10 Ways to Reach Out in a Mental Health Crisis

The definitive guide to speaking up about the “unspeakable.”

Note from the author: Hi there! Yes, you! I’m a little biased, but I’d really like for you to stay alive. If you feel you might hurt yourself, please consider going to the emergency room. I’ve done it twice, and I’ve never regretted it (I even wrote about how to prepare for such a visit in this article). If you’re not in immediate danger, carry on reading and please… carry on living.

I’m a mental health writer and advocate, and a suicide attempt survivor. I’ve told people this many times: “Keep reaching out.” I’ve written multiple articles preaching the importance of vulnerability, defying stigma, and owning your struggles.

This is my whole thing, okay? This is what I do.

So when one of my closest friends died by suicide, I wasn’t just shocked — I was completely gutted.

I thought there was never a question of whether or not my loved ones could reach out to me. But the very person who I’d talked to so often about mental health… didn’t call me.

Not even to say goodbye.

In the weeks following their suicide, my grief took me to dark places. I soon began having my own suicidal thoughts.

And when it was my turn to reach out? Even after losing my friend? I began to withdraw, too.

I watched, with painful awareness, as I did much of what my friend seemed to do leading up to their suicide.

I wrote myself off as a burden. I isolated myself. I got lost in my own head. And despite knowing the danger of where I found myself, I said nothing.

After an especially scary night, I realized something: No one ever explained to me how to ask for help. No one told me what reaching out even meant.

As my grief began to snowball, I hesitated to tell anyone I was struggling, largely because I didn’t know how. I didn’t know what to ask for, and without knowing what to ask for, it felt too complicated and futile to try.

“Why didn’t they tell me?” is such a common refrain when we talk about suicide or mental health challenges in general. It’s easy to make this remark, because “tell someone” seems like a simple request.

But in truth, it’s vague at best.

Reaching out is this skill we’re somehow expected to know, yet it’s never taught and rarely modeled for us.

It’s this vague, hopeful sentiment that people throw around, without ever really defining it. What are we asking people to do or say? It’s not exactly clear.

So I want to get more specific. We need to be more specific.

I don’t know if an article like this could’ve saved my friend. But what I do know is that we need to normalize asking for help and talk about what that might look like, rather than pretending it’s a simple and intuitive thing to do.

Maybe then, we can reach people sooner. We can meet them more compassionately. And we can find better ways to support them.

So if you’re struggling but you don’t know what to say? I get it.

Let’s talk about it.

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1. When you don’t know what you need: “I’m (depressed/anxious/suicidal). I’m not sure what to ask for, but I don’t want to be alone right now.”

Sometimes we don’t know exactly what we need, or we’re unsure of what someone can offer. That’s okay — that shouldn’t discourage us from reaching out.

It’s perfectly fine if you have no idea what you need or want, especially when all you can think about is how much you’re hurting.

Let someone know how you’re feeling. You might be surprised by the ways they offer to support you.

And if they aren’t helpful? Keep asking until you find someone who is, or seek out a hotline (I know it can be weird to talk to a stranger, but there are some awesome hotlines out there).

2. When you don’t have close people nearby: “I know we don’t talk much… I’m going through a tough time and I feel like you’re someone I can trust. Are you free to talk (day/time)?”

I wanted to include this because I realize that not all of us have people we’re close to that we confide in. That doesn’t mean that you’ve hit a dead end.

When I was a teenager, everything changed for me when I reached out to a teacher at my high school that I barely knew. She had always been incredibly kind to me, and I had a gut feeling that she would “get it.” And she did!

To this day, I still believe that she saved my life at a time when I had no one else to turn to. She connected me with a social worker, who was then able to help me access the resources I needed to recover.

While it’s important to be respectful of people’s capacities and boundaries (and be prepared, of course, if someone can’t be there for you or isn’t helpful — it’s not personal!), you might be surprised by the responses that you get.

3. When you feel stuck or out of options: “I’m struggling with my mental health and what I’ve been trying isn’t working. Can we (meet up/skype/etc.) on (date) and come up with a better plan?”

Feeling helpless or exhausted is part and parcel for dealing with a broken mental health system. But a team approach can make it a little more manageable.

Sometimes we need a cheerleader or researcher that helps us explore our options, especially when we’re having trouble believing that we have any.

Bonus tip: One thing you’ll also notice is that, for almost everything on this list, I suggest setting a time.

This is important for a couple of reasons. The first being that it helps the person you’re talking to understand the urgency behind your ask. It can also be helpful to know that there’s an event in the near future when you can expect to receive some support. This can help us hang in there when things get bleak.

4. When you can’t be alone: “I don’t feel safe by myself right now. Can you stay on the phone with me or come over until I calm down?”

I know this is a hard one to say. Because we often fear telling someone just how much we’re struggling, and admitting that we don’t feel safe? That’s a biggie.

Obviously you can replace the word “safe” if it’s not working for you, but I always encourage people to be direct, because it’s the surest route to getting exactly what we need.

Asking someone to be present might feel especially vulnerable. It might not even feel like, in the moment, it’ll make that much of a difference. But you’re more likely to feel better with support than without any.

And remember, from everything we know about mental illness, depression is more likely to be a liar than a truth-teller (I talk about that a bunch here).

5. When you don’t want to talk about it: “I’m in a bad place but I’m not ready to talk about it. Can you help me distract myself?”

You do not have to talk about what’s bothering you if you’re not ready.

Opening up a whole can of worms might not be the safest or best thing for you in that particular moment. And guess what? You can still reach out for help.

Sometimes we just need someone to shoot the sh*t with, so we aren’t stuck in our heads, making ourselves a little crazed. This is a valid and healthy thing to ask for! And it’s a subtle way of making folks aware that you’re having a rough time, without needing to go into detail.

The sooner the folks around you are aware that you’re having a hard time, the quicker they can show up to help you through it.

Early interventions are so critical for our mental health. In other words: Don’t wait for your whole basement to flood before you fix a leaky pipe — fix the pipe when you notice the problem has started.

6. When you need to feel connected: “Can you check in with me (on date/every day) just to make sure I’m alright?”

I cannot say it enough — do not underestimate the value of asking for a check-in. I am such a huge fan of this as a coping skill, especially because it can be super helpful for everyone involved.

If you take nothing else away from this article, it should be this: Please ask people to check in with you. It’s such a small thing to ask for in the age of texting, but it can help us stay connected, which is freaking critical for our mental health.

(If you’ve played The Sims before, remember the social bar? That’s you. You need to fill it. Humans need to connect with other humans. It’s not just about wanting to, it’s that we actually require it to survive.)

And this can happen in so many smart ways. A few of my favorites:

• “I haven’t been doing well. Can you text me every morning to make sure I’m okay? It would really help me.”
• “Hey friend. I’ve been kind of sad lately — do you maybe want to Snapchat/send selfies to each other before bed
  every night, just to check in? It’d be nice to see your face.”
• “I’m in a funk right now. Do you want to be self-care buddies? Like text each other once a day something that we
  did to care for ourselves?”
• “I’ve been isolating myself a little lately. Can you check in with me every so often, just to make sure I
  didn’t fall off the face of the earth?”

Add emojis wherever fitting if you want it to feel more casual (but really, you don’t need to, there’s nothing wrong with asking for what you need!).

Asking for people to check in with you when you’re struggling is just like buckling your seatbelt when you get in a car. It’s just one extra safety measure in case things get rough.

Both can actually save lives, too. Consider this a PSA.

7. When you feel like a mess: “I’m having a hard time taking care of myself. I need extra support around (task). Can you help?”

Maybe you need help getting to an appointment or the grocery store. Maybe you need a cheerleader to make sure you took your meds, or someone to send a selfie to, to prove you got out of bed that morning.

Are your dishes piling up in the sink? Do you need a study buddy? It doesn’t hurt to ask for support around tasks like these.

Sometimes these things add up when we’re struggling with our mental health. But we forget that it’s okay to ask for a hand, especially at those times when it could really make a difference.

Being an adult is already challenging. If you’re going through a rough time? It’s even harder. We all hit a point when we need some extra support. Don’t be afraid to let folks know directly how they could support you.

8. When you feel self-loathing: “I’ve been feeling so low. Can you share a favorite memory of us/remind me what I mean to you? It would really help me.”

I used to think that asking for something like this meant I was “fishing for compliments.” And what a lousy way of looking at it.

Sometimes we need reminders that we matter! Sometimes we can’t recall the good times, and need someone to help us remember them. This is true of every single human being on the planet.

It’s such a simple request, too. If you’re the kind of person that feels nervous about making a big ask (again, I’d encourage you to challenge that assumption — it’s okay to ask for help), this can be a small step in the right direction.

9. When you’re nearing the end of your rope: “I’m struggling right now and I’m afraid I’m reaching my limit. Can I give you a call tonight?”

To be honest, it wasn’t until my friend died that I finally found these words in particular.

Up until that point, I’d never been exactly sure how to raise the alarm. You know, that moment when you’re not at the end of your rope, but you’re getting there? It’s a crucial moment.

Yes, you can and you absolutely should reach out then, even if you aren’t sure if it might make a difference (spoiler alert, people might actually surprise you). I think about how much pain I could’ve avoided if I’d seen that moment for the opportunity it really was.

Listen to that little voice in the back of your mind, the one that’s trying to tell you that you’re a little too close to the edge for comfort. Listen to that nagging feeling that tells you you’re in over your head.

That’s your survival instinct — and it’s an instinct you should trust.

10. When you feel like you’ll snap: “I’m suicidal. I need help right now.”

Raise the alarm.

Raise the damn alarm, friends, and be as direct as you need to be. An emergency is an emergency, whether it’s a heart attack or a self-harm risk. Harm to you in any form is reason enough to ask for help.

I promise you, there’s someone in this world — an old friend or a future one, a family member, a therapist, even a volunteer on a hotline — who wants you to stay.

Find that person (or people), even if it takes time. Even if you have to keep asking.

Give people the chance to help you. It’s a chance that my friend deserved, and it’s a chance that you deserve.

(And if all else fails, I have this resource about going to the emergency room when you’re suicidal. I’ve personally been hospitalized twice, and while it’s not a ritzy vacation, it’s the reason I’m here today.)

Pick something from this list. Write it down, even if it’s on your hand or a sticky note. And then reach out — because now you know how.

Hell, bookmark this article while you’re at it. Print it off. I know I’m going to, because there are times when I need this advice, too.

If you’re struggling with your mental health, let me remind you that it’s never too soon or too late to let someone know.

The Healthline FindCare tool can provide options in your area if you don’t already have a doctor.

And it’s never, ever too heavy, too messy, or too much to ask — even if you asked 50 times the day before.

I would rather have had my friend “bother me” every day for the rest of my life than have to lose them forever. Their life was that precious.

And yes, so is yours.

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This article originally appeared here.

Article originally appeared on September 3, 2019 on Bezzy’s sister site, Healthline. Last updated on September 3, 2019.