Too often, we don’t get help or identify problems
until we’ve reached a total breaking point.
When you or someone close to you goes into crisis, it can be the scariest thing to ever happen. You don’t know what to do, but it seems like someone’s life might be at stake or they might get locked up, and everyone around is getting stressed and panicked. Most people have either been there themselves or know a friend who has been there. Someone’s personality starts to make strange changes, they’re not sleeping or sleeping all day, they lose touch with the people around them, they disappear into their room for days, they have wild energy and outlandish plans, they start to dwell on suicide and hopelessness, they stop eating or taking care of themselves, or they start taking risks, being reckless, and may (in rare circumstances) become frustrated and violent towards themselves or others. They become a different person. They’re in crisis.
The word “crisis” comes from the greek word krisis meaning "decision" or “judgment.” A crisis is a moment of great tension and meeting the unknown. It’s a turning point when things can’t go on the way they have, and the situation isn’t going to hold. Could crisis be an opportunity for breakthrough, not just breakdown? Can we learn about each other and ourselves as a community through crisis? Can we see crisis as an opportunity to judge a situation and ourselves carefully, not just react with panic and confusion or turn things over to the authorities? While everyone must be held accountable for their words and behavior, it is our collective responsibility to create a space for this to occur in a way that promotes movement, not containment, in people's lives.
If you’re trying to help someone in crisis, coordinate with others to share responsibility and stress. If you’re the one going through crisis, you may want to reach out to multiple people whom you trust. Human connection can be very healing for a crisis. The more people you have to support you, the easier the process will be and the less you will exhaust your support system.
Crisis can be made a lot worse if people start reacting with fear, control, and anger. Study after study has shown that if you react to someone in crisis with caring, openness, patience, and a relaxed and unhurried attitude, it can really help settle things down. Often times this approach is derailed because the supporters themselves are exhausted and stressed. Above all, the people who engage in crisis support must not be afraid of emotional intensity and altered states - they need to be able to both enter it with the person, and remain one hundred percent present and conscious of their interaction and surroundings.
When people act weird or lose their minds, it is easy to overreact. It’s also easy to underreact. If someone picks up a knife and is walking around talking about UFOs, don’t assume the worst and call the cops. If someone is actually seriously attempting suicide or doing something extremely dangerous like lying down on a busy freeway, getting the police involved might save their life, but it might also put them through more trauma from being forcibly locked up in a hospital ward. Likewise, if someone is cutting themselves, it doesn’t always mean they’re suicidal. People cut for a variety of reasons, most of which are deeply personal and incapable of being understood through diagnosis. Sometimes people who are talking about the ideas of death and suicide are in a very dangerous place, but sometimes they may just need to talk about dark, painful feelings that are buried. Use your judgment, and don't be afraid to ask others for advice. Also, don't be afraid to ask the person in crisis what they need. Sometimes you just need to wait out crisis. Sometimes you do need to make the difficult decision to take action to try to interrupt a pattern or cycle. What that action is can depend on a lot of things, like the person's trauma history, their physical needs, and the availability of support networks.
What do they need? What are their feelings? What’s going on? What can help? Sometimes we are so scared of someone else’s suffering that we forget to ask them how we can help. Beware of arguing with someone in crisis: their point of view might be off, but their feelings are real and need to be listened to. (Once they’re out of crisis, they’ll be able to hear you better.) If you are in crisis, tell people what you’re feeling and what you need. It is so hard to help people who aren’t communicating.
Many people come right out of crisis if they get some sleep, and any hospital will first try to get them to sleep if they are sleep deprived. Sometimes the psychiatric drugs hospitals provide can really help with sleep, but sometimes the lack of privacy and control in the hospital environment can itself cause or worsen insomnia. If the person hasn’t tried Benadryl, herbal or homeopathic remedies from a health food store, hot baths, rich food, exercise, soothing sound, or acupuncture, these can be extremely helpful. If someone is really manic and hasn’t been sleeping for months, though, none of these may work and you may have to temporarily seek out psychiatric drugs to break the cycle.
Did someone who regularly takes medication suddenly stop? This can cause a crisis because of the severe withdrawal effects of psychiatric drugs, which often get (mis)diagnosed as people's "mental illness" coming back. Ideally, someone quitting medication has a plan and support system in place to do so, but in the absence of such, try to respect their wish to go through withdrawal. The crisis may be physically necessary and may pass, although remember that a transition to no psychiatric drugs must be done carefully and slowly, not suddenly. If they are not deliberately trying to come off of their drugs, try to help them to get back on them.
Try to de-dramatize and de-stress the situation as much as possible. Crashing in a different space for a few days can give a person some breathing space and perspective. Perhaps caring friends could come by in shifts to spend time with the person, make good food, play nice music, drag them outside for fresh air and movement, and spend time listening. Often people feel alone and uncared for in crisis, and if you make an effort to offer them a sanctuary it can mean a lot. Make sure basic needs are met: food, water, sleep, shelter, exercise, friendship, and if appropriate, professional (alternative or psychiatric) attention.
Police and hospitals are not saviors. They can even make things worse. When you’re out of other options, though, you shouldn’t rule them out. Faced with a decision like this, try and get input from people who are thinking clearly and know about the person. Have other options been tried? Did the hospital help in the past? Were police and hospitals traumatizing? Are people overreacting? Don’t assume that it’s always the right thing to do just because it puts everything in the hands of the “authorities.” Be realistic, however, when your community has exhausted its capacity to help and there is a risk of real danger. The alternative support networks we need do not exist everywhere people are in crisis. If someone does get hospital or doctor care, be cautious about any diagnosis they receive. Sometimes labels can be helpful, but madness is ultimately mysterious and diagnoses aren't scientific or objective. Labels can confine us to a narrow medical perspective of our experience and needs and limit our sense of possibility. Having a disease label is not the only way to take someone's pain seriously and get help. If someone is hospitalized, try to visit them, or call if you can't visit. Knowing someone on the outside cares for them can mean a lot.
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