Is it that difficult to ask if someone is ok or to say that you're thinking of them?
No, it isn't, but as several pps have pointed out, that's virtually never all it involves, because in the case of the friend I am thinking of in my own life the reply will be a lengthy voice WhatsApp telling me she's suicidal, she's self-harming, her GP is useless, her rabbi is useless, OT and her line manager are useless, all her friends are useless, her neighbours are awful, no one cares and she sees no reason to stay alive.
Ball in my court. I have the choice to either ignore her voice message and wonder if she's cutting her wrists, or I have to find a quiet spot at work, or out of earshot of my young son if at home, because even my end of the conversation is pretty concerning/triggering and I don't want it overheard by a nine year old.
The upshot is then a long monologue in which she, mired in the extreme selfishness that is severe depression, doesn't even seem to recognise she's talking to another human being who also has claims on her time and attention, and dumps a load of incredibly upsetting stuff on me.
The last time it was recovered memories of sexual abuse by her brother in graphic detail. I stopped her and told her I'd been abused as a child myself and that I was sorry that it's a 'club' with far too many members but I don't think she even registered that I was a fellow-child victim, that she was upsetting me, or wondered whether I wanted to hear details. I have contacted a specialist charity that offers free counselling for adult survivors which another friend found very helpful, but she won't engage.
As pps have said, a side effect of depression is complete selfishness and tunnel vision. I have told this friend I've had two gynae surgeries this year and a cancer scare, and 2020 contained some challenging life events even on top of Covid (a move to a different country, leaving a job for another that then evaporated because of Covid, a house purchase falling through, long periods of living in AirBnBs during lockdown), but I have never had a single indication that she has even registered this.
When she rants about no one caring about her, she is apparently unaware that she has someone on the end of the phone who has been listening to her for an hour while trying to make dinner and supervise homework, and who has in the past lent her money, brought her groceries, liaised with her line manager, rabbi etc etc. She continually says that no matter how bad I think I have it, I don't have it as bad as her because I have a husband and a child. Which is realise is her depression speaking, but which is also incredibly insulting.
And it's also the reason she is phoning me I now live in another country because all the genuinely sympathetic colleagues she used to see outside of work have distanced themselves because of her expectations. These are nice, warm, concerned people, who have done a lot for her in the past, but have reached their limit.
And none of us can do what she actually wants, which is someone to rescue her.