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Dennis was sent back to the United States for psychiatric treatment. Through counseling and a period of medication, his physical and emotional problems leveled out.

Today, life isn't pain-free for Dennis. The back problem remains, and there's no guarantee he won't become depressed again. But he and Pat see the warning signs much more clearly now. Physical pain might mean there's something going on emotionally.

Dennis' illness might be an extreme example, but it fits Phillips's admonition to recognize when an unexplained condition interferes with normal life routines. It might be a symptom as simple as having chronic trouble getting to work on time or taking too many sick days.

When symptoms like these interfere with a normal routine, that's when you start to think a more serious condition needs to be looked into and treated, Phillips says.

Linda had been a single parent for twelve years before remarrying. The adjustment from being the single head of a household to sharing those responsibilities jolted her, though she didn't realize it immediately. Attending a new church and making new friends brought more stress.

One weekend pushed Linda over the edge. Her husband was away on a business trip, her daughter was home from college for the first time, and an intense rainstorm had flooded part of her house. When her daughter awakened her at midnight to tell her about a car problem, the dam broke.

"I had a hot feeling. It started at the top of my head and went all the way to my toes, and it tingled," she remembers. "I didn't know if something was shutting down inside or what. I tried to stay calm and not scare my daughter, and I think that aggravated it."

Linda was experiencing a panic attack. Hyperventilating, she was rushed to the hospital. "I thought they were going to open up my chest and pull my heart out and pump it," she says.

Emergency room doctors told Linda there was nothing physically wrong. But the experience sounded an alarm for her and her husband: She needed psychological help.

"It put me into the shock of asking, 'What am I doing to myself internally from all the stress I wear on the outside?" she says. "I guess I'm one of those people who doesn't want to admit that it is depression. But I believe it was probably there a lot longer than when I first acknowledged it."

Not everyone with a mental illness receives an indicator as unmistakable as a panic attack, but Phillips mentions other signs. Simple discouragement isn't necessarily clinical depression, but watch closely if it's paired with physical symptoms, such as insomnia, appetite change, weight loss or gain, drop in energy level, or change in sex drive, for more than a couple of weeks.

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