The following article includes information and a discussion on suicide, mental health issues, and mental health services. If you are experience feelings of depression or suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or www.suicidepreventionlifeline.org.
As many of us already know, veterinarians are at an increased risk of mental health crises. We believe that it is important for everyone to learn basic mental health crisis intervention skills. Throughout the course of their life, everyone will encounter a person with mental health issues and/or experience mental health issues themselves.
Mental health crises occur when an individual’s behavior puts them at risk of harming themselves or others. There are a variety of specific mental health crises. However, in this guide we will identify and learn how to help someone experiencing the three most common mental health crises: panic attacks, anxiety attacks, and suicidal ideation.
How to Identify a Mental Health Crisis
While not everyone experiences mental health crises the exact same way, there are a variety of ways that an individual can identify an ongoing mental health crisis displayed by another person. The following information can be helpful in identifying mental health crises, but it is important to note that a person’s mental health history plays an important role in the severity and presentation of mental health crises.
Some mental health crises include panic attacks, anxiety attacks, and suicidal behaviors.
Identifying Panic and Anxiety Attacks
While panic attacks and anxiety attacks appear to be very similar, the two are very different. The primary difference is that anxiety attacks are medically recognized as increased moments of anxiety in relation to an anxiety disorder.
Panic attacks can occur in those without a panic/anxiety disorder. Panic attacks occur suddenly – and sometimes without warning – while anxiety attacks are more like the pinnacle of ongoing, uncontrolled anxiety.
Those undergoing a panic attack may experience…
- A pounding or racing heart
- Breathing Problems
- Weakness or dizziness
- Tingly or numb hands
- Stomach pain
Those undergoing an anxiety attack may experience…
- A surge of overwhelming panic
- Feeling of losing control or going crazy
- Heart palpitations or chest pain
- Feeling like they’re going to pass out
- Trouble breathing or choking sensation
- Hot flashes or chills
- Trembling or shaking
- Nausea or stomach cramps
- Feeling detached or unreal
Warning signs of suicidal risks
Suicide can be a scary topic to talk about, but it’s an important conversation to have. Proper suicide intervention can save lives. The first step to proper suicide intervention is knowing the warning signs of someone at risk for a suicide attempt.
Those at risk for a suicide attempt may…
- Talk about wanting to die or kill themselves
- Look for a way to kill themselves
- Talk about feeling hopeless or having no reason to live
- Talk about feeling trapped or in unbearable pain
- Talk about being a burden to others
- Increase drug or alcohol use
- Act anxious or agitated; behave recklessly
- Sleep too little or too much
- Withdraw or isolate themselves
- Show rage or talk about seeing revenge
- Experience extreme mood swings
How to Help Someone Experiencing a Mental Health Crisis
Once you have identified that someone is experiencing a mental health crisis, you can begin to help them. When assisting with mental health crises, it is important to remain calm. The individual experiencing the mental health crisis is already at a heightened state of emotion, so a cool and collected force will help.
Assisting with Anxiety and Panic Attacks
For anxiety and panic attacks, grounding techniques can also be helpful to get someone through an anxiety or panic attack. There are a variety of grounding techniques that can leverage pattern recognition, using your senses, and other mental focusing exercises to combat the panic. Some common grounding techniques include:
Box breathing is a technique often used to combat the body’s fight-or-flight response. This is extremely simple and can be used in combination with other techniques. The box breathing technique requires you to hold your breath for five counts, inhale for five counts, hold for five counts, and exhale for five counts before starting the process again.
An anchoring statement can help someone going through an anxiety attack return to a core statement, like, “My name is Inigo Montoya. I am looking for a six-fingered man.”
The 5-4-3-2-1 technique pictured here can lead someone to re-focus their energy away from the anxiety.
Helping Someone With Suicidal Thoughts
The first step in providing suicide intervention is to ask: Are you feeling suicidal? While this question may be hard to ask, it is an important step because it shows that you’re willing to talk about suicide in a non-judgmental way.
The National Suicide Prevention Lifeline has four additional steps in assisting someone who is considering suicide.
- Be There
- Keep them Safe
- Help them Connect
- Follow up
If the person shares with you that they are considering suicide, handle the situation with care. There can be a long distance between thinking about suicide and actually doing it, but it’s never too early to start to help a friend or colleague get the help they need.
If you can, try to find out how deeply the person has considered suicide. The person is especially at risk if they have a plan, including
- The means of how they plan to commit suicide. For veterinarians, guns are the most common method of suicide, followed by poisoning by medications. If you notice a sudden decrease in certain medications in your animal practice, one of your team members may be at risk for suicide.
- A time. Suicide attempts can happen any day or any time, but if a colleague mentions a specific day, they have moved one step further towards suicide.
- A stated intention to end their life. A colleague may be considering suicide but far from being close to actually intending to do so. Verbally confirming that their intention makes this a very serious case.
When providing suicide intervention, do NOT leave the person alone. Not only does your physical presence help, but it also ensures that the person you’re helping is safe. Next, connect them to the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or text HOME to 741741.
Good Mental Health Starts at Home
We all are responsible for our own mental health. As a community and industry, we also have an obligation to look out for each other. The conversation about mental health has already started with #NOMV. Talking about your stress factors is a great way to relieve that pressure and understand that you are not alone.
Please reach out to a (human) medical professional if you are feeling symptoms of depression, stress, or over-fatigue. There are a variety of practitioners that provide free or low-cost mental health care. More and more health insurance plans are adding mental health services in their coverage, so check your insurance plan’s website to find providers.
The stress of being an associate veterinarian can be incredibly high. That doesn’t mean that you have to give up your passion for healing animals. If you can, talk to your practice manager about taking on fewer shifts or a short sabbatical. Sometimes, stepping away for a month or two can give you the space to regain your mental balance.
If your current position doesn’t give you the space for your mental health, relief veterinary work might be an option for you. You have complete control over when and where you work, allowing you to plan time for mental health maintenance or recovery with low financial risk.
Do you have other tips or ideas on handling mental health crises? Let us know in the comments below.