Ms McHugh, 25, had just moved from northern NSW to the Hunter for university when she started seeing changes in her behaviour, including pulling back and becoming much more reserved.

A friend in her tutorials noticed and asked her to go to the beach.

"While we were there she just said 'Mate, what the hell is going on?'" Ms McHugh said.

"She followed through, everything that R U OK is about, holding that connection, asking and actually listening to what I had to say.

"She was able to direct me to find a counsellor and I've been in counselling ever since.

"Between [her and my now husband] just saying 'It's okay to be feeling what you're feeling, but you don't need to be doing it by yourself and there is help and it's okay to seek that help' was the biggest step for me... had I not had that person have the guts to say something to me and to start that conversation I don't know that I would be here."

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The Largs woman is a community ambassador for R U OK Day, which is built around the importance of staying connected, having conversations that can help through difficult times and linking people with appropriate support before they are in crisis.

The campaign has four steps: asking if someone is okay, listening, encouraging action and checking in. Ms McHugh said it was important for those asking the question to ensure they were in a good headspace, to listen without judgement and not feel like they needed to have all the answers or fix or dismiss things.

She said those being asked may not want to share their story but it may be a prompt for them to share with others and receive help.

"Just releasing the fact you're not alright can be so empowering and so liberating ... admitting that to [yourself] and to someone else is really really hard so just be kind to yourself."

Ms McHugh grew up in a small town in a large family.

She was bullied at school and lost a lot of loved ones in her early teens.

She started experiencing depressive moods around 16.

"Because of where I lived and the outlook of what mental health was and the understanding of it, it was definitely not something I was able to be safe in speaking out about so I never had any counselling or assistance medically at that young age."

She moved to Newcastle at 18, had a falling out with some close family members and saw her symptoms "rapidly" worsen.

"That's when I started to really really get quite low and I was contemplating suicide and had a lot of intrusive thoughts, which are different to suicidal thoughts," she said.

"If I was out for a run or a walk and a bus or truck would be coming for me I'd be like 'I could just step out in front of that truck'.

"That's an intrusive thought because it's not premeditated and it's not thought through like a suicidal thought is."

Even with counselling she hit her lowest point a few years later. She had made a plan to end her life and "my now-husband was hiding my car keys and things like that to keep me safe".

She said that would have happened earlier without her university friend's intervention.

"It was constant connection with my family and them being supportive and listening to me and encouraging me to go and seek further medical support that was able to pull me through those times," she said.

"I wouldn't have had the experiences I've had now and been able to do the things I've been able to do the past couple of years had I cut my life short back then."

She said she had seen two young men in her extended family die by suicide.

"I was able to see the ripple effect on my family and the huge impact it has on the community and just being able to see that you go 'No-one is ever really alone', but how often do we know that, that all of these people do really care about us," she said.

"Between my own experiences and seeing that with the rest of my family, just talking about it and making it known how important connection is - it sounds sometimes like 'But we all connect everyday' but we don't really, not to the level that we need to - and the difference that makes to people's lives is absolutely astounding."

Ms McHugh said she saw a psychologist, psychiatrist and GP, who were working on a diagnosis. Medication means she is stable and well and able to work as a physiotherapist in neurology.

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