When Someone You Love Is Struggling: Recognizing a Mental Health Crisis and How to Help
You notice something is off. Your spouse has stopped sleeping. Your adult child has gone quiet in a way that feels different from their usual introversion. A close friend cancels plans for the third week in a row and, when you finally reach them, they say they're fine — but they don't sound fine at all.
Most of us have been in this position. Someone we care about is clearly struggling, and we don't know whether to push, back off, or panic. The uncertainty can feel paralyzing, especially when the stakes feel high.
According to a Colorado Public Radio statewide poll, three in five Coloradans reported experiencing mental health strain in the past year. More than four in ten of those who were struggling said they postponed getting care — and nearly half reported avoiding help altogether because of stigma. That means there are a lot of people suffering quietly, often surrounded by people who love them and don't know what to do.
This post is for those people — the partners, parents, siblings, and friends on the outside of someone else's pain, trying to figure out how to help.
What Does a Mental Health Crisis Actually Look Like?
A mental health crisis doesn't always announce itself dramatically. While some crises do involve visible distress — someone in tears, expressing hopelessness, or talking about not wanting to be here — many show up more quietly, as a slow change in patterns and behavior. Warning signs to watch for include:
Withdrawal from people and activities they used to enjoy. A sudden pull away from relationships, hobbies, or responsibilities — especially if it's out of character — can signal that something significant is happening internally.
Changes in sleep, eating, or basic self-care. Both extremes matter: sleeping far too much or barely at all, eating compulsively or losing appetite altogether, neglecting hygiene. These are often the first visible indicators that someone's nervous system is overwhelmed.
Increased agitation, irritability, or emotional volatility. Sometimes a person in crisis doesn't look sad — they look angry, reactive, or impossible to reach. This is still distress, just expressed differently.
Expressions of hopelessness or worthlessness. Statements like "what's the point," "nothing matters," or "everyone would be better off without me" are serious and should never be brushed aside.
Increased use of alcohol or substances. Many people in crisis self-medicate. A noticeable uptick in drinking or drug use — especially when paired with other warning signs — is worth taking seriously.
Giving away possessions or saying goodbye. This is a more acute warning sign and warrants immediate action. If someone begins giving away meaningful belongings or says things that sound like a final farewell, treat it as an emergency.
Not every person in crisis will show all of these signs, and not everyone who shows one of them is in crisis. But if you're noticing a cluster of changes, or a pattern that feels different from their baseline, trust that instinct.
Why People in Crisis Often Don't Ask for Help
One of the most frustrating parts of loving someone who's struggling is watching them not reach out — or actively push away support. This usually isn't stubbornness, and it isn't about you. There are several clinical reasons why people in crisis resist help:
Shame and stigma. Nearly half of Coloradans report avoiding mental health care because they fear being judged. Shame is one of the most powerful barriers to help-seeking, and it tends to intensify precisely when someone most needs support.
Cognitive distortions. Depression, anxiety, and trauma all affect how the brain processes information. A person in the grip of serious depression may genuinely believe that nothing will help, that they don't deserve help, or that asking will burden the people they love. These aren't melodramatic thoughts — they're symptoms.
Fear of what comes next. People often worry that reaching out will trigger consequences they're not ready for — hospitalization, medication, or losing control of the narrative around their own life. That fear can feel more manageable than the unknown.
Numbness. Some people in crisis don't feel like they're in crisis. Emotional numbness or dissociation can make it hard to recognize, from the inside, how serious things have become.
Understanding why someone isn't asking for help isn't the same as accepting that they don't need it. It just shifts how you approach the conversation.
How to Show Up for Someone in Crisis
You don't have to have the perfect words. In fact, trying to find them is often what holds people back from reaching out at all. What matters most is presence and consistency.
Ask directly, without flinching. If you're worried someone is having thoughts of suicide or self-harm, ask plainly: "Are you thinking about hurting yourself?" Research consistently shows that asking this question does not plant the idea — it creates an opening. People in crisis often feel immense relief when someone finally names what they've been carrying alone.
Listen more than you advise. Resist the urge to fix or problem-solve right away. People in crisis often need to feel heard before anything else. Staying present, asking gentle follow-up questions, and reflecting back what you're hearing goes further than most people expect.
Stay connected, even when it's hard. Don't take withdrawal personally, and don't give up when someone pushes back. A simple text — "I'm thinking about you. No pressure to respond" — keeps the door open without demanding anything.
Help reduce practical barriers. Sometimes the most useful thing you can do is offer to help someone find a therapist, make a phone call, or get to an appointment. The logistics of getting help can feel overwhelming to someone in crisis. Removing even one obstacle can tip the scale.
Take care of yourself, too. Supporting someone in crisis is demanding. It's okay — necessary, even — to acknowledge the weight of it and seek your own support. Secondary traumatic stress is real.
When to Call for Immediate Help
Some situations require more than a supportive conversation. If the person you're worried about is expressing active suicidal intent, has a plan, or is in immediate danger of harming themselves or others, don't wait.
988 — the Suicide and Crisis Lifeline — is available 24/7 by call or text. It connects callers to trained crisis counselors and can help you figure out next steps, whether you're the one in crisis or calling on behalf of someone you love. In Colorado, use of the 988 service increased 15 percent in the past year, which reflects something important: more people are reaching out, and it's working.
If there is immediate physical danger, call 911. Many communities now offer co-responder programs that send a mental health professional alongside law enforcement, which can help de-escalate situations more safely.
If the situation isn't immediately dangerous but you're genuinely worried, a licensed therapist can help you think through next steps — even if the person in crisis isn't ready to come to therapy themselves. That kind of conversation is something we welcome at Valor Counseling.
You Don't Have to Figure This Out Alone
Watching someone you love struggle is one of the hardest things a person can do. The helplessness, the fear, the not-knowing-what-to-say — all of it is real, and all of it matters.
If you're in Longmont, CO or the surrounding Northern Colorado area and you're looking for support — whether for yourself, for someone you love, or for both — Valor Counseling & Holistic Services is here. Our work is grounded in compassion, clinical depth, and a genuine commitment to meeting people where they are.
You don't have to have all the answers before you reach out. Reach out first. We'll figure out the rest together.
To schedule a free consultation with a licensed therapist in Longmont, CO, contact Valor Counseling & Holistic Services today. We'd be honored to help.
References
Colorado Public Radio / CPR News. (2024, August 13). Mental health is a serious challenge for Coloradans, according to new poll. https://www.cpr.org/2024/08/13/colorado-mental-health-concerns-poll/
Colorado Public Radio / CPR News. (2025). More Coloradans, especially men, are reaching out to the state's mental health crisis line. https://www.cpr.org/2025/07/28/men-colorado-988-mental-health-crisis-line/
National Alliance on Mental Illness (NAMI). Mental health by the numbers. https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/
National Institute of Mental Health (NIMH). (2024). Mental illness statistics. https://www.nimh.nih.gov/health/statistics/mental-illness
Substance Abuse and Mental Health Services Administration (SAMHSA). 988 Suicide and Crisis Lifeline. https://www.samhsa.gov/find-help/988
Mental Health Colorado. Colorado's shadow epidemic. https://www.mentalhealthcolorado.org/colorados-shadow-epidemic-heightened-anxiety-depression-testing-families-communities/
