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Licensed Clinical Social Worker Jenn MacMaster offers advice on how to recognize mental stress in your friends and loved ones during the holiday season. Nashville Tennessean

As depression, anxiety, drug use and thoughts of suicide soar, experts share some things to look for in those close to us — and what we should do to help

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Depression, anxiety, drug abuse and thoughts of suicide are up during the pandemic. And it's no wonder.

There's fear of a potentially fatal virus that has no cure. There are people out of work because of economic devastation from COVID-19.

And there are restrictions on gathering that leave many feeling lonely and isolated.

But how many people are struggling with mental health? Nearly half of the adults in the U.S. 

A federal government study in June revealed about 40% — two of five people — said they were struggling with mental health or substance use. The same study showed 11% seriously considered suicide this year. 

"While we’ve been very appropriately focused on the virus," said Vanderbilt psychiatrist Abhi Saxena, "almost everything we've done to try to protect ourselves on that front has affected our mental health."

The Tennessean got in touch with several of the Nashville area's top mental health experts to ask how we can tell if loved ones are struggling.

Warning signs

Big swings in personality or behavior

Is your boisterous outgoing cousin suddenly quiet? Is your laid back best friend suddenly seeking to be the center of attention?

Sudden, chronic irritability and sadness and anger also are signs something's wrong, experts said.

And be aware of loved ones who suddenly start getting into thrill seeking or start taking big risks.

RELATED: COVID-19 stress isn't taking a break for the holidays: How experts say you should cope

Conversely, some people lose interest in activities they love, like hobbies or exercise or going to church.

"They'll suddenly say, 'Eh, I don't feel like it," said Dr. Lloyda Williamson, chair of psychiatry and behavioral sciences at Meharry Medical College.

In short, "are they their regular self?" said Saxena, medical director for hospital services for Vanderbilt Behavioral Health. 

"How far are they off baseline?"

Changes in eating or sleeping

Watch for big swings in weight either way, experts said.

And look and listen for loved ones who talk about staying in bed half the day or those who say they're barely getting any sleep, experts said.

Heavy drinking or drug use

These can be the most destructive and easiest to detect among unhealthy behaviors.

Many who are in recovery for substance abuse are in danger of relapsing, a sure sign something's wrong, said psychotherapist Jenn MacMaster.

What to do

Listen, like, with your mouth closed

When we hear a loved one might be struggling, we sometimes get scared and want to jump in and fix things right away, experts said.

The best thing to do is to be a great listener. If a loved one says something that concerns you, stay calm.

Take that person on a walk or to a quiet spot away from others, Williamson said.

And listen with your full attention.

Suicide warning signs: this three-minute video from online resource Psych Hub, "What is a Mental Health Crisis? How to Support Someone In Need."

► If someone is in danger of hurting themselves or others, call 911.

► Nashville's Crisis Treatment Center, 250 Cumberland Bend Drive, provides 24/7 treatment for mental health emergencies.

► Call Tennessee's mobile crisis services at 855-274-7471 for mental health emergencies.

► Call Tennessee Redline at 800-889-9789 24/7 for help with drug and alcohol addiction issues.

Reach Brad Schmitt at brad@tennessean.com or 615-259-8384 or on Twitter @bradschmitt.

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