There may come a time in life when you meet someone in the throws of their mental illness symptoms. By this, I mean, someone that is either deeply depressed, highly manic, hearing voices, or having a panic attack.  I know it is hard to talk about these subjects, but there is really not enough advice out there about what to do when someone is in the middle of symptoms.  So, here I'm going to give you the down-and-dirty, honest advice about how to handle the situation.

1.If your friend is deeply depressed:  First, you need to assess the situation, and find out if they are safe.  By this, I mean, are they deeply depressed, but not thinking of hurting themselves, or are they, in fact suicidal?  There are many ways to assess this.  The easiest way is to ask them.  Chances are, if they are coming to you for help, they don't truly want to kill themselves.  However, if you do find that they are contemplating harming themselves, DO NOT TRY TO HANDLE THIS SITUATION ALONE.  You really want the professionals to assess your friend.  There are people trained to know if someone is really safe or not.  So, if you are in any way unsure what to do, call 911, and tell them what is going on.  Chances are, they will call the police, who will come and escort your friend to the emergency room.  It is not a good idea to leave the person while you make the phone call.  Let them know that you are going to do it.  They may say that they don't want you to call, but it is important to call anyway.  It is in their best interest.  I don't recommend trying to hide the call from your friend because this situation of having the police come can be a bit traumatic, and it's better to let your friend know ahead of time.  If you have the numbers for any close family of this person, alert them too, but wait until the police come to do this.  The police will then come with an ambulance as well, and the friend will be escorted to the nearest emergency room, where a trained professional (screener, psychiatrist, therapist, or all of the above), will ask questions and assess the situation further.  If they determine that your friend is a danger to himself, they may admit him to the hospital for further psychiatric care.  Hospitals are there to keep someone safe, so don't feel bad if this friend has to go there.  It is for the best.  You are saving a life.  

2.  If your friend is having a panic attack:    Panic attacks are distressing, but not dangerous.  It is important to reassure your friend of this.  They may be convinced that they are dying, but if there are no other medical complications, they usually aren't, it just feels that way.  Still it is important that you help them get to the hospital if they report chest pains, shortness of breath, dizziness, etc.  If they aren't having those symptoms, it is usually a panic attack.  Take them to a quite place, and tell them that they ARE NOT IN DANGER.  Panic attacks happen because the nervous system is sending out signals that the person is in danger, when actually they are not.  It is kind of like if you pulled a fire alarm when there was no fire.  The alarm would sound, but in actuality, there would be no danger.  Help your friend by making them aware of their breath.  Tell them to say in their mind "IN" on the inbreath and "OUT" on the outbreath.  This will bring them back to the moment, and help them to overcome this anxiety.  It is most important to know that panic attacks do not last forever.  They are temporary, and they will run their course faster when the person having them realizes that they are not in danger.  

3. If your friend is hearing voices:  This is not a situation that you should try to handle alone.  Usually, if your friend is hearing voices, it is a sign that their medication is not right.  It is important that you get them to a doctor right away, or to the emergency room.  Again, your best bet is to call 911.  While you are waiting for the police and ambulance to come, ask your friend what the voices are saying.  Make sure that the voices are not telling them to harm themselves or another person.  If they are, you need to give that info to the police/ambulance immediately, even if the person tells you that it is a secret.  Let the professionals handle this potentially dangerous situation themselves.  If you sense that you yourself are in danger, it is important that you leave, but stay close enough to direct the authorities there once they get there.  

4.  If your friend is highly manic:  How will you know this?  Usually you can tell this by their behavior.  Are they trying to do risky things?  Are they on an uncontrollable shopping spree?  Are they talking faster than usual, and not making much sense?  All of these are signs.  Again, this is an important reason to call 911.  Your friend may take a risk that could hurt them or someone else.  It is a sign that their medication is not right, and they need to have it adjusted.  Stay with them until the authorities come, unless you feel that you yourself are at risk.  

Although it is not easy to talk about these things, it is important to know what to do.  You can save a life that way.  The most important thing is, DON'T try to handle these situations alone.  Involve the professionals right away.  It is a hard thing to do, but it can be the difference between life and death.  Thank you for your careful attention to this entry.  

Much love, and Be Well.
~Emily