5. Alcohol/drugs.

Alcohol, whilst seemingly your friend, can ultimately end up causing more problems than it anaesthetises, and can be the first thing we turn to when in distress. Try non-alcoholic choices (there are some great options out there), alternate alcoholic drinks with soft drinks, and try alternative ways to relax – ‘special time’ with a lover is fantastic, as is meditation, and exercise. Many use therapy as their weekly ‘check-in’ to unravel the week’s challenges, and as a way of making sense of current difficulties.

6. Being on Medication.

Is your medication right for you? It could be worth talking to your GP if your despression isn’t easing up.

Medication is often described as being wrapped in cotton wool, and it doesn’t necessarily resolve matters, but can take the edge off. It can make some people feel worse. Therapy, on the other hand, will offer solutions for moving forwards meaningfully. Therapy has also been shown to have similar if not better effects than anti-depressants, and the effects last longer. But there can be a role for both, at times, and with proper medical supervision. But believe me, therapy is not the easy option, and does require at least some initial courage to get through the door.

7. Enjoyment.

Another sign of someone struggling is them taking less enjoyment in activities they once loved. Perhaps your friend no longer enjoys going out, or refuses to go to activities anymore? There is always a reason behind such change.

8. Irritability.

When we’re stressed or depressed, this can often affect our ability to be in a relationship with other people and can lead to greater irritability with people, especially loved ones. This is often unintentional. Rather than taking it personally, try to understand what the irritation is about, ask some questions, and remind them that, whilst you don’t want to be shouted at, you do care about them, and want to be able to help.

9. Promiscuity.

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Depression and anxiety can take their toll on the way we can put in boundaries, and we can end up making poor choices which we regret later. Whereas once we may have been only in monogamous relationships, we can begin to bring other people into relationships and use cottages and Public Sex Environments. Neither promotes intimacy. What they can do is lead to both the obvious risk of STDs and also a complete breakdown in relationships with others. This will ultimately not help. Again, therapy will support your friend and/or their partner in addressing this safely. What can also help is you being explicitly clear about expectations in the relationship – if you want monogamy, don’t compromise.

10. Preoccupation with Death.

Does your friend now talk about ending things more frequently (most of us joke about it at times)? Are they becoming more focused on a particular problem which is talked about repeatedly? Have they written a letter? Have they got a plan? When people start planning, they are potentially upping the ante. They need help, so get them some if they are unable to.

Above all, offer your friends some kindness and some interest. Do what you say you’re going to do. Be there. Treat people how you expect to be treated. Life can be rough for us all. Someone once said that growing older is not for the faint-hearted, and there is some truth to this. The best thing though is about making sure, wherever possible, you’re not doing it alone.