Does it tear you up inside when a friend is hurting and you can't seem to do anything to help?

No. Not any more. I had to let that stuff go. I help when I can and I focus on my health. Edit redacted for privacy.

You seem to be a very empathic and sensitive person from your posts here. It certainly does upset me to see a friend in pain, however, I’m also conscious of not getting more involved than I should be. Try to keep a close eye on your boundaries and be aware of other help they have and other support mechanisms – family, friends etc. That might help you to feel you can back-off more and not get too emotionally involved.

Wow. Definitely. I even feel this way with people I just meet.

@Earthbound_Misfit Re: “be aware of other help they have and other support mechanisms – family, friends etc.”

First, I would never assume this. There are plenty of people I know who have zero people in life that are a source of emotional support.
Second, @yankeetooter specifically said that this person is a friend, so then by your advice, @yankeetooter would be precisely a person you deem to be available for help.

@dxs, I did say ‘be aware’. I didn’t say dump your friend and leave everyone else to look after her/him. She may not be her friend’s ONLY friend or support mechanism. They may have family and a group of other people to help them. We don’t know what problem her friend is experiencing, but there may be support from their workplace. @yankeetooter doesn’t have to take on the whole, or even the major, burden of caring for and/or supporting this person herself and neither should she try. She can and should help and be supportive if she can, but as friends, our first responsibility is to ensure our own mental and physical help isn’t compromised by over-burdening ourselves. If we give too much and become overly involved, we can render ourselves useless to our friend.

If that is a close friend, then yes, I feel pain. Just like you, the stronger the bond is the more pain I feel. But I also know my limit and I try to accept that there are things beyong my abilities to help. It’s painful, but it’s the truth.

That is the reason why I still haven’t really reach the acceptance state after my friend’s death yet. The guilt of not being able to do something to save him still comes now and then. But at least now I have accept everything. I haven’t recovered, but I’m somewhere close, I guess.