The start of a new year offers a chance to take stock of your life and goals. It’s no coincidence that January is also Mental Wellness Month, which presents an opportunity to reflect on your mental health and make adjustments that might set you up for a fulfilling year. One important skill to keep in mind: learning how to ask for help.

If you’ve been feeling off lately, you’re not alone. While everyone experiences ups and downs, for some people those ups and downs can be more serious. According to the Centers for Disease Control and Prevention (CDC), mental health conditions are some of the most common health challenges people endure in the United States. In fact, more than one out of five adults lives with a mental health condition, and one out of five young people (ages 13 to 18) is experiencing or has experienced a serious mental illness.

For some people who aren’t feeling like themselves, it can be tough to know when you need help, or even how to find help. It can also be a tough thing to admit you need help to yourself and your loved ones. That’s why we’ve pulled together a list with information culled from renowned health experts, including the CDC, National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration, the American Foundation for Suicide Prevention and the American Academy of Pediatrics, which highlights signs to look for that could indicate that you and your people—including children—might need help. Our hope is that by posing the right questions and underscoring important signals, this list can offer a sense of clarity and give you courage to ask for assistance. Because no one should struggle in silence, or in solitude.

Do you need help, or does someone you love need help?

If you are trying to answer that question for yourself or a friend, here are some things to consider. Are you frequently feeling…

  • Sad, worried and afraid
  • Struggling to get out of bed in the morning
  • Angry or irritable
  • More moody than usual
  • Less energy, tired than what’s normal for you
  •  Overwhelmed
  • Having trouble sleeping
  • Changes to your appetite and weight
  • Difficulty concentrating
  • Diminished interest in activities you used to enjoy

Ask yourself: Have these feelings lasted for two weeks or more? Then it may be time to ask for professional help.

Are you finding that you are thinking frequently about…

  • Suicide or harming yourself
  • Accessing and using alcohol and drugs
  • Things that are not real

Then it may be time to ask for professional help.

Are you experiencing changes in behavior, such as…

  • Not taking care of your basic needs, such as showering and cleaning
  • Missing important appointments, such as doctor visits, work or school
  • Experiencing consequences, including legal consequences, from these kinds of behaviors as they relate to your mental health or using drugs and/or alcohol.
  • Feeling misunderstood by friends and family and even avoiding interacting with them
  • Cycling through new friends quickly

Then it may be time to think about asking for professional help.

Do your children need help?

Children also experience mental and emotional distress, but their symptoms may come across differently than adults do. Here are some signs that a child could need professional help:

  • There are changes in grades and school performance
  • There are changes to their sleep schedules, their weight, their eating habits or other daily routines
  • They frequently seem worried or anxious
  • They withdrawal from family members and friends
  • They are suddenly fearful or may cling to you
  • They won’t talk about what’s bothering them
  • They’re having nightmares frequently
  • They show signs of obsessing over a particular goal, and seem convinced that goal is everything
  • They’re using drugs or alcohol
  • They exhibit cuts, bruises or other signs of self-harm
  • They’re showing signs of hyperactivity
  • They’re ignoring directions from adults, or even acting aggressively
  • They throw frequent temper tantrums
  • They frequently seek comfort

Is your friend or family member at risk of a mental health crisis?

 If someone is suffering, the signs may be subtle, or they may be obvious. According to the American Foundation for Suicide Prevention, most people who die by suicide exhibit at least one or two signs. Things to look for include:  

  • Talk about killing themselves, feeling hopeless, having no reason to live, feeling like a burden, feeling trapped, experiencing pain that they can’t bear
  • Behaviors that could include an increase in the use of drugs and alcohol, searching for ways to die, withdrawal from activities, friends and family, giving away items they treasure, aggression, fatigue, sleeping too much or too little, saying goodbye
  • In addition, they could be experiencing any number of mental health symptoms and conditions, including depression, anxiety, loss of interest in activities they once loved, irritability, agitation, anger and more

If this sounds like someone you love, talk to them about it. Make it clear that you care. And encourage them to get help.

If you’re struggling with your mental health this winter, there are a number of actions you can take to try and feel better. For starters, read our checklist of “10 Ways to Help Your Mental Health.” Daily commitments to exercise more, get enough sleep and eat a healthy diet can make a big difference for some people.

But for those who are still suffering, it might be time to speak up and take action. Talk to your primary care provider, or make an appointment with a therapist or counselor. If you’re in crisis, call 988, or chat 988lifeline.org. Help is always available, but you need to be able to ask for it.