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COURTESY PHOTO Hard Conversations A top psychologist's advice on supporting those with mental health struggles A s the R.E.M. song goes, "Everybody hurts sometimes." But how can you know if someone you love is just feeling down, or if they're struggling on a deeper, more serious level? And what should you do if they are? Del Mar-based licensed clinical psychologist Dr. Richard Levak explains the distinction between normal bouts of sadness and something more severe. "Depression and anxiety are very common human responses to stress and loss," says Levak. "It's normal after those events to feel a period of sadness, withdrawal, or to experience less pleasure in life, [but] that usually should pass over time, and you get better. Longstanding depression, where it just gets worse and worse and you give up the will to live, is a much more serious condition." Levak advises of three things you can do if you suspect someone's circumstances may be growing more serious. e first is simply to pay attention and be available. Second, look for changes in behavior. Are they losing weight? Have they given up doing things they've enjoyed in the past? And finally, don't be afraid to reach out. "You just want to get them to open up and talk," he says. is third step comes with it the need to have difficult, and sometimes unthinkable, conversations. Levak understands the complicated emotional circumstances surrounding mental health, not just for the one who's hurting but also for those around them who are looking to help, and the hesitancy to address it head-on. "It's not easy," he acknowledges, but if you suspect someone you care about is having thoughts that might lead to self-harm, asking the cursory, "Are you OK?" isn't enough. "You want to be able to get into a conversation that's supportive," he says, even when it means pushing through your own discomfort. "One of the things that people are afraid of is that, if they go up and talk to a person who appears really sad or depressed or anxious, in a way, it's invading their privacy, but that is actually the right thing to do," says Levak. "Don't be afraid if you feel someone is suffering, just to go to them and say, 'Hey, can we talk? I've been worried about you lately.'" If their responses or actions trigger concern that things are beyond the boundaries of regular sadness, it's important to press on, as uncomfortable as it may be. "If it feels like they are going to hurt themselves, if it feels that severe, it is absolutely OK to say, 'Do you sometimes feel it would almost be a relief for life to be over?'" advises Levak. "is is what's really important. People are afraid that to ask that might be giving them the idea, planting a seed. But that's not what's happening." Harder still, but even more important, is asking if they have any plans to act on any thoughts of self-harm. "Because if they have a plan, they are more likely to do it," warns Levak. If the answer is yes, it's time to call 911 or the Suicide & Crisis Lifeline at 988 immediately. Finally, remember to be persistent and present for someone in crisis. "When someone is that defeated and demoralized, they just can't see anything as being hopeful," says Levak. "e most important thing is to give them a little hope." DEANNA MURPHY If you or someone you care about is struggling with depression or having thoughts of self-harm, please call the 24-hour Suicide & Crisis Lifeline at 988. Dr. Richard Levak Focus health ranchandcoast.com 48 MAY 2025 RANCH & COAST MAGAZINE