Wegweiser Crisis of meaning · Orientation & support Deutsch

🚦 When professional help is needed

Signs that self-help and conversations alone are no longer enough – and what to do in an acute emergency.

Warning signs Suicidal thoughts Depression Emergency Psychiatric emergency service

In brief

A crisis of meaning does not automatically need therapy. Medical or psychotherapeutic help does become important, however, when other signs are added to the question of meaning: low mood lasting more than two weeks, loss of joy and interest, changes in sleep or appetite, strong withdrawal, feelings of worthlessness or hopelessness, or when daily life, work and relationships are noticeably affected.

If you have thoughts of taking your own life, or are in acute despair, it is important to act immediately – this is not a sign of weakness, but a medical emergency like any other.

Step by step

  1. Assess acute dangerDo you have concrete thoughts or plans of harming yourself? Then contact 112, the nearest psychiatric emergency department or the TelefonSeelsorge (0800 111 0 111 / 0800 111 0 222 / 116 123, around the clock) straight away.
  2. Discuss persistent symptoms with your family doctorIf symptoms last several weeks, the family doctor's practice is a good first port of call; it can refer you and rule out acute causes.
  3. Use the appointment service centreFor a place in psychotherapy, the Terminservicestelle (appointment service centre) of the Kassenärztliche Vereinigungen (regional associations of statutory health insurance physicians) on 116117 arranges an appointment within a period that varies from case to case.
  4. If unsure: test the waters at a low thresholdIf it is unclear whether it is "only" a crisis or more, a conversation at a psychosocial advice centre or with the TelefonSeelsorge is a risk-free first step – they too will refer you on to medical help if needed.

Deadlines

Watch out – common mistakes
  • Waiting to see "whether it gets better by itself" can needlessly prolong depression – early assessment often shortens the suffering.
  • Self-medicating with alcohol or sedatives masks symptoms instead of treating them, and carries its own risks.
  • Suicidal thoughts should never be dismissed as mere "idle thoughts" – even vague or recurring thoughts are a reason to seek help.
In depth · legal basis, figures and practice – for advisers and professionals

Professional differentiation

To distinguish between a passing crisis and a depressive episode requiring treatment, care in Germany follows the AWMF's S3 guideline/National Disease Management Guideline "Unipolare Depression". Core criteria include duration (as a rule at least two weeks), the number and severity of symptoms and the degree of impairment of daily life and functioning. Self-diagnosis does not replace this professional assessment.

Emergency structures

In case of acute suicidality, the following are available around the clock: emergency medical services/emergency number 112, psychiatric hospitals with emergency departments, the TelefonSeelsorge and, in many places, socio-psychiatric crisis services. These services are free of charge and require no referral.

Who is responsible
  • Family doctor (Hausärztin/Hausarzt)
  • Psychotherapeutic consultation hour (Sprechstunde)
  • Terminservicestelle of the Kassenärztliche Vereinigung (116117)
  • In an emergency: emergency services (112), psychiatric emergency department, TelefonSeelsorge
Further reading
Recognising a crisis of meaning: an overviewTelefonSeelsorge and church pastoral carePsychotherapy for a crisis of meaning: cost coverage

Quick questions

Worum geht es bei „When professional help is needed“?
Signs that self-help and conversations alone are no longer enough – and what to do in an acute emergency.
What should I do first?
  • Assess acute danger: Do you have concrete thoughts or plans of harming yourself? Then contact 112, the nearest psychiatric emergency department or the TelefonSeelsorge (0800 111 0 111 / 0800 111 0 222 / 116 123, around the clock) straight away.
  • Discuss persistent symptoms with your family doctor: If symptoms last several weeks, the family doctor's practice is a good first port of call; it can refer you and rule out acute causes.
  • Use the appointment service centre: For a place in psychotherapy, the Terminservicestelle (appointment service centre) of the Kassenärztliche Vereinigungen (regional associations of statutory health insurance physicians) on 116117 arranges an appointment within a period that varies from case to case.
What do I need to watch out for?
  • Waiting to see "whether it gets better by itself" can needlessly prolong depression – early assessment often shortens the suffering.
  • Self-medicating with alcohol or sedatives masks symptoms instead of treating them, and carries its own risks.
  • Suicidal thoughts should never be dismissed as mere "idle thoughts" – even vague or recurring thoughts are a reason to seek help.
Evidence
  • S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression, AWMF register no. nll-005 (current version, awmf.org)
  • TelefonSeelsorge Deutschland (telefonseelsorge.de) – availability and emergency information
  • Kassenärztliche Bundesvereinigung: Terminservicestellen 116117 (116117.de)
As of

As of September 2026 · Sources and method

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