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When Things Are Breaking Down or Getting Worse


In spite of your best efforts, your symptoms may progress to the point where they are very uncomfortable, serious, and even dangerous. This is a very important time. It is necessary to take immediate action to prevent a crisis or loss of control. You may be feeling terrible and others may be concerned for your wellness or safety, but you can still do the things that you need to do to help yourself feel better and keep yourself safe.

Signs that things are breaking down:

Write “When Things are Breaking Down,” or something that means that to you, on the fourth tab. On the first page, make a list of symptoms that indicate to you that things are breaking down or getting much worse. Remember that symptoms and signs vary from person to person. What may mean “things are getting much worse” to one person may mean a “crisis” to another. Your signs or symptoms might include:

  • feeling very oversensitive and fragile
  • responding irrationally to events and the actions of others
  • feeling very needy
  • being unable to sleep
  • sleeping all the time
  • avoiding eating
  • wanting to be totally alone
  • substance abusing
  • taking out anger on others
  • chain smoking
  • eating too much

On the next page, write an action plan that you think will help reduce your symptoms when they have progressed to this point. The plan now needs to be very direct, with fewer choices and very clear instructions.

Some ideas for an action plan are:

  • call my doctor or other health care professional, ask for and follow his or her instructions
  • call and talk for as long as necessary to my supporters
  • arrange for someone to stay with me around the clock until my symptoms subside
  • make arrangements to get help right away if my symptoms worsen
  • make sure I am doing everything on my daily check list
  • arrange and take at least three days off from any responsibilities
  • have at least two peer counseling sessions
  • do three deep-breathing relaxation exercises
  • write in my journal for at least half an hour
  • schedule a physical examination or doctor appointment or a consultation with another health care provider
  • ask to have medications checked

As with the other plans, make note of the parts of your plan that work especially well. If something doesn’t work or doesn’t work as well as you wish it had, develop a different plan or revise the one you used—when you are feeling better. Always look for new tools that might help you through difficult situations.

Sourced in July 2017 from:

Center for Mental Health Services
Substance Abuse and Mental Health Services
5600 Fishers Lane, Room 15-99
Rockville, MD 20857