Dealing with a bipolar crisis

' I see you falling' by Sarah K Reece

Bipolar crises include times when the person becomes severely depressed or manic, unable to function or to look after themselves or others, or at high risk of suicide or other negative consequences. Helpful ways to deal with a crisis include to:

Get help!

Who to call

If you think that things may be reaching a crisis point, call the person’s clinician or mental health team and express your concerns (if the person does not call them). Do not hesitate to call the mental health crisis team, clinician or an ambulance if a crisis occurs. If the person urgently needs to be restrained to stop them from harming themselves or others, you might need to call the police.

Put safety first

If you are in danger, consider your own safety first and then get medical help for the person (see dealing with physical aggression).

If you don’t get the help you expect

If you do not get the help you expect from these emergency services, be persistent and contact another clinician (e.g. the GP), or take the person to a hospital emergency department. Sometimes caregivers find that emergency health services are not able to assist them in a crisis, and they need to care for the severely ill person at home. If you care for a seriously ill person at home, make sure you have the necessary support (e.g. from health professionals, appropriate family and friends and, if necessary, sources of financial or legal aid).

Helplines and counseling

It might be worth finding out about helplines in your area that assist people or their family or friends in a crisis (see your local phone directory and the resources section). Counselors are usually trained to listen and assist people to deal with crises and they may offer referral to appropriate services.

Communicate clearly and calmly

Try to remain calm when communicating with someone in a bipolar crisis. Don’t give them lots of instructions. Don’t argue, criticize or behave in a threatening way towards them. If appropriate, give the person choices to reassure them that they have some control over the situation (e.g. If you are trying to distract them from risky behavior, you could ask “Should we go for a walk or would you prefer to watch a movie?”).

Reduce stress

These times can be challenging for caregivers too. For ways to reduce stress see reducing stress in a bipolar crisis.

“In a bipolar crisis don’t be afraid to ask for assistance to prevent negative consequences.”

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