What to do in a mental health crisis: What are your options?

The following options are adapted from Marsha Linehan’s DBT Skills Training Handouts and Worksheets (see link under books I recommend on my website) page 10.

Solve the problem if now is a good time to solve it. Most people who avoid solving their problems end up avoiding their problems. When people avoid problems, problems tend to build up or become even worse. It is not a good feeling to know you are avoiding a problem, and solving problems is a practical and understandable path towards reducing distress. Skill building, practice, rehearsal, obtaining feedback, breaking things down into steps, evaluating the effectiveness of the steps, and challenging yourself slightly are all ways to approach problems. Emotional problems generally get us to take action or are telling us to do something about it. Consider this statement: Everything is as it should be unless or until something is done to fix or change it. In other words, don’t sit on your hands if you have some responsibly to speak up or do something about it.

If now is NOT a good time to solve it, don’t make it worse. Now may not be a good time to solve it because extreme emotions get in the way or extreme emotions make your attempts at problem solving ineffective. In this case you may need to work on regulating your moods, which can entail identifying your feelings, figuring out what the threat is or the trigger that sets you off, looking at how you interpret the incident, and coming up with a more adaptive means of interpreting and responding to the event. As Lori Gottlieb reminds us in her recent book, Maybe You Should Talk To Someone. And (of course), skills from the Dialectical Behavioral Therapy Handouts and Homework worksheets could be of assistance.

If you could do one tiny thing to make the current situation better, what might it be? Sometimes treating yourself or someone else with kindness, gently avoiding the situation for the time being, doing something to shift gears (self-soothing, exercising, activities, engaging your brain or body differently, or focusing on something or someone else for a while) can make you feel better. People who can’t do anything about a painful life situation generally want to ease their experience. Finding compassion for oneself generally generates an easier time of things, rather than critical self-blame or self-defeating behaviors.

Focusing on accepting and/ or tolerating what you can’t control. Resisting reality, throwing up one’s arms in defeat, doing something to make the situation worse, or staying miserable when there is something you could do to feel better about the situation generally don’t get people unstuck. Acceptance is a hard task and does not necessarily mean approval or passivity. It just means a willingness to bear with the uncertainty or difficulty of what you’re going through.