Overview

Mental illness covers a wide spectrum of conditions that affect children, teens, and adults. Almost one in five U.S. adults are diagnosed with a mental illness. Mental illness can be broadly separated into two categories: any mental illness and serious mental illness. Any mental illness covers all mental illnesses that have been recognized to date, whether that’s occasional depression or another behavioral, emotional, or mental condition that causes upset but can be dealt with without extreme intervention. Serious mental illness encompasses conditions that are more severe, including severe versions of things such as depression. These are behavioral, emotional, or mental conditions that cause serious functional impairment, interfering with one or more major life activities.

Common Mental Health Issues

Suicide

People struggling with suicidal ideation (thoughts) don’t usually kill themselves out of the blue. Instead, they often mentally prepare themselves for the moment, often keeping it secret. However, there are some signs to look for:

Verbal:

  • Feeling unbearable pain
  • Talking about killing themselves
  • Expressing hopelessness
  • Feeling like a burden to others
  • Feeling trapped

Behavioral:

  • Increasing use of alcohol or drugs
  • Looking for a way to kill themselves
  • Unexplained aggression
  • Being reckless
  • Giving away beloved possessions
  • Isolating behaviors

Mood:

  • Loss of interest in life
  • Depression
  • Feeling humiliated
  • Irritability
  • Anxiety

Stressful life events may push someone over the edge. They may have experienced prolonged stress at home, school, or work. They may also have access to a means of committing suicide (drugs or weapons).

Gambling

Not everybody gets addicted to gambling. But if you think you know someone who has gotten hooked, look for these signs:

  • Missing school, work, or other commitments because of a need to gamble
  • Gambling more than they intended
  • Hiding signs of gambling activity (betting slips or lottery tickets)
  • Always talking about gambling—it has become their lives
  • Being criticized by others for their gambling behavior
  • Spending more time or money on gambling than they can afford
  • Increasing their gambling to win back their losses
  • Gambling to escape problems at home or work, or to relieve boredom, depression, or anxiety
  • Selling things, stealing, or borrowing money to get money to gamble or to repay gambling debts
  • Developing financial difficulties after gambling away money intended for bills

Chemical/Alcohol Dependency

If someone you know is becoming dependent on alcohol or drugs, you’ll see several signs:

  • They need more and more of the substance or alcohol to get the same effect they used to get with a smaller dose
  • Even though they know their substance use is affecting their family or themselves psychologically and physically, they still keep using
  • They experience withdrawal symptoms if they stop using
  • They pull away from recreational or social activities they used to enjoy
  • They spend much of their time getting the substance, using it, and recovering from using

A few symptoms of dependence on alcohol or substances:

  • They get high or drunk regularly
  • They lie about how much they are using
  • They believe they need to drink or use to have fun

Eating Disorders

Someone suffering from an eating disorder (anorexia nervosa or bulimia nervosa) will avoid food for interpersonal, psychological, physiological, and/or cultural reasons.

Anorexia nervosa:

  • Refuse to maintain a minimally healthy body weight
  • Have an intense fear of weight gain
  • Females experience a loss of menstrual periods
  • Have a disturbed reaction to perception of their body weight

Bulimia nervosa:

  • Feel a lack of control over eating as they are eating
  • Eat an amount of food that is much larger than other people would eat in the same time period
  • Frequent compensatory behavior to prevent weight gain (self-induced vomiting, use of diuretics, laxatives, or excessive exercise)
  • Binge/purge recurs at least twice weekly for 3 months
  • Allows body shape and weight to influence self-evaluation
  • Bulimic disturbance doesn’t happen only during episodes of anorexia

Learning Disabilities

Reading disorders:

  • Reads below expected level for grade, age, or intelligence
  • Reads slowly and has difficulty understanding what they read
  • Have problems with word recognition, confusing words that look similar

Written expression disorder:

  • Difficulty with writing skills (understanding punctuation, grammar, spelling, paragraph organization, or composition of written information)
  • May have poor handwriting skills

Mathematics disorder

  • Has trouble with number skills (counting, adding, carrying numbers, copying numbers, learning multiplication tables, recognition of mathematical signs, and/or understanding mathematical operations)

Some of these learning disabilities can also be classified as or under Dyscalculia or Dyslexia. Learning disorders may be inherited or the child may have experienced troubles before birth, during birth, or in early infancy. Five percent of children enrolled in U.S. schools (K-12) have been diagnosed with some kind of learning disorder.

Depression

Depression is one of the best-known mental illness, but its symptoms aren’t always well understood:

  • Appetite or weight changes—Significant weight gain or loss (more than 5% of body weight) within one month
  • Feelings of hopelessness/helplessness—Bleak outlook, feeling as though nothing will improve their situation
  • Loss of energy—Feelings of fatigue or sluggishness
  • Loss of interest in daily activities—hobbies, sex, social activities, favorite pastimes
  • Sleep changes—Waking early with insomnia or oversleeping
  • Self-loathing—Strong feelings of guilt or worthlessness, harsh self-criticism
  • Anger or irritability—Feeling violent, agitated, or restless; low tolerance level, short temper, everyone/everything gets on their nerves
  • Reckless behavior—Using escapist behavior (substance abuse, reckless driving, compulsive gambling, dangerous sports)
  • Inability to concentrate, make decisions, or remember things

Anxiety and Stress Disorders

Too much stress or anxiety in a situation can indicate a problem.

Anxiety:

  • Difficulty controlling worry
  • Excessive anxiety/worry occurring more often than not (for several months)
  • Symptoms interfere with functioning (vocational, social, emotional)
  • Chronic stomach upset

Stress:

  • Too easily distracted
  • Feel unable to manage situation or stress effectively
  • Believe their problem is much bigger than they can cope with

While life hands out stress in the form of tough tests, financial burdens, tight deadlines, or caring for an ill loved one, it’s when the stress and anxiety overwhelm the person that it becomes a disorder. Recognizing that the person has crossed the line into a mental disorder is important but it may be difficult to do. While a person deals with stress, it can also contribute to the symptoms of anxiety.

PTSD

Post-traumatic stress disorder (PTSD) develops after a traumatic event, such as being threatened with serious danger. These events cause intense helplessness, horror, and fear.

  • Recurrent, intrusive memories of the event
  • Suddenly acting/feeling as though the event is happening again
  • Recurrent, distressing dreams about the event
  • Intense physical/emotional distress in events reminding person of their trauma
  • Avoiding things or places that remind them of the trauma
  • Avoiding thoughts/feelings about their trauma
  • Sense of a shorter future
  • Inability to remember something about the traumatic event
  • Lessened range of feelings
  • Loss of interest/participation in normal activities
  • Detachment or feeling apart from other people
  • Being hyper-alert in a normal situation

Grief

“Complicated grief” is an intense, persistent grief coinciding with dysfunctional behavior and maladaptive thoughts. The person has trouble adapting to their loss.

  • Dysfunctional behaviors
  • Avoiding reminders of their loss
  • May try to feel closer to the person lost via sensory stimulation, day dreaming, looking at pictures, smelling their clothes, or listening to their voice
  • Avoids people, places, or activities that remind them of their loss

Maladaptive thoughts:

  • Second-guessing the death of a loved one (often occurs when the death was unexpected, sudden, or untimely)
  • Wonder if they are grieving “the right way”
  • Dread the future without their loved one in it

Schizophrenia/Bipolar/Other Disorders

Schizophrenia is defined a breakdown in the connections between thought, emotion, and behavior. Here are some behaviors associated with this illness.

“Positive” symptoms (additional behaviors):

  • Delusions
  • Hallucinations
  • Thought disorders
  • Movement disorders

“Negative” symptoms (emotions, withdrawal, difficulty functioning):

  • Very little talking to others, even if important
  • Talking on a dull voice
  • Trouble planning and sticking to an activity
  • Showing no facial expressions
  • Trouble experiencing happiness (negative affect)

Cognitive:

  • Trouble paying attention
  • Difficulty processing information for decision-making

Those experiencing bipolar disorder often go through extreme emotional “highs” and “lows”.

Bipolar disorder (manic)

  • Inflated self-esteem
  • Indulging in pleasurable activities (buying too much, bad business moves, sexual indiscretion)
  • Less need for sleep
  • “Flight of ideas” (racing thoughts)

Hypomania:

  • Symptoms are similar to a manic episode

Major depressive episode:

  • Feels depressed most of the day, almost every day for at least two weeks
  • Recurrent thoughts of death, recurrent suicidal thoughts, no specific plan
  • Sharply diminished pleasure or interest in almost all daily activities

Autism

Autism displays with two core symptoms:

  • Restricted, repetitive behaviors
  • Social communication issues

These symptoms develop early in childhood, often going unrecognized. They can interfere with daily living and will persist through life.

Children can have difficulty with the following issues:

  • Facial expressions
  • Spoken language
  • Gestures
  • Expressions not intended to be taken literally
  • Eye contact
  • Tone of voice
  • Recognizing others’ intentions and emotions
  • Recognizing their own emotions
  • Expressing their emotions
  • Determining personal space
  • Seeking emotional comfort
  • Taking conversational turns
  • Feeling overwhelmed socially

Restricted, repetitive behaviors can include:

  • Need for a strict routine – resistant to change
  • Repetitive body movement (spinning, hand-flapping)
  • Narrow, extreme interests in specific topics (toy race cars)
  • Staring at spinning objects or lights
  • Ritualistic behaviors (touching items in a set order or lining them up)

Finding Support

When someone realizes that their loved one is showing worrisome signs of mental illness, they may not know where they can turn. They may also feel confused about how to support them.

Before lining up support services, the person should show their own love and support, and find out if their loved one is already getting help. If not, they should let them know help is available. If the question of mental health comes up, they can respond to their loved one, listen to their ideas, and offer to help them with daily tasks. It’s also vital to include them in family gatherings.

They should treat those who have mental health issues with dignity and compassion. They should also educate others, so they know what mental illness is and what it isn’t.

Finding support may be a challenge. If their loved one is suicidal, they can call the National Suicide Prevention Lifeline (1-800-273-8255). If the situation isn’t an emergency, they can schedule an appointment with the loved one’s primary healthcare provider or pediatrician. Find a services locator online for behavioral health providers. There are several, with resources for specific types of mental health issues.

Local Services

  • Crisis hotlines and warm lines
  • Crisis assistance listening line
  • Kid Talk, a warm line children can call for support
  • Local domestic violence shelter and hotline
  • Mobile crisis services
  • Narcotics Anonymous, where they can learn about a family member’s substance addiction
  • National Suicide Prevention Lifeline

Support Groups

Counseling:
These practices can address anger management for those who are struggling to moderate their expressions of anger. Counselors may also work with clients who struggle with anxiety, depression, and addiction to substances or alcohol.

Marriage & Family Therapy:
Private practice clinicians works with couples, individuals, and families throughout the lifespan. Specialties include anxiety, substance use/abuse, depression, child and family play therapy, and family therapy. Most practices rely on theoretical approaches.

Teenage Support Group:
The title is self-explanatory. A counselor will work with teens who are addressing school issues, anxiety, or depression.

Wellness Centers:
These establishments can offer comprehensive, integrated medical, psychological, and recreational services to students, employees, or community members.

Hospital/Facility Care

At times, hospitalization or in-patient facility care may be necessary. Facility care or hospitalization should be used when the person is a threat to themselves or others, or they are in active psychosis. Hospitalization in a psych ward also allows psychiatrists, psychologists, and other mental health professionals to create a discharge plan, any needed treatment plan, and sufficient support services for the person so they remain stable.

A residential facility is voluntary. Mental health personnel work with residents to help them to address their issues. Once the person is able to see family, they can explore any family relationships that may be causing problems.

Organizations

Judge Baker Children’s Center:
This organization is a Harvard Medical School-affiliated organization where children receive mental health services that help them increase their ability to function more normally in society. The Children’s Center is the oldest mental health organization in New England.

Mental Health America (MHA):
This organization is based in the community, helping to address the needs of the mentally ill and promoting better mental health. MHA believes that mental health is only one part of overall wellness. It treats mental health conditions before they become severe enough to cause individual suffering.

National Institute of Mental Health (NIMH):
This organization is one of 27 health institutes making up the National Institutes of Health. NIMH is focused on mental health research based on the understanding, treatment, and prevention of mental illness.

American Foundation for Suicide Prevention (AFSP):
This non-profit organization strives to save lives and offer hope to those who have been touched by suicide. With chapters in every state, its main strategies focus on education for mental health professionals and the public, and funding scientific research.

Emergency Care

Call Lines

Mental Health Hotline:
People with mental illnesses call out to mental crisis hotlines as they struggle with issues ranging from anxiety, PTSD, depression, bipolar disorder, and eating disorders. Whether the person has resources in their community or not, a hotline can help them to reach badly needed support in the midst of a crisis.

Lines for Life:
Available 24/7, this hotline offers anonymous and confidential support and assistance. Staff and volunteers provide assistance and compassionate support in-the-moment. They also refer callers to resources that can help them find the help they need.

Washington Recovery Help Line:
This hotline aids people who are struggling with substance abuse issues. It also offers crisis interventions and referrals to needed services for people within Washington State. Staff and volunteers offer emotional support 24/7. They also recommend local treatment resources to address substance abuse, mental health issues, and gambling issues.

The Veterans Administration Mental Health “Get Help” Line:
This help line offers confidential help to U.S. military veterans who are experiencing challenging mental health issues. Along with the Get Help line, the Veterans Crisis Line is available for vets who are in the midst of a crisis.

Emergency Rooms

Hospitals that treat patients with physical illnesses are being overwhelmed by people in the middle of a mental health crisis. If, for instance, they are in the middle of a panic attack, they may understandably think they are having a medical crisis, so they go to the emergency room.

The practice is called “psychiatric boarding”, which means that a mental health patient stays in the emergency room because of the lack of an appropriate mental health facility nearby. Mental health patients don’t always have sufficient resources to turn to in the midst of a mental health crisis.

Some communities do have psychiatric emergency rooms. They provide walk-in/emergent services to people with mental illness. They may provide crisis phone services 24/7, as well as evaluations of a patient’s current condition.

These emergency rooms are able to provide mental health referrals, crisis intervention, psychiatric evaluations, treatment recommendations, and screenings for inpatient psychiatric hospitalization.

Who Treats Mental Illness?

Psychiatrists

The medical professional with the most specialized knowledge to care for the mentally ill is the psychiatrist. They are MDs and may hold a Master of Public Health (MPH) degree with concentrations in a mental health discipline.

These doctors work closely with mental health patients, helping to deliver the services they so badly need. A psychiatrist focuses on their patient’s mind and emotions. They are able to prescribe medications while, in most states, psychologists cannot prescribe medications. Psychiatrists treat more serious mental illnesses (schizophrenia or major depression).

Psychologists

Psychologists are also mental health professionals. While they don’t hold an MD, they do possess the knowledge needed to help their clients. Like psychiatrists, psychologists provide psychotherapy (“talk” therapy). They also introduce clients to coping methods. Psychologists focus more on behaviors and thinking since they usually are not able to prescribe medications.

Someone with a Master of Social Work who has completed a concentration in mental health also has the knowledge to work with clients as psychiatric social workers or behavioral health clinicians. In their coursework, master’s social work students focus on advanced theory and research in mental health, trauma, and substance abuse. They also approach mental health assessments from a framework that takes bigotry and cultural bias into considerations as they develop diagnoses. Their treatment approach comes from a psychotherapy theoretical perspective (strengths/empowerment and solutions focused).

Counselors/Therapists

Counselors and therapists also help people with mental illnesses. This is a good starting point for children who are showing signs of suffering from a mental illness. These professionals begin treatments, identify clients who need mental health interventions, and provide referrals to other professionals.

Family counselors work with all family members who recognize a problem exists. One family member might be suffering from mental illness, but the whole family feels its effects. They coordinate care and help them get through a crisis.

Finding a Care Provider

People of any age may worry that they are experiencing mental health symptoms. If this happens, they may wonder about resources that may be able to help them. For children who have experienced a stressful event, symptoms of PTSD may show up. Asking for a referral from the pediatrician can lead to finding the right mental health professional.

Teens or young adults can talk to an adult they trust and explain what they are experiencing. The adult or a friend may have already noticed changes in the teen/young adult, wanting to refer them to a mental health professional.

If someone is worrying relentlessly about something, they may be developing an anxiety disorder. These can also present as panic attacks, which may cause the person to think they are seriously physically ill. Talking to their doctor may result in receiving a referral for mental health services.

Those Providing Prescriptions

PeerSpecialist

Therapists help guide clients through stressful events, helping them get to a place where they feel less overwhelmed. If the person has already been diagnosed with a mental health condition, they should see a psychiatrist or psychologist.

Psychologist

Psychologists offer ADHD evaluations, couples counseling, alcohol self-assessments, individual counseling, trauma support, and stress coping skills. In some states, they can also prescribe medications to help clients who are working on being able to function in various settings.

Psychiatrist

As an MD, a psychiatrist has full prescribing privileges for clients who must rely on psychotropic medications. They can assist patients by adjusting their medications or dosages as their needs change over time.

Nurse Psychotherapist

Nurses with advanced education and training can provide psychotherapy services to mental health clients. They may also perform hypnotherapy with the required training. The client’s family may participate in therapeutic services with nurse psychotherapists.