Symptoms

Signs and symptoms of mental illness can vary, depending on the particular disorder and other factors. Mental illness symptoms can affect emotions, thoughts and behaviors. Sometimes symptoms of a mental health disorder appear as physical problems.

Abnormal thinking, behavior and emotions
These types of mental illness signs and symptoms can include:

• Feeling sad or down
• Confused thinking
• Excessive fears or worries
• Withdrawal from friends and activities
• Problems sleeping
• Detachment from reality (delusions) or hallucinations
• Inability to cope with daily problems or stress
• Alcohol or drug abuse
• Significant changes in eating habits
• Sex drive changes
• Excessive anger, hostility or violence
• Suicidal thinking

Physical symptoms
Physical signs and symptoms of mental illness may include:

• Fatigue
• Back pain
• Chest pain
• Digestive problems
• Dry mouth
• Headache
• Sweating
• Weight gain or loss
• Rapid heart rate
• Dizziness

Is it mental illness?
Deciding when a symptom might mean you have a mental illness can be difficult. For instance, what's considered an excessive fear — for example a fear of spiders or of public speaking — can vary from person to person. And in some cultures and situations, certain behaviors or thoughts may be considered normal, while in other cultures and situations they may be considered abnormal.

In general, signs and symptoms may indicate a mental illness when they make you miserable and interfere with your ability to function in your daily life. You may have trouble coping with stress, anger or other emotions. Or you may find it difficult to handle family, work or school responsibilities.

With some types of mental illness, though, such as schizophrenia or bipolar disorder, you may not realize the extent of your problems — instead, it may be family members or friends who first become aware that you have a mental illness.

When to see a doctor
If you have any signs or symptoms of a mental illness, see your doctor, mental health provider or other health professional. Most mental illnesses don't improve on their own, and if untreated, a mental illness may get worse over time and cause significant problems.

If you have suicidal thoughts
Suicidal thoughts and behavior are common with some mental illnesses. If you think you may hurt yourself or attempt suicide, get help right away:

• Call 911 or your local emergency number immediately.
• Call a suicide hot line number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor.

If you're feeling suicidal but you aren't immediately thinking of hurting yourself:

• Reach out to a close friend or loved one — even though you may be reluctant to talk about your feelings.
• Seek help from your doctor, a mental health provider or other health care professional.
• Contact a minister, spiritual leader or someone in your faith community.
• Call a suicide hot line.

Helping a loved one
If you have a loved one who you think may have symptoms of mental illness, have an open and honest discussion with him or her about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You may even be able to go to an appointment with him or her. If you have a loved one who has harmed himself or herself, or is seriously considering doing so, take him or her to the hospital or call for emergency help.

Causes

There's no specific identifiable cause of mental illness. Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:

• Inherited traits. Mental illness is more common in people whose biological family members also have a mental illness. You may have a genetic vulnerability to developing a mental illness, and your life situation may trigger the actual mental illness if you're already at risk.
• Biological factors. In addition to inherited traits, outside forces can sometimes be linked to mental illness — for example, traumatic brain injury or exposure to viruses or toxins while in the womb.
• Life experiences. Challenging situations in your life, such as the loss of a loved one, financial problems and high stress, can play a role in triggering mental illness. Life experiences can also be a factor, such as an upbringing leading to poor self-esteem or a history of sexual or physical abuse. Life experiences can lead to unhealthy patterns of thinking linked to mental illness, such as pessimism or distorted ways of thinking.
• Brain chemistry. Known as biochemical causes, changes occurring in the brain are thought to affect mood and other aspects of mental health. Naturally occurring brain chemicals called neurotransmitters play a role in some mental illnesses. In some cases, hormonal imbalances affect mental health. It's thought that inherited traits, life experiences and biological factors can all affect brain chemistry linked to mental illnesses.

Risk factors

Although the precise cause of mental illness isn't known, certain factors may increase your risk of developing mental health problems, including:

• Having a biological relative, such as a parent or sibling, with a mental illness
• Experiences in the womb — for example, having a mother who was exposed to viruses or who had poor nutrition may be linked to schizophrenia
• Undergoing stressful life situations, such as financial problems, a loved one's death or a divorce
• Having a chronic medical condition, such as cancer
• Undergoing traumatic experiences, such as military combat or being assaulted
• Use of illegal drugs
• Being abused or neglected as a child
• Having few friends or few healthy relationships

Mental illness is common. About 1 in 4 adults has a mental illness in any given year. And nearly half of them have more than one mental illness at the same time. Mental illness can begin at any age, from childhood through later adult years.

Complications

Mental illness is a leading cause of disability. Aside from reducing your overall quality of life, untreated mental illness can cause severe emotional, behavioral and physical health problems. Mental illness can also cause legal and financial problems. Complications linked to mental illness include:

• Unhappiness and decreased enjoyment of life
• Family conflicts
• Relationship difficulties
• Social isolation
• Substance abuse
• Missed work or school, or other problems related to work or school
• Heart disease and other medical conditions
• Poverty
• Homelessness
• Suicide

Preparing for your appointment

You may decide to schedule an appointment with your primary care doctor to talk about mental health concerns. Or your doctor may ask about your mood, thoughts or behavior during a routine medical appointment.

Because mental illness often requires specialized care, your primary care doctor may refer you to a mental health provider, such as a psychiatrist, psychologist or other mental health provider.

What you can do
Being an active participant in your care is an important part of managing your mental illness. One way to do this is by preparing for your appointment. Write down a list of questions to ask. These may include:

• What type of mental illness might I have?
• Why can't I get over mental illness on my own?
• How do you treat my type of mental illness?
• Will counseling or psychotherapy help?
• Are there medications that might help?
• How long will treatment take?
• What can I do to help myself?
• Are there any brochures or other printed material that I can take home with me?
• What websites do you recommend?

In addition to the questions that you've prepared, don't hesitate to ask questions during your appointment if you don't understand something.

What to expect from your doctor
During your appointment, your doctor or mental health provider is likely to ask you a number of questions about your mood, thoughts and behavior. You may be asked such questions as:

• When did you first notice symptoms?
• How is your daily life affected by your symptoms?
• What treatment, if any, have you had for mental illness?
• What have you tried on your own to feel better or control your symptoms?
• What things make you feel worse?
• Have family members or friends commented on your mood or behavior?
• Do you have biological relatives with a mental illness?
• What do you hope to gain from treatment?
• What medications or over-the-counter herbs and supplements do you take?
• Do you drink alcohol or use illegal drugs?

Tests and diagnosis

Your doctor will try to rule out any physical problems that could be causing your symptoms, pinpoint a diagnosis and check for any related complications. These steps may include:

• Physical exam. This generally involves checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.
• Psychological exam. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You'll also discuss any thoughts you may have of suicide, self-harm or harming others. You may be asked to fill out a questionnaire to help pinpoint what's going on.
• Laboratory tests. These may include a check of your thyroid function or a screening for alcohol and drugs, for example. Often lab tests aren't necessary to diagnose a mental illness.

Pinpointing which mental illness you have
It can be difficult to determine which particular mental illness or mental illnesses may be causing your symptoms. For one thing, many mental illnesses share similar symptoms. Also, a diagnosis is often based largely on how you describe your symptoms, along with how your doctor interprets those symptoms. Because of this, it can take some time and effort to get an accurate diagnosis. Stick with it, though, so that you can get appropriate treatment for your particular illness and situation.

The defining symptoms for each mental illness are detailed in a book called "Diagnostic and Statistical Manual of Mental Disorders." This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

To be diagnosed with a particular mental illness, you must meet the criteria for that illness listed in the DSM. Mental illnesses are grouped in the DSM based on their symptoms. Doctors sometimes disagree about what's considered normal or abnormal mental health. The process of deciding what's a mental illness continues to evolve.

Classes of mental illness
The main classes of mental illness are:

• Mood disorders. These include disorders that affect how you feel emotionally. Examples include depression and bipolar disorder.
• Anxiety disorders. Anxiety is an emotion characterized by the anticipation of future danger or misfortune, accompanied by feeling ill at ease. Examples include panic disorder, obsessive-compulsive disorder, phobias and post-traumatic stress disorder.
• Substance-related disorders. These include problems associated with the misuse of alcohol and illegal or legal drugs.
• Disorders of detachment from reality (psychotic disorders). These disorders cause detachment from reality (delusions). The most notable example of this is schizophrenia, although other classes of disorders can be associated with detachment from reality at times.
• Disorders of thinking (cognitive disorders). These disorders affect your ability to think and reason. They include delirium, dementia and memory problems. Alzheimer's disease is an example of a cognitive disorder.
• Developmental disorders. This category covers a wide range of problems that usually begin in infancy, childhood or adolescence. They include autism, attention-deficit/hyperactivity disorder (ADHD) and learning disabilities. But just because they're all grouped in this category doesn't necessarily mean they share a common cause or require the same treatment.
• Personality disorders. A personality disorder is a characterized by a lasting pattern of emotional instability and unhealthy behavior that causes problems in your life and relationships. Examples include borderline personality disorder and antisocial personality disorder.
• Other disorders. These include disorders of impulse control, sleep, sexual functioning and eating. Also included are dissociative disorders, in which your sense of self is disrupted, and somatoform disorders, in which there are physical symptoms with no clear cause.

Treatment and drugs

Your treatment depends on your particular mental illness, its severity and your life situation. Often a team approach is appropriate to make sure all of your psychiatric, medical and social needs are met. This is especially important with severe mental illnesses, such as schizophrenia.

Treatment teams
The team involved in your treatment may include your:

• Family or primary care doctor
• Psychiatrist, a medical doctor who diagnoses and treats mental illnesses
• Psychotherapist, such as a psychologist or a licensed counselor
• Pharmacist
• Social workers
• Family members

If you have a mild mental illness and your symptoms are well controlled, you may need treatment from only your primary care doctor, a psychiatrist or a psychotherapist.

Treatment options
Numerous treatments for mental illnesses are available. The particular treatment or treatments you'll need depends on the type of mental illness you have, the severity of your symptoms, and what you and your doctor think will work best for you. In many cases, a combination of treatments works best.

Medications
Although psychiatric medications don't cure mental illness, they can often significantly improve symptoms, whether you have depression, schizophrenia, an anxiety disorder or another condition. Psychiatric medications can also help make other treatments, such as psychotherapy, more effective.

Here's an overview of some of the most commonly used classes of prescription psychiatric medications:

• Antidepressant medications. Antidepressants are used to treat various types of depression and sometimes other conditions. Antidepressants can help improve such symptoms as sadness, hopelessness, lack of energy, difficulty concentrating and lack of interest in activities. Antidepressants are grouped by how they affect brain chemistry, and a number of different types are available. The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and citalopram (Celexa). There also are numerous other types of antidepressants; the best one for you will depend on your particular situation and how your body responds to the medication.
• Mood-stabilizing medications. Mood stabilizers are most commonly used to treat bipolar disorder, which is characterized by alternating episodes of mania and depression. Mood-stabilizing medications include lithium (Lithobid), divalproex (Depakote), lamotrigine (Lamictal) and others. Sometimes mood-stabilizing medications are added to antidepressants to treat depression.
• Anti-anxiety medications. Anti-anxiety medications, as their name suggests, are used to treat anxiety disorders, such as generalized anxiety disorder and panic disorder. They may also be useful in helping reduce agitation and insomnia. These medications are typically fast acting, helping relieve symptoms in as little as 30 minutes. A major drawback, however, is that they have the potential to cause dependency. Anti-anxiety medications include alprazolam (Xanax), lorazepam (Ativan) and several others.
• Antipsychotic medications. Antipsychotic medications, also called neuroleptics, are typically used to treat psychotic disorders such as schizophrenia. Antipsychotic medications may also be used to treat bipolar disorders or added to antidepressants to treat depression. Antipsychotic medications include clozapine (Clozaril), olanzapine (Zyprexa) and others.

Psychotherapy
Psychotherapy is a general term for the process of treating mental illness by talking about your condition and related issues with a mental health provider. During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behavior. Using the insights and knowledge you gain in psychotherapy, you can learn coping and stress-management skills. Psychotherapy often can be successfully completed in a few months, but in some cases, long-term treatment may be helpful. Psychotherapy can take place one on one, in a group or along with family members.

There are many specific types of psychotherapy, each with its own approach to improving your mental well-being. The type of psychotherapy that's right for you depends on your individual situation. Examples of psychotherapies include cognitive behavioral therapy (CBT), interpersonal therapy (IPT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT).

Brain-stimulation treatments
Brain-stimulation treatments are sometimes used for depression and some other mental health disorders. They are generally reserved for situations in which medications and psychotherapy haven't worked. They include:

• Electroconvulsive therapy (ECT). Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through your brain, deliberately triggering a brief seizure. This seems to cause changes in brain chemistry that can quickly reduce symptoms of certain mental illnesses, such as depression. Because it can provide significant improvements in symptoms more quickly than psychotherapy or medications, ECT may be the best treatment option in certain situations. Deciding whether electroconvulsive therapy is a good option for you or a loved one can be difficult. ECT can cause a number of side effects. Make sure you understand all the pros and cons.
• Transcranial magnetic stimulation. This approach uses powerful magnets to stimulate cells in the parts of your brain linked to emotions. This appears to relieve depression symptoms in some people.
• Vagus nerve stimulation. This procedure uses a small, battery-powered device (pulse generator) implanted in your upper chest. It connects with a wire to a nerve in your neck that leads to the brain (the vagus nerve). The pulse generator periodically stimulates the vagus nerve. Electrical signals then travel up the vagus nerve to the brain. This is thought to help relieve depression by stimulating brain cells.
• Deep brain stimulation. With this procedure, a pulse generator located in your upper chest sends electrical stimulation via wires to areas deep in your brain. This is thought to affect parts of the brain linked to mood, easing depression symptoms. It may also be helpful for obsessive-compulsive disorder. Because it involves brain surgery and chest surgery, this is considered a last-resort treatment.

Hospitalization and residential treatment programs
Sometimes mental illness becomes so severe that you require psychiatric hospitalization. Hospitalization is generally recommended when you aren't able to care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric hospitalization options include 24-hour inpatient care, partial or day hospitalization, or residential treatment, which offers a supportive place to live.

Substance abuse treatment
Substance abuse commonly occurs along with mental illness. Often it interferes with treatment and worsens mental illness. If you can't stop using drugs or alcohol on your own, you need treatment. Substance abuse treatments include:

• Psychological counseling, also called psychotherapy
• Medications, which may help ease withdrawal symptoms or reduce cravings
• Inpatient treatment such as withdrawal (detox) treatment
• Outpatient treatment programs, which require regular attendance for a set period of time
• Support groups or 12-step programs such as Alcoholics Anonymous (AA)

Participating in your own care
Be an active participant in your treatment. Working together, you and your doctor or mental health provider can decide which treatment options may be best for your situation, depending on your symptoms and their severity, your personal preferences, insurance coverage, side effects, and other factors. In some cases, a mental illness may be so severe that a doctor, loved one or guardian may need to guide your care until you're well enough to participate in decision making.

Lifestyle and home remedies

In most cases, a mental illness won't get better if you try to treat it on your own, without professional care. But you can do some things for yourself that will build on your treatment plan. In addition to professional treatment, follow these lifestyle and self-care steps for mental illness:

• Stick to your treatment plan. Don't skip therapy sessions, even if you don't feel like going.
• Take your medications as directed. Even if you're feeling well, resist any temptation to skip your medications. If you stop, symptoms may come back. You could also experience withdrawal-like symptoms from stopping a medication too suddenly.
• Learn about your condition. Education about your condition can empower you and motivate you to stick to your treatment plan.
• Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Consider involving family members or friends in watching for warning signs.
• Get active. Physical activity and exercise can help manage many symptoms, such as depression, stress and anxiety. Activity can also counteract the effects of some psychiatric medications that may cause weight gain. Consider walking, jogging, swimming, gardening or taking up another form of exercise you enjoy.
• Avoid drugs and alcohol. Alcohol and illicit drugs can worsen mental illness symptoms or interact with medications.
• Get routine medical care. Don't neglect checkups or skip visits to your family doctor, especially if you aren't feeling well. You may have a new health problem that needs to be addressed, or you may be experiencing side effects of medication.

Coping and support

Coping with a mental illness can be challenging. Talk to your doctor or therapist about improving your coping skills, and consider these tips:

• Learn about your mental illness. Include your family, too — this can help the people who care about you understand what you're going through and learn how they can help. Your doctor or therapist may provide information directly or may recommend classes, books or websites.
• Join a support group. Connecting with others facing similar challenges can help you cope. Support groups for mental illness are available in many communities and online. One good place to start is the National Alliance on Mental Illness.
• Stay connected with friends and family. Try to participate in social activities, and get together with family or friends regularly. Ask for help when you need it, and be upfront with your loved ones about how you're doing.
• Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what triggers or improves your symptoms. It's also a healthy way to explore and express pain, anger, fear and other emotions.

Prevention

There's no sure way to prevent mental illness. However, if you do have a mental illness, taking steps to control stress, to increase your resilience and to boost low self-esteem may help keep your symptoms under control. Follow these steps:

• Stick to your treatment plan. Even if you're feeling better, resist any temptation to skip your medications. If you stop, symptoms may come back. You could also have withdrawal-like symptoms if you stop a medication too suddenly. Don't skip therapy sessions, even if you don't feel like going. If you have bothersome medication side effects or other problems with your treatment, talk to your doctor before making changes.
• Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Consider involving family members or friends in watching for warning signs.
• Get routine medical care. Don't neglect checkups or skip visits to your family doctor, especially if you aren't feeling good. You may have a new health problem that needs to be treated, or you may be experiencing side effects of medication.
• Get help when you need it. Mental health conditions can be harder to treat if you wait until symptoms get bad. Long-term maintenance treatment also may help prevent a relapse of symptoms.
• Take care of yourself. Getting enough sleep, eating regular, healthy meals and exercising regularly can all help with mental illness.