• You cannot always tell when someone is struggling: A cheerful, social person may still be experiencing emotional distress privately.

• Small signs should not be dismissed: Withdrawal, repeated expressions of sadness or changes in behaviour can be reasons to check in and listen.

• Checking in can make a difference: Ask honest questions, listen without judgment and encourage professional help when someone needs more support.

Some people are the ones who keep everyone laughing.

They are the friend who cracks jokes in the group chat, organises outings, checks on everyone else and somehow always seems to have the energy to make other people feel better.

So when they say, “I’m fine,” we believe them.

But according to Dr. Maame Afua M.Dzifa Kpodo- Tay appearances can be misleading. Someone can be cheerful, social and constantly making other people happy while still struggling emotionally.

That is why, she says, we need to become more intentional about checking on the people around us.

“Because honestly, you notice that a lot of people who commit suicide usually is the very bubbly person who tries to make everybody happy,” Dr. Dzifa said.

Her point is not that every cheerful person is secretly struggling. Rather, we should not assume that we can always tell what someone is going through simply by looking at them.

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Here are five reasons we need to check on each other more.

Mental health struggles do not always have an obvious appearance.

A person can show up for work, attend social events, joke with friends and still be dealing with intense emotional distress privately.

Dr. Dzifa said this is one of the reasons people should pay attention to their friends rather than assuming that everything is fine because they appear happy.

“It is so difficult to know who wants to kill themselves and who is that strong,” she said.

The World Health Organization similarly notes that warning signs can sometimes be difficult to recognise. Changes in mood, withdrawal, expressions of hopelessness or talking about ending one’s life are among signs that should be taken seriously.

That does not mean we should become suspicious of every change in someone’s personality. It simply means we should be willing to notice when a friend does not seem like themselves.

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Sometimes the signs do not come as a dramatic announcement.

It could be the friend who suddenly stops attending outings. Someone who no longer answers calls as often. A person who repeatedly says they are sad but everyone has become so accustomed to hearing it that nobody asks what is really happening.

Dr. Dzifa recalled her own experience with a friend who frequently said she was sad.

“Personally, I’m even embarrassed because I have a friend who would always come and always be doing, ‘I’m sad, I’m sad.’ I’m like, ah, she’s an energy drainer,” she said.

But the friend later told her that she had been thinking about suicide.

That experience changed the way she viewed such comments.

It is easy to become frustrated when someone repeatedly talks about being unhappy, especially when you do not know how to help. But repeatedly expressing sadness or withdrawing from normal activities should not automatically be dismissed as attention-seeking or negativity.

It may be a reason to pause and ask, “What is really going on?”

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For many people, admitting that they are struggling emotionally can feel like admitting weakness.

“We shouldn’t bottle things,” she said, adding that people should be able to say when they are angry, hurt, sad or overwhelmed. “We should normalise speaking about our emotions.”

That can start with everyday conversations.

Instead of automatically responding to “I’m tired” with “We are all tired,” we can sometimes ask, “Tired from what?”

Instead of brushing off “I’m sad,” we can ask, “Do you want to talk about it?”

And instead of assuming that someone will eventually get over it, we can let them know that they do not have to pretend to be okay around us.

Creating that kind of environment matters because talking about suicide does not cause someone to become suicidal. WHO says asking someone directly about suicide can actually reduce anxiety and help the person feel understood.

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You do not always need the perfect words. Sometimes, it can simply be a phone call.

Dr. Dzifa encouraged people to make checking on their friends a habit.

“Sometimes just call your friend and ask them, how are you? Are you happy?” she said.

That question may seem simple, but it gives the other person an opportunity to say more if they want to.

And if they do open up, listening can be more important than immediately trying to solve the problem.

WHO recommends finding an appropriate time and quiet place to talk, listening without judgment, encouraging professional help and continuing to check in.

If someone tells you they are thinking about suicide, take them seriously. Encourage them to get professional help and, if they appear to be in immediate danger, do not leave them alone while help is being arranged.

This is an important part of looking after someone who is struggling.

You can care deeply about your friend without becoming their therapist.

Dr. Dzifa said supporting someone experiencing depression or serious emotional distress can also affect the person trying to help.

“Sometimes trying to help a depressed person can depress you,” she said.

That is why people should know their limits and encourage professional support when necessary.

“But when the person says this and you think you are not strong enough to handle it,” she said, you should not feel that you have to carry everything alone.

“Let’s understand that mental health is a specialty and leave it to the specialists.”

Support can take different forms. You can listen. You can check in. You can encourage your friend to speak to a mental health professional. If possible, you can accompany them to an appointment or help them access care.

But you do not have to solve everything yourself.

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Dr. Dzifa’s message ultimately goes beyond suicide prevention.

It is about creating relationships where people feel comfortable enough to say, “I’m struggling,” “I’m hurt,” “I’m angry,” or simply, “I’m not okay.”

And it works both ways.

While checking on your friends, learn to speak about your own emotions too.

Do not wait until someone looks visibly distressed before asking how they are doing. Send the message. Make the call. Ask the extra question. And when someone answers honestly, listen.

Because sometimes, the person who is always asking everyone else, “Are you okay?” may need someone to ask them the same question.

And sometimes, you may never know how much that simple question meant.