It can be hard to see a loved one struggle with depression, even when depression is managed. When depression is not managed, and has turned into a crisis, it can be very scary. It’s critical to know how to respond, especially during a global pandemic.

You may feel ill-equipped to help. You might not know what to say or what to do. You might feel powerless. But you can help. You might save a life.

What is a depression crisis?

Depression is always serious. So, what’s a crisis?

A crisis is when someone is at risk of hurting themselves or someone else. How do you know? There are a few signs that someone might be in crisis.

Someone might talk about:

• Unbearable pain.
• Feeling trapped.
• Having no reason to live.
• Killing or hurting themselves or another person. They might say things like “after I’m gone.”
• Feeling totally hopeless. They might say things like “I can’t take it anymore.”

Behaviors that signal a crisis can include:

• Big changes in alcohol or drug use.
• Looking for ways to hurt themselves, like researching or buying a gun.
• Suddenly withdrawing from other people and activities.
• Giving away important possessions.
• Calling people to say goodbye.
• Sleeping too much or too little.
• Acting aggressively or recklessly.
• Acting with rage, irritability, or shame.

How to have a conversation

Start a conversation if you think someone might be considering suicide. Talking can help you to understand how serious the situation is. Assume you’re the only person who will reach out for help. Don’t assume that others will and that you can wait for them to do it instead of you.

It’s OK if you feel nervous. Try to speak calmly and with a reassuring tone. Tell the person that you’re concerned for their well-being and that you’re there to help.

Here are a few tips to start a conversation with someone in crisis:

• Find a private place to talk.
• Let your loved one talk about how they feel.
• Tell them you care about them. Say things like: “I’m here,” “I care,” “I want to help,” and “How can I help?”
• Ask directly if they’re thinking about suicide.
• Try your hardest not to judge what you hear. Don’t tell them that their feelings are wrong or bad.
• Resist the urge to try to solve or downplay the person’s problems.
• Don’t take your loved one’s actions or hurtful words personally.
• I find that it helps if your body language shows you’re giving a person your undivided attention. Eye contact and leaning forward signals that you’re listening.

Professional organizations that can help in a crisis

Call for help immediately if you think a person is at risk of hurting themselves or another person. You don’t have to handle a crisis alone.

Take what they’re telling you seriously. Stay with the person. Remove any means of potential harm. Call for help and consider escorting them to an emergency room if necessary.

Any of the following resources can help:

• Call 911 in the case of a life-threatening emergency. Tell the operator that it’s a psychiatric emergency. Ask for an officer who’s trained to assist people in a psychiatric emergency.
• National Suicide Prevention Lifeline provides free and confidential support over the phone to people in distress as well as crisis resources for loved ones and professionals. Call 800-273-8255 to speak with a trained crisis counselor.
• Crisis Text Line is a 24-hour service that provides crisis resources via text messages. Text HOME to 741741 to help the person connect with a trained crisis counselor to receive crisis support via text message.
• National Domestic Violence Hotline is a 24-hour service that provides crisis resources to anyone experiencing domestic violence or seeking resources and information on the topic. Call 800-799-7233 to speak with trained experts who provide confidential support.
• National Sexual Assault Hotline is a 24-hour service that provides crisis resources to people affected by sexual violence. Call 800-656-4673 to connect with a trained staff member in your area.

It can be scary to take the first step if someone you love is going through a mental health crisis. Know that you have backup. You can save a life by connecting a person to the help they need.

If you feel overwhelmed and have thoughts of hurting yourself, call 911. For support and resources, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741741 for the Crisis Text Line.

For more information on how to manage depression, reach out to your doctor or healthcare team.