• Your relative stops or refuses to take her medications;
• Her medications are not effective or the dosage needs to be reevaluated;
• She is abusing drugs or alcohol;
• Events that normally cause stress can trigger a crisis. These include situations such as losing a loved one, losing a job, holidays or illness.

People seldom lose control suddenly. There are usually warning signs that you will recognize long before the crisis.

During these early stages, you can take steps to avoid a full-blown crisis. If you feel a crisis coming on, try to get your family member to visit her psychiatrist, therapist or attend her support group. You may need to make the appointment yourself and make sure she has transportation.

If you haven’t been able to avoid the crisis, be calm and act rationally. Accept the fact that your relative has a mental illness. You are not the cause of it. The following guidelines may help:

• Don’t threaten the person. This may cause her to become more excited or afraid and people who are afraid may act out aggressively.
• Don’t shout. If she isn’t listening, she’s probably not ignoring you on purpose. She may be distracted by her hallucinations.
• Don’t criticize. Criticizing will not calm a frightened person or make the voices go away. It will only make the situation worse.
• Don’t argue. The person is not experiencing the same reality that you are.
• Don’t dare your relative to act on what she is threatening to do.
• Don’t stand over the person. If she is sitting down, sit down also.
• Avoid direct continuous eye contact or touching the person.
• Comply with requests your relative makes if the requests are not dangerous or unreasonable. This lets her feel somewhat in control.
• Don’t block the doorway, but don’t let the person escape.
• Be positive. Even if the person is out of touch with reality, your support can provide a measure of comfort.