Written by Elevated Healing Clinical Team · Medically reviewed by Elevated Healing Clinical Team
Quick Answer
It’s not always obvious when a loved one’s struggles have reached the point of needing professional help. Knowing the warning signs — across behavior, mood, physical health, and daily functioning — can help families recognize when it’s time to act. This guide outlines signs that a loved one may need help for a mental health or substance use problem, and what to do.
One of the hardest things for families is knowing when a loved one’s struggles have crossed the line into needing professional help. It is not always obvious. Difficulties can develop gradually, be hidden or minimized, or be hard to distinguish from ordinary hard times. Families often sense something is wrong but are unsure whether, or when, it warrants action.
Knowing the warning signs — across behavior, mood, physical health, and daily functioning — can help families recognize when it may be time to act. This guide outlines signs that a loved one may need help for a mental health or substance use problem, and what to do with that recognition. The goal is not to alarm, but to equip families to notice meaningful signs and respond, since recognizing the need for help is often the first step toward a loved one getting it.
Changes in behavior are often among the more noticeable signs that a loved one may need help. These can include:
Behavioral changes can signal either a mental health condition, a substance use problem, or both. A pattern of such changes — especially withdrawal, secrecy, and neglected responsibilities — is worth taking seriously. Isolated instances may mean little, but a sustained shift in behavior, particularly away from connection and responsibility, is a meaningful sign that something may be wrong and worth attending to with care and concern.
Changes in mood and emotional state are another important category of warning signs. These can include persistent sadness, hopelessness, or low mood; increased anxiety, agitation, or irritability; dramatic mood swings; emotional numbness or flatness; or expressions of worthlessness, despair, or being overwhelmed. Significant, persistent changes in a loved one’s emotional state can indicate a mental health condition or significant distress.
It is worth paying particular attention to emotional signs because they can point to serious conditions and, in some cases, to safety concerns. Persistent hopelessness or despair, in particular, should be taken seriously. While everyone has emotional ups and downs, a sustained, significant change in mood or emotional functioning — especially toward despair, severe anxiety, or instability — is a meaningful sign that a loved one may be struggling with something that warrants help and attention.
Physical and functional changes can also signal that a loved one needs help. Physical signs might include changes in sleep or appetite, weight changes, decline in personal hygiene or appearance, or physical indications of substance use. Functional signs include declining performance at work or school, difficulty meeting daily responsibilities, and a general deterioration in how a person is managing life.
These signs reflect the way mental health and substance use problems often affect the body and a person’s ability to function. A noticeable decline in physical self-care or daily functioning, especially alongside behavioral and emotional changes, strengthens the picture that a loved one may be struggling significantly. When someone who once managed life well begins visibly struggling to do so — physically, or in meeting their responsibilities — it is a meaningful sign worth attending to, particularly as part of a broader pattern of concerning changes.
Some signs point more specifically toward a possible substance use problem. These can include changes in behavior and social circle, secrecy around activities, financial problems or unexplained money issues, physical signs, neglect of responsibilities tied to substance use, and continuing to use substances despite negative consequences. The hallmark of a substance use problem is often continued use despite the harm it is causing.
Substance use problems can be hidden, and signs may be subtle or attributed to other causes, so a pattern is more telling than any single sign. If a loved one shows signs of substance use that is causing problems in their life — and especially if it continues despite those problems — it suggests a substance use issue that may warrant help. Because substance use and mental health problems often co-occur, signs of one should prompt attention to the whole picture, not just the most visible problem.
Some signs are not just indications that help may be needed eventually, but signals that urgent help is needed now. Most importantly: any signs of suicidal thoughts, self-harm, or being a danger to oneself or others require immediate action. These include talking about wanting to die or having no reason to live, expressions of hopelessness combined with such talk, or any indication a person may harm themselves.
If you notice these signs, do not wait — seek help immediately. You can call or text 988 to reach the Suicide and Crisis Lifeline any time for guidance and support, including support for how to help your loved one, and call 911 in an emergency or if someone is in immediate danger. Urgent signs warrant an urgent response. While most warning signs call for thoughtful action over time, signs of immediate danger call for immediate help, and recognizing the difference is critically important for a loved one’s safety.
Recognizing the signs is the first step; the next is acting on them thoughtfully. This generally means approaching your loved one with care and concern, encouraging them toward help, and seeking guidance yourself on how to support them. Recognizing that a loved one needs help does not mean you must have all the answers — it means it is time to engage and seek support, for them and for you.
For situations beyond an urgent crisis, a thoughtful conversation, professional guidance, and connecting your loved one to appropriate help are the paths forward. If a more structured approach is needed and a loved one is resistant, professional guidance — rather than a confrontational intervention attempted alone — is wise. You do not have to navigate this alone; you can reach out for guidance on how to help. Recognizing the need for help, and then seeking support to act on it, is how families help a loved one toward getting the help they need.
Recognizing when a loved one needs help means noticing the warning signs — behavioral, emotional, physical and functional, and those pointing to substance use — and, crucially, recognizing urgent signs that need immediate help. A sustained pattern of concerning changes is a meaningful signal worth attending to, and recognizing it is often the first step toward a loved one getting help.
If you recognize these signs in someone you love and want guidance on how to help, you do not have to figure it out alone. You are welcome to reach out with questions, or explore our programs. And if you ever notice signs of suicidal thoughts or immediate danger, act now — call or text 988, or call 911 in an emergency.
Reach our admissions team for a free, confidential assessment — in Woodland Hills or by phone across California.
Get a Free AssessmentIt is not always obvious, since difficulties can develop gradually, be hidden or minimized, or be hard to distinguish from ordinary hard times. The key is to look for a sustained pattern of warning signs across several areas: behavioral (withdrawal, secrecy, neglected responsibilities, loss of interest, isolation), emotional (persistent low mood, hopelessness, anxiety, mood swings), physical and functional (changes in sleep, appetite, hygiene, or declining performance), and signs pointing to substance use. A pattern of concerning changes, especially away from connection and responsibility, is more telling than any single sign and is a meaningful signal that a loved one may need help worth attending to.
Behavioral changes are often among the more noticeable signs and can include withdrawal from family, friends, or valued activities; secrecy, dishonesty, or unexplained changes in routine or whereabouts; neglecting responsibilities at work, school, or home; loss of interest in things once enjoyed; changes in who they spend time with or increasing isolation; and behavior that seems out of character or concerning. These can signal a mental health condition, a substance use problem, or both. Isolated instances may mean little, but a sustained shift in behavior, particularly away from connection and responsibility, is a meaningful sign that something may be wrong and worth attending to with care.
Important emotional warning signs include persistent sadness, hopelessness, or low mood; increased anxiety, agitation, or irritability; dramatic mood swings; emotional numbness or flatness; or expressions of worthlessness, despair, or being overwhelmed. Significant, persistent changes in emotional state can indicate a mental health condition or significant distress. Emotional signs deserve particular attention because they can point to serious conditions and, in some cases, safety concerns — persistent hopelessness or despair especially should be taken seriously. While everyone has emotional ups and downs, a sustained, significant change in mood, especially toward despair, severe anxiety, or instability, is a meaningful sign a loved one may be struggling.
Signs pointing more specifically toward a possible substance use problem can include changes in behavior and social circle, secrecy around activities, financial problems or unexplained money issues, physical signs, neglect of responsibilities tied to substance use, and continuing to use substances despite negative consequences — the hallmark of a substance use problem is often continued use despite the harm it causes. Substance use problems can be hidden, with subtle signs attributed to other causes, so a pattern is more telling than any single sign. Because substance use and mental health problems often co-occur, signs of one should prompt attention to the whole picture, not just the most visible problem.
Any signs of suicidal thoughts, self-harm, or being a danger to oneself or others require immediate action — these are not just indications that help may be needed eventually but signals that urgent help is needed now. They include talking about wanting to die or having no reason to live, expressions of hopelessness combined with such talk, or any indication a person may harm themselves. If you notice these, do not wait — call or text 988 to reach the Suicide and Crisis Lifeline any time for guidance and support, and call 911 in an emergency or if someone is in immediate danger. Recognizing the difference between urgent signs and other warning signs is critically important for safety.
Recognizing the signs is the first step; the next is acting thoughtfully, which generally means approaching your loved one with care and concern, encouraging them toward help, and seeking guidance yourself on how to support them. Recognizing the need for help does not mean you must have all the answers — it means it is time to engage and seek support, for them and for you. For situations beyond an urgent crisis, a thoughtful conversation, professional guidance, and connecting your loved one to appropriate help are the paths forward. If a structured approach is needed and a loved one is resistant, professional guidance rather than a confrontational intervention attempted alone is wise.
Uncertainty is common, since difficulties can be gradual, hidden, or hard to distinguish from ordinary hard times. A helpful guide is to look for a sustained pattern across areas rather than a single sign, and to weigh whether the changes are significant and persistent. If you are concerned enough to wonder, that concern is itself worth acting on — you do not have to be certain to seek guidance. Reaching out for professional guidance can help you assess the situation and decide how to respond, without committing to anything drastic. It is reasonable to seek advice when worried about a loved one. If you ever notice signs of immediate danger, call 911, or call or text 988.
Medically reviewed by Elevated Healing Clinical Team
Clinical review for accuracy and compliance.
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