Stress and uncertainty are part of life, but when they begin to affect how you sleep, work, connect with others or enjoy the things you normally do, it may be time to pay closer attention to your mental health.

Many people are juggling competing demands — from work and family responsibilities to financial pressures, health concerns and major life changes. For parents, balancing the needs of children with the demands of work and everyday life can add another layer of stress.

Anxiety, depression and other mental health concerns are very common, and recognizing the signs early can make it easier to get support.

When is it time to seek help? Behavioral health therapists at Novant Health’s Forsyth Medical Center Emergency Room shared their expertise on healthy coping strategies and how to recognize when someone may need mental health support.

What are signs of anxiety? *

• You worry — a lot. Your mind keeps jumping to what could go wrong.
• You can’t switch off. You feel restless, tense or constantly on edge.
• You’re avoiding things. You skip places, people or activities because they make you anxious.
• Your body is reacting. You notice a racing heart, tight muscles, stomach problems or trouble sleeping.
• You’re having trouble concentrating. Your worries make it hard to focus on everyday tasks.
• It’s getting in the way. Anxiety is affecting your work, relationships, sleep or ability to enjoy life.

What are signs of depression? *

• You feel down or empty. And the feeling sticks around.
• You’ve lost interest. Things you normally enjoy don't feel enjoyable anymore.
• You’re exhausted. Even everyday activities can feel like a lot of work.
• Your sleep or appetite has changed. You’re sleeping or eating noticeably more or less than usual.
• You’re pulling away. You’re spending less time with friends, family or activities you care about.
• You’re feeling hopeless. You’re struggling with feelings of worthlessness or wondering whether life is worth living.

*These signs don’t necessarily mean you have an anxiety disorder or depression. But if symptoms persist or begin interfering with your daily life, it’s worth talking with a health care professional.

What are healthy ways to cope when I'm overwhelmed?

• Stay physically active. Walking, stretching, dancing, yoga or other forms of exercise can help reduce stress and support mood.
• Keep a regular sleep schedule. Aim for consistent bedtimes and wake times, and create a calming wind-down routine.
• Eat regular, balanced meals. Nutritious foods and regular meals can help support energy and overall well-being.
• Practice slow, deep breathing. Intentional breathing can help calm the body's stress response when anxiety starts to build.
• Try mindfulness or meditation. Even a few minutes of focusing on the present moment can help quiet racing thoughts.
• Stay connected. Spend time with people who make you feel supported, whether that's in person, by phone or through a video call.
• Do something you enjoy. Music, reading, hobbies, time outdoors or other enjoyable activities can provide a healthy mental break.
• Break overwhelming tasks into smaller steps. Focusing on one manageable task at a time can make challenges feel less daunting. For example, if cleaning your house is overwhelming, make a goal to clean just one 4-foot section at a time.
• Limit alcohol and avoid recreational drugs. They may temporarily change how you feel but can worsen anxiety, depression and sleep over time.
• Pay attention to your thoughts. Notice negative or anxious thought patterns without automatically accepting them as facts.
• Spend time outdoors. Getting outside, especially while moving your body, can provide a change of scenery and a mental reset.
• Set healthy boundaries. Give yourself permission to say no and protect time for rest and activities that matter to you.
• Keep a routine. Regular times for sleeping, eating, working and relaxing can provide structure when life feels unsettled.
• Ask for help. Talk with a trusted friend, family member, primary care clinician or mental health professional if you're struggling.
• Know when it's more than stress. If anxiety or depression is interfering with daily life, relationships, work or your ability to care for yourself, it's time to seek professional support.

How can I tell if a friend of loved one may be experiencing anxiety or depression?

Watch for a change in behavior, in the pattern of how a person typically acts. If it’s your child, for instance, you might notice a decline in their school grades, they could be acting out, maybe they’re not socializing as much or are withdrawing from friends and family. With adults, you might notice increased drinking or a change in mood. Perhaps they’re angry more often or acting withdrawn.

Looking out for symptoms of depression —including feelings of sadness, emptiness or hopelessness, as well loss of interest in most or all normal activities — is critical when it comes to supporting the people around you. Around 720,000 people die by suicide annually, according to the World Health Organization. While depression may require long-term treatment, suicides are preventable and showing your support for someone who is going through a tough time can save lives.

What’s the best way to support someone who is experiencing anxiety or depression?

Don’t minimize people’s feelings. Don’t be dismissive. You want to acknowledge what they’re feeling and empathize with them. Say, "I can understand why you feel that way." But also acknowledge that there is a brighter side, they can feel better and create an action plan together.

It’s important to keep in mind that everyone is different. Approaching family members or loved ones can be a challenge, especially when folks aren’t receptive to a suggestion to get help.

Have a calm conversation. Do not bring it up in a time that’s heated, or a moment of passion where people may get angry. Wait until they calm down and say, "Hey, can we talk about this?" And suggest they call a help line or schedule an appointment to speak with someone. Let them know there are resources to help. Try to be there for them and show support in a way that they can receive it.

For children, talk with your pediatrician about getting a mental health assessment. Ask their teacher questions about their behavior and overall demeanor. It’s important to speak to the adults around them.

How is Novant Health helping patients be proactive about their mental health?

Anytime a patient comes in for an annual visit, such as a physical, primary care or OB-GYN appointment, they answer a series of questions about depression. This depression screening, known as PHQ-9, is an important tool that we use to gauge people’s mental health. It gives us a good idea as health care professionals to know if someone should be referred to a behavioral health therapist and we have a real sense that it has saved lives.