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Acute Withdrawal from GHB and Date-Rape Drugs: Why It Mimics DTs

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Reggie was a 38-year-old graphic designer in Long Beach, California, who walked into a small community hospital on a Thursday afternoon complaining of insomnia, anxiety, and an “overwhelming feeling that something was about to crawl out of my skin.” Triage assessed him as a routine anxiety presentation. He was handed a cup of water and … Read more

Acute Mental Health Crisis on College Campuses: How University Counseling Centers Handle Emergencies

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It was 2:47 a.m. when Maya, a sophomore at the University of Michigan, finally typed the message into her residence hall group chat: “I don’t think I want to be here anymore.” Her roommate Ainsley, asleep until her phone buzzed, woke up, read the screen twice, and ran across the hallway barefoot. She had heard … Read more

Pet Death Mental Health Crisis: When Bereavement Becomes a Medical Emergency

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Helen had lived alone in a one-bedroom apartment in Tucson, Arizona for eleven years after her husband died. Her companion through every one of those years was a small black poodle named Otto. When Otto was diagnosed with hemangiosarcoma at thirteen and declined rapidly, Helen stayed up with him for the last seventy-two hours, hand-feeding … Read more

Workplace Mental Health Crisis: When an Employee Threatens Suicide or Violence on the Job

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Diane had been an HR director at a mid-sized logistics company in Memphis for eleven years before the call that defined her career. It came at 9:14 a.m. on a Tuesday in March: a warehouse supervisor named Curtis had walked into the break room, set his phone on the counter, and told three coworkers, “I’m … Read more

Acute Reactive Psychosis: Single-Episode Brief Psychotic Disorder

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Lieutenant Sarah Chen, a 27-year-old Army nurse, returned home to Tacoma after her second deployment with no warning sign more dramatic than fatigue. Two weeks after she landed, she woke at three in the morning convinced that the air conditioning vent in her bedroom was transmitting orders. She paced the house, repeated phrases under her … Read more

Acute Sleep Deprivation Psychosis: When Insomnia Causes Mental Health Emergency

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Marcus, a 34-year-old software engineer in Austin, Texas, had been chasing a deadline for nine straight days. By the third night without real sleep, he started seeing shadows shift on his apartment wall. By the fifth night, he believed his coworkers were planting microphones in his keyboard. When his sister found him on day six, … Read more

Severe Tobacco Withdrawal: When Quitting Triggers Acute Mental Health Crisis

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Diane, a 52-year-old elementary school teacher in Kansas City, had smoked a pack and a half a day for thirty-four years. When her doctor delivered the abnormal chest CT result, she walked out of the office, drove straight to a drugstore, and bought nicotine patches and gum. By the third day cold turkey, she could … Read more