This post was written based on an appearance by Matthew Runyan, MD, DFAPA, section chief, PPG – Psychiatry Hospital Section, Medical Director Inpatient Services, Parkview Behavioral Health Institute, on the wane program Real Talk on Mental Health.
What does crisis look like?
We all have these episodes where we're feeling kind of depressed or anxious. But people often ask me how they know when it’s a bigger problem. I always tell them it’s when it starts to impact function. So, when somebody's not sleeping, not eating, not able to go to work or school, that’s a sign of a larger issue.
With teenagers, parents often wonder about the distinction between the age and a true mental health crisis. Again, I advise them to watch for those big functional changes. A child who’s usually very social, is suddenly withdrawn. Or their grades drop dramatically. These can be warning signs.
Why we need others
It can be hard to see these changes in ourselves, so it's helpful if someone close to you does the kindness of pointing out what they’re seeing. This is why I recommend having people in your life who are aware and willing to intervene if needed.
People need people. No one should worry alone. You should have work people, who you can talk to about work stuff. You should have social people, who you can talk to about personal matters. Having a person or two that you can trust and go to, knowing they’re on your team, makes all the difference.
Sometimes, I even recommend connecting with people you trust, and giving them permission in advance to say something, if they ever notice a change.
Expressing concern
These are tough conversations to have, but they don’t have to be. Depending on your relationship, it can be as simple as saying, “I’ve noticed things are a little off.” If you’re a parent, approaching your child, or another family member, the conversation might look a little different, but the general guidance is the same.
These conversations need to be empathetic and genuine. If you can offer those two things, most people recognize you're coming from a place of caring. You're not accusing them, you’re expressing concern.
You can say, “Here’s what I’m hearing, here’s what I’m seeing, and I’m just curious, are you OK?” Ask questions and be interested.
And one thing I want to put out there, is asking questions about mental health, and specifically things like, are you depressed, are you feeling suicidal, does not increase the risk of somebody hurting themselves. So, don't be afraid to ask people in your life if they’re alright. It won’t increase the risk of a negative outcome. If anything, showing them you care might motivate them to get help.
I’d also say, we need to do a better job of listening, rather than just hearing. We always ask each other, “How are you?” And the answer is often, “Oh, I’m fine.” That doesn’t mean it’s true.
A lot of people just feel lonely. They feel alone. And the opposite of that is connection. And somebody who's coming to them out of a sense of curiosity, out of a sense of empathy, and genuine concern, they're going to be open to that.
If you or anyone you know is in need of help, call the PBHI HelpLine at 260-471-9440 or 1-800-284-8439 to receive an assessment or learn more about services 24 hours a day, seven days a week.
