Most people go through stretches of stress, sadness or poor sleep. Knowing when those experiences have moved beyond an ordinary rough patch is harder. There is no single test, but national public health agencies describe signs that suggest it may be time to reach out. This guide summarizes them for people in Bryan–College Station and across Texas. It cannot tell you whether you have a condition; only a qualified clinician can evaluate that.
SAMHSA, a federal mental health and substance use agency, puts it this way: it may be time to ask for help if you have had two or more weeks of changes in your thoughts, moods or body that make it hard to manage work, school, home or relationships. The two ideas to hold onto are duration and impact: how long something has lasted, and how much it is getting in the way of daily life.
SAMHSA's list of common signs includes feeling very worried, afraid, sad or down; being much more angry or irritated than normal; big mood changes, including highs and lows; feeling tired or low on energy; and feeling like you cannot manage everything you need to do in a day.
SAMHSA also lists signs related to thinking: thoughts that feel mixed up, trouble focusing or remembering things, thoughts that center on one thing you cannot get out of your head, and a sense that things are not real. Thoughts about suicide are on the list as well, and they call for support right away rather than waiting for an appointment. You can call or text 988 to talk with a trained counselor at any time of day or night.
Mental health can show up physically. SAMHSA lists times you felt sick and did not know why, such as headaches, stomachaches and aches and pains that keep coming back, along with changes in sleep and changes in eating. Behavior changes on its list include not taking care of yourself and facing consequences at work or in relationships because of changes in your mental health or substance use. Under connecting with people, it lists avoiding friends, family and social activities.
For young children, SAMHSA describes signs such as changes in how they are doing in school, too much worrying or anxiety, being unusually fearful and clingy, frequent nightmares, frequent temper tantrums and needing a great deal of comfort. For young people more broadly, SAMHSA lists trouble keeping up with daily tasks like going to school, not wanting to do things they usually enjoy, fighting a lot with family and friends, and feeling hopeless or numb.
Many people start with their primary care provider, which SAMHSA describes as a good place to begin. The National Institute of Mental Health (NIMH) adds that a primary care visit can include a first mental health screening, followed by a referral to a mental health professional. A psychiatric evaluation may make sense when you want a closer look at what is behind your symptoms, when you are wondering whether an earlier diagnosis still fits, or when you have questions about medication. Depending on the state, SAMHSA notes, psychiatrists and psychiatric nurse practitioners can prescribe for mental health conditions, and physician assistants, nurse practitioners and other doctors, including primary care providers, can prescribe for many conditions, such as depression and anxiety.
In College Station, Ruhwell Med offers psychiatric evaluations and medication management by video for children, teens and adults. Its About page lists Maria Baig, PA-C, as its psychiatric clinician and Almas Baig, MD, as the Medical Director and supervising physician. The practice frames an evaluation as a conversation, not a test to pass or fail, and says no diagnosis is needed in advance.
Some situations should not wait for a scheduled visit. If you or someone else is thinking about suicide, talking about wanting to die, or is in danger, call or text 988 or call 911. NIMH describes the 988 Lifeline as providing 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Ruhwell Med's evaluation page is explicit that the practice provides outpatient care and is not a crisis service.
You do not need to be certain before asking. SAMHSA reminds readers that everyone needs help sometimes and that it is okay to need help. If you are not sure whether what you are feeling counts, that uncertainty is itself a reasonable thing to raise with a clinician. Bringing a few notes about what has changed, how long it has lasted and how it is affecting your life to a primary care provider or a psychiatric clinician is a sensible place to begin.
If you are noticing these signs in someone else, SAMHSA's suggestions include letting the person know you are concerned, reassuring them that you care, and helping them reach professional help. You do not have to have the right words. Showing up and staying with the conversation counts.
This article is general information, not medical advice. If you or someone you know is in crisis or thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 in an emergency.