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Is it Stress or Something More? When to Get Help.

With all that has happened in 2020, it is normal to feel some level of stress, burnout, worry, sadness, or mental exhaustion. However, rates of mental illnesses have also risen significantly in 2020 (Czeisler, 2020). It can be hard to tell if what you are feeling is part of a normal reaction to an abnormal set of circumstances or if it is part of a mental illness requiring professional treatment. Here are some signs that it's time to get help: 1. Thoughts of death or suicide. It is never normal to wish that you were dead or to think about suicide. These thoughts can take the form of wishing that you wouldn’t wake up in the morning, feeling your family would be better off without you, fantasizing about death, or thoughts about actually harming yourself or taking your own life. Suicidal thoughts like these signal that something is wrong, even if the thoughts are fleeting or you don't intend to harm yourself. It's so important to reach out for help as these thoughts usually stem from treatable mental illnesses. It may not feel like it, but things can get better. 2. Your symptoms interfere with your life. Normal stress shouldn't make you feel so anxious, sad, exhausted, or unmotivated that you can't carry out your normal day-to-day tasks or do the things you want to do. For example, you may find that your grades have slipped in school, you're too anxious to socialize even when you want to, you're unable to keep up with tasks at work, or you're late or absent more often. Any of these changes mean it's time to reach out for help. That being said, even if you are still able to function, your symptoms could still represent an underlying mental health condition. Some people can muster up the strength to do what they need to do, despite feeling miserable (sometimes termed "high-functioning" depression or anxiety). 

3. Lasting changes in your appetite While it may be normal for your appetite to decrease when feeling stressed or to crave comfort foods when you’re feeling down, these kinds of changes shouldn’t last long. If you find that your appetite increases or decreases significantly for more than a few days at a time, or if you have significant weight loss or weight gain, it's time to see a professional. 4. Difficulty with sleep Not every night of sleep will be perfect, especially when you are stressed. But if you find yourself having trouble falling asleep or staying asleep night after night, that's a sign that your stress may actually be due to an underlying mental health problem.

5. You start to cope in harmful ways We all have various ways of coping with stress. We might meditate, go for a run, talk to a friend, or take a day off. But if your coping mechanisms become destructive habits, it's time to get help before they take on a life of their own. Overspending, engaging in high-risk sexual activity, self-sabotaging, abusing drugs or alcohol, overexercising, and overeating are just a few examples of how our methods of coping with stress can end up doing more harm than good in the long run. It is important to treat any underlying mental health condition if you want to address harmful coping mechanisms.

The Bottom Line: Seeking Help is Never Wrong Please note that not everyone with a mental health condition will show all of these signs. Mental illness can present in many forms, and there are many other reasons to seek help. Don't feel like you have to know all the answers before making an appointment. You are never wrong for seeking help. 

References Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic—United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. 

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©2020 by Melissa Shepard, MD