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May 13, 2021
Mental Health

Are You Consumed by Crisis?

By
David Macfarlane, CEO and Co-Founder
What You'll Learn
How Do I Spot a Crisis? Signs and SymptomsPre-Crisis: What Can Lead to a Crisis?The Actual Crisis: What Can I Do? Crisis Resolution: Coming Out of It and the Moments After

Crisis can hit at any time. It can be unexpected as much as it can be something building over a period of time. It can feel all-consuming and be difficult to understand. It can be frightening, even if it's not a life-threatening situation. Here's what you should know and how you can help, whether the person in crisis is you or someone else in your life.

How Do I Spot a Crisis? Signs and Symptoms

Crisis affects everyone - whether they are existential, spiritual, financial, or tied to mental health conditions. Being in crisis can be frightening, both for the person in crisis as well as their loved ones or caregivers. Typically, crises are brief, intense, and unexpected scenarios. They can be single incidents or "straws" (as in leading to the straw that broke the camel's back).

A critical element in crisis prevention, recognition, and resolution is relationship building. Whether this is yourself, a friend, or a family member, get to know what that person is struggling with. Are there triggers that bring on feelings of overwhelm or fear? Are there certain environmental factors that seem to consistently “set the person off”? Are there patterns that can help you identify the onset of a crisis state?

Here are a few common warning signs that someone may be in crisis, as shared by the National Alliance on Mental Illness (NAMI):

  • Inability to perform daily tasks, bathing, getting dressed, etc.
  • Rapid mood swings
  • Increased agitation, risk-taking/out of control behavior
  • Abusive behavior to self or someone else
  • Isolation from school, work, family, and friends
  • Loss of touch with reality
  • Paranoia

There are typically 3 stages to a crisis: pre-crisis, the actual crisis, and crisis resolution. We'll discuss each one.

Pre-Crisis: What Can Lead to a Crisis?

The pre-crisis stage is important to understand and recognize. Higher levels of anxiety are typically present, as well as heightened awareness or increasing paranoia. As a crisis state evolves, a person's anxiety level increases, ability to reason decreases, and the person will ultimately come to a state of flight/fight/freeze.

Many things can lead to a mental health crisis; here are a few examples of elements that can contribute to a crisis:

  • Home or environmental stressors
  • School/work stressors
  • Using or abusing drugs/alcohol (or a relapse)
  • Starting new medication or new dosage of current medication
  • Stopping medication or missing doses
  • Treatment stops working

Some specific examples of environmental factors might be:

  • news/work/school announcements that trigger feelings of stress or emergency
  • having to meet or work with new people
  • lack of a reliable support structure or person(s)

Some individuals who are dealing with a mental health illness may not exhibit any warning signs - the crisis state may come on abruptly without any apparent trigger or warning. Remember, no one is to blame - not the person, nor the family, nor someone or something in their environment.

The Actual Crisis: What Can I Do?

The best intervention is prevention. If you know someone has a mental health condition or has been in crisis before, take time to understand those aspects of the person. Get to know their goals for recovery or a healthier path forward, as well as their coping strategies. This becomes useful to help them if/when they are in crisis again. By building your relationship with them, you become a safe person if/when they are in crisis in the future. The time to build a relationship (with someone else or YOURSELF) is before a crisis. But what do you do once the crisis hits?

Sometimes just validating feelings can prevent full-blown crisis situations

  • First, take a long, deep breath. This helps you get grounded.
  • Assess the potential impact of a crisis or crisis state. Crisis can involve harm to self, property, others, and does not always involve potential of suicide. Is there an immediate need to protect yourself, property, or the person in crisis? A crisis can also lead to onset of further/additional crises. It's also useful to understand the elements that can be at play: the person themself, someone who may be helping them (e.g., a therapist), external factors, and situational factors.
  • Validate what the person is experiencing. Ask them what they're feeling, and listen without judging or dismissing. This is not the time to point out irrational thinking; the essence of validating a person’s perspective is acknowledging that it makes sense. This may include saying things like, “I can see why you feel trapped” or, “Yes, I get that you’re angry.” Where is the person right? Acknowledge that. Help the person identify their feelings and point out that those feelings are valid.


Crisis Resolution: Coming Out of It and the Moments After

There is always a start and end to every crisis, even the crises that seem to last for days. As you are with the person (or yourself) in the crisis, the next steps will help lead to resolution.

Take time to listen and ask questions; you don't have to solve the situation.
  • Explore and explain. What has the person done in the past when a crisis strikes? What has helped the person resolve a crisis before? What social support or existing coping strategies do they have? Ask them. Statements like, “It will be OK” or, “I know how you feel” can be counterproductive. Instead, help them connect with what they feel and what they can do. Explain and educate: This is a single moment. This is not forever. You are in a safe place.
  • Problem solve. Offer options. If you know coping strategies that have worked for them in the past, bring those up. This is where you discuss their goals with them. Rather than telling them what to do, ask them what they know. This helps them get into their reasoning mind. Offer ideas as a question, such as: "I remember you saying you do some things to feel better when you're getting anxious? Can you tell me what one of those was? Was going for a walk one?"
  • Debrief as much as the person is comfortable. The goal here is to reinforce that the person is OK and that they can prevent a subsequent crisis. Ensure the person has returned to a state of calm - this may be an hour later or a week later. Revisit their goals: what can help them stick to their goals? Explore their triggers: are there things you can do, as a support person, to help diminish the effects of or remove those triggers? For example, if they say the loud TV makes it so they can’t relax, you can consider turning the TV down or giving them noise-cancelling headphones.

If appropriate, encourage the person to talk through the experience with a professional mental health provider. If they don’t already have one, you can help the person work up a safety plan using this template. Validate the person and ensure them this experience does not change how you feel about them. Reinforce who and what their safe people and places are. If the person in crisis was YOU, know that crises can happen and that there is hope. You are a person of worth. There is help. For additional resources, visit https://www.hoperecoveryandhealing.com/crisis-support.


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ABOUT THE ARTICLE AUTHOR
David Macfarlane

David holds a bachelor’s degree in business management and a master’s degree in instructional psychology and technology, both from Brigham Young University. His professional life has included roles as a teacher, trainer, product manager, and program administrator.

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