How do I know if I need help?
It is time to get help when low mood or anxiety has lasted for weeks, is getting in the way of daily life, or is frightening you. The National Institute of Mental Health (NIMH) says that if signs of depression persist or do not go away, you should talk to a health care provider, and notes that a depression diagnosis looks for symptoms most of the day, nearly every day, for at least two weeks.
NIMH also notes that people with only a few symptoms may benefit from treatment. You do not have to wait until things are severe or until you meet a definition. Many people put off asking for help because they think others have it worse, or that they should be able to handle it themselves. Neither is a good reason to keep struggling alone.
Signs it has gone beyond a rough patch
Everyone has low days and anxious weeks, especially during stress or loss. These are some signs that something more is going on. Signs of depression and signs of anxiety go into each in more detail.
- Low mood, emptiness or hopelessness most days for two weeks or more.
- Losing interest in things you used to enjoy, or feeling flat about everything.
- Worry that you cannot switch off, on most days, about many different things.
- Avoiding places, people or tasks because of anxiety, so that your life is getting smaller.
- Sleep that has changed a lot: lying awake, waking very early, or sleeping much more.
- Struggling to keep up at work or at home, or others noticing that you are not yourself.
- Drinking more or using other things to cope.
- Physical symptoms, such as aches, stomach trouble or a racing heart, without a clear medical cause.
When it is urgent
Some signs mean you should reach out today, not after waiting to see. NIMH's list of suicide warning signs includes talking about wanting to die, feeling trapped or a burden, feeling hopeless or in unbearable pain, making a plan, saying goodbye or giving things away, and using alcohol or drugs more often. NIMH says to get help as soon as possible, particularly if the behavior is new or has increased recently.
If that is you, or someone you are worried about, call or text 988 to reach the 988 Suicide and Crisis Lifeline, which NIMH describes as offering 24-hour, confidential support from trained crisis counselors. Veterans can call 988 and press 1. If someone is in immediate danger, call 911 or go to the nearest emergency room. North Carolina and South Carolina also have local crisis services; our page on crisis and support resources lists some for the foothills, and finding support in the Charlotte area covers Charlotte.
Why it is worth not waiting
Depression and anxiety tend to feed themselves. Low mood leads to doing less, which leads to feeling worse; anxiety leads to avoiding things, which keeps the fear alive. The longer the pattern runs, the more of your life it can take over, and the harder it can feel to start.
Getting help early also gives you more options. NIMH notes that for milder depression, therapy is often tried first. Checking in with a doctor can rule out physical causes, since NIMH notes that some medical conditions, such as thyroid problems, and some medications can cause symptoms that look like depression. And sometimes a few conversations are enough to help you see what is going on and what you need.
What a first step can look like
NIMH suggests a primary care provider as one good starting point: they can do an initial screening and refer you to a mental health professional. You can also go directly to a counselor or psychotherapist. Either is fine, and many people end up seeing both.
It can help to write down a few notes before your first appointment: what you have noticed, when it started, how often it happens and what it is getting in the way of. NIMH suggests the same thing for medical visits. You do not need to know what to call it. Saying "I have not felt like myself for a while and I do not know why" is a perfectly good opening.
If you are not ready to talk to anyone yet, the resources pages on low mood that will not lift and when anxiety becomes the default may help you think it through. Therapy for depression and anxiety explains what the work involves, and therapy, medication or both covers how those choices are made.
Talking with Laura Bass
Laura Bass is a psychotherapist in Charlotte, North Carolina, who works with adults, and depression and anxiety are among the concerns she sees. She does not prescribe medication, so if medication becomes part of the conversation, that goes to your physician or a psychiatric prescriber. Counseling with Laura is not a crisis service; for anything urgent, use 988 or 911.
If you are wondering whether counseling makes sense for you, you can read about individual counseling or simply get in touch and ask. You do not have to have decided anything to make that first contact.
Common questions
How long should I wait before getting help for depression?
You do not have to wait any particular length of time. NIMH advises talking to a health care provider if signs of depression persist or do not go away, and a diagnosis of depression looks for symptoms most days for at least two weeks. If you are struggling now, it is reasonable to reach out now. If you have thoughts of suicide, call or text 988 straight away.
Is my anxiety bad enough for therapy?
If you are asking, it is probably worth talking to someone. Signs that anxiety deserves attention include worry that is hard to control on most days, avoiding things because of it, trouble sleeping, and physical tension that does not ease. You do not need a diagnosis to start counseling. Our page on is it anxiety or stress may help.
Should I see my doctor or a therapist first?
Either is a reasonable start. NIMH notes that a primary care provider can do an initial screening, check for physical causes and refer you on. Going straight to a counselor is also fine, especially if you already know you want to talk things through. If medication may be part of the picture, you will need a doctor or psychiatric prescriber, since therapists like Laura Bass do not prescribe.
What if someone I love needs help but will not go?
You cannot make another adult get help, but you can tell them specifically what you have noticed, say you are worried, and offer practical support such as finding a provider or a ride to an appointment. NIMH suggests patience, encouragement and inviting them to do things with you. If they talk about suicide or seem in danger, call or text 988, or call 911.