Woman struggling with depression looking out the window

News, Your Health | 2 years ago

The Warning Signs of Mental Health Distress and How to Help

Sometimes it’s hard to identify the signs of a mental illness or crisis or substance use disorder. Atrium Health is here to help.

Have you ever wondered about your friend or loved one’s recent changes in mood or behavior? For example, if they were once very active and talkative and now spend more time alone and in bed, this could be a sign they are struggling mentally and need help. 

Our experts with Atrium Health Behavioral Health Services in Charlotte and Atrium Health Wake Forest Baptist have compiled a list of warning signs recommended by the National Alliance on Mental Illness (NAMI). 

10 Warning Signs of Mental Health Distress:

  1. Feeling very sad, withdrawn or unmotivated (for more than two weeks)
  2. Planning to or trying to harm or kill oneself
  3. Out-of-control or risk-taking behaviors
  4. Overwhelming fear with a racing heart or fast breathing
  5. Sudden weight gain/loss or loss of appetite
  6. Severe mood swings 
  7. Excessive use of drugs or alcohol
  8. Drastic changes in behavior, hygiene or sleeping habits
  9. Extreme difficulty in concentrating or staying still
  10. Intense worries or fears impacting daily activities


While it’s scary to identify these signs in someone you know or even yourself, there is hope.

“Depression, as well as suicidal thoughts, tend to be temporary. People can get better – with therapy and sometimes with medication,” says James Rachal, MD, senior academic chairman of the Department of Psychiatry and psychiatrist at Atrium Health. “People can go on to live normal lives.”

How Can You Help Someone Struggling Mentally?

You’ve spotted the signs, but now what? Atrium Health follows the Mental Health First Aid (MHFA) five-step action plan called ALGEE to help those who may be dealing with suicide, mental illness or substance use disorders. Here are the steps:

  1. Assess for risk of suicide or harm – Some warning signs include threatening to hurt or kill oneself, seeking access to means to hurt or kill oneself, talking or writing about death and feeling hopeless.
  2. Listen nonjudgmentally – MHFA teaches you to use verbal and nonverbal skills such as open body posture, comfortable eye contact and other strategies to take part in appropriate conversation.
  3. Give reassurance and information – MHFA provides information and resources you can offer to someone to offer emotional support and practical help.
  4. Encourage appropriate professional help – Types of professionals include primary care physicians, psychiatrists, social workers, counselors and certified peer specialists. Types of professional help include talk therapies, medication and other professional supports.
  5. Encourage self-help and other support strategies – People with mental illness can support their own recovery and wellness through exercise, relaxation, meditation, participating in peer support groups and self-help books.

Seeking professional help can be overwhelming, but finding the right treatment can save someone’s life. 

“The general recommendation is to provide therapy as a first-line treatment, adding medications for moderate to severe cases or when therapy alone has failed,” says Tyler Cecil, DO, the associate program director of Atrium Health Wake Forest Baptist Department of Psychiatry and Behavioral Health. “I highly encourage anyone to seek professional help to further discuss when to start therapy and/or medication.” 

If you spot one or more of these and need mental health crisis support, call Atrium Health’s Behavioral Health Help Line at 704-444-2400to speak with a licensed professional 24/7. Also, the National Suicide Prevention Lifeline provides 24/7 service at 1-800-273-8255.

To support healthy, growing communities, Atrium Health offers a free Mental Health First Aid (MHFA) course. Email mhfa@atriumhealth.org if you’re interested in scheduling a class.