One in five adults, about 43 million people, experience mental health issues in a given year, the National Mental Health Institutes says.

The consequences of not getting help are severe. NAMI says that people with mental illnesses face an increased risk of treatable chronic health conditions, and adults in the U.S. with mental illness die an average 25 years earlier than others.

Those consequences also include death. Suicide is the 10th leading cause of death in the U.S. More than 90% of children who die by suicide have a mental health condition, and every day, around 20 veterans die by suicide. Keep reading to learn more about the signs it’s time to get help.

Understanding Mental Health Crises

A mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others, NAMI says. Some warning signs of a mental health crisis include:

• An inability to perform daily tasks like bathing, brushing teeth or hair, changing clothes.

• Rapid mood swings, an increased energy level, inability to stay still, suddenly depressed or withdrawn, or suddenly happy or calm after a period of depression.

• Increased agitation, verbal threats, violent, out-of-control behavior.

• Abusive behavior to themselves or others.

• Isolation from work, school, family or friends.

• Loss of touch with reality, including being unable to recognize family or friends, confusion, strange ideas and not understanding what people are saying.

Risk of Suicide

People who attempt suicide usually feel overwhelming emotional pain, frustration, loneliness, worthlessness, guilt, rage or hopelessness, according to NAMI. Social isolation is a common feeling, with people with mental illnesses feeling like no one cares if they live or die.

Any mention of suicide should be taken seriously. Common warning signs of suicide include:

• Giving away possessions.

• Talking as if they’re saying goodbye.

• Taking steps to tie up loose ends, like organizing personal papers or paying off debts.

• Making or changing a will.

• Stockpiling pills.

• Getting a weapon.

• Preoccupation with death.

• Sudden cheerfulness or calm after a period of despondency.

• Withdrawal from friends, family and normal activity.

If you think that someone is thinking about suicide, start the conversation. Start off by saying what signs you’ve noticed. Then be frank, and ask if you’ve been thinking about suicide. If the answer is yes, call a therapist immediately. Take away any potential means of action by removing weapons and medications. Call the National Suicide Prevention line at 800-273-8255.

Focus on being understanding, caring and nonjudgmental.

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