How do you know when it’s “just the blues," or when it’s something more serious, like depression? And how do you even begin the process of getting better?

The constant uncertainty and stress of the pandemic, the upheaval of routines, loss of self-care opportunities, and the news (climate change, the war in Ukraine, the recent mass shootings in Buffalo and Uvalde) is enough to spiral the heartiest of us into depression and keep us there. If you’re concerned about your mental health or that of a loved one, you’re not alone. Mental health problems have been on the rise.

Blue Cross and Blue Shield of North Carolina medical director Dr. Ish Bhalla said there are some signs of depression to be looking for.

“Life has been hard for all of us the past two years,” he said. “But there comes a point when you have to ask yourself, is this just part of the human experience, or is this something that would benefit from medical treatment?”

He pointed to these classic symptoms of depression:

• Changes in sleep (sleeping too much or too little).
  
• Changes in appetite (eating too much or not enough).
• Changes in mood; irritability.
• Loss of interest in activities you once enjoyed.
• Low energy; persistent fatigue.
• If you’re experiencing these symptoms, it may be time to reach out for help.

“The first step, once you persistently recognize one or more of these symptoms in yourself, is to talk to someone you trust,” Dr. Bhalla said.

That could be your primary care provider, a counselor through your house of worship, a therapist, or even a close friend or family member with a medical background, Dr. Bhalla said.

After you’ve talked to someone you trust, the next step is to get help from a medical professional who can make sure you are otherwise healthy, and who can prescribe medication if that is deemed appropriate. Some conditions, such as low Vitamin D levels, anemia, or hypothyroidism can mimic depression – it’s important to get these or other conditions ruled out.

It’s often easiest and most comfortable to reach out to your primary care doctor at first, but they may recommend that you see a psychiatrist, which is a physician that specializes in mental health.

Your doctor will go over options with you such as starting an antidepressant, starting therapy, or a combination of the two.

If you’re looking for a therapist, we've got some tips to get you started.

If you are concerned about seeing someone in-person during the pandemic, many mental health providers are still offering virtual therapy.

Until you take those first three steps, you may not even feel like making progress on your own. You know how it is when you need to lose weight, and you see those first few pounds come off, then you really get into it? It’s sort of like that. Once you start feeling a little better, you’ll be very eager to feel “normal” again.

It could be doing things like exercising, getting outside in the sunshine, reaching out to an old friend (even when you don’t feel like being social), asking for help where you need it (the house, the kids, etc.) so that you have more space to take care of yourself. There’s no one-size-fits-all for recovery.

If you find the news is too heavy or triggering for you right now, take a break. You can stay informed without having to read all of the upsetting details.

You might start to feel better and think – I don’t need this medication; it’s a pain to remember to take. I don’t need therapy; it’s expensive and time-consuming. I don’t need my house cleaned; it’s annoying to pick up this mess for the housecleaner. And so on and so forth. This strategy may work for a while, but something inevitably will happen that knocks down this house of cards.

When you feel better – fantastic! Keep up the good work and don’t stop! Life will throw you curveballs, but if you are putting in the work of taking care of yourself, you’ll better be able to handle it.

The good news is that depression is treatable. The heartbreaking news is that untreated depression can be deadly. If you’re unsure if you’re just “feeling down” or if it’s clinical depression, reach out to someone you trust today.