Nobody’s perfect. And the stressors we all face on a regular basis can bring out the worst in pretty much everyone. But some people’s emotional turmoil runs a bit deeper than your average, everyday angst.

The National Alliance on Mental Illness estimates that 1 in 5 Americans lives with a mental health issue that can make their relationships, careers, and physical health feel a lot harder to handle. These issues include depression, anxiety, mood or personality disorders, as well as obsessive compulsive disorders, eating disorders, and addictions. Many of these problems crop up by age 24 and can affect people throughout adulthood. But the sooner you pick up on their symptoms, the better shot you have at managing them so they don’t steer the course of your life.

Worried you’re struggling with something more serious than stress? Here are 10 vital signs you may need to reach out for help.

1. Your sleep is out of whack. Difficulty falling or staying asleep, or sleeping way more than you usually do are prime signs your mental health may need a bit more attention, says psychiatrist and trauma specialist Sudhir Gadh, M.D. Sleep is one of our body’s most basic — and necessary — functions. So it makes sense that its soundness is a barometer of how OK our minds and bodies are.

Occasional restlessness is to be expected. But if you’ve felt for more than a week that you can’t wind down without prescription drugs, alcohol, or OTC sleep aids like melatonin, or you consistently struggle to get out of bed in the morning, Dr. Gadh points out your body is trying to tell you something.

2. Your interest in things you used to enjoy is totally flagging. “If you’re starting to not enjoy what you usually do, that may be a sign you’re dipping into depression or that your anxiety is getting the best of you,” Dr. Gadh says. Same goes for when you just aren’t feeling present or thrilled to be around people.

3. Your bar tab’s gone (way) up. Drinking more than you used to or reaching for other substances to quell the chaos in your mind are key signs something inside you is begging to be cared for, says Dr. Gadh. The downside of this approach to facing our problems, he adds, is that many substances can exacerbate mental disarray while doing nothing to resolve the initial problem.

4. Literally everything makes you ragey. If you’re over-focused on all the negative aspects of most people you know; lashing out at your partner, friends, family members, or coworkers more than usual; or if you’ve decided humanity is 100% horrible, there’s likely a deeper reason for this than the fact that everybody sucks.

Sure, increases in irritability, aggression, or swings in mood can be normal responses to some substances, a significant loss of adequate sleep, or a serious bout of low blood sugar (read: hanger). And yes, there are some people who are straight up annoying. But if you’ve eaten, slept enough, and aren’t otherwise intoxicated (or over-caffeinated) yet still find yourself regularly freaking out at almost everyone around you, this could indicate you’re struggling with a personality or mood disorder, says Dr. Gadh.

A heightened reactivity to minor frustrations combined with a history of volatile friendships and romances, for instance, is a hallmark of borderline personality disorder, while major shifts in excitability, energy levels, and aggressiveness toward others could be red flags for bipolar disorder.

5. You’re engulfed by shame and guilt. Still hung up on a nasty comment someone made about you months ago? Fretting that you’re the source of everyone else’s sadness or frustration? Convinced you’re a failure in some significant area of your life? If thoughts like these are a regular part of your inner life, this may mean, according to Dr. Gadh, that something more serious needs to be addressed.

“Excessive rumination — that coulda shoulda woulda thought process — or a preoccupation with everything you’re doing wrong in your life,” he adds, “indicates you’ve hit some kind of breaking point and need more support.”

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