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Asking for mental health is a sign of strength. Here’s how to do it.

A Kaiser Permanente psychiatrist outlines what to say when you’re ready to reach out—and how to spot signs of mental health concerns in yourself and others.

Man and woman sitting and talking in hallway

Not to understate things, but it’s been a tough year-and-a-half. We don’t need to list all of the reasons why; suffice it to say that the pandemic has wreaked havoc in nearly all aspects of our lives. As a result, more people than ever are struggling with anxiety and depression.

Knowing you’re not alone can help—nearly one-fifth of adults in the U.S. and 25 percent of 13- to 18-year-olds are dealing with anxiety disorders—but that doesn’t necessarily make it easier to reach out and share that you’re struggling. “It is a societal group effort to try to normalize mental health concerns,” says Sara Vogel, MD, an adult psychiatrist with Kaiser Permanente Colorado. She sees the recent global conversations led by superstar athletes like Simone Biles and Naomi Osaka as a major step toward eradicating stigma. Still, whether you’re seeking treatment for yourself or are concerned for someone you care about, taking that first step can be scary.

Dr. Sara Vogel

We’re here to make things a little easier by sharing some common indicators of mental health issues and the actual words you can use to find out how someone’s doing or to ask for help yourself.

Signs that someone needs support and what you can say

Everyone’s experience with mental health issues is different, but there are some general red flags you can look out for in yourself and others, Dr. Vogel says. They include:

  • A change in performance at work or academically (repeatedly showing up late or slipping grades, for example)
  • Changes in interactions with loved ones
  • Loss of interest in activities you usually enjoy
  • Sleeping too much or too little
  • Fatigue or low energy
  • Problems focusing or remembering
  • Social isolation
  • Changes to your appetite and/or weight
  • Thoughts of death or suicide, hopelessness
  • Alcohol or drug use or dependence

Among kids and teens, also keep an eye out for trouble at school, irritability, signs of self-harm, and recurring physical symptoms like stomachaches.

If you are concerned, one way to parse out what’s going on is to broach the topic in a casual, open-ended manner. Try a simple, “How have you been doing lately?” Or, “I noticed you haven’t attended virtual book club in a while. Is everything OK?” “Then just see where the person takes it,” Dr. Vogel advises. “You’re not looking to interrogate someone…You’re trying to help them give permission to take the conversation a little further, opening the door, letting them know it’s a safe space.”

Listen with an open mind, reassure them they’re not alone, and ask how you can support them. Depending on your comfort level, you can also inquire if they’ve thought about reaching out to a professional.

If you’re worried about your own well-being, Kaiser Permanente offers an online self-assessment through its Find Your Words initiative, which empowers people to ask for help and to speak out about mental health. Mental Health America has also published online assessments for anxiety, addiction, and other mental health concerns, including some specifically aimed at children.

How to ask for help

You’ve concluded that something is wrong. Now what? If you or the person you’re speaking with is considering harming themselves, there are crisis lines available (try the National Suicide Prevention Lifeline or Colorado Crisis Services).

But you don’t have to go straight to a counselor or therapist if that sounds overwhelming. Instead, you can start the conversation with someone familiar, like your primary care doctor, Dr. Vogel says.

You may not feel like you have the words to describe what you’re dealing with, but your job is not to diagnose yourself, she says. It’s to share what you’re going through, whether that’s not sleeping well or that your friends have expressed concern because you’re spending a lot of time alone. “A lot of patients don’t realize that what they’re describing could be depression. Or, we sometimes see someone’s severe anxiety manifest as gastrointestinal complaints,” she explains.

Kaiser Permanente has embedded behavioral health specialists in most of its Colorado medical offices, so you can immediately connect with a specialty provider, if necessary, no referrals needed. “At Kaiser Permanente, we try to help make it as user-friendly as possible,” Dr. Vogel says. “When you’re in crisis, everything can be so overwhelming and trying to sit there and Google and figure out what phone number to call, that may be too much and might make a person say, ‘Forget about it. I’ll just deal with it myself.’”

That happens all too often, which is why Kaiser Permanente offers myriad ways for individuals to connect with doctors, both in person and virtually. The array of telehealth options includes Online Chat, on-demand video visits, phone calls, and even email—meaning there’s always a way for you to connect with someone for help.

Your first step can also be reaching out to a trusted friend or colleague or spiritual advisor. Begin the conversation by simply explaining that you’re not feeling like yourself, or use one of these icebreakers:

  • “I think something’s wrong because I feel _____. I’m worried that I may be depressed. Can we talk?”
  • “I want to talk to you about something that’s hard for me to put into words. I feel _____, and it’s been going on for a while now.”
  • “I think I should see a therapist, but I’m scared. Can you help me find one and make sure I keep the appointment?”

Things will flow from there. The most important part is opening the door and extending a hand so you can access the help you or your loved ones need. Remember: You are not alone.

If you or someone you know is struggling, contact the National Suicide Prevention Lifeline at 1-800-273-8255, or text “WORDS” to 741741. Colorado Crisis Services can be reached at 1-844-493-8255 or by texting “TALK” to 38255.