When to Seek Help: Recognizing the Signs

If someone is in immediate danger, call 911. If you are thinking about death or suicide, call or text 988, the Suicide & Crisis Lifeline. It is free, confidential, and open 24/7. You can also text HOME to 741741 for the Crisis Text Line. Our crisis page lists the county psychiatric emergency screening centers for Middlesex and Camden counties.

You do not need a diagnosis, or a breaking point, to ask for help. The bar is lower than most people set it. If something has changed, it has lasted a couple of weeks or more, and it is getting in the way of work, school, sleep, or the people around you, that is enough reason to talk to a professional. Sorting out whether it is a disorder is the clinician's job, not yours.

"Other people have it worse" is a common way people talk themselves out of a first call. It does not change the answer. Struggling does not have to be justified by comparison.

Signs that are worth a call

None of these alone means something is wrong. Several of them together, lasting two weeks or more, usually means it is time to talk to someone:

• Feeling down, empty, or hopeless most of the day, most days
• Losing interest in things you used to enjoy
• Sleeping far more or less than usual, or waking up exhausted
• Appetite or weight changes you did not intend
• Worry or dread that will not switch off
• Irritability or anger that feels out of proportion
• Pulling away from friends, family, or activities
• Falling behind at work, at school, or at home
• Relying on alcohol or other substances to get through the day

Signs that do not wait

Thoughts of death or suicide, or feeling like a burden, as if others would be better off without you, are a reason to reach out now. Use the numbers at the top of this page. You do not need to be sure how serious it is before you call or text 988. If someone may act on those thoughts now, or has already been hurt, call 911.

Find the guide that matches what you are seeing

A general list like the one above is a starting point. The guides below go into the specific signs for each situation, and each one explains where to get help in New Jersey.

Low mood that has not lifted. Our depression guide walks through the diagnostic line clinicians use: five or more of nine symptoms during the same two-week period, with at least one being depressed mood or loss of interest. It also has a side-by-side table of a hard stretch and major depression.

Worry you cannot shut off. The anxiety disorders guide explains why clinicians look at how long the worry has lasted, how hard it is to control, and what it is costing you, and how the four common types differ.

After a baby. The postpartum guide explains the two-week line between the baby blues and postpartum depression or anxiety. Postpartum psychosis is a medical emergency. If someone who recently gave birth is seeing or hearing things that are not there, holding strange or paranoid beliefs, or talking as if they mean to harm themselves or the baby, call 911.

A child or teenager. Ordinary teenage moodiness and a warning sign can look alike at first. What separates them is usually what the behavior does over time. The child and teen guide has a table of both. For a youth crisis that is urgent but not life-threatening, New Jersey's Mobile Response teams are reached through PerformCare at 1-877-652-7624, 24 hours a day.

Someone else who will not go. If you have noticed changes in a partner, parent, or friend, start by describing what you have seen rather than naming a diagnosis. "I have noticed you have not seemed like yourself lately, and I care about you. How are you doing?" If they are not open to help, our guide for when someone you love will not get help covers what tends to work and what backfires.

Once you have decided to call

For most people the first call is a therapist. Our guide to the difference between a therapist, a psychologist, and a psychiatrist explains when it is someone else. The guide to finding a therapist and our local resources page cover the next step in Middlesex and Camden counties. If part of the hesitation is not knowing what you would be walking into, read what a first therapy session is like. And if you are wondering how much support you might need, the levels of mental health care guide lays out the options.