It is common for pALS to feel depressed around the time of diagnosis. For most pALS however, time helps to reduce depressive feelings. Caregivers can also suffer from feelings of depression or anxiety. How do you know when you need help in dealing with depression? First you should determine how long you have felt sad, down, or blue. If you feel this way only once in a while and it does not interfere with your daily activities like work, friendships, or self-care, then your feelings are probably not too concerning. However, if you or a loved one is sad, tearful or hopeless for most days over at least a 2-week period, then depression may be developing into a problem. Also, if feelings of sadness are accompanied by feelings of guilt, helplessness, thoughts of suicide, changes in sleep/appetite, or problems interacting with others, then you may need to seek help. There are many services available to address changes in mood, including supportive therapy, support groups, and medications. Sometimes caregivers think that a pALS is depressed, when they are actually tired, conserving energy, or feeling apathetic. Apathy refers to reduced interested in or motivation about certain things. Apathy can be common in ALS and does not mean that the person is depressed. Getting this clarified can be a relief to family members, who may worry that their loved one is suffering when in fact they may not be. Talking to your doctor may help you determine whether depression is present or not, and what forms of intervention are available to you.