1. Get enough sleep – have the person sleep until they wake up. Call in sick to work one day, don’t go to class, have the kids cared for by a neighbor.
   If waking up after a few hours of sleep is a problem, a little hard physical exercise can help– jumping jacks, sit ups, running in place, to burn off adrenalin.  Eating something.  Putting in earplugs. 
   
   DO SOMETHING TO GET ENOUGH SLEEP.
   If this is 10-12-14 hours of sleep – it was needed. 
   
   If the person is too wired to go to sleep at all, find out what helps them sleep.  Warm milk?  A calcium/magnesium drink (there is a commercial product called CALM available in health food stores). A meal?  A long walk?  If they are really too wired, consult a physician and get a mild sedative so they can get a good night’s rest. (This can especially be needed if the person has just had a very traumatic experience – survived a car accident, are grief stricken over the death of a relative or friend.)  Find a way to help them get some good, long, solid rest

2. Get them to eat – real food.  Not fast food.  Not soda and chips or cookies.  A real meal, with whatever they like.  (If they’re vegetarian or a meat eater it doesn’t matter– get them enough food and make them have a real meal.)  Get them vitamins and minerals if they’ll take them.  They might need a few of days of real food and good sleep. Especially they haven’t really eaten for days as they’ve been stressed out and living on cigarettes and coffee.  (Happens more often than you think.)

3. Get upsetting factors in the environment cooled of.  If there is a stressful relationship situation, a job situation, or some other upset have all those involved cool off so the person who is over-stressed by what is going on has a chance to get things together.  Usually whatever is happening can wait a day or two – even a week.  (You’d be surprised how much these kinds of situations affect all other aspects of life.)  If it’s a mess that didn’t happen overnight, it’s not going to go away fast.  It is going to need more communication and right now the person who is unstable cannot handle it, so the others involved are going to have to just chill for a few days.

4. After the person has had some rest and food, and is more on top of life, then a conversation is in order about sorting out what in life is troubling them.  Keep it calm.  Let them talk.  See what can be done about it.  Is there something that can be done as a first step?  And then another?  Something that can be gotten under control while other factors can be sorted out?  Start with at least something is a first step, and the person can be helped from there.

Too simple you say?  Not if you have talked to people who have gone over the edge.  The first thing you will too often find out is that they haven’t been sleeping or eating – sometimes for days.  What a surprise that all the stresses of life just get too big and they demonstrate what a psychiatrist would call acute anxiety or psychosis or depression.

One example comes from a story that ran in the New York Times Sunday Magazine on June 2004. The writer described the time he was having hallucinations as a young adult.  The kicker is that he was getting up at 5:00 am, doing a paper route, going to school all day, then working nights to support his pregnant wife.  At most he was probably getting about 4-5 hours sleep a night, day after day, week in week out.  He never got labeled, never took medications. He just felt crazy.

What happened? He was fired from his night job, started getting more sleep and surprise – no more hallucinations and he was suddenly sane again.

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