Understanding What a Mental Health Crisis Looks Like 

Trigger warning: This article discusses mental health issues and suicide, but we believe having difficult conversations and discussing these topics in respectful and non-stigmatizing ways is important. If you or someone you know is in a life-threatening situation, please: 

• Call the National Suicide Prevention Lifeline at +1 (800) 273-8255
• Call or text 988 for the Suicide and Crisis Lifeline
• Use these resources to get immediate help.

A mental health crisis involves an urgent, heightened state of distress that poses an immediate risk to an individual’s well-being or the safety of those around them. Mental health crises can result from exposure to abusive or dangerous situations in the home, school, work, or anywhere else. Anybody, at any age, from any background can have a mental health crisis — it’s not limited to those diagnosed with a mental health condition, and it doesn’t always mean there’s been a long history of trauma. 

According to the Centers for Disease Control (CDC), suicide is now one of the leading causes of death in the United States. Rates increased by more than 2.5% from 2021 to 2022. Recognizing the warning signs of a mental health crisis is vital for providing intervention and preventing escalation quickly and effectively. 

Learn about the signs and how to identify the different types of a mental health crisis, and find out what to do if you or someone you know is in crisis. What you know and how you react can literally save a life. 

What is a Mental Health Crisis?

A mental health crisis is a period of intense, often dangerous, emotional distress or instability that needs help beyond someone’s coping skills. It can include feelings of daunting despair or anxiety, hopelessness, helplessness, and intrusive, powerful thoughts of self-harm or wanting to harm others. 

The National Institute of Mental Health (NIMH) estimates that more than 14 million adults in the United States have a “serious mental condition” (SMI). If you experience a mental or emotional health crisis — your own or someone else’s — fast intervention is critical and can drastically improve the outcome.

Signs That You or Someone You Know is in a Mental Health Crisis

There are countless signs that you or someone you care about might be either heading toward or already in a mental health crisis and need help. Some of the more apparent signs include drastic mood or behavior changes, withdrawal, or suddenly expressing hope after a prolonged period of instability and despair. There are other, sometimes more subtle, signs as well. 

Emotional signs of a mental health crisis:

• Intense feelings of sadness or despair
• Overwhelming anxiety, constant worry, or panic attacks
• Extreme irritability
• Persistent feelings of guilt or worthlessness, often without cause
• Loss of interest in previously enjoyed activities, environments, or people

Physical signs of a mental health crisis:

• Changes in sleep patterns, including sleeping too much or experiencing insomnia
• Changes in appetite that cause weight loss or weight gain
• Headaches, stomach aches, or unexplained pain
• Lack of energy or fatigue, even when getting enough sleep
• Increased restlessness or agitation
• Feeling unable to relax

Behavioral signs of a mental health crisis:

• Sudden withdrawal from social interactions
• Avoiding friends and family
• Partaking in risky behaviors like substance use or abuse or reckless driving
• Difficulty concentrating
• Finding it hard to make decisions
• Becoming forgetful
• Increasingly isolating oneself
• Spending excessive time in bed
• Expressing feelings of hopelessness or having thoughts of self-harm
• Talking about death or dying by suicide 

Types of Mental Health Crises

Unfortunately, there isn’t just one single type of mental health crisis to be aware of. They can result from an acute episode related to a psychiatric condition — like bipolar disorder or schizophrenia. They can also be the result of a traumatic event or overwhelming stress,

Because mental health crises can widely vary in nature and severity, each has its own challenges and requires a tailored, individualized approach to intervention.

Suicidal ideation and behavior

Suicidal ideation — having thoughts or fantasies about or contemplating dying by suicide — is a profound crisis. It indicates severe, extreme emotional distress and poses a significant risk of self-harm. 

Suicidal thoughts and behavior can be the result of several factors, including a mental health condition, trauma, overwhelming stress, or a combination of these that result in an inability to cope.

Panic attacks

A panic attack can induce sudden, intense fear or discomfort and cause physical symptoms like sweating, increased heart rate, shortness of breath, chest pain, or intense feelings of impending doom. 

Panic attacks can become a mental health crisis that requires prompt intervention. Support, coupled with access to mental health resources, help alleviate symptoms and prevent future episodes.

Psychotic episodes

A psychotic episode is defined as a break from reality that can include delusions, hallucinations, disorganized thinking, paranoia, and an altered perception of reality. 

Because there can be severe disruption in the ability to function, psychotic episodes often represent a mental health crisis that demands psychiatric assessment and care. It’s essential to ensure the safety and well-being of the person experiencing a psychotic episode, as well as those around them. 

Trauma and stress-related disorders

Trauma and stress-related disorders are triggered by exposure to traumatic events like sexual, physical, or emotional abuse, natural disasters, accidents, or witnessing or experiencing violence. They become a mental health crisis when they result in intrusive memories, flashbacks, avoidance behaviors, extreme depression or anxiety, or any other debilitating symptoms that impair the ability to function.

Addressing trauma and stress-related disorders may require therapy, medication management, and other support systems as one learns to cope with what they’ve experienced and reclaim a sense of safety.

Severe depression

Depression comes in many forms and levels of severity. It can cause persistent feelings of sadness, worthlessness, hopelessness, apathy, or a loss of interest in things once enjoyed. Depression is also associated with physical symptoms, like sleep disturbances, changes in appetite, and constant fatigue. 

In some cases, depression can escalate into a mental health crisis that causes extreme emotional suffering, including thoughts of suicide or self-harm. Addressing severe depression might require access to mental health professionals and therapy, learning and using self-help coping mechanisms, and medication.

Manic episodes

Manic episodes, a key characteristic of bipolar disorder, can present in various ways. While some may experience extreme “highs” with feelings of euphoria, others may exhibit symptoms that are less obviously negative, such as unusually good moods.

Symptoms of mania can include: 

• Risky behavior
• Decreased need for sleep
• Erratic behavior
• Mood instability (including irritability or rapid shifts in mood)
• Difficulty concentrating

It’s crucial to note that mania is not always about feeling euphoric; it can also manifest in dangerous and disruptive ways to daily life.

Substance-induced crises

Excessively consuming (or experiencing withdrawal) from drugs or alcohol can result in significant cognitive or emotional impairment or behavioral dysfunction. 

Substance-induced crises may quickly turn into a mental health crisis resulting from severe intoxication, overdose, withdrawal, or a psychiatric complication like psychosis or a mood disorder episode. 

Address a substance-induced crisis as soon as possible, especially if detoxification is warranted. Substance abuse treatment can identify and then help address possible underlying addiction issues in an effort to prevent future relapse. 

Aggressive or violent behavior

Aggressive or violent behavior can include threatening, physically harming, or intentionally intimidating someone. This type of behavior can be fueled by anger or frustration, and oftentimes, psychological conditions or factors are also involved.  

Violent behavior involves loss of control, extreme hostility, violence, or uncontrollable impulsivity. Immediate intervention can sometimes work to de-escalate a situation, but addressing the behavior is almost always needed if you hope to ensure the safety of everyone involved. A psychiatric assessment, therapy, and medication can all be part of a comprehensive treatment plan that helps someone learn to manage their anger in more appropriate ways. 

Disorientation or confusion

Feeling disoriented or confused might mean experiencing a lack of awareness of one’s surroundings that’s accompanied by difficulty recalling information or thinking clearly. It can also directly impact decision-making abilities. 

If disorientation or confusion causes severe cognitive impairment, it might lead to an inability to function appropriately or independently. This type of mental health crisis demands intervention and assistance to determine any potential underlying issues. A combined approach using a professional evaluation, an assessment, therapeutic intervention, and medication is common. 

What to Do in a Mental Health Crisis

Mental health crises must be handled with empathy, care, and concern in a calm environment. You should always prioritize safety, remove threats, and encourage professional help if you see someone in a mental or emotional crisis. 

If you’re having a crisis

If you’re experiencing a mental health crisis, first and foremost, know that you’re not alone. Help is available, and seeking it is both brave and commendable. Don’t be afraid to reach out to someone you trust who will keep you safe as you navigate your journey. 

If you’re in crisis:

• Find a friend or family member you trust
• Seek professional support
• Call a mental health hotline
• Contact a crisis intervention service
• Use self-care techniques and coping mechanisms — mindfulness, deep breathing, and grounding exercises are all beneficial in managing anxiety or stres

“The first thing to remember is you are not alone. Help is available. Please reach out even when it feels hard, call 911 or 988 in an emergency, or go to your local emergency room. Reach out to trusted friends, family, or a medical/mental health professional to take the steps to get the support and care that you deserve. Slow down, take a deep breath and remember thoughts and feelings are temporary and support is available to help you navigate these stressors.”

– Talkspace therapist Jill Daino, LCSW-R

Responding to a crisis

If someone you care about is having a mental health crisis, reassure them that you care and love them and that you’re there to help and protect them. The most crucial part of responding to a situation is making sure they’re safe. Get help if you need support so you can offer them what they need. 

If someone you know is in crisis:

• Be calm and empathetic
• Reserve judgment
• Listen actively and validate their emotions or words
• Encourage them to seek help
• Offer them resources and access to support services
• Stay with them
• Call 911 or get them to the emergency room if the help they need is urgent and beyond what you can provide

Resources & Support

Navigating a mental health crisis — whether it’s yours or someone else’s — can be a daunting, frightening experience. Awareness of the types of support and available resources can be critical.

• Local mental health organizations: Local organizations can offer a range of services, from support groups to counseling, tailored to your community’s needs. They often provide valuable resources and can connect you with local mental health professionals.
• Community centers: Many community centers offer support groups and counseling services that can provide a sense of community and understanding during difficult times.
• National mental health organizations: Organizations, like the National Institute of Mental Health, provide information and advocacy and often have local chapters that offer support groups and educational resources.
• Crisis intervention teams or mobile mental health units: These teams are trained to respond to mental health crises quickly and effectively, providing immediate support and resources.
• National or local mental health hotlines: These hotlines offer immediate assistance and support, connecting you with trained professionals who can provide guidance and resources.
  • National Suicide Prevention Lifeline – 1-800-273-TALK (8255)
  • Crisis Text Line – Text “HELLO” to 741741
• Online chat services: Services like Lifeline Chat and Text offer real-time support and guidance from crisis counselors.
• Mental health professionals: Therapists, counselors, and psychiatrists can provide ongoing support, medication management, and crisis intervention tailored to your specific needs. At Talkspace, you can virtually connect with a licensed online psychiatrist or therapist for ongoing mental health support.
• Support groups: Connecting with others in a support group who have shared experiences can provide valuable support and understanding, helping you feel less alone during difficult times.
• Peer networks: Peer support can be a powerful tool in recovery, providing a sense of belonging and understanding that is essential for mental health.

By knowing where to turn for help, you can ensure that you or your loved ones receive the support and care needed during a mental health crisis. 

Get Help with Online Mental Health Treatment

Knowing the warning signs of a mental health crisis ensures you know what to do when it matters the most. Online therapy can be an essential tool for helping someone learn how to improve their mental health. It offers convenience, affordability, and accessibility, all while bypassing many of the traditional barriers to getting help — including long wait times, the need to travel, and cost. 

Talkspace is an online therapy platform that offers access to experienced licensed mental health professionals who are experts in dealing with crises. If you or someone you love needs help, start therapy with a Talkspace mental health care provider.