Anxiety, depression and other behavioral health conditions are serious. They require our attention as much as cancer, diabetes or a serious injury.

It’s easy for us to pretend it’s not happening, but ignoring mental health conditions is not an option, because they have a potential serious outcome. The National Institute of Mental Health reports that more than 90% of people who die from suicide have depression and other mental disorders, or a substance abuse disorder. Almost 46,000 people die by suicide in the U.S. every year.

Professionals in behavioral health care often refer to stigma. Nobody is embarrassed because they broke their leg. Few folks ask for apologies when it comes to a newly diagnosed disease like cancer.

But stigma with mental health exists. Talking about how we feel, inside and out, is not a “norm” in society, especially here in the Midwest where people have the mentality of “pulling yourself up by your own bootstraps.”

Farmers and ranchers especially deal with stressors such as bad weather, rising expenses, unfavorable commodity prices, uncertain government policies and debt. In communities like ours, we are blessed with connections with those around us. Yet too many people might feel alone in their struggle.

Warning Signs of Suicide

• Thinking, talking or writing about dying from suicide

• Developing a plan about attempting suicide

• Believing that death is the only solution to their problems

• Displaying depression, fatigue, anxiety, irritation, aggression or anger

• Holding onto feelings of humiliation, shame or hopelessness

• Withdrawing from relationships with family and friends

• Losing interest in things they usually enjoy

• Using alcohol or drugs

• Sleeping too much or too little

• Poor work or school performance

• Giving away things they own

How to help a friend or family member

If someone you care about — a friend or family member — seems to be displaying these signs, you can help. Research shows that directly asking someone if they are thinking about suicide in a compassionate and caring way is effective. It can open a meaningful, honest conversation that might save a life. Use these tips to ask the question sensitively and with sincerity:

• Be compassionate and respond with kindness.

• Allow the individual to express themselves in full.

• Actively listen. Be aware of their nonverbal cues as well as your own.

• Reaffirm that their concerns and pain are valid — and they are worthy of help and recovery.

• Be courageous and ask the question: “Are you thinking about suicide?”

If the person says “yes,” be sure to stay by their side and help ensure that person gets help. Learn more at Avera.org/AskTheQuestion.

Seeking Help

Your local primary care provider can help you or a family member with mental health concerns, and if needed, they can refer you to the right resources.

Another new national effort is the 988 Suicide and Crisis Lifeline. You — or anyone you know – can call or text this number 24/7/365 and speak to a qualified person who can listen and refer you to additional resources or whatever else you might need. Calls are confidential.

In a crisis situation, go to your nearest emergency department.

If you or a family member is dealing with any type of mental health issue or stress, you can also call the Avera Farm and Rural Stress Hotline at 800-691-4336 to talk to a mental health professional who can connect you to resources close to home.

Sometimes in the sunshine of a fall afternoon, when the chores are done and our evening is free, we can still feel like we’re under a dark cloud.

Let’s all remember that mental health is as vital as breathing or a heartbeat. We can focus on good connections, knowing any challenge can be overcome.

— Debbie Streier is regional president/CEO, Avera Marshall Regional Medical Center