Depression Emergency Action Plan

Personal Information

• Name: _________________
• Date: _________________
• Emergency Contact: _________________
• Phone: _________________
• Therapist/Psychiatrist: _________________
• Phone: _________________

Warning Signs That I'm in Crisis

• Thoughts of self-harm or suicide
• Inability to sleep or sleeping too much
• Loss of interest in daily activities
• Isolation from friends and family
• Feeling hopeless or trapped
• Increased anxiety or panic attacks

My Safety Steps

Step 1: Things I Can Try Myself

• Practice deep breathing exercises
• Use grounding techniques (5-4-3-2-1 method)
• Listen to calming music
• Call a trusted friend or family member
• Use my prescribed medications as directed

Step 2: People I Can Call for Help

1. Name: _________________ Phone: _________________
2. Name: _________________ Phone: _________________
3. Name: _________________ Phone: _________________

Step 3: Professional Support

• Call my therapist/psychiatrist during office hours
• Contact my primary care physician
• Call crisis hotline: 988 (Suicide and Crisis Lifeline)

Step 4: Emergency Response

If I'm having thoughts of suicide or feel I might harm myself:

• Call 988 immediately
• Go to the nearest emergency room
• Call 911

Making My Environment Safe

• Remove access to potentially harmful items
• Keep emergency numbers easily accessible
• Have someone stay with me if necessary
• Keep my medications in a safe place

Important Reminders

• This crisis will pass
• Help is always available
• My life has value
• People care about me

Patient Signature

Healthcare Provider Signature