If any of the following persists longer than two weeks:
- Restlessness and agitation
- Feelings of worthlessness and guilt
- Lack of enthusiasm and motivation
- Fatigue or lack of energy
- Difficulty concentrating
- Thoughts of death or suicide
- Sadness or hopelessness
- Irritability, anger, or hostility
- Tearfulness or frequent crying
- Withdrawal from friends and family
- Loss of interest in activities
- Changes in eating or sleeping habits
Immediate referral is warranted if someone is aggressive, suicidal, is abusing drugs or alcohol, or there has been an extreme change in behavior.