It’s important to know what to do in the case of a psychiatric emergency. Sure, you could float along with treatment, righting every issue before things get really bad. You could catch everything early. You might have a proactive psychiatrist. Or, then again, this may not be your experience. I would argue that people with serious mental illnesses like bipolar disorder are just crises waiting to happen. That’s not anyone’s fault; it’s just the nature of the disease. Thus, knowing what to do when a psychiatric emergency arises is critical. Here are some psychiatric emergency tips and things to think about.

Having a Psychiatric Emergency Isn’t Your Fault

I talk about mental illness all the time, but most pieces assume you have enough spoons, resources, and sanity to wait until you have your next psychiatric appointment. But, of course, this isn’t always the case. Psych appointments can be spaced too far apart, or you can have a mental health breakdown anytime — even if you just saw your psychiatrist yesterday. But the thing to remember about bipolar (or other mental illness) emergencies is that they are not your fault. No matter how carefully you live your life, no matter how thoughtfully you plan, no matter how much you try to avoid emergencies, sometimes they just happen. Don’t beat yourself up about it. That will only hinder the way you deal with it.

What Is a Psychiatric Emergency?

For my purposes, I’ll say that there are two kinds of psychiatric emergencies:

  1. Acute
  2. Ongoing

Acute psychiatric emergencies are when your life is actually in danger in some way. This might be because you are so manic that your actions endanger your life or health, this could be because you are psychotic and don’t appreciate what you’re doing, or this might be because you’re acutely suicidal and threatening to take your life. An acute psychiatric emergency is one that must be taken care of immediately. (You may or may not be the one to make the call concerning such an emergency. We all know that sometimes it’s other people calling for help because they can see more clearly than we can at that time.)

Ongoing psychiatric emergencies, I guess, could be called crises. An ongoing psychiatric emergency might be when you feel extremely suicidal, or when you see your warning sign that things are about to get really bad, or when you just can’t stand what’s going on in your head or body any longer. In these cases, you’re not “on the ledge,” so to speak, but you do need to have the situation handled immediately so that things don’t escalate. I consider these psychiatric emergencies, too; they just aren’t acute.

What to Do If You Have an Acute Psychiatric Emergency

Whether it’s you handling an acute psychiatric emergency or someone else, the right action is the same: get professional help immediately. (And yes, getting help immediately may mean calling 9-1-1.)

Getting immediate help for an acute psychiatric emergency means calling a professional to assess and deal with the situation. Ideally, this should be a mental health crisis team. Crisis teams are used to dealing with psychiatric emergencies and are best equipped to assess and handle what’s happening in the moment. Crisis teams usually contain people like social workers, specially-trained police officers, and even others with mental illness.

If you don’t have access to a crisis team, the best thing to do may be just to walk into a treatment facility and tell them your life is in danger. If you’re a loved one of the person, make sure to provide examples of why you think the person’s life is in danger. The idea is that you want to admit yourself to the treatment facility (hospital, etc.). This will put you in a much better position than being admitted against your will. Of course, specifically calling for an ambulance can also get you to the hospital if you don’t have a way of getting there yourself. If you do call 9-1-1 for an ambulance, make sure to tell the person on the line that you are not violent and don’t want to hurt anyone. You need treatment at a hospital. That’s less likely to see the cops at your door. Remember, first responders need to be kept safe, too, and if they don’t know if a situation is safe, they may send out police just to make sure. That sucks, but they are trying to keep everyone safe.

While doing the above, also call your psychiatrist in whatever emergency way you can (some doctors can be paged, others have an emergency line, etc.). Your psychiatrist may be able to advise the crisis team or meet you at the treatment facility. Ideally, you want your psychiatrist to treat you, not just some random doctor.

Also, call one or more loved ones and tell them what’s happening. Have them come to you and help the crisis team. Have them meet you at the hospital. At least tell them where you’ll be and what you’ll need (pillow, toothbrush, tissues, etc.).

Learning what to do if you have an acute psychiatric emergency is no fun, but it is critical. And remember, don’t blame yourself for this. Most of us have been there.

What to Do If You Have an Ongoing Psychiatric Emergency

My next post will be about what to do about an ongoing psychiatric emergency. I’ll also be talking about planning ahead for a psychiatric emergency. Watch this space for that one.