Write and share a crisis plan

Purpose

Choose people from your support structure who are very close to you (live with you or are in contact with you daily). They can be authorised to make decisions for you when you experience an episode. Let them know how they can support you.


Help them understand 

  • more about the disorder,
  • the role they play, 
  • what you both can do to help prevent episodes,
  • that they need to take their role seriously, and
  • what you need from them in your time of need. 

A safety box

Find or make a box. This box will be a safety box that will contain your crisis plan and all its necessary components. Keep it powerful and make sure it is nearby. What to put in your box:

  • The lists you create that are explained below
  • Objects that stimulate your senses such as picture or photographs, meditation music on a USB stick, fragrances such as perfume or incense, something to taste such as chocolate and things you like to touch like materials, soft and furry plush toys or stress balls.

Instructions

Print out hard copies or share a document online. It is important to keep this plan up to date.

Your plan is made up of the following which is described below:

  • common signs and symptoms;
  • your preferred treatment plan;
  • how to deal with a specific episode;
  • the medication you take;
  • any health problems you have or are experiencing; and
  • who to contact and why.

Create motivational lists

A bucket list

Create a list of things you still want to do, places you want to go to, people you want to meet. 

What you will miss

Make a list of things you will miss which can include smells, tastes, sounds, visuals, sensations, people and animals you love, objects, activities. Try to be as specific as possible so that you really dig deep into the motivation, like "The smell of cinnamon in the kitchen when my mother is baking."


Some examples are

  • The taste of chocolate ice cream from Paul's ice cream shop
  • My sister's giggle when I do something funny
  • The taste of popcorn when I go to the movies
  • The sight of the waves crashing when I sit on the beach
  • The feeling of stretching at my yoga practice
  • My father hugging me tightly when I see him
  • My dog looking at me with her head tilted waiting to be scratched
  • The bonfire lit up while camping with friends
  • Scuba diving in a coral surrounded by wonders of the ocean

Motivations

Create a list of hobbies and things you really love doing, things you almost obsess about. Make sure they are really important to you and that they motivate you almost daily.

Photos

Create a collection of photographs of people you love and places you enjoy going to.

Risk of suicide

Catch this early

The desire will gradually get worse. Put steps into place before you hit dangerous levels that could jeopardize your safety. The chances are that you will no longer care when you reach your ultimate low. You may need to be hospitalised.

Stay with someone close to you

Stay with someone close to you so that they can monitor you and your behaviour. They should not have to take responsibility, rather help and guide you through your time of need.

Your medication

Give all the medication in your house to someone you stay with or lives nearby. Let them give you the necessary medication that you need. Make sure you give them the instructions to follow for you psychiatric medication so that they know what to give you.

Dangerous objects

Try to stay away from dangerous objects. Lock them away if you can. Staying someone in your support structure may help you.

Look at your lists

Read your bucket list, the list of things you will miss, your list of motivations and look at your photographs. Keep these lists in your safety box. These can spark your will to live.

The importance of your life

Know how important you are, how loved you are, how much you will be missed and how devastated your loved ones will be should you take your own life. Remind yourself of the important roles you play in other people's' lives.

Your crisis plan

Common signs and symptoms

People with bipolar have good days and bad days. This is normal. It becomes a problem when the good days blow up into mania or hypomania and when the bad days fall deep into a major depression.


Describe the common signs and symptoms that you usually experiencing during a manic, hypomanic and major depressive episode. Note the sign and the type of episode it is usually linked to. The people in your support structure will know what to look out for and how to deal with that episode. 


Examples of common signs and side effects are:

  • Extreme energy
  • Racing thoughts
  • Little sleep required or sleep too much
  • No desire to eat or eat more than usual (binge eating)
  • Can't get out of bed
  • Making poor decisions, serious impulsivity and risky behaviour
  • Substance and alcohol abuse
  • Difficulty keeping a job
  • Severe depression
  • Lost the will to live
  • Threatening suicide

Your preferred treatment plan

Make a note of who should treat you and where:

  • Which psychiatrist you are willing to see.
  • Which psychologists you want on standby.
  • What psychiatric and general hospital you want to go to.
  • What you want to avoid at all costs, such as public or specific hospitals.

Dealing with an episode

In some cases your members of your support structure may need to monitor your behaviour, take control of your medication, take away your car keys and bank cards, help you self-soothe or call one of your doctors.

Medication

Note what medication you take, the dosage and what it has been prescribed for in case you need to go to a hospital and see doctors who are not familiar your treatment plan. 

Health problems

Note any allergies to make sure you don't get an allergic reaction to any medications they may administer. Note any diseases and common side effects of the medication that you are currently experiencing or have experienced in that past. Doctors can keep this in mind during your care at a hospital.

Contact details

Note contact details for your


  • emergency contacts
  • any close family and friends and next of kin who may not be emergency contacts so they can be notified of hospitalisation
  • psychiatrist
  • psychologist
  • GP
  • medical aid details - medical aid scheme, plan and number (supply a copy of your ID)
  • your prefered hospitals


Note who needs to be contacted when you are in a specific state. Also note what needs to be said so that the member of your support structure can effectively get the message across especially when they could be panicking.