How to Recognize a Friend in Crisis and How to Help

Recognizing when a friend is in crisis and needs our help is never easy. Whether one is considering drug use for the first time, a relapse into addiction or even ending their life, the signs are there.

Acknowledging and acting on the signs of an impending crisis is the most important part of avoiding it. By being patient, methodical, introspective and willing to help or be helped, it’s not hard to avoid the worst outcomes to life’s pressures.

Warning Signs of Drug Abuse

There are a number of reasons why people try drugs for the first time. Though for many it may be a matter of curiosity alone, for some it’s a way to escape from life’s problems or numb emotional pain. Though casual drug use doesn’t automatically lead to addiction, the risks are far greater for those who may already be emotionally vulnerable.

A potential emotional crisis or mental breakdown can come from anywhere, whether someone is a recovering addict or not. Life is not always easy and tragedy and pain are real.

Here are some examples of life events that can drive someone into initial drug use:

  • Death of a loved one
  • Terminal illness
  • Divorce or separation
  • Loss of job, income or home

It’s important to remain vigilant during these times, especially if someone has exhibited depression or past emotional distress. Our genes, specific mental health, family history and social surroundings all play into initial drug use or addiction.

Risk factors that contribute to potentially dangerous behavior include:

  • History of addiction within the family
  • History of physical, mental, emotional or sexual abuse
  • Traumatic childhood experiences
  • Specific mental disorders such as depression, anxiety or bipolar disorder

Unfortunately there are times when, despite our best efforts, we fail in preventing initial drug use. In those cases, the next line of defense lies in recognizing the signs of drug abuse. We must act before it turns into a full-blown addiction.

In an effort to avoid detection, drug abusers will often attempt to conceal their symptoms or erratic behavior. Denial and obfuscation are often the first manifestations of casual drug abuse turning into addiction.

There are three specific signs that indicate drug abuse is manifesting itself:

  1. Physical
  2. Behavioral
  3. Psychological

The physical signs of addiction are often the hardest to conceal, and thus are the first to keep an eye out for. When we are on drugs we may be able to moderate our mood and mindset (for a time), but it’s impossible for us to control how drugs are affecting our bodies.


The Physical Signs of Drug Use:

  • Bloodshot eyes
  • Pupils that appear larger or smaller than normal
  • Sudden changes in appetite
  • Sudden changes in sleep patterns
  • Sudden weight loss or weight gain
  • Sudden deterioration of physical appearance
  • Sudden change in physical hygiene or grooming habits
  • Body tremors, impaired speech or decreased coordination

If once we were able to handle what life threw our way, when we start abusing drugs we begin to drop the ball. How we manage the affairs in our life can be another obvious sign of potential onset of addiction.

The Behavioral Signs of Drug Use:

  • Inability to manage finances
  • Engaging in suspicious activities or secretive behavior
  • Sudden decrease in performance at work or school
  • Sudden change in friends or social surroundings
  • Committing illegal activities
  • Engaging in fights
  • Getting into accidents

Drugs ruin our psychological state and cause our very personalities to change. It’s no secret that many people become almost unrecognizable after sustained drug abuse and addiction. As someone transitions from drug abuse to addiction, these are the signs that signal urgent help is needed.

The Psychological Warning Signs of Drug Use:

  • Sudden and unexplained change in personality, actions or attitude
  • Intense mood swings, constant irritability or unusual outbursts
  • Periods of agitation followed by giddiness or hyperactivity
  • Appearing to be lethargic or having a lack of drive or motivation
  • Appearing paranoid, fearful or anxious without cause to be

Preventing initial drug use from occurring represents the vanguard in stopping addiction. Unfortunately this doesn’t always work. If addiction sets in, the next step is charting a path through recovery that avoids the pitfalls of relapse.

Warning Signs of Relapse

Maintaining true sustained recovery is one of the hardest things we can do in our life. It’s a very difficult ordeal and for many, if not all of us, relapse remains a real danger.

We have begun to build the foundation for a new future, but old ways lurk at the periphery. It’s incredibly important not to allow a nascent recovery to lull us into a sense of complacency. Far too often, we may appear well in our recovery while we are actually on the verge of relapse. We must be honest with ourselves and those around us to avoid any missteps.

Practice sound relapse vigilance by watching for these types of feelings:

  • Hopelessness: “Nothing is going to get better no matter what I do.”
  • Powerlessness: “It doesn’t matter because there’s nothing I can do.”
  • Worthlessness: “I’m just not good enough.”
  • Shame: “I’ve already ruined so much, so what’s the point?”
  • Guilt: “No one will ever forgive me.”


The difficulty of recovery is mitigated by having a close network of people who can provide encouragement, support and love. It’s in proximity that loved ones discover and act on the signs that signal an impending relapse.

There are also signs that the recovering addict can introspectively seek out within themselves. By allowing the clarity of recovery to clear our vision, we can acknowledge any relapse signals before they reach expression.

These are the potential relapse warning signs that we should always be on the lookout for:

  • Inability to assimilate into normal society or make normal friendships
  • Romanticizing the old days and past friendships that led to unhealthy behavior
  • Proactively trying to re-establish some of those past friendships
  • Believing that we can use “just a little bit” without becoming addicted again
  • The desire to substitute one substance for another in the mistaken belief that addiction won’t develop
  • A lack of desire to address the problems that led to the addiction
  • Falling back into a pattern of denial
  • Severe changes in mood, attitude or behavior
  • Sudden expressions of loneliness or intense depression
  • Always seeming stressed out or tense
  • Expressing sudden anger or resentment
  • Lack of belief or negative self-talk

Relapses are actually quite common, and not just for recovering addicts. According to recent statistics, the relapse rate for drug addiction is between 40 and 60 percent. These numbers come in below the relapse rates for hypertension and asthma.

Remember that relapse warning signs or even a relapse itself doesn’t mean we are failures. We are fallible humans and even the strongest of us makes mistakes.


Warning Signs of Suicidal Behavior

Though initial drug use or relapses are terrible answers to life’s problems, perhaps the worst is attempted or committed suicide. According to the U.S. Centers for Disease Control and Prevention, suicide is the 10th leading cause of death in the United States.

The threat of suicide should be taken incredibly seriously. The most common problem is being unable to recognize the signs of suicidal depression or despair.

To those who could never imagine contemplating suicide, the idea of it can be extremely foreign. When loved ones either aren’t receptive to or don’t notice the signs of an impending crisis, the worst can happen.

Remember to avoid these actions or feelings when faced with someone contemplating suicide:

  • It’s all talk. Thinking that people who talk about suicide don’t actually do it is a dangerously false myth. Almost two-thirds of those who commit suicide gave indications of their intent in the weeks and days leading up to it. Ignoring someone who is in deep despair is not only unhelpful, it’s potentially fatal.
  • They’re just crazy. Also beware of the mistaken idea that anyone who tries to commit suicide must be crazy. Only a small fraction of people who commit suicide were actually psychotic or delusional. Most suicidal people are suffering from more common mental and emotional ailments, such as depression. An absence of serious mental illness does not beget an absence of suicide risk.
  • It couldn’t possibly be that bad. We never know what is going on inside someone’s head when they are contemplating suicide. When we try to shine the light of our own lives into the darkness of others’ problems, it doesn’t always illuminate the way. Everyone copes with the pressures of life in their own way. It’s a dangerous risk to falsely assume that whatever they are going through just couldn’t be bad enough to produce suicidal thoughts.
  • Nothing will stop them. That a person is alive is proof enough that they want to live. It’s not their life that the suicidal person wants to end; it’s the pain that’s making life seem so unbearable, whether it be emotional or otherwise. The root of that pain cannot be addressed without proper intervention and help from closed loves ones. Hope should never feel lost when life remains.
  • It shouldn’t be talked about. Not talking about suicide doesn’t mean the idea is absent in someone’s mind. Asking the question if it’s suspected isn’t a bad thing. By raising the topic, we show the person that we care and are taking them seriously. This also gives them an opportunity to discuss the real reason for their suicidal thoughts.

Once we have dispelled any false notions about suicide, we must know what to look for. In many cases, someone contemplating suicide will provide a great number of indications that they plan to do so.

Remain diligent and watch for the following signals of suicidal thoughts:

  • Explicit statements of intent
  • Developing a suicide plan
  • Self-inflicted injuries to the body
  • Careless or reckless behavior
  • Making out a will
  • Giving away possessions

Ambiguous statements such as: “I’ll be gone, don’t worry;” “I’m taking a long trip;” “I can’t go on;” “I can’t take it anymore;” “Is suicide wrong?”

The fact is, suicidal people are conflicted about the prospect of ending their own life. Deep down, no one wants to die — but in some cases it can be hard to see an alternative.

Once the signs have been recognized, it’s time to take action. If problems have gone past the point of mere drug use or relapse and one’s life is in danger, speed and decisive actions are crucial.

Remember these key steps in addressing potential suicidal thoughts:

  • Act quickly: Preventing suicide obviously doesn’t merit procrastination. A life is at stake. When one is coping with depression or severe pain of any type, help should be on the way. Many times someone contemplating suicide may feel ashamed and fear they’ll be considered foolish, stupid or judged. As a result, it’s necessary to recognize the signs and act quickly.
  • Listen before talking: A pedestal is the last thing we need when trying to help a friend in crisis. We should studiously avoid argumentative or condescending tones. Though we may be tempted to immediately start dishing out what we think is sage advice, it’s more important to ensure our loved ones understand we’re patient, sympathetic, accepting and ready to help.
  • Urge professional help: In many cases, trying to keep a lid on a crisis boiling over at home results in a potentially dangerous emotional explosion. If the dysfunction that is feeding the crisis has roots within the family, or perhaps is too complex for loves ones alone to address, professional help may be needed.

Addressing drug abuse, relapses or suicidal thoughts isn’t easy. In some cases all the tools we have at our disposal still may not be enough to break the cycle that leads to negative outcomes.

If professional help is needed to overcome a potential or realized crisis, help is out there.

The 12 Keys Crisis Hotline


If you or someone you love is either on the verge of or in a crisis that could or has led to drug abuse, relapse or suicidal thoughts, 12 Keys Rehab is here to help. Our crisis hotline is available 24 hours a day, seven days a week.

We provide a judgment-free atmosphere and use a holistic approach to recovery. We have a staff of experienced professionals, counselors and therapists. Our goal is to provide a clear path to recovery and welcome those that need our help into the open arms of true life change.

When you call you’ll be connected with a qualified and compassionate staff member who will provide you with information on the recovery process and what we have to offer. We will ask a few basic questions to get an idea of the situation and, as always, maintain the highest levels of patient confidentiality.

Our counselors can help arrange an intervention and manage travel arrangements to and from our recovery center.

Our program provides a diverse range of cutting-edge treatment options, effective therapies and tried-and-true 12-step care. We customize each and every program to meet the specific needs of you or your loved one.

For more information on how we can help, call 12 Keys today at 1-800-338-5770.

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