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Manic situations can be intense and traumatizing for anyone who experiences them. High energy and mania both require a lot of help to manage. When people are aggressive or inconsolable, it can be dangerous and may require law enforcement or emergency services to get involved. Continue reading to learn the main objectives of de-escalation and how to accomplish them.
A new and widely adopted term for a manic episode is agitation or an agitated episode. According to the Western Journal of Emergency Medicine, an agitated episode is an “acute behavioral emergency that requires intervention.”
Traditional methods of de-escalation used to treat agitated people often did not de-escalate them at all. Methods used in the past included restraints, involuntary medication, and other stressful experiences. Today, a shift in focus has made all the difference in the evolution of traditional de-escalation methods.
Instead of living in the mindset of “calming the patient,” which often comes off as controlling and can actually escalate the situation further, we now focus on “helping the patient calm themselves” – a process that is more collaborative and in the end, more effective. This new approach builds trust and mutual understanding between the agitated person and the person helping to de-escalate them. The agitated person can also learn methods of self-control to help them calm themselves down before they become manic again.
There are four main objectives for de-escalating situations of extreme agitation:
#1. Ensure everyone’s safety. This includes the safety of the agitated person, the person who is attempting to de-escalate the situation, and any other bystanders.
#2. Help the agitated person regain control of their emotional state. Again, this is meant to help the agitated person help themselves, rather than using de-escalation to force the agitated person to stop their behavior.
#3. Avoid the use of restraint if at all possible. Try talking the agitated person through their emotions, validating their frustrations, and suggesting calming methods like taking deep breaths together. Pacing or walking out their frustrations may also be a good way to help the agitated person release the energy they are holding. Encourage them to talk about what is bothering them and give them time to gather their thoughts.
#4. Avoid coercive interventions that escalate agitation. Do not be abrasive or attempt to control the agitated person. Instead of threatening them with the consequences of agitation – which they usually already know – work together with them to help manage their emotions. Consequences can be discussed later when everyone is calm.
If you ever find yourself in a situation where you cannot assure your safety, a bystander’s safety, or the safety of the agitated person, call for help immediately. Even though you are trying to work together with the agitated person, a boundary is crossed if they hurt themselves, others around them, or property. Try to avoid saying “Don’t do this” or giving the agitated person ideas that are harmful. That is not helpful.
Instead, if it looks like they might hurt themselves, others, or property, try saying “Please be careful because no one wants to see you get hurt.” If they are still unable to calm themselves, that is when you may need to step in as a restraint, as long as you are in a setting where you have been trained to do so. If you feel like you are not reaching the agitated person and things may become violent, call for help immediately.
If your interpretation of de-escalating a manic episode is more in the realm of a highly emotional conflict, there are ways of de-escalating these as well. When de-escalating an emotional conflict, starting simply by asking questions or validating the other person’s frustrations. If the emotional conflict is something that warrants discussion, it is okay to walk away and say “I’ll talk to you when you’re calm.” Make a point to say when you are coming back, and give them a timeline to help calm themselves down. Simply exiting the situation is not helpful and can escalate it even further.
Communication is key to de-escalating situations, whether it is an emotional conflict or a true manic episode. If you cannot understand why the agitated person is being so emotional, ask yourself what their behavior is telling you. The agitated person may have specific reactions to specific situations and not even realize it. Try to determine what the agitated person is communicating through their behavior and talk through what it means for them.
If you and a loved one are experiencing frequent emotional conflicts or agitated episodes, it may be time to try family or couples therapy. Talking to a mental health professional to process your thoughts and pain can help you learn new strategies for success, including de-escalation methods that will be more effective.
If you or your loved one are dealing with the trauma of constant agitation, you may be longing to find de-escalation methods that work. If you or your loved one are suffering from addiction as well as highly emotional and stressful situations, the constant agitation can be unbearable. Therapy, treatment, and methods for de-escalation and emotional management are vital for your future. The team at RECO Intensive is here to help. At RECO Intensive, we understand how stress and agitation can trigger and worsen substance abuse issues. With our substance use treatment programs, therapy solutions (including family and couples therapy), and the input of our experienced alumni, we help people and their relationships heal. Our professional staff can create a treatment plan that is specifically catered to you or your loved one. To learn more, call RECO intensive at (561) 464-6533. We want to support you. Let’s get back to a brighter future.