Appendixes are known for causing trouble. While these tube-shaped sacs are usually harmless, an infected appendix can disrupt an otherwise functioning system and if ignored for too long, take a life. Mental illnesses such as depression can be dangerous as well, often going untreated for months, years, or even lifetimes. Failing to acknowledge the significance of this condition will only make matters worse. Ignorance isn’t bliss in the case of a burst appendix, or when it comes to the mental health of those we care about. With rates of depression at an all-time high, it’s imperative that we check in on our loved ones on a consistent basis.

Appendicitis is often characterized by intense cramping in the right side of the abdomen. While pain isn’t typically ignored, patients will often attribute their cramps to a stomach flu or not eating enough. When my 12-year-old sister began to show signs of emotional distress a few years ago, I tried to rationalize. “Maybe she’s not getting enough sleep,” I argued. “She’ll be fine in a day or two.” But as days turned into weeks, Lauren continued to spiral downwards; her friends came by less often, and her grades began to take an unsatisfactory turn. Cramps aren’t always merely cramps. Some problems don’t fix themselves.

Slowly but surely, others began to notice Lauren’s decline. One night at the dining table, my parents decided to intervene. Like a doctor about to give the “you have appendicitis” speech, my dad shot a glance at my mom and mustered the courage to speak.

“So we noticed that you’ve been… scratching yourself.” Obviously “scratching” was a euphemism– deliberate phrasing for self-harm, intended to take all the awkward and taboo and scary out of the situation. I sat in conflicted silence as my sister brushed them off, as if to say, “No, doctor, I won’t be needing that surgery. My appendix just needs some time to recover.” I can’t be sure whether my parents believed her dismissive response. But the nightly dinner table discussions that followed gave no mention to the “scratching” or the depression that persisted.

My sister’s mental state continued to deteriorate over the next few months. Her self-harming persisted, as did my denial. While I understood the severity of Lauren’s circumstances, I was afraid that confrontation would drive my sister away. My parents avoided the issue as well, still feeling bruised from their failed intervention at our dinner table. Looking back, I realize that we had prioritized my family’s comfort over Lauren’s mental stability and safety.

When appendicitis isn’t properly dealt with, the sac becomes so inflamed that it bursts, inflicting enough damage to threaten someone’s life. In spite of the many signs, I failed to anticipate my sister’s impending rupture. Our family was heading to a dinner party one night; Lauren wanted to stay home.

“Are you leaving too?” The question seemed heavy, as if she were forcibly weighing it down. I ignored the desperation in her voice and left, thinking surely that night wouldn’t be any different from the others. She’d managed for this long, right? What would one more night do?

But there was a burst.

“I’m gonna need you to set the knife on the kitchen counter. Can you do that for me?” My father’s voice was steady and flat, as if he’d been temporarily possessed by Siri. But Siri couldn’t have talked my sister out of attempting suicide that night. I sat in the backseat of our worn-down Honda Civic with my heart pounding and hands shaking. “If only I’d stayed at home,” I thought. But deep down I knew that my being there wouldn’t have changed anything; we should have addressed Lauren’s depression before the damage had been done.

While the bursting of an appendix can be deadly, some patients can still recover. The police escorted Lauren to a mental institution; she eventually made a full recovery. Unfortunately, this can’t be said of everyone who suffers from a mental illness. Many people fail to check in on their loved ones due to the awkwardness it may entail. Others think that the emotional state of someone else isn’t their business, and should be left alone. While privacy should certainly be respected, addressing a concern doesn’t have to be intrusive. Sometimes even a “how have you been doing” is enough to make a difference.

Appendicitis itself doesn't cause fatalities; the removal of an appendix is a fairly simple surgery if done before a rupture has occurred. Had my family confronted Lauren and sought professional help when she first showed signs of distress, her depression could have been better managed. We need to change the way that depression is viewed by both individuals and society; staying silent only leads to a deadlier burst. I feel that we owe it to those who are suffering to put forth our best efforts, and address this problem before it explodes.