It would likely come as no surprise to others that patients diagnosed with a life-threatening illness, such as pulmonary fibrosis (PF), have many intense emotions and valid fears associated with their disease. These emotions can manifest themselves in many different ways. For example, even the emotions associated with a positive medical appointment can physically impact a patient by keeping their mind from restful sleep. A patient might be busy thinking about whether or not something was missed in their appointment, or if they asked their specialist all the questions they wanted to, or what their next appointment might show. Lack of sleep due to emotions and fears is something that most patients have to deal with.

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There are several physical signs that may indicate you’re dealing with something more than just worrying or feeling sad. Below are four symptoms that might indicate depression, and if you are experiencing these regularly, it might be beneficial to seek professional help.

Loss of appetite
This is often a classic indicator that something is wrong. A sudden loss of appetite usually accompanies stress and anxiety, but  if the feeling persists, it’s important to address it. Being chronically under-oxygenated due to a lung disease does enough damage to your body, but avoiding food doesn’t give your body the fuel it needs to keep going. This should be especially concerning if you’re someone who usually eats well.

Turning inwards and avoiding previously enjoyed social activities
This can be common, as everyone needs their alone time. However, if suddenly you’re regularly canceling plans to spend time alone or you find yourself anxious in social situations, it’s important to seek professional help. It’s nearly impossible to face a chronic illness alone, and everyone needs support from his or her friends and family. Suddenly losing interest in activities can be an indicator of depression.

Trouble sleeping
This is a hard one because so many patients with PF lose out on sleep due to excessive thinking, worrying or even due to physical symptoms like a dry cough. However, if attempts to improve sleep are ineffective, it may be time to seek professional help.

Excessive crying
Some patients dealing with a lung disease are on steroids for the treatment of their symptoms, which can lead to excessive emotions and lots of tears. Based on other columns and social clips, this has been a shared experience among many patients. However, excessive crying without reason may be a cause for concern.

For those living with a life-threatening illness, seeking help is important for survival. Considering professional help is an important way to help with that emotional pain, especially if you are experiencing symptoms for prolonged periods of time. If you aren’t already connected with a social worker or some type of counselor, your doctor can make a referral and point you in the right direction.

MORE: The Realities of a Pulmonary Fibrosis Diagnosis

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