Here, Dr. Greenwald provides guidance on noticing a mental health issue and how to navigate a conversation about it.

Seeing a problem

Some emotions and behaviors that can signal mental health challenges are:

• Severe sadness or gloominess
• Extreme mood swings
• Misuse of alcohol or drugs
• Withdrawing from friends and activities
• Thinking about suicide

Start the Conversation

If you believe someone in your life needs some mental health support, take some time to reflect on the person and consider their likely reaction before you start talking. Is this someone who is generally receptive to concerns, or are they typically resistant? Plan to phrase your words appropriately so that they have the best chance of being well-received.

Start the discussion by being supportive. Let the person know you are there for them and care about their well-being. Dr. Greenwald recommends taking a flexible but supportive approach.  For example, mentioning to a friend who may be depressed, "maybe it's just me, but you've seemed more down than usual. If you ever want to talk about it, I'm here." Also, a simple "How can I help?" can get the conversation going. 

"It gets you out of the responsibility of having to dispense any kind of profound advice that maybe you are not qualified to give," he says.

Continue With Care

As you're listening to someone discuss their mental health, be mindful of your responses and choose your words carefully. Try not to be hostile or dismissive. You may be afraid of seeing someone you know and love acting in an unusual way without knowing the reason behind their behaviors, but be sensitive to what they are going through.

"You should treat people with mental illness with kindness and respect. Like the rest of us, they have strengths and weaknesses," says Dr. Greenwald. Minimizing someone's mental health can make it seem like they are to blame — which is never true.

These are some insensitive statements and questions to avoid:

• "It's all in your head."
• "You need to be more cheerful and think happier thoughts."
• "Snap out of it."
• "Just relax."
• "Why aren't you seeing a therapist?"
• "Why aren't you on medication?"

Remain Supportive

Continue checking in with the person you are concerned about. This makes people feel valued and supported, says Dr. Greenwald. "Having family or a sense of community makes people feel like there is someone who has their back, and if they are going through hard times, there is a support system for them to rely on," he notes.