Toss out the regular rules
When times were toughest with Janey, during days when she literally screamed all day, or cried all day, it sometimes took me longer than it should have to realize that it wasn't the time for consistency. I at first would cling to the notion that if I gave in and did unusual things, like let her watch TV all night, eat chips all day, go for car rides day and night, take showers all day long, that it was going to somehow set a bad precedent. I now realize---who cares? When times are as tough as they can be, you are focused on survival. If something gives you five or ten minutes of a happy or at least not as sad a child, and it's something that won't hurt them or you, do it. You aren't in regular times.
This is the time to beg your spouse to call in sick or take some vacation time. If you are a single parent, hopefully you have someone that can help in times of emergency. Either way, you MUST get a break now and then. It can seem impossible, and you can feel as I have at times that you have to be there. But even if it's only for 5 minutes, you need to have time to recover. You need to be able to breath. I remember the times Janey was in the hospital, when I'd get a chance to go eat in the cafeteria. Those 15 minutes or so would feel like a miracle, and I'd come back able to go on. And I remember times for whatever reason I couldn't take a break, and feeling quite literally like I could not go on. You NEED to grab moments for yourself.
Get some mental support from those who get it
I am very, very lucky to have made some friends through this blog who are fellow autism parents. I hope the rest of you are as lucky. When you are in the midst of a crisis time, you need to be able to talk to someone who gets it, without "it" having to be explained. You need to be able to speak freely, to rant and rave and cry, to have someone who won't say "now, it's not that bad", to have someone who doesn't necessarily offer advice but just listens, to have someone who doesn't say something like "You REALLY need to get respite care!" when there IS no respite care...that kind of person. That is part of why I made the Facebook page. If you ever need to, post there. I can guarantee there are others there who get it, and will listen.
Put off going to the emergency room as long as you can
You might not have been thinking emergency room, but I think most of us have had that thought at times, when your child has been screaming or biting themselves or banging their heads or crying for days. It IS an emergency, and it's reasonable to think ER in an emergency. And I would never, ever discourage anyone from getting help, but I know, from personal experience, that the ER is not a good place to be in a crisis. It might be necessary, in order to get the next level of help, but it's a nightmare while you are there. All my life, until my dying day, I will remember the approximately 24 hours we spent in the ER at Children's Hospital, before getting a room, as the worst 24 hours of my life, and the worst 24 hours I hope beyond hope I will ever have. The ER is not set up to deal well with children with autism, to say the very least.
Don't be shocked if your child winds up in a psychiatric hospital
I was shocked. I never, ever saw it coming, even though Janey was certainly in crisis. When her school called and said they were sending her to the hospital by ambulance, well---I can't really describe that moment well. And then when she was seen there, and the psychiatrist said she needed to be in a psychiatric hospital---again, blindsided. Sure, things were pretty bad. Horrible, even. But for whatever reason, I just didn't realize what that probably meant. I won't get into right now whether the psych hospital was the right place or not, but I can say it was a safe place for her, and if nothing else, it let us recover for a few days while she was being taken care of.
Take it from me---it WILL get better
If anyone had told me how relatively calm and happy the last few years have been with Janey when we were in the midst of the toughest times, I would have laughed at them. It did not feel possible. It truly didn't. But it was. And talking to quite a few other people who have lived through such times, I've found that it does get better for almost everyone. I'm not making promises about WHEN it will get better, or how long it will STAY better, but the very worst times somehow seem to be self-limiting. If you can make it through those weeks or months, and keep yours sane and alive, there will be a day when you can look back at them and, no, not laugh, but marvel. Marvel at how you made it through.