How to tell if a Loved one should see a Psychiatrist

If a member of your family suddenly had a heart attack, you’d call 911 immediately. If your little daughter fell 20 feet out of a tree (ours did!), you’d call for an ambulance and ride to the hospital (we did!) with her. If your four-year-old son’s temperature spiked at 105 (ours did!), you’d stick your head into the oxygen tent (we did!) with him to help calm his fears. While our kids were growing up, there were many emergencies to get loved ones to doctors and hospitals, and there was no shame in it.

However, in our society, families too often deny, suppress or hide mental illness, often for years, rather than seek the necessary medical help. The old cliche still exists, of keeping crazy old Uncle Charlie in his locked attic room. Books and movies of the 1930s and 1940s emphasized the unfortunate practice, such as “Rebecca”, “Suddenly Last Summer,” and “The Three Faces of Eve.”

Fortunately, no one in my family needed psychiatric treatment, but as the manager of a 40-person advertising division of a large company, I had many occasions to observe the onset of mental illness. One I recall most clearly was a young woman copywriter who was very creative and productive, until one day I saw that she was just sitting at her desk staring straight ahead. As I walked by, another employee shook her, and she seemed to snap out of it.

I didn’t think anything of it the first time, because she was young, pretty, unmarried and, I assumed, was trying to get through a hangover from some weekend drinking. It would pass, of course, as soon as she had some rest. It didn’t pass. For several days after that, her stiff silence periods increased from a minute or two to five and ten minutes.

Although some other employees tried to talk me out of it, I reported the incidents to our human resources reps and then immediately called her family. At first I thought I had done the wrong thing, because the immediate response from the family was anger directed at me. Apparently they knew of the gradually-increasing illness, but had been denying it for months, maybe years.

Our Human Resources reps told me I would need to document more than just one incident where she was “refusing to do her work.” I tried to explain that she wasn’t refusing, but was showing signs of mental illness. I was told to observe her again, and if the incidents happened two more times, Human Resources would take steps to terminate her. Frustrated, I called her family again, and was met with more anger and denial.

The story ending is a very sad one. The young woman resigned from the job, and two months later committed suicide. Did I do everything I could to help her? Yes. Do I feel guilty about her suicide? Yes.

The symptoms I observed were just the tip of her mental iceberg, and her family should have sought serious medical and psychiatric help for her long before incidents at the office. Most symptoms are very evident. They include, but are not exclusively the only ones: inability to concentrate, severe depression, inability to perform normal daily duties, frequent disorientation, hopelessness expressed verbally, unusual changes in personality, deliberate isolation from family and friends, insomnia and exaggerated fits of anger.

Of course, there are the ultimate symptoms that can endanger life. Immediate help or actual confinement may be necessary when there are hints or outright threats of suicide, and/or causing death or injury to others. There will always be the regrets and speculation as to whether lives could have been saved if the Columbine or Virginia Tech murderers could have been stopped by correctly-timed intervention.