Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek urgent or emergency help if you or someone else:
Has thoughts of suicide with an intention or plan
Has recently attempted suicide or serious self-harm
Cannot stay safe because of impulsive or dangerous behaviour
Is hearing or seeing things others do not, or has lost touch with reality
Is severely agitated, aggressive, confused, or unable to meet basic needs
Contact local emergency services or a crisis service.
If possible, stay with a trusted person and move away from weapons, large amounts of medicine, or other means of harm.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact a healthcare professional promptly if symptoms intensify, you sleep very little, your behaviour feels difficult to control, or others notice a major change.
Prompt review is also important if medicine makes you unusually restless, energised, impulsive, or low.
3
Does any of this apply?
Book an appointment
Arrange a routine appointment if repeated periods of unusually high and low mood have continued for months or years.
Seek assessment if they affect relationships, work, education, sleep, spending, or substance use.
Every sign above is quoted from the sofidex article on Cyclothymic disorder. If you are not sure, err upward — it is always reasonable to be checked.