May is mental health awareness month. The stigma surrounding mental health and mental illness illness can result in people being critical, fearful, judgmental and generally dismissive of those suffering from a mental disorder. Such stigma causes many people to attempt to hide their mental concerns and thus often avoid treatment or be unwilling to take medication.

NAMI, the National Alliance of Mental Illness lists the following symptoms that you may notice in friends and close relatives.

Excessive worrying or fear

Feeling excessively sad or low

Confused thinking or problems concentrating and learning

Extreme mood changes, including uncontrollable “highs” or feelings of euphoria

Prolonged or strong feelings of irritability or anger

Avoiding friends and social activities

Difficulties understanding or relating to other people

Changes in sleeping habits or feeling tired and low energy

Changes in eating habits such as increased hunger or lack of appetite

Changes in sex drive

Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)

Inability to perceive changes in one’s own feelings, behavior or personality, lack of insight

Abuse of substances like alcohol or drugs

Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”)

Thinking about suicide

Inability to carry out daily activities or handle daily problems and stress

An intense fear of weight gain or concern with appearance

Mental health conditions can also begin to develop in young children. Because they’re still learning how to identify and talk about thoughts and emotions, their most obvious symptoms are behavioral. Symptoms in children may include the following:

Changes in school performance

Excessive worry or anxiety, for instance fighting to avoid bed or school

Hyperactive behavior

Frequent nightmares

Frequent disobedience or aggression

Frequent temper tantrums

Failing to get help can have disastrous results including suicidal thoughts, attempts and death by suicide.

Talented and successful University of Pennsylvania freshman, Madison Holleran took her life in 20014. Madison, like many young people presented a very different view of her life on Instagram than the reality of how she was actually feeling.

After the death of their daughter, her family has made it their purpose to help others know that “It’s OK to not be OK. It’s OK to show people you’re not OK.”

One criticism of the reporting of this powerful story is that her suicide method is described thus risking others to copy.

National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

So, if someone you love shows signs that they are struggling please help them find help even when they tell you that everything is fine. Be open minded when listening to their concerns. Remember if “they could just buck up” they would.