When Does a Mental Health Issue Require Treatment?
Mental illness is a broad term, covering mild to severe disturbances in thoughts, emotions, and behavior. Changes can range greatly, from becoming more socially isolated and addicted to intoxicating substances to harming oneself or experiencing hallucinations. There are over 200 classifiable mental illnesses, which have a wide range of symptoms but are all characterized by brain chemistry or structure changes, which cause outward symptoms that disrupt the person’s life.
- Feeling sad, down, or guilty
- Trouble concentrating
- Confused or disordered thinking
- Excessive fears or worries
- Extreme mood fluctuations
- Withdrawing from friends and family
- Low energy, high energy, or rapid cycling between the two
- Trouble understanding situations or relating to others
- Changes in eating habits, leading to dramatic changes in body weight
- Excessive anger, hostility, or violence
- Suicidal thinking
It is extremely important that people experiencing mental illness get evidence-based care. Chronic health effects, including shortened lifespan and increased risk of comorbid conditions like substance abuse, become more likely when a person experiences mental illness, and they will get worse as the underlying condition remains untreated.
Types of Mental Illness
There are a few categories for types of mental illnesses, according to the National Alliance on Mental Illness (NAMI). These are:
- Anxiety disorders: Anxiety disorders are a type of mood disorder that is extremely common. About 18 percent of adults in the United States, and 8 percent of children, struggle with an anxiety disorder. Women are 60 percent more likely to receive a diagnosis for anxiety or panic than men. Generalized anxiety disorder, panic disorder, specific phobias, and social anxiety disorder are all kinds of anxiety disorders. These are characterized by consistently experiencing apprehension, dread, restlessness, tension, racing heart, shortness of breath, headaches, insomnia, fatigue, and upset stomach.People who struggle with an undiagnosed or untreated anxiety disorder are at risk for abusing central nervous system depressants, especially alcohol or narcotics, because these calm the fight-or-flight response. They may also struggle with abuse of drugs that are prescribed to treat panic, especially sedatives like benzodiazepines.
- Attention deficit hyperactive disorder (ADHD): This condition affects about 9 percent of children between the ages of 3 and 17. It is most often diagnosed in children and adolescents, but occasionally, adults receive this diagnosis after struggling through ADHD symptoms in childhood. ADHD is characterized by inattention, hyperactivity, and impulsiveness. People who have undiagnosed ADHD often develop other mental and behavioral disorders because the underlying ADHD causes them to struggle with school, work, and social interactions. People who grew up with ADHD without appropriate treatment often develop anxiety, depression, and substance use disorders.
- Bipolar disorder: There are four basic types of bipolar disorder: I, II, mixed, and cyclothymic disorder. Each kind of bipolar disorder involves cycling through periods of depression and periods of mania or intense excitement and high energy. Without an appropriate diagnosis and treatment, cycling through emotional and energetic highs and lows can be disruptive to a person’s life, sense of self, and sense of personal safety. People with any kind of bipolar disorder are at significant risk for developing substance use disorders to regulate their moods.
- Borderline personality disorder (BPD): This condition’s primary symptom is difficulty regulating emotion, which can lead to mood swings, emotional instability, impulsive behaviors, poor self-image, and difficulty maintaining relationships. While about 1.6 percent of the US population likely has BPD, the numbers could be as high as 5.9 percent. Nearly three-quarters of people who are diagnosed with BPD are female, but this could be because men do not seek treatment for their symptoms, or it could be that men are initially misdiagnosed with post-traumatic stress disorder or depression.
- Depression: There are several subsets of depression, including major depression, chronic depression, seasonal affective disorder (SAD), and postpartum depression. These are all characterized by feelings of sadness, guilt, loneliness, low self-worth, disturbances in sleep, changes in appetite, fatigue, and poor concentration. Depression can also manifest in other psychiatric conditions, like anxiety, or through physical illnesses, like chronic pain. Generally, more women than men suffer from depression. A person experiencing untreated or undiagnosed depression may develop a substance use disorder to self-medicate more intense symptoms.
- Dissociative disorders: The most famous dissociative disorder is dissociative identity disorder (DID), colloquially called split personality disorder or multiple personality disorder. However, there are two other types of DD: dissociative amnesia and depersonalization disorder.
- Dissociative amnesia: Characterized by trouble remembering essential information about oneself, such as a specific event (e.g., combat, abuse, or natural disaster), personal identity, or life history. Amnesic episodes can occur suddenly and may last for minutes to days, or more rarely, months or even years.
- Depersonalization disorder: The person experiences consistent emotional detachment from feelings, actions, sensations, and thoughts. The experience is likened to watching a movie. Symptoms can occur suddenly and last for a few seconds, or years. Generally, the first experience of this condition occurs around 16 years old, although it can occasionally occur earlier in life.
- Dissociative identity disorder (DID): This is an alternation between multiple identities. The experience includes symptoms of dissociative amnesia and depersonalization disorder. The person may feel like there are multiple voices in their head, trying to control them. They will have memory gaps of everyday events and related trauma.
- Eating disorders: A preoccupation with weight and compulsive behaviors associated with food and exercise characterize these disorders. About one in 20 people will be affected by an eating disorder at some point in their lives, according to NAMI. Types of eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. Intentional starvation, food avoidance, excessive exercise, or eating too much and throwing up are all symptoms of these disorders.
- Impulse control and addiction disorders: These disorders are characterized by irresistible, uncontrollable urges, usually resulting in self-harm or harm to others. Many people who struggle with addiction to drugs or alcohol, for example, know that these substances harm them, but they are unable to stop their consumption. Other kinds of impulse control disorders include kleptomania, pyromania, and compulsive gambling.
- Obsessive-compulsive disorder: Repetitive, unwanted, and intrusive thoughts (obsessions) and irrational, excessive, and uncontrollable urges to perform certain actions (compulsions) characterize this disorder. Obsessions include thoughts about harming oneself or others, doubts about performing an action like locking the door or turning off an oven, disturbing sexual images, or fear about saying or doing something inappropriate or disturbing publicly. Compulsions may be tied into an attempt to ward off or get rid of obsessions, or they are outlets for stress caused by obsessions. Compulsive actions include hand-washing, counting or recounting objects, or repeating certain statements like prayers or incantations over and over.
- Other personality disorders: BPD and OCD are types of personality disorders. Others include Cluster A, Cluster B, and Cluster C disorders.
- Cluster A: paranoid, schizoid, and schizotypal; false beliefs about oneself and the world
- Cluster B: antisocial, histrionic, and narcissistic; differences in understanding of oneself and how the individual relates to rules in society
- Cluster C: avoidant and dependent; persistent anxiety and fear that lead to latching on to one solution to get rid of stress
- Post-traumatic stress disorder (PTSD): This stress disorder is triggered by experiencing a dangerous event, like combat, a natural disaster, an act of terrorism, an assault, or a serious accident. About 3.5 percent of the adult population in the United States struggle with PTSD. While the condition is largely associated with military veterans, there is greater recognition of the condition among those who have experienced domestic abuse, childhood abuse, and other conditions. Symptoms include intrusive memories, flashbacks, avoidance of specific locations or people, emotional dissociation with the event, and hypervigilance. Unfortunately, many people suffer from PTSD for a long time before receiving an appropriate diagnosis, and they may begin to abuse drugs or alcohol to cope with symptoms.
- Schizoaffective disorder: This mental illness involves symptoms of both schizophrenia, like delusions and hallucinations, as well as symptoms of a mood disorder, such as depression or mania. This is a rare condition, affecting about 0.3 percent of the population, and it affects men and women equally. In addition to mood and schizophrenic symptoms, the person will also experience disordered thinking.
- Schizophrenia: While this condition is also rare, with about 1 percent of the population affected, it is widely stereotyped in the media. Generally, more men than women develop schizophrenia, and average onset is late adolescence and early adulthood. Symptoms of schizophrenia include hallucinations, delusions, flat emotional reactions, emotional disconnection, symptoms like clinical depression, disordered thinking, and cognitive issues.
Treating Mental Illnesses
Getting evidence-based treatment for mental health is very important. There are two foundational pillars for treating both mental and behavioral conditions, which often overlap: psychotherapy and prescription medications. While there is no cure-all for mental and behavioral conditions, balancing these treatments based on symptoms and severity will help the person manage their condition and live a healthy, normal life. Over time, adjustments to psychotherapy and medication will need to occur, but working with a team of care professionals can ensure this is consistently managed.
Mental Health America (MHA) reports that a list of effective treatment for mental illnesses and any comorbid behavioral conditions like substance abuse includes:
- Psychotherapy: There are several forms of psychotherapy, although the most effective for treating most mental and behavioral health conditions is Cognitive Behavioral Therapy. Working with a counselor one on one, in groups, and with one’s close friends or family can help the person understand the emotional causes of their disruptive behaviors and begin to make changes in these patterns.
- Medication: Medications like anti-anxiety drugs, antidepressants, and antipsychotics do not cure mental illness; however, they do help stabilize the individual’s brain chemistry, reducing panic attacks and hallucinations or improving mood and energy. This helps the person stay in treatment and make progress over time. Psychotherapy and medication together are the most effective forms of treating mental and behavioral conditions.
- Case management: An individual or group can help a person in treatment maintain their long-term care plan by organizing and managing resources.
- Hospitalization: Often the first step into a larger treatment plan for people suffering from severe mental or behavioral disturbances, hospitalization can help stabilize the brain and body. A social worker or case manager may begin to work with the person on entering treatment as soon as they are discharged from the hospital.
- Support groups: These social groups support ongoing recovery and help each individual in the group know that they are not alone in their struggles. Support groups are a fantastic way for people leaving rehabilitation and reducing their counseling sessions to stay on track.
- Complementary treatment: Yoga, mindfulness meditation, nutritional counseling, massage therapy, aromatherapy, art therapy, and many more programs can be part of the person’s larger treatment plan. However, no complementary or alternative treatment should replace counseling and prescription medications.
- Self-help plan: The individual, their therapist, and their doctor will work together to organize strategies for the person outside of rehabilitation to maintain the person’s path to wellness. This plan should be re-evaluated regularly, so the individual’s needs are consistently provided for.
- Peer support: Friends and family must support their loved one through the treatment process. This likely means attending family therapy, going to individual therapy for personal mental or behavioral conditions, and offering other forms of support as they are able.
Mental health can be effectively managed with evidence-based practices and planning. Getting this help early and often is very important for long-term health; however, those who suffer from mental illness, behavioral disorders, or co-occurring substance abuse and mental illness should seek treatment at any time, regardless of how long they have struggled.