Worried about my friend

My friend has been going through mental issues as long as I can remember.

He keeps having ups and downs and at this moment he seems to be at his lowest and I'm really worried though I don't know what to Do?

He self harms, has no self esteem and honestly I feel like one day he is just going to end it and I feel so helpless..

He once said he goes to a psychiatrists but it doesn't seem to help. He doesn't abuse substances too much (unless he is with friends)

I know he is going downhill fast and I can't even reach out to him anymore.. I feel like I'm the problem because I'm not very good at showing sympathy where as he is always there for me whenever I have issues with my girlfriend or band or something.

Watching him fall like this is killing me..

So please. What can I do?

All you can do is let him know you are there. You can't take his pain on personally. You can't fix him. All you can do is remind him that you care about him and remind him that you are there.