Background: Suicidal young adults often confide their distress to peers. It is unclear, however, what types of assistance a friend may offer in response to various symptoms of distress as well as whether the sex of either individual affects responses. Aims: We examined open-ended responses to e-mail vignettes from a fictitious friend exhibiting depressed, irritable, or overtly suicidal communications. Method: College student participants (n = 106) read e-mail messages from a fictitious friend, to which they composed a reply. Replies were coded to reflect the presence/absence of mention of professional help, problem-oriented (personal) help, and social support. Results: Problem-oriented help was offered the most across conditions; professional help was offered least in response to depressed or irritable vignettes. Women were more likely to offer any type of help than men. Patterns of help-giving and sex differences in help-giving varied by condition. Conclusions: Results indicate students’ preferences for solving peer problems personally rather than professionally. Campus prevention and intervention efforts should focus on enhancing students’ peer support and referral skills.