession for them. I am the only true friend they’ve ever had and the only one they’ve ever told about this as well as one of the very few people they’ve never thought of killing. I know that this person has a very high tendency to bottle up emotions — they have panic attacks, extreme social anxiety, ect. In short, they’re a trouble individual. Could you give me a general idea as to what tends to cause homicidal fantasy? And, more importantly, what is the best way for me to support them through this as their friend? What can I do to help? And how can I find help provided that they don’t have the money to go see a true professional?

A. It’s important to realize that your friend needs help beyond what you can provide. Strongly encourage them to consult a mental health professional. Contact the school guidance counselor and ask for their help. They will know what to do.

If that is not an option, then speak to a trusted adult, perhaps even your parents, about getting help. You may not have to reveal the homicidal ideation, but try to say enough to get your point across. You could mention the panic attacks and extreme anxiety.

It’s not clear why some people have homicidal thoughts. It could be a maladaptive coping skill. Some people are struggling with emotional problems. The homicidal thoughts might be a response to the frustration of experiencing strong, unpleasant emotions. It’s also probably linked to their anxiety.

There are many potential theories, but even if you knew why your friend had homicidal thoughts it would not help very much. Knowing why is interesting, but it doesn’t solve the problem.

The bottom line is that your friend needs help. These symptoms are highly treatable by mental health professionals. Do your best to encourage them to seek help. Don’t hesitate to call the authorities if you believe that they are a danger to themselves or to others. Understandably, you don’t want to upset your friend by revealing information that was shared in confidence, but it is far better to act before something bad happens. Please write again if you have additional questions.

Dr. Kristina Randle