We all have our bad days, but when those bad days happen more often than the good ones, it is time to start paying attention. It could be a sign that you or a loved one is depressed. You may want to reach out with a voice of concern, comfort, and support if you notice any of the following signs and symptoms. Change in appetite. There can be either increases or decreases in appetite with depression. Also, watch for unexplained weight changes. If you notice you or a loved one is losing or gaining weight without trying to, it could be due to changes in eating habits. Change in interests. Sometimes life gets busy and it can be challenging to find time to fit fun things into our day to day. Not enjoying activities like we used to, however, can be a sign of a depressed mood. Decreased concentration and/or forgetfulness. Depression not only brings down mood, it can make it hard to focus. You may find your loved one seems distractible or tends to forget things more often. Isolation. People tend to withdraw from social situations when they are depressed. Has your loved one stopped going out? Stopped calling you on the phone? Stopped using social media, if they did before? Fatigue/lethargy. Decreased energy can be a sign of many things, including stress and poor sleep. These can also be signs associated with depression. Depression physically and emotionally wears us out. Irritability. Even the sweetest, nicest person can get snippy when they are depressed. If you see a trend of bad moods, not just someone having a bad day, take notice. Substance use. Some people turn to alcohol or even drugs as a way to dull their emotional pain. Has your loved one increased his drinking? Has she upped drug use or dependence on prescriptions? You may want to ask yourself why. The first step is to recognize there could be a problem. It can be hard to see the symptoms in ourselves. When someone points concerns out to you, it can be more evident. Sometimes when people see how they are affecting those around them they are more prone to take action. Awareness is key. By reaching out and simply asking, “How are you feeling?” or asking gently, “You seem a little irritable lately, is everything OK?”, you could begin an important conversation. By offering to talk with, “I may not be going through everything you are right now but I can listen”, you could offer an outlet to seek the help. Pulling away from someone who is maybe a little harder to get along with because of their depressive symptoms could make things worse. As a family physician, I have evaluated and treated many people with depression who have had all, some or even none of these symptoms. I encourage people to reach out to their loved ones if you think they could be depressed. The truth is, they may not reach out for help themselves. Compassion without judgment may be the thing that gets them the care need. I cannot assist them as a medical provider until the problem is brought to my attention. On the front lines, you are the one who may make the biggest difference.