Sometimes people use the terms 'emotion' and 'feeling' interchangeably, but emotions are deeply felt feelings, not filtered through the thinking part of the brain. When someone is angry, most people easily recognise what is being communicated. People involved in healthcare come into daily contact with people who, to varying degrees, are distressed or suffering. This chapter provides information on how to recognise signs of acute distress and how to offer help. It can feel very difficult to be with an acutely distressed person. People show acute distress in different ways, but some common signs include: crying, screaming, agitation, shaking, inappropriate displays of emotion, disorientation, depersonalisation, regression, unexplained aggression and abusive behaviour. Other conditions that can result from extreme distress include panic attacks, disorientation and regression. It is important to remember that distress may, for some people, be underpinned by a mental health condition.