It's not always easy to tell when someone you care about is struggling, especially when they're used to holding it together in front of others. Here's what each of these seven signs can actually mean, why it happens, and what to do if you notice it.
1. Withdrawing From People or Activities
Pulling away from friends, family, or hobbies someone once enjoyed is often one of the earliest and most reliable signs of depression or chronic anxiety. Part of what's happening is a symptom called anhedonia, a reduced ability to feel pleasure or interest in things that used to be rewarding, which makes previously enjoyable activities feel flat or pointless, so there's less pull to engage in them.
Depression and anxiety also drain the energy and mental bandwidth that socializing requires, so even wanting to see people can feel physically exhausting to act on. Withdrawal tends to feed itself: the less someone engages, the more isolated and disconnected they feel, which can deepen the very symptoms causing the withdrawal in the first place.
This is why noticing the pattern early, before it becomes entrenched, matters. A person who's pulled away for a few weeks is often easier to reconnect with than someone who's been isolated for months.
2. Changes in Sleep or Appetite
Sleep and appetite are both regulated by overlapping brain systems that are highly sensitive to chronic stress hormones, particularly cortisol. In depression, this can show up as either insomnia, trouble falling or staying asleep, often with early-morning waking, or hypersomnia, sleeping far more than usual and still feeling exhausted. Both are common, and neither is more real than the other.
Appetite changes work similarly: some people lose interest in food and eat noticeably less, while others eat more, often reaching for high-sugar or high-carbohydrate foods that offer a brief mood lift. These aren't just side effects of feeling bad; disrupted sleep and appetite each independently make mood regulation harder, creating a cycle where the depression disrupts sleep, and the poor sleep worsens the depression.
A change that's lasted more than two weeks, in either direction, is generally considered clinically significant rather than an ordinary rough patch.
3. Increased Irritability
Irritability is frequently overlooked as a depression or anxiety symptom because it doesn't match the stereotype of quiet sadness, but for many people, especially men and teenagers, irritability is the primary way underlying distress shows up, sometimes with little to no visible sadness at all.
This happens partly because chronic stress and low mood reduce a person's tolerance for frustration and their capacity for emotional regulation, so things that wouldn't normally bother them start to feel unmanageable. It can also function as a kind of emotional camouflage, whether consciously or not, since anger is often more socially acceptable to express than sadness or fear, particularly for people raised to see vulnerability as weakness.
A noticeable shift in someone's baseline temperament, not just a bad day but a sustained change, is worth paying attention to, especially if it's paired with any of the other signs on this list.
4. Expressions of Hopelessness
Comments about feeling like a burden, having no purpose, or feeling permanently stuck are not just pessimistic talk. Hopelessness is one of the most consistently studied predictors of worsening depression and, in its more severe forms, suicide risk.
Part of what makes hopelessness dangerous is that it distorts a person's sense of time: someone in this state often isn't just saying things are bad right now, they're expressing a genuine belief that things will never get better, which removes the motivation to seek help or wait things out. This is different from ordinary venting or a bad week, which usually comes with some acknowledgment that the feeling will pass.
Statements like these deserve a direct, caring response rather than reassurance that dismisses them. Acknowledging the pain first tends to open the door to further conversation more effectively than jumping straight to solutions.
5. Increased Use of Alcohol or Drugs
Turning to alcohol or drugs more than usual is frequently a form of self-medication, an attempt to numb difficult emotions, quiet anxious thoughts, or fall asleep when the mind won't settle on its own. The trouble is that this strategy works only briefly and tends to make the underlying problem worse over time, since alcohol is a depressant that disrupts the same brain chemistry involved in mood regulation.
Reliance on any substance to cope can also prevent someone from developing or using healthier coping strategies, and there's a tolerance effect where the amount needed to get the same numbing effect tends to increase over time, which can turn an emotional coping mechanism into a separate substance use problem layered on top of the original one.
A noticeable increase in drinking or drug use, especially framed as just to relax or just to sleep, is worth a direct, non-judgmental conversation.
6. Difficulty Concentrating
Trouble focusing, forgetfulness, or a persistent mental fog are common cognitive symptoms of both depression and anxiety, not just signs of being tired or distracted. In anxiety, a significant share of mental bandwidth gets consumed by hypervigilance, the brain's threat-detection system running in the background scanning for problems, which leaves less working memory available for the task actually in front of someone.
In depression, rumination, repetitive circular negative thinking, can occupy attention in a similar way, while the sleep disruption discussed earlier compounds the problem further, since poor sleep independently impairs concentration and memory regardless of mood.
Someone who's normally sharp and organized suddenly missing deadlines, losing track of conversations, or struggling to complete simple tasks may be dealing with more than a busy week.
7. Talking About Death or Self-Harm
Any mention of wanting to die, feeling like they'd be better off gone, or not wanting to be here anymore should always be taken seriously and never dismissed as attention-seeking or exaggeration. Public health research consistently shows that most people who die by suicide communicated some warning sign beforehand, whether directly or indirectly, which means these comments function as a genuine opportunity to help, not just a phrase to worry about privately.
Asking someone directly and calmly whether they're thinking about suicide does not plant the idea or increase risk, despite a common fear that it might. Research shows the opposite is true, and a direct question often brings real relief to someone who's been carrying the thought alone.
What matters most in the moment is a calm, caring, non-judgmental response, and knowing when to involve additional support immediately rather than trying to manage it entirely on your own.
How to Start the Conversation
You don't need the perfect words. Something as simple as I've noticed you seem different lately, how are you really doing, opens the door without pressure. Listen more than you talk, and resist the urge to jump straight to solutions before the person feels heard.
If Someone Is in Immediate Danger
If a loved one talks about wanting to end their life, call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7, or go to the nearest emergency room.
Wondering If It's Depression?
If several of these signs sound familiar, either for yourself or someone you're worried about, CareArc's free, confidential online depression assessment can help clarify whether what you're seeing may be depression. It takes just a few minutes and does not require an appointment to take.
Take the free depression assessment
How CareArc Can Help
Our behavioral health team, including Jada England and Tricia Dillingham, offers a judgment-free space to work through anxiety, depression, and other challenges, for the person struggling and for the people supporting them. Support doesn't have to wait until a crisis.
Ready to talk to someone, or help a loved one take that step? Call 620-342-4864 to schedule a behavioral health visit.
If you or someone you know is in crisis, call or text 988 for the Suicide & Crisis Lifeline, available 24/7.
