Depression is often subtle. Before someone seeks medical help and receives a definitive diagnosis, their symptoms may masquerade as other issues, ranging from a poor attitude or alcohol abuse to a sleep disorder or an eating disorder. Behavior that may seem strange can actually be a sign of a more serious problem.

Part of the difficulty in recognizing depression is that it can manifest in so many different ways. Some people with depression may become aggressive, irritable, and even abusive. Others may simply become lethargic, anxious, or restless. Depression may also cause people to become more withdrawn or to become less interested in activities they once enjoyed. They may even express feeling of guilt, hopelessness, or worthlessness. Any of these behaviors may be evident in men or women who experience depression.

Other signs of depression may include:

  • notable changes in appetite, accompanied by sudden weight gain or weight loss
  • trouble concentrating
  • difficulty remembering things
  • sleeping too much or too little
  • talk of death or suicide
  • attempts to commit suicide
  • aches, pains, or cramps that don’t go away, even after treatment

If someone you know is showing signs of depression, it may be time for you to intervene. However, it can be difficult to know when and how you should do it. Experts recommend consulting a medical or mental health professional when any signs of depression last longer than a few weeks. It’s normal to feel sad or depressed in the wake of a stressful or tragic life event, such as a divorce or loss of a loved one. However, these feelings are normally short lived. If your friend or family member is experiencing persistent and intense feelings of sadness for extended periods of time, then they may have depression.

Some people with depression become so overwhelmed by feelings of sadness and hopelessness that they begin to have suicidal thoughts. If your loved one ever talks about suicide or threatens to commit suicide, it’s extremely important to take the threat seriously.

Even if your friend or loved one isn’t in immediate danger, it’s still important to speak to them about the challenges they may be facing. Express your concern and encourage them to seek medical treatment. Offer to help them find a doctor or mental health professional, to make a phone call, or to go with them to their first appointment. Once your loved one receives treatment, help them follow their healthcare provider’s advice. Most people with depression will feel better after they start taking an antidepressant and going to therapy on a regular basis.

It’s critical to take action if you’re in a position to help. Starting a conversation and expressing your feelings can motivate your loved one to seek treatment and can ultimately help them recover.

As a concerned friend or family member, your actions may be critical in helping your loved one get help. However, it’s important to approach them in the right way.Here are some things you should and shouldn’t do when you talk to them:

  • Don’t criticize, nag, or ignore your loved one. Never tell them to “just snap out of it.”
  • Don’t become angry or react negatively if your loved one isn’t receptive to your suggestions and concerns. It’s best to stay calm and to continue speaking in a reassuring tone, regardless of how your loved one is acting.
  • Take all talk or threats of suicide seriously. If the threat is immediate, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255. While you wait for help to arrive, stay with your loved one. Calmly reassure them that all will be well. Remove any obvious means of causing self-harm, such as firearms, sharp objects, or dangerous medications.
  • Provide support and encouragement. Help your loved one remember to eat, sleep, or dress for the day. Offer to assist them with basic hygiene tasks or to run errands for them.
  • Be gentle, but persistent, in encouraging them to seek medical help. Remind them that depression is a legitimate illness that’s serious but treatable. Tell them that their challenges can be overcome and that things can improve.

If your friend or family member agrees to receive medical treatment, help them follow through with the doctor’s advice. You should also keep an eye on your loved one, especially during the two months of drug therapy. Thoughts of suicide may temporarily increase during this period. It’s also important to continue offering support and encouragement.

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Sources: National Suicide Prevention Lifeline and Substance Abuse and Mental Health Services Administration