"I'm fine," "It's nothing," "Everything's great."

Have you ever had a friend tell you these things and wonder if they're true? Something in their facial expression, body language, or tone of voice tickles the back of your brain and makes you think there might be more going on than they're admitting.

But who are you to second guess, right? If there were something they wanted you to know, they'd tell you – wouldn't they?

Knowing when someone needs help can be challenging. Most people don't want to ask for help or admit they're struggling, so they stay silent and try not to let on that they need more than usual.

However, it's often when people are suffering silently that they need help the most. Does this pose a problem, though? How can you help if someone tells you there's nothing wrong?

Seeing the Signs of Suffering

As we go through the busyness of our daily lives, it can be easy to accept that everyone around us is doing okay blindly. No matter what they're dealing with, most people will tell you everything's fine. Great, right? Onward you go.

Most of us, however, can usually sense when something's off. The challenge is that something being off might be as small as having missed their morning coffee or as large as feeling hopeless and depressed.

So, how do you know if they need a friend or a shot of espresso?

Admittedly, it can be tough to tell, and your sensitivity to someone's masked pain can vary greatly depending upon how well you know them. There are, however, some tell-tale clues that can help you decide whether to push a little harder or leave things alone.

If any of the signs below stand out, something is likely going on.

• Their demeanor has changed. If you regularly interact with someone, you know what's generally expected for them and what's not. If they usually greet you with a smile and now it's a half-raised cheek and downcast eyes, something's wrong. Or, if they seem moody or angry in ways that are outside what you've experienced from them in the past, you should take notice.
• Their appearance has changed – for the worse. When people make an effort to look well, it's generally a positive sign. The opposite is true when they seem to stop making an effort at all. Neglect of regular grooming is a sign there's a problem.
• They seem distracted. If the person that greets you with a smile suddenly doesn't seem to see you at all or see anyone for that matter, it would be a good idea to know if they're doing okay.
• They're withdrawn. People who suddenly seem to disengage from being social or even just talkative have something on their minds. What that something is maybe good or bad, but the change in their behavior should prompt further investigation.

If you've noticed a common theme to the signs above, you do not imagine it. If you didn't, then, I'd be clear – it's change.

When people change for positive or growth purposes, it's great. But negative changes like those above can be signs of suffering.

How to Start the Helping Process

Depending on how close you are with the person you're concerned about, offering help or support can feel awkward. But know that, depending upon how you approach things, it will likely seem like kindness from their perspective. So, consider the following tips if you feel someone could use your support.

• Approach things gently. If someone is dealing with something heavy, then pouncing on them with a barrage of demanding questions, accusatory observations, or a know-it-all attitude won't help. Even if it's not serious, that approach won't help. Instead, consider gentle questions like, "How are you doing – really?", "Is everything in your world going okay?", or "Are things good with you?" These may not get someone to talk initially, but they're opening a door and showing genuine interest.
• Follow-up with what you've noticed to explain your interest. Now that you've opened the door, you can explain why you're asking. "You don't seem like yourself these days," "I've noticed a change in you," or "It seems like something is weighing on you."
• Now you listen – if they want to talk.
• Leave the door open if they don't. Opening up to someone is hard for many people. There's a fair chance that your efforts won't result in an in-depth conversation right away, but letting them know that you're available if they'd like to talk in the future may.

Of course, it's not a given that your efforts will be appreciated. Not everyone reacts well to uninvited attention, even if it's with the best of intentions. So, be prepared to respect their space and not take it personally if the person you're concerned about doesn't thank you for your interest.

As an empathetic and caring human being, showing concern for someone who seems to be troubled can feel like personal responsibility. It's just the right thing to do.
In the best-case scenario, the person about whom you're concerned will be at minimum comforted by the idea that someone cared enough to show interest genuinely. However, the worst case is that you open Pandora's box and unwittingly become their best friend or 24/7 lifeline by asking.
When you want to help someone, it can be very easy for boundaries to blur. It can also be easy to overlook, considering boundaries at all before you engage. However, boundaries are crucial to establish for the person you're helping and for yourself.

In the end, though, being able to help someone who needs it is the best part of humanity. You'd want someone to be there if you needed it or if someone you love needs it. So, with the proper boundaries in mind, offering to help someone suffering is worth the effort.