I have a friend who lives about 2,000 miles away from where I live, and she was diagnosed with PTSD following an armed robbery over a year ago in which a gun was pointed at her.

This year I visited her for the first time since this incident, and it was during this trip that she shared this incident and the PTSD with me for the first time. It made sense because her communication with me had slowed right around the time of this incident. She, however, denies that she still is affected by PTSD. This is despite that she refused treatment from the start, has never gone to therapy, and I can see she still has a number of symptoms of PTSD. For example, she is now very easily startled or irritated, and she has become very withdrawn from various people in her life including myself and family members. I noticed a marked change from when I had last seen her, shortly before this incident. Perhaps the change is more noticeable for me than it would be for family who see her on an ongoing basis.

I'm no doctor, but I know this is someone who needs help and I don't think she's getting it. She's also not the kind of person would would readily admit to needing help.

I have periodically tried updating her on my life since I came back from this trip, but I haven't heard from her. (Part of that is also due to the nature of her job, which involves very long hours.) I know now that I need to take a different approach with her, but I don't know how to approach her. I'm very concerned about her. The PTSD, in my opinion, has been a strain on our friendship, although I have taken the stand in my mind that none of what has happened is personal against me and that I will always be there for her.

She has been a special friend to me for years and I love her to death, and I want to do whatever I can do for her at this distance. For reasons beyond my control my only options for contact with her right now are email and text messaging.

My main questions are, what approach should I take with her and say to her, and what can I do for her at this distance without smothering her or turning her off.

Any advice from this community would be greatly appreciated.