immediate intervention advice
April 6, 2005 11:53 PM   Subscribe

My otherwise quiet housemate is up at 3 am very agitated. Walking around, talking to himself non-stop, very angry and irrational. I think he is mentally not well. What should I do?

I've tried talking to him (How you doing, you had a couple drinks) and he responds coherently but without meaning (God created god because these people need to go to their homes...). He's usually a mild-mannered guy, works with troubled kids. I think his job has been causing him a lot of stress and maybe this is some sort of mental 'break'? I have no experience with dealing with this situation, I have lived with him for a few months and we are friendly but I don't know him well. He is pacing, walking up and downstairs, hitting walls, swearing. "I fucking now it! These motherfuckers!". I think he is 9/10ths sober. He took some adderal earlier but he's got a prescription so nothing out of the ordinary there. I am going to be up all night so I might as well have some metafilter advice. Sometimes he stops and goes "Hey what's up man." I'm pretty worried about him. Please help.
posted by pants to Health & Fitness (34 answers total)
It sounds to me like you're right. This could be a mental episode or a drug reaction. Suggesting that he might be reacting badly to the drugs might be the best way to get him to a hospital, where they can call psych in for an evaluation.

If he seems like he might hurt you, or himself, call 911.

The ramifications of these things aren't pleasant. People who get involuntarily committed don't have an easy time escaping the system again, but if you're really worried about him - and hitting walls is not a good sign - it might be necessary.
posted by jacquilynne at 11:59 PM on April 6, 2005

Realise for a moment here you are asking the internet. Keep an eye on him and let him know politely and calmly if he needs to talk or anything like that you will be around. Put a kitchen knife under your bed.
posted by Dean Keaton at 12:08 AM on April 7, 2005

Next time he asks you "what's up" try telling him that he seems upset and is there anything you can do. While you should keep danger to yourself at the forefront of your mind and be prepared to call 911 if necessary, don't just freak out and treat him like a 5150 off the bat. You live with this person and will have to deal with him in any event so I think it's probably worth approaching (warily) before you call in John Law. Your other alternative is to shut yourself in, let him have a bad night and talk to him about it later on. You think he's sober but you don't really know him. You think he's under stress but you're not sure. You're definitely missing something in the picture, probably a drug habit or personal problem he's going through. I don't suggest you hastily involve the cops unless it's very easy for you to flush this person out of your apartment for good. Try talking to him. Have your guard up.

I once spent the night in an apartment with someone who had definitely had a psychotic break. I hid the obvious kitchen knives under the couch cushions and spent the night there with one eye open. The next day we discussed the event and how it had changed things between us quite rationally. I'm not sure if I over-reacted, but I'm still here.
posted by scarabic at 12:13 AM on April 7, 2005

Wow. I've been crazy before, and that sure sounds crazy. If you try to get him official help he sounds like he might balk, since he is hitting stuff... Um... Doing what you can to keep him from hurting himself or others seems to be so obvious I'm not sure why I'm even typing it. Not sure what advice to offer here. I know nobody told me I was crazy when I was crazy, and I'm not sure how I would have reacted if they had. Sounds like he needs a psychiatrist, as soon as you can convince him to see one. He might need an antipsychotic or something.

Wish I had some better advice. Sorry. I hope it turns out well.
posted by beth at 12:18 AM on April 7, 2005

why you haven't called 911 yet is beyond me. The guy is hitting things and getting angry. If you're concerned about his and your safety, let the professionals handle it. Don't create a post about it.

posted by Tacodog at 12:25 AM on April 7, 2005

This sounds like some of the methamphetamine experiences I've had, are you sure he hasn't taken anything stronger than adderal?
posted by cmonkey at 12:29 AM on April 7, 2005

And yeah, it's possible that having someone take him to the nearest psych ward for evaluation might be a good idea if it's not drug related, this could escalate quickly.
posted by cmonkey at 12:30 AM on April 7, 2005

The more I think about it, the better the idea of calling 911 sounds. Let the professionals handle this - they are trained for this, and they have the resources to get him the help he needs, and to minimize problems should he become combative. Plus they work in pairs, so that's two more people to help.

I think it's too much to ask a roommate without mental health training to try to convince the guy to get to proper psychiatric help.

The ambulance guys can be the Bad Guys too if it turns out not to his liking once he gets his senses back. A roomie calling 911 out of genuine concern for the other roomie's health, safety, and wellbeing is a totally reasonable thing, so in theory he shouldn't blame you much if the authorities handle things in a way he doesn't like.
posted by beth at 12:30 AM on April 7, 2005

You could just leave if your worried about your safety.. go stay at a freinds, come back in the morning and discuss it. kick him out or move out if he is unrepentant.
posted by phyle at 12:39 AM on April 7, 2005

I think it's a toss-up between calling 911 and just hiding sharp objects and trying to monitor him to see if he calms down in an hour or so. If you feel comfortable doing the latter, that would probably be the kindest option. Otherwise, you'd be perfectly within your rights to call him an ambulance. I vote against leaving him alone because he might hurt himself.

Even better - can you find contact information for anyone in his family, maybe in his address book if he has one? Even if they're out of town and can't help, they could at least tell you if he has a history of schizophrenia, which is what this sounds like to me.
posted by hazyjane at 12:57 AM on April 7, 2005

911 was dialed, ambulance came. EMTs went in his room and found bags of legal substances - morning flower seeds? I've never heard of them. Sounds like he mixed those with too many prescription meds. Anyway. Hopefully the worst is over. I know asking MeFi was silly but I was at a loss having never dealt with this before.
posted by pants at 1:02 AM on April 7, 2005

Morning Glory seeds. They contain a chemical, closely related to LSD. Your friend was probably tripping on a combo.
posted by Gyan at 1:32 AM on April 7, 2005

You did right. Whether or not the seeds had anything to do with it, it looks like an Adderall overdose (if this is the case here — and if so, it could be accidental) can be life threatening, and symptoms include "restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, panic states, hyperpyrexia".

Calling 911 was the best thing to do.
posted by taz at 1:47 AM on April 7, 2005

Wow. He was basically combining methamphetamine and LSD. That REALLY doesn't sound like a good combination to me. Very much not.

Amphetamines: They're not just for junkies anymore!
posted by Justinian at 2:28 AM on April 7, 2005

holy shit. yeah: that's a terrible mix. I've seen a dude kick in a windshield (with his bare feet) on a mix of acid and crystal (he a bag boy at my local supermarket, oddly enough).

Morning glory seeds alone, from what I've heard, will put you through ONE SHITLOAD of a trip.
posted by fishfucker at 3:03 AM on April 7, 2005

Justinian: Nothing like some stretching the facts, is there? Adderall, which contains dextroamphetamine, and Morning Glory seeds, which contain LSA (1/10th as potent as LSD by quantity) become meth and acid. Even though I speculated that he was tripping (on a combo), from taz's link, a Dex OD seems sufficient by itself to account for this experience.
posted by Gyan at 3:10 AM on April 7, 2005

pants, you did the right thing and as for asking here - well, I think I might be a bit quicker to just dial 911 if I were ever in a similar situation now, so thanks.
posted by CunningLinguist at 4:29 AM on April 7, 2005

re, Gyan's comment... Yes, we shouldn't conflate. And I'm generally leery of assuming too much with the basic information we have now. I once had a high fever over several days, and ended up "overdosing" on aspirin, because I simply was a mess and didn't realize how much I was taking to combat the fever (I would wake up every few hours and take aspirin, not realizing how little time had actually passed since I last did this).

When I went to the emergency room, the "doctor" was a teenaged* jerk who decided that I had idiotically tried to either "get high" or suicide myself with aspirin of all things, and treated me with utter contempt. I will never forget that feeling of being so sick and weak, and helplessly unable to counter this ridiculous notion. I've never felt so powerless in the face of a wrong assumption.

So... I'd just like to inject the idea that if the problem turns out to be drug-related, it actually could have been purely accidental.

* Well, that's how he looked to me. A resident, I guess.
posted by taz at 4:45 AM on April 7, 2005

taz: I've seen docs pull that kind of crap. All too often, young and lots of education = naive, and that can get bad in a doc!

pants: if you don't mind, why did the EMTs enter his room? Sounds suspiciously like a search to me. A person ought not have to get busted to get medical care. Hope he'll be okay! Please keep tabs on him, he might be in an ugly situation and need an advocate.
posted by Goofyy at 4:59 AM on April 7, 2005

Humor the guy until you find a new place, which should be soon.
posted by euphorb at 5:38 AM on April 7, 2005

The ramifications of these things aren't pleasant. People who get involuntarily committed don't have an easy time escaping the system again...

Yeah, that's the truth. I wish your roomie the best of luck pants, but it sounds like you did the right thing. I don't think it was inappropriate to ask about it here. I had a similar situation 2 years ago and it was utterly painful and mind-numbing trying to figure out what was going on inside this kids head - never having dealt with a person who had a severe mental illness or drug-enhanced schizophrenic activity, I was at a complete loss.
posted by prostyle at 6:24 AM on April 7, 2005

pants: if you don't mind, why did the EMTs enter his room? Sounds suspiciously like a search to me. A person ought not have to get busted to get medical care.

If it's relevant to his medical condition in an emergency, it's not a search. And EMTs are not law enforcement (many times they're private, not government, and thus wouldn't be subject to search and seizure prohibitions). Moreover, you may be assuming to much to suggest that he's been "busted" because of the seeds.

fwiw, pants, I think you did exactly the right thing.
posted by pardonyou? at 6:32 AM on April 7, 2005

pants: if you don't mind, why did the EMTs enter his room? Sounds suspiciously like a search to me. A person ought not have to get busted to get medical care.

I just completed EMT-B (Basic) training and I will be taking my state certification test on Monday. I don't know what the protocol is in the state/country where this occurred, but in NJ, EMT's are *not* Narcs; their primary concern is the effective emergency treatment of a patient, not gathering evidence. The only time that I'm aware of that EMT's are required to report evidence of a suspected crime is in cases of child/spouse/elder abuse. The only times that EMT's will facilitate the gathering of evidence for the police is in cases of violent crime (cutting around instead of through bullet holes/stab holes in clothing, disturbing the scene of a crime as little as possible).

However, EMT's should gather as much information as possible to allow for the most appropriate treatment of the emergency. In the case of an overdose/poisoning that includes making every reasonable effort to ascertain exactly what the patient took and possibly bring it along to the hospital. Depending on what substance(s) someone has taken, the use of certain medical interventions may be inappropriate. Also, again at least in NJ, any patient can refuse any action of the EMT's at any point, including telling them just to F' off and leave him alone.

If you call 911 and an ambulance service responds, it is in your best interest to be completely honest with them. They are*not* agents of the police, they are an extension of the medical system and are bound by the same patient confidentiality laws as any other medical personnel.
posted by de void at 6:33 AM on April 7, 2005 [1 favorite]

I did a ride-along with Memphis police officers earlier this year as part of my psychology internship training. These officers were trained to deal with people who seem mentally unstable at the time of the call. They have to check out the scene to determine what substances the person is on. It's just good practice. It's what they are supposed to do. It is in the best interest of the person for whom the call was made that the people who respond to the scene know exactly what is going on. Is this a stomach pump situation? Is this person having a psychotic break? The answer to that will determine the best treatment. So, in short, the answers above are totally correct and nothing to feel nervous about. My guess is that even if your friend is upset with you at first, you did the right thing, and eventually, they will be glad you called.
posted by abbyladybug at 6:55 AM on April 7, 2005

You can't take morning glory seeds by accident. They taste horrible and you have to eat many (like ten packets).

He wanted to trip.
posted by recurve at 7:05 AM on April 7, 2005

I had to sit through a very long night of someone acting like this while on LSD. Breaking windows, throwing furniture... I can only imagine the experience not knowing why the housemate was behaving as such. The only logical move was to call 911.

Pants' housemate made a mistake, and now he has to live with the consequences.
posted by joelr at 7:10 AM on April 7, 2005

The consequences will probably be having his stomach pumped or being injected with stuff until he comes down, then being released from the hospital. The long-term consequences, if he doesn't have health insurance, will be a hefty hospital bill. I seriously doubt that he'll be held involuntarily at any hospital or get some kind of new lable attatched to his "permanent record."

I know folks who've overdone it and been sent to the hospital in similar situations. You're not going to get involuntarily committed for OD-ing, or not knowing how to hold your stuff.

I'd also like to say that the morning glory seeds alone would not have done this. They might have given him some mild hallucinations and made him really naseous, but that's about it without other chemicals involved.

In the morning this guy is probably going to be really sore and really embarrased. I don't know what your attitude is about drugs, pants, but in the same situation myself I would not let this incident ruin my roommate relationship. I would, however, insist on being told in advance of any future drug experiments so that I could react appropriately. I might even insist that the roommate do his experimenting somewhere else, or get a babysitter for himself in the future.
posted by croutonsupafreak at 8:10 AM on April 7, 2005

Ack. Recurve, joelr - we don't even know if the seeds had anything to do with it... They were simply found in his room. And my point was that Adderall alone can cause exactly the sort behavior pants' roommate was exhibiting, and that it could happen fairly innocently, as a result of trying to control his own dosage, for example, as this person's story shows.
posted by taz at 9:10 AM on April 7, 2005

I don't understand some of the touch-me-not reactions here (e.g. flee, move, put a wall between you, avert responsibility). Maybe it was unintentional. Maybe he took them for a reason. Whatever, this sounds exactly like a time that the roommate would need someone the most, and if this guy has no other friends or family, it would be so COLD to leave him alone at a time like this. It is precisely because of pants's concern that the worst was averted. You did the right thing, pants.

Be a pal. He probably needs one right now.
posted by Lush at 10:43 AM on April 7, 2005

Gyan - dextroamphetamine and methamphetamine are so similar as to be indistinguishable from their effects. Thats why I said "basically". They are not the same thing, but they might as well be... the primary difference is in clearance rate not effects. I don't understand why you are taking umbrage.

Adderall, Ritalin, Desoxyn are all essentially speed. Note: I am NOT saying that they are not medically important for some people, but we should be honest about what they are. They can be safe if taken under strict guidelines; the person in question here was not doing that, apparently. In which case it *is* basically just crystal meth with another name.
posted by Justinian at 12:05 PM on April 7, 2005

Justinian: Their effects might be indistinguishable, but I believe there's a twofold difference in potency. Also, LSD is a psychedelic with a stimulant component, LSA is a milder psychedelic with a sedating component. So, the combo, even if taken, isn't equivalent to acid+meth.
posted by Gyan at 12:26 PM on April 7, 2005

Without insulting pants or implying s/he did anything wrong by calling 911, I think it's worth noting that it is possible to talk someone down from this kind of often-temporary (though still very bizarre) incoherence. Sometimes (most times?), it's enough to just be there for the person, listening to the disjointed speech and accepting the freakish thinking, while not letting them hurt themselves or break anything valuable. Pacing, going up and down stairs, cursing, talking to yourself, smacking walls, etc., can seem frightening, but it's not necessarily something that requires emergency medical attention. In fact, I know of at least one person whose life was severely altered after he wound up in a parental/medical environment instead of a supportive pal environment while in a similar state.

Again, not saying pants didn't do exactly what was required in this instance, particularly given the nature of the relationship, but there might be other options available in slightly different situations.

I really wish "Dealing with Roommates' Bad Trips" was a required course in modern educational systems.
posted by mediareport at 8:06 PM on April 7, 2005

The thing is, though, mediareport, that this requires one to make a layman's assessment of whether it is a potentially life threatening or severe situation or not. If the problem is an overdose, symptoms like these could be precursors to coma or death (at least from the impression I got upon briefly reading about Adderall overdose). Or not.

Basically, I sort of agree with you, and under certain circumstances I might try to deal with something like this on my own, but having as little info as pants had, I don't see how he/she could have done otherwise than call for qualified help in this situation.
posted by taz at 5:39 AM on April 8, 2005

Yep, it was the smart thing to do. I think croutonsupafreak's last paragraph above has good advice, too, particularly if the episode had been planned rather than arising from a self-dosing mistake.
posted by mediareport at 7:01 AM on April 8, 2005

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