If someone you care about is having an extremely hard time right now, we have to do our best to keep him safe and alive. When we, as responsible and caring humans, see someone suffering deeply or in danger we cannot just look away. We have to do what we can to help. Sometimes it can be scary and hard to know what action will be helpful. Read on, please. This information may be useful to you in deciding how you can help most.

First, we have to err on the side of safety. We have to keep the person alive if we can. If they are feeling so despondent they don’t want to live any more, or if they are so upset you fear they might do something dangerous to themselves or someone else, YOU HAVE TO GET SOME OUTSIDE HELP.

Sometimes that could be friends and/or family members who have a wise, calming presence (this is too much for children to handle). This level of support might provide enough stability to soothe someone who is moderately upset. But if the person is really falling apart and is in acute distress, you may be in over your head. If that is the case call 911. Summon an ambulance, or take the person to the hospital yourself. THAT IS WHAT THESE SERVICES ARE FOR. Don’t stay alone with this. You are not the best one to assess how much risk the hurting person is at. I strengthen this exhortation even more if the person has been drinking and may have taken some prescription medications at the same time. If they have been drinking they can easily have lost track of how much medication they took. And their judgment is so distorted then. Don’t be too embarrassed to get some help. DO NOT HESITATE.

The person who is suffering may beg you not to call anyone else. They may even threaten to make things worse if you call. That tells you how unstable they are, and actually is a clue that THEY do, and YOU do, need extra help. Don’t hold back due to embarrassment or a “What will the neighbors think?” mentality.

This is way too urgent—it may be life and death!

Maybe you have done all this before and you have come to realize that the emergency mental health system is very limited in the assistance they render. I know. I have seen it, too. But it is still the system that is in place. It is all there is. Use it. It’s the right and responsible thing for you to do.

Perhaps you have gone to the Psych ED before and you waited for a long time to be seen, and the whole exercise seems to be long and slow and not too helpful. Sigh. Yes, that happens. And while this may not seem like a very efficient approach, it may help in an unintended way: many times the hurt person calms down as distress is replaced by boredom. Boredom is not the same as treatment, of course, but it means you are no longer alone with a person who is right on the edge of hurting himself or someone else. The storm has blown itself out—at least for now. Maybe your loved one then gets checked in to the hospital and has his meds reevaluated. But that doesn’t always happen. He may just be sent home after a few hours of hanging around the ED. But at least the current crisis is past. That’s not a cure—it’s hardly even treatment—but it got you by this time, and for that we can be grateful.

For some folks, the idea of hurting or killing themselves may hover in the back of their mind a lot of the time, more than they tell anyone. It may have been around for years! But so far it hasn’t pushed them to act. The notion is more like a possibility than an urgent plan. However frightening this sounds to outsiders, to YOU, they have come to accept this as their normal. They have been living this way for a long time and nothing has happened yet. If you know someone like this, it will be your challenge not to overreact each time they say they ‘wish they could just go to sleep and never wake up,’ and not to under react if you sense that their level of suicidality has gotten much more intense and difficult for that person to contain. Often you might be able to sense the difference in intensity, but not always. Sometimes we miss how much distress the sufferer is in, and sometimes they may hide it better. Then they may go ahead and attempt to take their life. They might even succeed. Thousands do each year.

So back to my statement that we have to err on the side of safety. If you aren’t sure how dangerous they may be, you have to take action that will help keep the person alive. Hopefully they stabilize and want to live later. Maybe a different regimen of meds will help. We hope.

If you have had this experience ONCE in your life you no doubt found it very stressful and exhausting. If you have been supporting a person who struggles with suicidality for years then I expect that you are very tired of it. You have to be worn out, and as much as you love the person, resentful. This is so hard for you! It is the right thing for you to support your loved one when he is in acute danger and I respect you for your loyalty. But we also have to come to terms sooner or later (sooner is better!) with the toll this caring takes on you and your life.

For some thoughts on nourishing yourself and replenishing your own energy supply please hike on over to menu item My Thoughts on Treatment and look at my article Helping Others. You’ll like it.



		If Someone You Care About is in Crisis Right Now


			If someone you care about is having an extremely hard time right now, we have to do our best to keep him safe and alive. When we, as responsible and caring humans, see someone suffering deeply or in danger we cannot just look away. We have to do what we can to help. Sometimes it can be scary and hard to know what action will be helpful. Read on, please. This information may be useful to you in deciding how you can help most. First, we have to err on the side of safety. We have to keep the person alive if we can. If they are feeling so despondent they don’t want to live any more, or if they are so upset you fear they might do something dangerous to themselves or someone else, YOU HAVE TO GET SOME OUTSIDE HELP. Sometimes that could be friends and/or family members who have a wise, calming presence (this is too much for children to handle). This level of support might provide enough stability to soothe someone who is moderately upset. But if the person is really falling apart and is in acute distress, you may be in over your head. If that is the case call 911. Summon an ambulance, or take the person to the hospital yourself. THAT IS WHAT THESE SERVICES ARE FOR. Don’t stay alone with this. You are not the best one to assess how much risk the hurting person is at. I strengthen this exhortation even more if the person has been drinking and may have taken some prescription medications at the same time. If they have been drinking they can easily have lost track of how much medication they took. And their judgment is so distorted then. Don’t be too embarrassed to get some help. DO NOT HESITATE. The person who is suffering may beg you not to call anyone else. They may even threaten to make things worse if you call. That tells you how unstable they are, and actually is a clue that THEY do, and YOU do, need extra help. Don’t hold back due to embarrassment or a “What will the neighbors think?” mentality. This is way too urgent—it may be life and death! But This is Not the First Time! Maybe you have done all this before and you have come to realize that the emergency mental health system is very limited in the assistance they render. I know. I have seen it, too. But it is still the system that is in place. It is all there is. Use it. It’s the right and responsible thing for you to do. Perhaps you have gone to the Psych ED before and you waited for a long time to be seen, and the whole exercise seems to be long and slow and not too helpful. Sigh. Yes, that happens. And while this may not seem like a very efficient approach, it may help in an unintended way: many times the hurt person calms down as distress is replaced by boredom. Boredom is not the same as treatment, of course, but it means you are no longer alone with a person who is right on the edge of hurting himself or someone else. The storm has blown itself out—at least for now. Maybe your loved one then gets checked in to the hospital and has his meds reevaluated. But that doesn’t always happen. He may just be sent home after a few hours of hanging around the ED. But at least the current crisis is past. That’s not a cure—it’s hardly even treatment—but it got you by this time, and for that we can be grateful. Assessing What to Do For some folks, the idea of hurting or killing themselves may hover in the back of their mind a lot of the time, more than they tell anyone. It may have been around for years! But so far it hasn’t pushed them to act. The notion is more like a possibility than an urgent plan. However frightening this sounds to outsiders, to YOU, they have come to accept this as their normal. They have been living this way for a long time and nothing has happened yet. If you know someone like this, it will be your challenge not to overreact each time they say they ‘wish they could just go to sleep and never wake up,’ and not to under react if you sense that their level of suicidality has gotten much more intense and difficult for that person to contain. Often you might be able to sense the difference in intensity, but not always. Sometimes we miss how much distress the sufferer is in, and sometimes they may hide it better. Then they may go ahead and attempt to take their life. They might even succeed. Thousands do each year. So back to my statement that we have to err on the side of safety. If you aren’t sure how dangerous they may be, you have to take action that will help keep the person alive. Hopefully they stabilize and want to live later. Maybe a different regimen of meds will help. We hope. If you have had this experience ONCE in your life you no doubt found it very stressful and exhausting. If you have been supporting a person who struggles with suicidality for years then I expect that you are very tired of it. You have to be worn out, and as much as you love the person, resentful. This is so hard for you! It is the right thing for you to support your loved one when he is in acute danger and I respect you for your loyalty. But we also have to come to terms sooner or later (sooner is better!) with the toll this caring takes on you and your life. For some thoughts on nourishing yourself and replenishing your own energy supply please hike on over to menu item My Thoughts on Treatment and look at my article Helping Others. You’ll like it.