You Don't Get to Schedule Your Mental Health Crisis

One of my first supervisors when I did mental health crisis intervention work had a playful sign that hung in her office. It read "No Crisis Allowed This Week: My Schedule is Already Full." Whether related to physical health, a natural disaster, or a mental health; a crisis is never planned. Yet, when we are experiencing a mental health crisis (and after), we tend to hold ourselves quite a bit more accountable for something that is ultimately out of our control.

What is a mental health crisis?

A mental health crisis is a storm of strong mental health symptoms that temporarily interrupts our lives. It can include things like severe depression, a psychotic episode or mania. Sometimes hospitalization is necessary to get through one. It can be intense.

This sort of experience does not care how much work you have to do, whether you're about to go on vacation, or how it might affect those around you any more than a tornado cares about what houses it hits. When a person has an illness like bipolar disorder or schizophrenia, a major mood or psychotic episode can onset rapidly.

Following a crisis, there tends to be a lot left in the rubble to be recovered. In Cognitive Processing Therapy (CPT), an intervention for trauma, there is something called the 'just world' myth (Resick et al., 2017). As kids, we are often taught that if we do good things, good things will happen, and if we do bad things, bad things will happen. After a traumatic event, like a mental health crisis, we might have a sense that this is somehow a punishment or our "karma." It's not.

Most people wouldn't chastise someone for having a seizure. Unfortunately, the same is not always the case with mental health.

Countless people question, "Why did I let this happen?" No one chooses to have a crisis. We can take steps such as avoiding substances, getting enough sleep, and monitoring stress. Still, someone can do everything "right" and still fall into an episode. Even if someone did make a choice that may have contributed to their relapse, they probably wouldn't have made that choice if they knew what would have happened. In CPT this is called hindsight bias.

Sometimes we can hear the sirens and take certain steps to avoid the crisis. But not always, and life does not always accommodate what people need. After a crisis, we can reflect on contributing factors and make a plan to take care of ourselves.

It's natural to feel a kaleidoscope of emotions in the wake of an episode ranging from anger to shame to loss. Still, after a mental health crisis, what we need most is compassion, from ourselves and others.

Here are three ways to show yourself kindness after a mental health crisis.

1. Take Care of Your Physical Needs

It sounds basic, but when you are coping with major mental health symptoms it can be very difficult to stay on top of things like eating, sleeping, and personal hygiene. After these have been neglected for a bit, it can be difficult to get back on track. Still, taking care of your body at this time is non-negotiable.

2. Give Thanks Rather Than Apologies

During a time of being unwell, others may have picked up some of your duties such as work shifts or taking care of pets. You may also have behaved in ways that don't match your norms. It's not your fault. It's okay to acknowledge what happened, but rather than saying "I'm sorry," try "thank you."

3. Return to Things Slowly

Feeling guilty after a mental health crisis can set us up to try and rush in and restart life as normal as soon as possible. Usually, this is not the best course. Returning to things before you are ready can take a toll on your mental health. Instead, take stock of what needs to be done and do it a bit at a time.