What Constitutes A Crisis?

[Muttly]

It seems like there's this vague (to me, at least) idea of "crisis". I have never known, for myself, what constitutes being in crisis. I have talked to therapist/psychs about it at times, and they seem hesitant to define a crisis. But then various mental health folks talk about "if you're in crisis....."

So here are my questions... What do you consider a crisis? And what indicates to you, that you are in a crisis. I imagine the answers are going to vary from person to person. So, does anyone want to share?

 

[Suzetig]

For me being in crisis means that I'm at a level of distress where I can't keep myself safe. So, significant self harm, suicidal thoughts, struggling with impulse control all mean I need to speak to someone, usually a helpline or present at A&E.

There's a step back from that, where I'm anxious or distressed and can't ground myself enough to stop it disrupting my day to day life or where something has come at me completely out of the blue. That's when I'd contact my T to arrange an additional session and she will always find a space for me.

 

[Muttly]

@Suzetig thanks for your answer. I hope you don't mind me asking a clarifying question. You don't have to answer of course. You mentioned significant self-harm,but what is that?

And I guess I will add one more question, for all those who have DID. How does that figure into, defining a crisis?

 

[Suzetig]

For me significant self harm is anything that could harm or injure permanently. That means anything beyond surface scratching, cutting, skin picking because I know my own emotional limits but that will mean different thing to different people.

 

[Muttly]

Ok, so this is where I always stumble. I spent a couple solid years with daily, strong suicidal thoughts. I've attempted. I've got SI scars all over my body. I have done permanent body to my body because of eating disordered behaviors. And during much of that time, I had no support or a flaky, somewhat disinterested psych who didn't understand trauma and didn't realize I had DID. I survived. So.. to me "severe" means I'm in imminent danger of death or disabling body damage. And then I have the voices that tell me I'm a fake. So, if I dare to call it a "crisis", parts say I need to follow through and attempt suicide or self-harm that should have medical care.. Otherwise I'm a liar and attention seeking and on and on and on. So I just swirl around.

And then there's all this other confusing stuff. At what point does going into eating disorder behaviors become a crisis? Or is that never a "crisis". Especially if it's my old pattern of a slow slide into starvation, that's covered with lies to myself about how I'm just too busy, or not hungry, or can't deal with the freaking evil kitchen. At what point does not sleeping become a crisis?

Or what about when the suicidal thoughts are loud and constant and yet I know I won't do it, because after all I lived through then so now is a walk in the park....

.... and I really didn't mean to make this all about me. I think it's a uniquely personal thing and I don't think I'm the only one who has struggled with this question.

 

[shimmerz]

Maybe the word crisis isn't a good one for you. I wonder if you reframe the word and say perhaps 'dangerous' or 'harmful' or some other word that can mean the same, really, but doesn't start all of that dialog in your head that tries to dismiss what is happening to you.

 

[Freedomfighter]

Crisis to me is when the patient spirals out of a healthy way of life, panicking to the point of not being able to make sound decisions. A patient can be in a crisis without noticing it first and then when a critical life moment appears can be in dire straits because the crisis will prevent the patient from making sound decisions.
Such matters can actually be very complicated which I have learned. When someone has PTSD it is not always evident that the patient is already in a crisis. When then additional stress is added it can got to a life threatening event rather fast.

That is what I hate about PTSD, because so often I am not aware of the fact that I am within a certain stage of disassociation, crisis, or other stage of this condition. Then it is very easy to encounter huge panic attacks too.

PTSD is very very complicated.

 

[Panda Bear]

When I am no longer able to reign in my thoughts and they end up becoming actions.

When my thoughts and feelings turn outwards to my family and my kids are no longer safe with their mother.