How to Recognize Signs of Anxiety or Depression — and How to Get Help (or Help Others)
Feeling tired and worn down, no matter how much you sleep? Snapping at people? Can't muster up interest in another Zoom happy hour? Does your neck hurt? What about your stomach? Having a lot of headaches? Don't ignore it: Your body might be trying to tell you something.
"We've gotten accustomed to just pushing through our days," says Dr. Lindsey McKernan, 36, associate professor of Psychiatry and Behavioral Sciences at Vanderbilt University Medical Center. "A lot of the time, particularly in the past year, when we've been faced with so much stress, we've just been soldiering on."
Just trying to get through the day, people often ignore signs and symptoms of anxiety and depression. As part of PEOPLE's Let's Talk About It initiative to encourage readers to have vital conversations about mental health, PEOPLE spoke to mental health experts about some of the more surprising signs that you – or someone you love – might be suffering from anxiety and depression -- and how to get help.
If you've been feeling sad and "down" for more than two weeks (for many of us, that's going on about 17 months now) and feel that you've lost interest in things that used to make you happy, you may be depressed.
"Think about depression as low batteries," says Dr. Luana Marques, 43, President of the Anxiety and Depression Association of America. "You feel like it's hard to keep going." She gave some signs to look for that might indicate you are suffering from depression.
Changes to your sleep and energy
Are you sleeping too little? Are you sleeping too much? "Some people I work with with depression can sleep up to 20 hours a day," McKernan says.
You may feel totally depleted — but at the same time, keyed up and on edge. Or you may sleep a lot — but never feel rested. "You can feel perpetually fatigued," McKernan says.
Changes to how you're eating
Some people hoover the entire fridge when they're depressed. Others just stop feeling hungry and stop eating. You may skip meals because you totally forget to eat, McKernan says.
When you're depressed, you can also experience "brain fog," McKernan says.
"You might have trouble making decisions, or you might not feel as sharp or 'on point' as normal," McKernan says. "You get slowed down. Your thoughts may be racing and traveling to different places in your mind."
You could also be distracted by being hard on yourself: dwelling on mistakes, beating yourself up over bad decisions, and constantly feeling guilty.
Anxiety can occur on its own, but often is hand-in-hand with depression.
"They're best friends, they show up together all the time," says Brittany Little, 33, clinical social worker at Mountain Valley Residential treatment Center.
Anxiety is excessive worry all the time, says McKernan.
"Your mind focuses on the worry a lot and it can be difficult to control," McKernan says. "Your mind is running, but you can't put the brakes on."
Some anxiety serves a purpose, Marques says; for example, a new mother has some anxiety, which propels her to take care of her child and protect her baby. But if the mother is so paralyzed by fear and worry that she can't even change a diaper, then that's a problem.
Difficulty relaxing, body aches and tension
Asking "what if?," playing out different "coulda-woulda-shoulda" scenarios, and constantly questioning life choices is both mentally and physically exhausting, says McKernan, who syas anxiety "can be very depleting."
Many of McKernan's patients chalk up feeling tired to a bad night's sleep and move forward. But fatigue can be a "subtle sign" that you're too anxious, she says: being unable to calm your mind and stop worrying might mean that your body is also unable to be at rest. Anxiety may lead to restless dreams that wake you up throughout the night, or lead to it taking hours to fall asleep when you used to crash.
Changes in mood or behavior
When your thoughts are consumed with worry, it can be hard to focus on two things at once — to execute a task at work, or remember little things you need to do. You might find yourself easily distracted and irritable.
Changes in your body
"Often I hear from my patients that they don't understand that anxiety can cause physical things, like stomach aches or headaches," says Marques (who is also an associate professor at Harvard Medical School's department of psychiatry). Other physical symptoms could be neck ahces or headaches.
In severe cases, some people may get as-seen-on-TV full blown panic attacks – where they feel like they're having a heart attack. "Your body is sweating, you're trembling and shaking, and having trouble breathing – like a choking sensation," McKernan explains.
How to Fight the Symptoms
First off: Get moving!
Even if it seems like the last thing you want to do, the doctors say, push yourself to take a walk, go on a bike ride, or do 10 minutes of a yoga app.
"If you're feeling anxious or depressed and you feel like not doing much, remind yourself that our bodies are like batteries of our car – we have to actually drive our cars to recharge the battery," Marques says, adding that moving even a little, can help "jump start your battery."
"Set really small, realistic goals for yourself," McKernan advises. If you pledge to work out two hours a day, six days a week – you may be setting yourself up to feel like a failure. Perhaps aim to walk on a conference call a couple times a week, or do a few yoga poses during TV ads.
Give your brain a break
Plan out your day so you know what to expect, Marques suggests: "Our brain hates uncertainty – and right now everybody has a lot of uncertainty."
If you're teleworking, she suggests deciding what time you're going to log off and walk away from your desk, Marques says. And try to schedule in things that might pick you up, like a short call to a friend or heading to the dog park to watch puppies play.
"Working little moments of joy back into the day can be really helpful when you're struggling," McKernan says.
Find a Therapist
You may not feel like your anxiety and depression is "bad enough" to need therapy. But more mild cases are much easier to treat, Little says: "Like other medical diagnoses, you would much rather catch it early."
And note that scheduling a consult doesn't mean committing to a year of weekly sessions; you may only need a couple to see progress. "By proactively seeking out help, you may be making it easier on yourself," McKernan says.
For some, the financial component of therapy can feel daunting. But check your health insurance and the APA site to see if you can find a provider in-network. Also see if the company you work for offers an Employee Assistance Program which may offer mental health services.
Additionally, telemedicine rules have recently changed for mental health care, meaning you can meet with any provider in your state who practices virtually. Some health insurance companies offer video calls with therapists at discounted rates as low as $10 per session.
"Access has really increased," McKernan says. "There are multiple roads to help."
If you are interested in trying medication, McKernan suggests talking to your primary care doctor, who may prescribe something or refer you to a specialist.
Need to talk to someone about mental health or anxiety — or know someone who does? Maybelline's Brave Together initiative aims to make these conversations easier, and has partnered with Crisis Text Line to provide access to the tools you need to get help. Text TOGETHER to 741741 to be connected with a counselor.
How to help someone you love
If you notice that someone you love might be struggling with anxiety and depression, don't try to solve their problems. Instead, just listen.
"You can feel helpless, like you're watching from a window," McKernan says of trying to help a loved one. "Our urge is to jump in and to try really hard ... to fix it, to try and put a positive spin on whatever's going on, [in order] to help the person feel better."
What is more helpful, Marques says, is just to be present. Sit with them, ask open-ended questions, and listen. Invite them to do something with you that could also be good for them, like taking a 10 minute walk. Ask if they'd like help finding a therapist, or offer to go with them.
"When we say to somebody who's really struggling, 'What can I do?' That's often met with silence," McKernan says. "If someone's really anxious or depressed, they might be overwhelmed by the idea of change, or not have any idea how to help themselves."
You can also offer to share resources, such as:
- The Anxiety & Depression Association of America has a therapist directory.
- National Alliance on Mental Illness
- PsychologyToday.com has a provider directory where you can search for a therapist by zip code
- American Psychiatric Association
- International OCD Foundation
- You or they can text STRENGTH to Crisis Text Line at 741741 to be connected with a counselor.
Children and Teens
Though there are some children who can present typical signs of anxiety and depression (like panic attacks and fatigue), more often, children and teens with anxiety or depression present with constant headaches and stomachaches, says Little. Or they avoid things that they normally could or would do.
If your child isn't turning in their homework, or takes forever to get dressed in the morning, or is unable to make it to class on time, those might be signs of depression or anxiety, Little says.
"Think about what are the things that the average teenager can and should be able to do: Go to school, do their homework, talk to friends, volunteer, have a job, drive a car, call a grandparent on the phone, things like that. And then when parents start seeing teenagers who cannot or will not do it, then that's a signal," Little says. "In general, teens should be able to keep up with their assignments at school, get to school on time, go through the day and not really need check-ins with mom and dad or caregivers."
Another sign of anxiety in kids might be constantly checking in to ask parents, "Are you okay?," and texting their parents when they're apart.
"It can come off as really loving or sweet," she says, but it could be a sign of a lot of worry or anxiety.
Talk to your kid, she says, and make it clear you're not being accusatory. Tell them what you notice is happening, and ask them if they know why it's happening. They may not have the answer, she says. And that's okay.
"That can open up a conversation of like, 'Well, why don't we go see somebody who could help us figure that out? Because I don't have all the answers either,' " Little suggests. And if they won't go to therapy, go yourself. "Normalize it," she says.