Emergency help in psychiatric crisis

If your own mental or emotional state quickly gets worse, or you’re in some crisis or despair or you’re worried someone you know is in big trouble help is available. It’s important to get help timely and quickly. You just have to take some step at right time so that you can prevent things from getting worst. Everyone hope emergency and crisis situations never arise, but they do. Symptoms of psychiatric illness can be worse at times. This happens when people are doing their best to manage their illness, too. Experiencing worsening symptoms for a short period of time is a normal part of the recovery process. Sometimes we need outside help when symptoms become worse. Some people may also need urgent emergency help if they’re at risk of hurting themselves or others. Fortunately, we can take steps to help control mental health crises and emergencies. There may be times when you have to deal with aggressive behaviour, are worried about your safety or aren’t able to locate your family member. Crisis and emergency situations are often confusing and frightening. There are things you can do to prepare and to respond when a situation occurs.

Recognizing potential warning signs
  • talking about death or suicide
  • pre-occupation with death
  • depression
  • hopelessness
  • alcohol and drug misuse
  • low self-esteem
  • bereavement
  • break-up of relationship
  • changes in behaviour
  • previous history of suicide attempts or family
  • self-loathing or self-hatred
  • getting affairs in order
  • social isolation
  • self-destructive behaviour
  • sudden sense of calm or appearing very up-beat following a period of depression

Addiction / Alcoholism

Addiction is bio-psycho-social dependence on any mind altering substance. People, who have disease of addiction, have no control over what they are doing, taking or using. Their addiction will make them enter into a vicious cycle they are unable to get out of it. If a person is addicted to a substance then it will be process addiction but people also get involved to behavioral addictions as well.

Mood Disorders

Everyone experiences “highs” and “lows” in life, but people with mood disorders experience them with greater intensity and for longer periods of time than most people. Depression is the most common mood disorder; a person with depression feels “very low.” Symptoms may include: feelings of hopelessness, changes in eating patterns, disturbed sleep, constant tiredness, an inability to have fun, and thoughts of death or suicide. People with bipolar disorder have periods of depression and periods of feeling unusually “high” or elated. The “highs” get out of hand, and the manic person can behave in a reckless manner, sometimes to the point of financial ruin or getting in trouble with the law.

The Relationship between Psychiatric Disorders and Mood Disorders

Depression is a common feature of mental illness, whatever its nature and origin. A person with a history of any serious psychiatric disorder has almost as high a chance of developing major depression as someone who has had major depression itself in the past.

Types of Mood Disorders

Major depression is the most common mood disorder. This debilitating illness causes mental anguish and physical ailments. It often prevents normal daily function. While some people with depression may experience only one episode of major depression in a lifetime, most endure multiple episodes. Dysthymic disorder, or dysthymia, is a milder form of depression. It may not hinder a person’s ability to function in daily life, but increase long term moodiness. Bipolar disorder, also called manic-depressive illness, is less common. Bipolar disorder is a combination of extreme elation, which is known as mania, and depression.
Depressive Disorders and Major Depressive Disorder
Dysthymia is diagnosed when a person suffers from depression for two or more years. Although it is not as debilitating as major depression, dysthymia can prevent normal functioning. People with dysthymia can also experience episodes of major depression. Depressive disorders and major depressive disorder differ in severity and length of symptoms. Minor depression is defined by a period of at least two weeks of depression. Minor depressive episodes do not fully meet the criteria for major depression but can develop into major depression if left untreated. Other forms of depression exist as well. Psychotic depression occurs when psychosis, a complete break from reality, and depression are both present. Postpartum depression is sometimes experienced by new mothers. This form of depression results from physical and hormonal changes combined with the pressure of caring for a newborn. Seasonal affective disorder is a type of depression that affects people during times of decreased sunlight, particularly in the winter months when the days are shorter.
Bipolar Disorder
Bipolar disorder is a dangerous and debilitating disorder that causes a person’s mood, activity and energy levels to shift unexpectedly. People with bipolar disorder experience severe mania, and they may or may not have episodes of depression. They usually have some periods of partial or full stability as well.
Dual Diagnosis: Substance-Induced Mood Disorders
The most common psychiatric co-occurring disorders are substance abuse and mood disorders. It is common for people with mood disorders to turn to substance abuse. The substance abuse, in turn, exacerbates the effects of the mood disorder. With careful assessment and screening, a psychiatrist can better distinguish between symptoms of mood disorder and substance intoxication or withdrawal. Some people experience reduced cravings for substances once their co-occurring depression or bipolar disorder is treated.

What Causes Mood Imbalances?

What causes mood imbalances is difficult to pinpoint. Depression is thought to be caused by a combination of environmental, psychological, biological and genetic factors. The most enduring theories involve neurotransmitters, which are chemicals in the brain, causing an imbalance that leads to depression. So far, this theory has been difficult to verify. Scientists are still studying the causes of bipolar disorder, but the consensus is that bipolar disorder is caused by several factors working together. As bipolar disorder tends to be hereditary, researchers are currently trying to find a gene that may increase the risk of developing the disorder. Brain imaging studies show that the brains of people with bipolar disorder and depression differ from healthy brains, which suggests that brain structure and functioning may play a role in the development of mood disorders.

Emotional Symptoms of Mood Disorders

Emotional symptoms of mood disorders are not the same for all people. Emotional symptoms of depression include:
  • Thoughts of and attempts at suicide
  • Loss of interest in activities that were pleasurable in the past
  • Unyielding anxiety, sadness or feelings of emptiness
  • Feelings of worthlessness, helplessness or guilt
  • Feelings of hopelessness or pessimism
Emotional symptoms of mania include:
  • Prolonged periods of elation
  • Restlessness
  • Irritability, agitation or excessive energy
  • Feelings of grandiosity
  • Impulsive, risky or hedonistic behavior

Physical Symptoms of Mood Disorder

As with emotional symptoms, physical symptoms of mood disorder may differ from one person to the next. Physical symptoms of depression include:
  • Decreased energy or fatigue
  • Headaches, body aches, pains, cramps or digestive problems
  • Difficulty remembering details, making decisions or concentrating
  • Loss of appetite or overeating
  • Excessive sleeping or insomnia
Physical symptoms of mania include:
  • Racing thoughts and jumping from one idea to the next
  • Pressured or rapid speech
  • Increased goal-directed activities
  • Being easily distracted
  • Insomnia
  • Hypersexuality

Short-Term and Long-Term Effects of a Mood Imbalance

People with mood disorders tend to alienate friends and family. They often have trouble in school and at work and have difficulty keep a job. Those with mania tend to have problems with authority figures. Those with depression have a high risk of suicide. With mania comes the risk of death, injury or trauma caused by reckless and dangerous behavior.

Self-Assessment for Mood Disorders

Mood disorder tests are available on the Internet, but their reliability is questionable. If you suspect you have depression or bipolar disorder, you should speak with a doctor. Talk to your general practitioner, who should be able to help you or refer you to a mental health professional.

Treatment Option

 Mood Stabilizing Drugs
Depression is typically treated with antidepressant medications. Antidepressants work to restore neurotransmitters. The specifically targeted neurotransmitters are serotonin, norepinephrine and dopamine. Bipolar disorder is first treated with mood-stabilizing medications.
Counseling
Individual counseling plays an important role in treatment of Mood Disorders. Willing Ways is a state of the art facility with highly trained and experienced professionals who work with the patient and teach them the skills by which they can live with the daily stream of life happily.

Getting Help for a Mood Disorder

If you need help finding treatment on mood disorder, please don’t hesitate to Contact Us. We are here 24/7 to assist you.

Psychotic Depression

Psychotic depression is a subtype of major depression that occurs when a severe depressive illness includes some form of psychosis. The psychosis could be hallucinations, delusions or some other break with reality. Psychotic depression affects almost one out of every four people admitted to the hospital for the treatment of depression

Symptoms of psychosis

A person who is psychotic is out of touch with reality, (National Institute of Mental Health). Being through psychosis (psychotic episodes) means experiencing:
  • Delusions – thoughts or beliefs that are unlikely to be true
  • Hallucinations – when a person hears (and in some cases feels, smells, sees or tastes) things that aren’t there, a common hallucination is hearing voices
The delusions and hallucinations almost always reflect the person’s deeply depressed mood – for example, they may become convinced they’re to blame for something, or that they’ve committed a crime. People with psychotic depression may:
  • Get angry for no obvious reason.
  • Spend a lot of time by themselves or in bed, sleeping during the day and staying awake at night.
  • Have poor hygiene, like neglecting appearance by not bathing or changing clothes.
  • Be hard to talk to. Perhaps he or she barely talks or else says things that make no sense.
  • Have “Psychomotor agitation”, i.e., not being able to relax or sit still, and constantly fidgeting. Or, at the other extreme, a person with psychotic depression may have “psychomotor retardation”, where both their thoughts and physical movements slow down.
  • Be at greater risk than normal of thinking about suicide.
People with other mental illnesses, such as schizophrenia, also experience psychosis. But those with psychotic depression usually have delusions or hallucinations that are constant with themes about depression (such as worthlessness or failure), whereas psychotic symptoms in schizophrenia are more often odd or doubtable and have no obvious connection to a mood state (for example, thinking strangers are following them for no reason other than to persecute them). People with psychotic depression also may be humiliated or ashamed of the thoughts and try to hide them. Doing so makes this type of depression very difficult to diagnose. But diagnosis is important. Its treatment is different than for non-psychotic depression. Also, having one episode of psychotic depression increases the chance of bipolar disorder with recurring episodes of psychotic depression, mania, and even suicide.

Symptoms of Psychotic Depression

The common symptoms for patients having psychotic depression include:
  • Agitation
  • Anxiety
  • Constipation
  • Hypochondria
  • Insomnia
  • Intellectual impairment
  • Physical immobility
  • Delusions or hallucinations

Symptoms of severe depression

Having severe clinical depression means feeling sad and hopeless for most of the day, practically every day, and having no interest in anything. Getting through the day feels almost impossible. Other typical symptoms of severe depression are:
  • fatigue (exhaustion)
  • loss of pleasure in things
  • disturbed sleep
  • changes in appetite
  • feeling worthless and guilty
  • being unable to concentrate or being indecisive
  • thoughts of death or suicide

Causes of Psychotic Depression

The cause of psychotic depression is not fully understood. What we do know is that there’s no single cause of depression and it has many different triggers. For some, stressful life events such as bereavement, divorce, serious illness or financial worries can be the cause. Genes probably play a part, as severe depression can run in families, although it’s not known why some people also develop psychosis. Many people with psychotic depression will have experienced hardships in childhood, such as a traumatic event.

Treatment of psychotic Depression

Treatment for psychotic depression involves:
  • Medication – a combination of antipsychotics and antidepressants can help relieve the symptoms of psychosis
  • Psychological therapies – the one-to-one talking therapy cognitive behavioral therapy (CBT) has proved successful in helping some people with psychosis
  • Social support – support with social needs, such as education, employment or accommodation
The patient may need to stay in hospital for a short period while they’re receiving this treatment. Treatment is usually very effective, although patients may need to be continuously monitored in follow-up appointments.

Help your Loved Ones

People with psychosis are often unaware that they’re thinking and acting strangely. Because of this lack of insight, it’s often down to the friends, relatives or carers of a person affected by psychosis to seek help for them. If you’re concerned about someone you know and think they may have psychosis, you should contact “us”, because we have trained and experienced team of professionals to handle these conditions. If you think the person’s symptoms are placing them at possible risk of harm you can:
  • Contact with us urgently for Emergency Help in Psychiatric Crisis.
  • Call us and ask for an ambulance.

Suicide Prevention

Suicide is a major public health concern. Suicide is dreadful, but it is oftentimes preventable. Understand the risk factors and warning signs for suicide can help reduce the suicide rate. Many people have some of these risk factors but do not attempt suicide. Suicide is not a normal response to stress. It is however, a sign of extreme distress, not a harmless bid for attention. The risk for suicidal behavior is complex. Research suggests that people who attempt suicide differ from others in many aspects of how they think, react to events, and make decisions. There are differences in aspects of memory, attention, planning, and emotion. These differences often occur along with disorders like depression, substance use, anxiety, and psychosis. Sometimes suicidal behavior is triggered by events such as personal loss or violence.

Risk for suicide! How to Identify?

Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk for suicide. But people most at risk tend to share certain characteristics. Risk factors are mostly confused with warning signs of suicide. It is important to note that factors identified as increasing risk are not factors that cause or predict a suicide attempt. Risk factors are elements that make it more likely that an individual will consider, attempt, or die by suicide. Protective factors are characteristics that make it less likely that individuals will consider, attempt, or die by suicide.

The main risk factors for suicide are:

Risk Factors
  • Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
  • Alcohol and other substance use disorders
  • Hopelessness
  • Impulsive and/or aggressive tendencies
  • History of trauma or abuse
  • Major physical illnesses
  • Previous suicide attempt
  • Family history of suicide
  • Family violence, including physical or sexual abuse
  • Job or financial loss
  • Loss of relationship
  • Easy access to deathly  means
  • Lack of social support and sense of isolation
  • Stigma associated with asking for help
  • Lack of health care, especially mental health and substance abuse treatment
  • Exposure to others who have died by suicide (in real life or via the media and Internet)
  • Having guns or other firearms in the home
  • Imprisonment, being in prison or jail
The main protective factors for suicide are:
Protective Factors
  • Effective clinical care for mental, physical and substance use disorders
  • Easy access to a variety of clinical interventions
  • Restricted access to highly deathly means of suicide
  • Strong connections to family and community support
  • Support through ongoing medical and mental health care relationships
  • Skills in problem solving, conflict resolution and handling problems in a non-violent way
  • Cultural and religious beliefs that discourage suicide and support self-preservation
The following signs may mean someone is at risk for suicide. The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change. If you or someone you know manifest any of these signs, seek help as soon as possible by calling the us at our given contact numbers.

Warning Signs

  • Talking about wanting to die or to kill themselves.
  • Looking for a way to kill themselves, such as searching online or buying a gun
  • Talking about feeling hopeless or having no reason to live.
  • Talking about feeling trapped or in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious or agitated; behaving recklessly.
  • Sleeping too little or too much.
  • Withdrawing or isolating themselves.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

Prevention of Suicide

Effective suicide prevention is based on strong research. Programs that work take into account people’s risk factors and promote interventions that are appropriate to specific groups of people. For example, research has shown that mental and substance abuse disorders are risk factors for suicide. Therefore, many programs focus on treating these disorders in addition to addressing suicide risk specifically. Psychotherapy, or “talk therapy,” can effectively reduce suicide risk. CBT can help people learn new ways of dealing with stressful experiences by training them to consider alternative actions when thoughts of suicide arise. Another type of psychotherapy called dialectical behavior therapy (DBT) has been shown to reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self-image, and behavior. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations. Medications may also help; effective medications and psychosocial treatments for suicidal people are being tested. If you think the person’s symptoms are placing them at possible risk of harm you can:
  • Contact with us urgently for Emergency Help in Psychiatric Crisis
  • Call us and ask for an ambulance

Domestic violence

Domestic violence is the willful terrorization, physical attack, sexual assault, and/or other abusive behavior. It can be a systematic pattern of control, power committed by one intimate partner against another. It includes sexual violence, physical violence, psychological violence, and emotional abuse. The frequency and severity of domestic violence can vary dramatically.  Domestic violence can result into physical injury, trauma, and in severe cases, fatal consequences e.g. death.

Home runaway

Home runaway is a problem when a person under an arbitrary age, who has left their parent or legal guardian. Many teens decide to run away from home at some point their lives. There are several reasons behind teens runaways, i.e. abuse, parental separation or divorces, arrival of a new stepparent, death of a loved one, financial family worries, problems at school, peer pressure or failing or dropping out of school.

Honor Killing

An honor killing also called shame killing is the homicide of a member of a family by other members, due to the executioner’s belief that the victim has brought shame or dishonor upon the family, or has violated the principles of a community or a religion, usually for reasons such as refusing to enter an arranged marriage, being in a relationship that is disapproved by their family, having sex outside marriage, becoming the victim of rape, dressing in ways which are deemed inappropriate, engaging in non-heterosexual relations or renouncing a faith. Human Rights Watch defines “honor killings” as “Honor killings are acts of vengeance, usually death, committed by male family members against female family members, who are held to have brought dishonor upon the family”. A woman can be targeted by (individuals within) her family for a variety of reasons, like refusing to enter into an arranged marriage, being the victim of a sexual assault, seeking a divorce even– from an abusive husband– or (apparently) committing adultery. The only perception that a woman has behaved in a way that “dishonors” her family is sufficient to trigger an attack on her life. The perceived dishonor is normally the result of one of the following behaviors, or the intuition of such behaviors. The details are discussed in later section.
  1. Dressing in a manner unacceptable to the family or community,
  2. Wanting to terminate or prevent an arranged marriage or desiring to marry by own choice,
  3. Engaging in heterosexual sexual acts outside marriage, or even due to a non-sexual relationship perceived as inappropriate, and
  4. Engaging in homosexual acts. Women and girls are killed at a much higher rate than men.
In Pakistan, honor killing is known locally as karo-kari, کاروکاری‎. Originally, karo and kari were metaphoric terms for adulterer and adulteress, but it has come to be used with regards to multiple forms of perceived immoral behavior. Once a woman is labeled as a kari, family members consider themselves to be authorized to kill her and the co-accused karo in order to restore family honour. In the majority of cases, the victim of the attacks is female with her attackers being male members of her family or community.

Methods Used for Honor Killing

Methods of killing include stoning, stabbing, beating, burning, beheading, hanging, throat slashing, lethal acid attacks, shooting and strangulation. The murders are sometimes performed in public to make an example and warn the other women within the community of possible consequences of doing so what is perceived as illicit behavior.

Triggers of honor killings

Refusal of an arranged marriage
Refusal of an arranged marriage is often a cause of an honor killing. The family which has prearranged the marriage risks disgrace if the marriage does not proceed.
Seeking a divorce
A woman attempting to obtain a divorce or separation without the consent of the husband can also be a trigger for honor killings. In cultures like Pakistan where marriages are arranged and goods are often exchanged between families, a woman’s desire to seek a divorce is often viewed as an insult to the men who negotiated the deal. By making their marital problems known outside the family, the women are seen as exposing the family to public dishonor.
Allegations and rumors about a family member
In some cultures, an allegation against a woman can be enough to stain her family’s reputation, and to trigger an honor killing. The family’s fear of being rejected by the community is an epic.
Victims of rape
In many cultures, victims of rape face severe violence, including honor killings, from their families and relatives. In many parts of the world, women who have been raped are considered to have brought ‘dishonor’ or ‘disgrace’ to their families. This is especially the case if the victim becomes pregnant. Central to the code of honor, in many societies, is a woman’s virginity, which must be preserved until marriage. “A woman’s virginity is the property of the men around her, first her father, later a gift for her husband.
Homosexuality
There is evidence that homosexuality can also be perceived as grounds for honor killing by relatives. It is not only same-sex sexual acts that trigger violence – behaviors that are regarded as inappropriate gender expression, a male acting or dressing in a “feminine way” for example, can also increase the feelings and lead to honor violence. If you think that you are placing at possible risk of harm, then:
  • Contact with us urgently for Emergency Help in Psychiatric Crisis
  • Call us and ask for an ambulance