A crisis for me is when my symptoms cannot be managed on my own using the skills that normally do work. Generally that means I have become actively suicidal (not just thoughts - those can generally hold until business hours), but more intense ruminations, plans, feeling impulsive, etc. I can call my T, but he will tell me to call my pdoc (as he should since at that point I require medical management and probably hospitalization).

The other category of "crisis" is more of a life crisis that has put me in great distress; for instance, my husband becoming quite ill, my sister's impending death, the time I ended up needing surgery -- things along that line.

Both my T and Pdoc have told me if I think I may need to call, I'm probably in crisis because I have never called in an instance when they felt I could or should have waited.