Crisis and crisis reactions

Experiencing crises is a normal part of the human experience, although it can be painful and it can feel as if you are losing power over your life. In some cases, crisis reactions can lead to mental illness.

What is a crisis?

A crisis can be explained as a problematic period in a person’s life triggered by one or more difficult events. These may be losses or major life changes through sudden events such as a natural disaster, major accident or terrorist act. Longer-term problems with work, finances, separations or receiving bad medical news can trigger a crisis.

Facing situations involving demands that seem overwhelming can also lead to crises. This is known as change-related crisis, and it can make someone feel they are losing themselves and no longer know who they are or what they want. Some examples are when the youngest child leaves home, or when someone has not achieved what they had hoped by a certain age. A crisis can also be triggered by positive changes such as getting married or becoming a parent.

What effect may a crisis reaction have on someone’s life?

People respond differently to crises depending on their level of sensitivity and past experiences. It is common to feel anxiety, uneasiness and fatigue, and to have trouble sleeping. Feelings of despair, loneliness, emptiness and abandonment may also occur. This is normal and is not the same as being ill.

It is important to allow yourself to feel during a crisis, and not to bottle everything up inside. Talking to others about what happened is helpful for processing it. Many people get through a crisis with the support of their relatives, but in exceptional cases crises lead to serious mental illness and disorders such as adjustment disorder and post-traumatic stress disorder (PTSD).

Is it possible to feel better?

The diagnosis of adjustment disorder is made when other diagnoses can be ruled out. It is dominated by uneasiness, anxiety or depression, and may also cause changes in behaviour. Adjustment disorders may increase the risk of suicide, especially in young people.

Adjustment disorder has a good prognosis when it is treated, and the earlier treatment begins the lower the risk of future mental illness. One problem is that the boundary between a so-called normal crisis reaction and an adjustment disorder is not easy to determine. Many people are never diagnosed as a result.

If you need more support or suspect more serious mental illness after a crisis, contact a healthcare centre. School health services or youth clinics are also available for young people to turn to. Psychiatric outpatient treatment or BUP is recommended in the case of more alarming symptoms such as suicidal impulses.

Treatment

Treatment of crisis reactions may consist of emergency intervention or psychotherapy. An effective crisis intervention means getting the patient into care rapidly, helping to mobilise their social network, understanding what happened, identifying and solving problems and providing support and encouragement. Short-term treatment with medication can help address sleep problems.