Psychiatrists Share The Symptoms That Told Them A Patient Wasn't Doing Well
Nik Shuliahin on Unsplash

Therapy is a must for everyone in life. We need to make it accessible worldwide.

Why is mental health not considered not as important as physical health?

Maybe if everyone could afford to be in weekly care, we'd have a person looking over us who can call out the signs when we're falling apart.

And then maybe we'd all be a little happier and a little safer.

Redditor Downtown_Put8673wanted the mental health workers out there to please share with us signs to be looking for, they asked:

"Psychiatrists, what made you realize that the person was not doing well?"


The following contains material that can be triggering and not suitable for minors.

'flight to health'

"I can teach you guys about the 'flight to health' that happens after someone survives a suicide attempt. You’ll talk to them, and they have all these genuine plans to make their life better. They’re enthusiastic and ready to get out of the hospital to start their new life."

"They’re going to quit their horrible job, love their family more, etc etc. I am always incredibly worried for these patients because soon the depression slowly brings them down again. It’s hard because convincing these people that they still need a lot of help is difficult because they’re completely genuine." ~ UptownShenanigans

Let's Talk Sleep

"Serious answer: I've worked both inpatient and outpatient. It truly is rewarding to see your care plan help someone. First time I meet them, I go through a whole history, physical, and review of systems and symptoms (psych symptoms). I get people that genuinely start crying . Usually sleep pattern disturbance is a big indicator."

"Adhedonia is the hallmark sign of depression. It is a loss in pleasure in things that you use to enjoy. Like gardening or video games. There are suicide warning signs, such as giving personal belongings away. There are so many signs for different illnesses."

"Such as bipolar, I'll get a man who is spending his rent check or having risky and unsafe sex. It truly is interesting and rewarding. Very subjective." ~ TonyNevada1

I should’ve charged him...

"I knew my psychiatrist wasn’t doing well when he spent the whole 15 minutes pacing the room, complaining how his ideas were not taken seriously by the other doctors at the hospital unit he headed. It was pretty surreal and hilarious - I just let him vent because he seem to need it. I should’ve charged him." ~ peuxcequeveuxpax

Nice Lady

"When I told my therapist the events that led to my marriage, she kinda muttered under her breath 'dude…' So I stopped telling the story to acknowledge her reaction and she apologized. At which point I joked with her, 'aren’t you ethically required to not do that?' Funny thing was that was what made me realize I needed to change my approach, more than anything we discussed. Nice lady, she helped out a bunch." ~ Arsene3000

Too Happy

"Not a psychiatrist but my close friend is an LCSW. She always tells me that 'marked improvement in a short time without any root cause' is a huge red flag. For example, if a clinically depressed patient suddenly starts seeming incredibly happy for no reason, it's a sign that something is wrong." ~ MadameBurner

We're all falling apart. Don't think you're alone.

Speak Up

"Psych nurse here. I had a friend who was never happy, she was in ok moods, could laugh and all that, but she rarely voiced positive emotions. Had a history of past suicide attempts, so she was a friend we always checked on and kept her close with us The week before her suicide, she became extremely happy and giddy, she behaved like she had never done before, before her life got ruined thanks to some events i won't discuss."

"I saw this and voiced my concerns, I knew it was a sign that a suicide attempt was coming. This behaviour is typical on patients who are planning to end it (in most cases). This time we dint get to her in time. We miss her dearly. I married someone with BPD and I know the signs when she isn't well, but thankfully i can act before stuff happens and she has not attempted on her life or harmed herself in 2 years." ~ thatdudefromPR

I'm not haunted...

"After seeing my psych for almost a year, finding out that no, I'm not haunted, it's just the PTSD and anxiety, and a bunch of other revelations, I had an appointment where I told her that for the last month I'd been happier than ever. I was walking on sunshine and for the first time in 15 years I'd gone a week without any suicidal thoughts, food issues, self harm urges, or anxiety attacks."

"At this, she urged me to immediately set up talk therapy and schedule all my appointments ahead while I had energy. She saw that uptick as the red flag it was, but I didn't listen to her. Now 8 months later I've called her one time, barely shower or eat, and I'm back at my worst mentally. (It's fine though I'm used to it)." ~ ImprovSalesmansWitch

Things to Notice

"I'm a psychotherapist not a psychiatrist. I notice a client getting worse if their sleep or eating habits change, anhedonia, trouble with concentration/focus when there wasn't an issue before, or they start to socially withdraw. Huge red flags if they start to give away personal items and all of a sudden feel 'happy.' It takes a while to get severely depressed, etc and it'll take a while to feel better. These huge red flags indicate suicidal thoughts and possible planning." ~ psychness

Not Doing Well...

"As a mainly inpatient psychiatrist, I already know before I see them that they aren’t doing well just by nature of them being admitted. When I see folks in the ER and am determining if they need admission in the first place, it depends. Not doing well because they are manic looks much different than not doing well because they are depressed vs not doing well because they’re psychotic, etc." ~ housetowilson


"Not a psychiatrist but a therapist. When a person has a hard time understanding that their self-destructive behaviors are effecting themselves and their loved ones. To me, that’s an indication that something else is/was going on. Trauma, addiction, etc." ~ abin-sur

“feel better”

"I’ll never forget what someone said to me. He was talking about how he works out to meditate and help his body cope with the issues he has. He was a counselor and said that even though he feels better at the gym the problem is still there. Going to the gym didn’t solve the problem. It helped him get ready to face it. We can be given the tools to fight it but we still have to deal with it. So many people are given the 'feel better' but don’t know how to deal with the feeling of confronting the issue. We all have challenges the best we can do is prepare for what we can and know we can do it. There are lots of options to solve problems the right way." ~ clevernamehere123


"Patient here: When I mentioned I dismantled every object in my house that had screws, she thought I might be just tad bit manic. She was right." ~ Local64bithero


"I'm not a psychiatrist but I do have a masters in clinical psychology and worked in the mental health field for 10 years before I had to switch careers."

"1-Anytime somebody describes themselves as 'lazy' I almost immediately know they're probably experiencing anhedonia or some other mental health symptom."

"2-A lot of people underestimate how bad their mental health is. People often think others have it worse and think theyre somehow taken away from people who need the help?"

"3-They say they haven't had any energy lately."

"There's more but I'm tired." ~ NerdyHussy

The Quiet

"I did home-based therapy because she was too depressed to get out of bed. Some sessions we just sat in silence." ~ Catflappy

"My brother had a session where him and the therapist just sat in silence and after that he wanted to cancel the therapy out of shame. The therapist talked him out of it luckily." ~ elibright1


"I’m working on my PhD in psychology, so not a psychiatrist. At the beginning of the pandemic I started working with a kid over telehealth. Her parents wanted her to do therapy for depression. She was pretty hard to work with over video because she would take a while to respond to what I was saying and sometimes I would have to repeat myself. She would also start randomly smiling/laughing at whatever was on her screen."

"I figured she was messing around on the computer during our sessions until one day I saw that she was looking at herself in the video call. From that and the disorganized thinking, my supervisor and I figured out she had psychosis. Parents wouldn’t listen and she had a full blown psychotic episode that led to a multiple week hospitalization. Poor kid was completely lost to her delusions and hallucinations with her parents more concerned about her not being able to do her schoolwork." ~ megaspark90

Read out Loud

"I was the patient. Before our first meeting, she asked me to write her an email summarizing the concerns I had that led me to seek help. Upon arriving, I asked if she’d read it yet, and expressed concern that I was overreacting, making too much of very little, and wasting her time. I was even a bit embarrassed."

"She had read it, and I was informed that based upon my description of what led me there, a huge part of my problem was I’d slowly, over time, allowed myself to be convinced that everything I was enduring was normal, when in fact, it was highly abusive, in the emotional sense."

"That revelation was huge, when I realized addressing what I needed to face and overcome was much larger than I’d ever imagined, and just how much doing what I needed to do was going to hurt, and that it was going to hurt for a long time. I say all that to say, if anyone is wondering if they really need help, or if they’re just mentally overreacting, in either case, it certainly wouldn’t hurt to seek out a professional you’re comfortable with, and get some feedback." ~ ArmyOfDog

I’m still here...

"I had to tell my psychiatrist recently that I found an old friend in the cemetery (visiting my dad who passed unexpectedly.) He told me he can’t go there because he would recognize too many names. The man has been with me over ten years, has seen me through a lot and is one of the reasons I’m still here. I always figured I needed plenty of help though." ~ PublicThis

Different Personalities

"I've worked in psychiatry as an MD, but not a psychiatrist. Sometimes you can have a polite, friendly conversation with someone who seem normal. Then you talk about a specific topic and an enormous system of delusions unravels. Then you're like 'CRAP' and it makes sense why they are admitted. Then there are the obvious ones crying, hallucinating, etc. People most often are very honest and want the help, so it's quite obvious what the problem is and that they are not doing well. :) " ~ Dysp-_-


"As a patient, about halfway through my first session with a psychologist she stopped me to ask if I was medicated and what I was prescribed... I was not, and the look of disbelief and tentative concern was both an amusing and 'damn, I really AM broken' moment lol."

"PS: still not medicated and I know I'm not broken. :) " ~ mcfeet

Like ME!

"Not a mental health professional, the patient, hi. I swear I saw the light bulb go off in my therapists head when I admitted in our second session that I'd cried for 2 hours after our first session because I was convinced she hated me for being so selfish. Turns out she didn't hate me, wild." ~ SaxAndViolince

Mental health workers are also miracle workers. We should pay them more. Speak up. Get help.

If you or someone you know is struggling, you can contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

To find help outside the United States, the International Association for Suicide Prevention has resources available at

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