10 Things to Do in a Mental Health Crisis

1. If this is a true mental health crisis, inpatient treatment (psychiatric hospitalization) may be necessary. I have been hospitalized five times (I seem to have a thing for holidays because I was there for Thanksgiving and then Valentine’s Day and then Christmas). Inpatient treatment is only necessary if the person is in danger of hurting themselves or others, has already severely injured themselves or others, or is in an advanced state of psychosis, so far gone that they do not know what reality is. I have also done several outpatient/ partial hospitalization programs which are much less severe. For one thing, you are free to come and go as you please generally. Secondly, you can go home at the end of the day. You can have your cell phone and use regular pens. If your social worker or therapist deems it necessary they might transition you from inpatient to outpatient or vice versa. Both have happened to me.

2. Stay off dating apps and chatrooms, both of which can get you into trouble particularly if you are bipolar or have lowered inhibitions. You are in no condition to date or meet new people. You are in an altered state and even though these people may temporarily make you happy or feel good that is all it is…temporary. This is a harsh reality that those of us with severe mental illness must learn. What’s good in the moment isn’t always good for us in general.

3. Be honest with everyone about how you’re feeling. This is especially true with your therapist/ psychiatrist and your caregivers, should you have any. They can’t help you if they don’t know how you feel. You might be embarrassed or ashamed. Don’t be. Professionals have seen it all. This is not you, it’s your disease. It’s not your fault, though it can feel like it is.

4. Stop blaming yourself for everything. As I just said, this is not your fault. No one is 100% sure what causes mental illness. It could be genetics, sometimes it’s severe stress like a job or a breakup or a family situation, more likely it’s a combination of both. The most important thing to do is (and this can be hard to accept for many young people) to avoid drugs and alcohol. I’ve been sober for seven years of alcohol and marijuana and it’s vastly improved my life. Marijuana has been linked to psychosis in those predisposed to it so if you have a family history of schizophrenia, schizoaffective disorder, or bipolar disorder it is wiser to avoid it.

5. Stop talking to toxic people. I have had many friends over the years who were a drain on my self-esteem or influenced me to doubt myself and make bad decisions. My best friend, Derrick, is someone I will probably never get over but I would never be friends with him again after the way he has treated me and his family. Toxic people are destructive not only to themselves but to others. Stay away.

6. Take your meds as directed. People with certain disorders (such as schizophrenia) are notorious for not taking their medications because (and I say this as a generalization) they lack insight and believe they do not need meds. Some people even believe it is part of some kind of persecutory plot. Even people with bipolar disorder might not take their meds because they feel like it gets in the way of creativity or the euphoria that can come with mania. People might not take medication for other reasons such as side effects from the medication like weight gain or decreased sex drive. It is dangerous to play doctor and go off meds without your psychiatrist’s permission just as it is dangerous to do street drugs or even drink alcohol without consulting with your psychiatrist first.

7. Try to get outside. Right now there are Canadian wildfires raging that are impairing air quality, so it’s not exactly something I’d suggest at this moment. But in general Vitamin D and fresh air and especially exercise are very important for feeling good. I try to go on a walk every day and it really freshens up my mind for a good day of writing.

8. Listen to music. Music can change our moods like a remote control changes the channel. It can calm us down, rev us up, make us cry or remind us of a time when things weren’t so bad. Music can be a friend, almost like a sympathetic voice in your ear echoing your thoughts. Make a playlist for each of your emotional states. My computer is filled with playlists labeled things like “feel good” and “dance” and “hope” and “eighth grade”. No doubt your phone or iPod is similar.

9. Pray. I try not to save my prayers for the most desperate moments but I usually end up doing that anyway. It doesn’t matter what religion you are, if you want someone to talk to God is always an option. If not that, then write down your feelings in a notebook. It isn’t good to keep them inside and sometimes your pain is too much for one human person to handle or counsel. In this case, you can turn to outlets outside yourself.

10. Have hope. I have had many moments, including two suicide attempts where I don’t believe things will ever get better. In every single instance, I have been wrong. Sometimes it takes longer than I am comfortable with but it always turns itself around. This is where resilience comes in. Especially for those of us with mental illness dealing with a mental health crisis, we have to be resilient. We have to have hope.