How to help a friend in mental health crisis

Approximately 280 million people in the world have depression, according to the World Health Organization (WHO).

Despite a range of effective treatments, many barriers remain that prevent people from receiving the care they need — including a lack of investment in mental health care and trained providers, as well as social stigmas.

When left untreated and at its worst, depression can lead to suicide. More than 700,000 people die by suicide each year, according to the WHO.

Depression and suicide risk does not discriminate. The key is recognizing the signs and symptoms of depression and/or suicidal thoughts, starting the conversation and getting the appropriate help.

What does depression look like?

Depression can be challenging to identify, both for those experiencing it and those around them. To a person with depression, they may think they’re in a “funk.” To an outside observer, a person experiencing depression may appear healthy.

There are two types of depression. In major depression, depression symptoms interfere with your ability to function in all areas of life (work, family, sleep and so on). In dysthymia, a mild but long-term form of depression, symptoms are not as severe but can still affect your ability to function at normal levels.

Common symptoms of depression include:

• Agitation, restlessness, irritability
• Depressed mood (feeling sad or empty)
• Fatigue or loss of energy
• Feelings of worthlessness, hopelessness, guilt
• Lack of interest in previously enjoyable activities
• Inability to think or concentrate, or indecisiveness
• Insomnia or hypersomnia
• Significant weight loss or gain, or changes in appetite
• Recurrent thoughts of death
• Recurrent suicidal ideation, suicide attempts or plans for completing suicide

People experiencing depression feel some range of these symptoms almost every day.

How to tell if someone is suicidal

Depression symptoms also serve as visible warning signs of potential suicidal thoughts. But keep warning signs in context, says David Lim, licensed clinical social worker for Navos.

It helps if you have knowledge about a person’s past or what they’re currently dealing with. Has the person had a recent loss, such as divorce or death of a loved one? Is the person unemployed? What kind of social support do they have? Have they talked about feeling hopeless?

“Even just a little bit of historical information can be helpful,” Lim says.

Another big warning sign: Pay attention if someone who has seemed depressed suddenly seems exceptionally happy. Especially if they’re also being very generous and giving things away.

“A lot of times that’s something to pay attention to,” Lim says. “Suicidal ideation does give relief. It serves as a way to reduce anxiety over pain.”

And the dangerous part is that the increase in mood and energy may actually help a person act on their suicidal thoughts, he adds.

“It’s deceiving,” Lim says. “If a person is depressed, they may not actually have any energy to take their own life. But if they do have energy, it increases the likelihood.”

How can you help?

If you or someone you love is experiencing symptoms like those above, an assessment from a trained mental health professional is an important first step. Don’t let fears or stereotypes about mental health keep you from getting treatment or looking out for those around you.

If you have a feeling a loved one could be suicidal, but they haven’t vocalized it or they deny it when asked, you can always call or text the crisis line to ask for advice — or call the police on behalf of the person if you’re worried they may hurt themselves.

“The only way we’ll be able to move the needle on suicide is to normalize the conversation,” says Sabrina Votava, FailSafe for Life founder and board president.

FailSafe for Life is a Spokane-based nonprofit that provides training and resources for suicide intervention and prevention.

Votava stresses the importance of checking in with those around you. Completely avoiding the topic only reinforces the stigma surrounding mental health and suicide, she says. You might make the difference for someone else without realizing it.

There are both local and national resources available to help 24 hours a day, seven days a week in a crisis:

• Call or text the Suicide & Crisis Lifeline at 988
• Call 911 for life-threatening situations
• If worried about a friend’s social media updates, you can contact social media platforms’ safety teams