Birgit, how does someone recognise that they're in a mental crisis?

That's a hard question to answer, as it varies from person to person. A crisis can manifest in mental symptoms, physical complaints or difficulty forming interpersonal relationships. The most common mental symptoms or complaints that some, but not all of us, might experience in a crisis include feelings of anxiety, panic or helplessness. Tension and agitation prevent us from relaxing properly. We also often feel on edge. Even minor setbacks are enough to cause our condition to deteriorate (again).

How does a crisis affect our thoughts?

The way we think is also impaired. We see the world around us in black and white, with little differentiation between people and situations. It becomes almost impossible to tell good from bad or right from wrong. Our thoughts become trapped in an almost inescapable cycle. We struggle to concentrate, which can make learning and working difficult.

How do people behave in a crisis?

People experiencing a crisis are often agitated and chaotic. This makes them seem erratic and uncoordinated, or even aggressive. It's common to engage in displacement activities that seem absurd to outsiders. These might include cleaning your home after being told that someone close to you has died. In extreme cases, you might start having suicidal thoughts or become violent towards objects or other people.

How does this behaviour affect those around us?

The psychological consequences of a crisis also affect our social relationships. We withdraw from our friendship groups or families, and isolate ourselves. We often don't feel like doing the things we enjoyed before the crisis occurred. We aren't understood by those around us, and we don't understand them either. This exacerbates our social isolation.

Does a crisis also trigger physical symptoms?

Yes, it also affects the body. People in crisis situations feel very tired and/or depleted. They usually have trouble sleeping. They also experience stomach and/or intestinal problems. Headaches and/or dizziness are often reported. Their heart rates can go up, and they can shake or struggle to breathe. Their entire musculoskeletal system can start to give them problems. Their appetite is also often decreased or increased, which usually causes them to lose or gain weight.

How can we deal with crises?

People face difficult situations throughout their lives, and dealing with these challenges gives them the life experience they need to cope with each new crisis. However, whether a crisis can be managed effectively, or how intense or challenging it is perceived to be, depends on how quickly help is available to the person affected. Our ability to help ourselves in a crisis is as crucial here as assistance from others.

How do we do that?

We need to be aware of what we have been through or are currently going through. We should view our situation not just in rational terms, but also from an emotional perspective. This establishes a link between the situation as we perceive it and the feelings we associate with it, which is helpful when it comes to processing a crisis. If you are still in the crisis situation, you need to leave it as soon as possible. It's important to go to a place where you feel safe and protected. You don't have to be a hero; you just need to treat yourself with care and kindness.

Do you have any other tips?

You should reach out to someone you trust. That isn't always easy on account of our tendency to shut others out in crisis situations. But a positive connection with someone who cares about us and keeps us grounded is important in order to overcome the crisis.
If you're unable to cope with the crisis yourself, it's essential to seek professional help. The earlier you get this help, the sooner the crisis can be overcome. It doesn't have to be psychotherapy, but the support should be temporary and tailored to the situation as you experience it. It also requires a proactive attitude on the part of the person providing the support.

What about young people? How can we support them in times of crisis?

Young people often don't yet have the life experience that adults have gained. During puberty in particular, their brains are still maturing, which is why their behaviour is heavily influenced by the limbic system (the seat of our core emotions). Young people in crisis situations sometimes have to deal with their own intense emotional responses. They're more reliant on outside help than adults when it comes to coping effectively with a crisis.

What can parents do for their teenagers?

Parents and other key figures who provide them with stability and guidance have a vital role to play. It's not always easy, because puberty makes young people want to increasingly distance themselves from their parents. This makes it all the more important for parents to offer their children understanding in crisis situations. Accusations, blame and lectures are counterproductive. You shouldn’t force them to open up. It's much better to wait for the opportunity to present itself. 

During the conversation, you should give the young person confidence and hope that a good solution can be found or that the situation can improve. The best way to help them is to make sure that their daily routine changes as little as possible. This means that, if possible, they should keep going to school or attending their training, and also keep up their hobbies and leisure activities. Both parents should be on the same page. As with adults, however, young people may need professional help in order to overcome a crisis. Instead of a psychotherapist, municipal youth workers can also offer valuable support.