• Attempts to harm or kill oneself, making plans to do so
• Threats to hurt oneself or others
• Verbal or physical abuse
• Excessive withdrawal
• Not sleeping or eating for several days
• Acute psychotic symptoms causing distress (delusions, hallucinations)

Reduce the intensity of the crisis as much as possible. Speak calmly, softly, and slowly; relax your body and voice; be genuine – do not talk to the individual like they are a child; and be non-judgmental to the person’s experience rather than assessing, judging or pushing solutions. Ask how you can help your loved one feel safe. Try to find out what would help them feel more secure and in control.

If the person is willing to seek care, begin establishing a game plan. Is there a doctor, therapist, or other care provider you could call? Ask the individual what has helped when they have had similar feelings in the past. Does the individual have a written plan for crises or other ideas about what works for them?

Ask the individual what their preferences are for resolving the crisis. Would they prefer a hospital, clinic, or non-medical support? Would they like to take anything along with them? Is there anyone else the individual would like called? When we get there do you want me to stay with you or drop you off?

Involve professionals: Is the person in immediate physical danger and unwilling to seek care? Is the person in immediate danger and unwilling to seek care? If yes, call 911 and explain.

• Crisis does not happen because someone is weak, “cracked,” or not trying hard enough to get well.
• Crisis is not an inevitable or unavoidable part of living with a mental illness.
• Crisis often signals problems with the services and/or support, not with the person’s ability to get well.
• Crisis looks and feels differently for every person.
• Someone in a self-defined crisis should never be turned away from services.

• Mental illnesses are conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and/or daily functions.
• Mental illness refers to many different diagnoses. Each person’s experience with mental health issues is unique. People have wide-ranging preferences about the language used to describe their experience.

Modern science cannot pinpoint the cause of mental illness. However, researchers generally agree that multiple factors play a role, rather than a single cause. Mental illnesses have nothing to do with personal weakness or lack of character. Examples of possible factors include genetic predispositions, trauma, chronic stress, and serious loss. To learn more about mental illness please visit https://namiwisconsin.org/.

Recovery as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) is a “process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”

Recovery is non-linear, characterized by continual growth, and occasional setbacks. Recovery is holistic. It encompasses an individual’s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated.

For more information on recovery please see SAMHSA’s Guiding Principles of Discovery at https://namiwisconsin.org/recovery/what-is-recovery.

Affecting over 42 million people nationwide each year, anxiety disorders are a group of mental illnesses that cause people to feel excessively frightened, distressed, or uneasy during situations in which most people would not experience these same feelings. Examples include:

• Panic Disorder
  Panic attacks, sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, and fear of dying.
• Obsessive Compulsive Disorder
  Repeated, intrusive, and unwanted thoughts or rituals that seem impossible to control.
• Generalized Anxiety Disorder (GAD)
  Chronic, exaggerated worry about everyday routine life events and activities, lasting at least six months; almost anticipating the worst even though there is little reason to expect it.
• Post-Traumatic Stress Disorder (PTSD)
  When people experience or witness a traumatic event such as abuse, a natural disaster, or violence, it is normal to feel distressed and feel “on edge” for some time after this experience. Some people who experience traumatic events have severe symptoms such as nightmares, flashbacks, being easily startled or scared or feeling numb/angry/irritable/distracted. If these symptoms last for weeks/months after the event, the person may be suffering from PTSD.

Depression affects almost 16 million Americans each year. Sadness is a normal human response to loss, failure and disappointment. Major depression is different. It is a serious condition that affects one’s thoughts, feelings, behavior, mood and physical health.

People experiencing depression often experience periods of wellness that alternate with periods of illness. Depression may require long-term treatment to keep symptoms from returning, as with any other chronic illness.

Common symptoms of major depression:

• Sleep pattern changes
• Decreased or increased appetite
• Poor concentration/inability to make decisions
• Loss of energy or ability to perform regular routines
• Lack of interest in activities the person used to enjoy
• Low self-esteem. During periods of depression, people often dwell on memories of losses or failures
• Strong feelings of hopelessness or guilt

Affecting 6.1 million Americans, bipolar disorder is a persistent illness with recurring episodes of mania and depression that can last from one day to months. Not everyone’s symptoms are the same and the severity of mania and depression can vary. Because of its irregular patterns, bipolar disorder is hard to diagnose.

Common symptoms of mania:

• An abnormally increased level of irritability
• Overconfidence or an extremely inflated level of self-esteem
• Increased talkativeness
• Decreased amount of sleep
• Engaging in risky behavior, such as spending sprees and impulsive sex
• Racing thoughts, jumping quickly from one idea to another

Common symptoms of depression:

• Diminished capacity for pleasure or loss of interest in activities once enjoyed
• Long periods of feeling hopeless, helpless, or low self-esteem
• Decreased amount of energy, feeling constantly tired
• Changes in eating, sleeping or other daily habits
• Thoughts of death and/or suicide attempts

Affecting 2.4 million Americans, schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions, and relate to others. Like diabetes, schizophrenia is a complex illness that affects everyone differently. The course of treatment for the illness is unique for each person.

Common symptoms of schizophrenia:

• PSYCHOSIS, defined as the loss of contact with reality, is a common symptom that usually involves:
  • Delusions – The belief in things not real or true
  • Hallucinations – Hearing and/or seeing things that others do not perceive
  • Disorganized speech/inability to generate logical sequence of ideas

Other symptoms may include::

• Emotional flatness or lack of expressiveness
• Inability to start and follow through with activities
• Lack of pleasure or interest in life
• Trouble with prioritizing tasks, memory and organizing thoughts

These disorders may interact differently in any one person (e.g. an episode of depression may trigger alcohol abuse, or cocaine use may exacerbate or trigger the onset of symptoms of schizophrenia.) Co-occurring disorder varies among individuals and in the same individual over time. Although substance use and mental illness are closely linked, one does not directly cause the other. Many people seek treatment for one condition and only later receive support for the other (SAMHSA.GOV).

Ideally, people with co-occurring disorders receive integrated services and support for both their mental health and substance use issues. Services and support from providers who work together on both issues at the same time is key to successful outcomes.

Integrated services means that the person receives support from both substance use and mental health care providers or dually certified providers. These providers work together (have regular meetings, share information) to coordinate care for substance use and mental health issues at the same time.

• A person receives services and support for substance abuse and mental health issues, but their providers do not coordinate or communicate about treatment plans.
• A person works on one issue (mental health or substance use) with the expectation that after some progress, they will then work on the other issue.