Step One: Trust your instincts. This is especially true if you are very close to this person …. it’s your spouse or your child or your best friend. If their behavior seems unusual and demonstrates one or more of the warning signs of mental illness, you need to pay attention. The worst thing you can do is to ignore it.

If the person is a teenager, you may be tempted to dismiss this as a stage. Yes, many teenagers have episodes of sadness, anxiety, frustration and feelings of being overwhelmed. The episodes should not last more than a few days at most.

If the feelings last for weeks or months, speak to your child about your concerns and consult your family doctor. Teenagers who have stopped participating in activities, no longer connect with friends, and are chronically disconnected, angry and sad are exhibiting abnormal behavior and need help.

Likewise, it is never normal to have a psychotic episode. Even if someone appears to go back to normal, they need a professional assessment.  It won’t hurt anything to check into the situation. Go along with the delusion to get the person to a doctor.

What to Say and How to Say It

So what kind of conversation should you have with them? Here are some tips:

• Speak in a calm voice.
• Say what you mean and listen. “I am concerned about you because …” “How are you feeling about this?”
• Try not to interrupt the person.
• Avoid sarcasm, whining, threats or yelling.
• Don’t criticize or call names.
• Try not to use the words “always” or “never.”
• Deal with the now.
• Remember: This has nothing to do with you.  It’s a brain condition.
• Acknowledge that you are in this together.
• If things get heated, take a break and come back to the discussion later.

If you are seeing behavior or hearing language that indicate the person is a threat to themselves or others, take them to the emergency room. Tell the staff at the check-in what is going on immediately. If you have a specialized system for dealing with people in psychiatric emergencies in your town, you can call that organization (Netcare in Columbus, Ohio, for example) instead.

Otherwise, make a doctor’s appointment. Some psychiatrists who do not take regular insurance may be able to see you more quickly. Your loved mental health organization may have some names you can call.

While you are waiting for the appointment, help the person take steps to reduce their stress. Encourage them to do something relaxing. Try to help them keep a regular routine of sleep, activity, meals and medication. Again, trust your instincts. Go to the emergency room if you suspect psychosis or suicidal thoughts.