How to cope with the early signs of mental health problems
Explains the early signs of mental health problems, giving practical suggestions for what you can do and where you can go for support.
What are mental health problems?
Mental health problems include a wide range of experiences: some problems may be quite mild or moderate, while others may take on a more severe form, affecting a person’s ability to cope with day-to-day living. You may have heard about some of the more commonly discussed problems, such as depression, anxiety, self-harm, eating disorders, schizophrenia, psychosis, stress and bipolar disorder.
According to some estimates, 1 person in 4 may have some form of mental health problem each year. For as many as 1 person in 50, this problem will be serious enough to affect their ability to work or to form and maintain personal relationships.
Although figures and definitions vary, what is clear is that millions of people in the UK will encounter problems themselves, or know someone else who does.
The first signs of mental health problems will differ from person to person and are not always easy to spot. In many cases of moderate depression or anxiety – the most common mental health problems – the person becoming distressed may not display symptoms, or may seek to hide them because they worry about what others will say or think about them. The signs can often be more noticeable to other people first: for instance, if your mood starts changing, it may take some time for you to become aware of it; other people may be much more conscious of the difference.
Some common early signs of a mental health problem are:
- Losing interest in activities and tasks that were previously enjoyed.
- Poor performance at work.
- Mood swings that are very extreme or fast and out of character for you.
- Self-harming behaviour, such as cutting yourself.
- Changes in eating habits and/or appetite: over-eating, bingeing, not eating.
- Loss of, or increase in, sexual desire.
- Sleep problems.
- Increased anxiety, looking or feeling ‘jumpy’ or agitated, sometimes including panic attacks.
- Feeling tired and lacking energy.
- Isolating yourself, socialising less; spending too much time in bed.
- Wanting to go out a lot more, needing very little sleep, feeling highly energetic, creative and sociable, making new friends rapidly, trusting strangers or spending excessively – this may signal that you are becoming 'high'.
- Hearing and seeing things that others don't.
- Other differences in perception; for example, mistakenly believing that someone is trying to harm you, is laughing at you, or trying to take over your body.
All of these signs can vary in severity. Often they can be relatively minor, or pass quickly. However, if they are particularly severe or distressing, or continue for more than a short while, you may want to seek support
What's happening to me?
Am I going mad?
While this experience, particularly at first, is likely to be upsetting and create fear, it is a common human experience. Mental health problems can happen to anyone, at any time. For most people this will only be for a short period.
If you are in mental distress, you may begin to doubt yourself and become desperately afraid you are going mad. You may question your ability to think and reason properly, and be afraid of becoming a danger to others or of being locked up in an institution.
These fears are often reinforced by the negative way that people experiencing mental health problems are portrayed on TV, in books and by the media: you may also be scared of being seen as 'mad', of losing friends, family and freedom. These fears may stop you from talking about your problems. This, in turn, is likely to increase your distress and sense of isolation.
I was hiding in my flat. I didn't answer the front door or the phone. I felt nobody in the whole world was in as much pain as me, that no one would understand.
In reality, almost everyone will know more than one other person who has experienced mental distress within their family, and more among friends or colleagues. Contact with these people is often something that helps with your own mental health problems (also see self-help groups in the section 'what can help').
There is a common, but misplaced belief that there's a link between mental health problems and violent behaviour toward others. This is reinforced by excessive and inaccurate reporting of the dangers posed by people with psychiatric diagnoses, especially schizophrenia. However, the most common forms of mental distress have no significant link to violent behaviour.
In fact, there are relatively few serious acts of violence committed by people in mental distress. Someone with a mental health problem is actually more likely to harm themselves than someone else; although, the majority of people with mental health problems do not harm themselves at all.
People with serious mental health problems are more likely to be the victim of a violent crime than to commit one; for example, those diagnosed with psychosis are 14 times more likely to be victims.
You may worry that if you become highly distressed you might hurt others or yourself. If you feel like this, it is important to contact a doctor, or a crisis service if necessary. (See crisis services)
What causes mental health problems?
What causes mental health problems?
No one really knows why some people react to life events far more than others. There are various medical, psychological and social factors which may contribute to a decline in your mental health, but there is no one ‘cause’.
It's possible that some people may be more prone to developing problems than others. For example, some problems seem to run in families, suggesting there is a genetic reason for some diagnoses; for example, schizophrenia.
There are many reasons why you may get depressed or elated in response to what's happened in your life, and certain events may trigger your mental distress. It has been suggested that we all have the potential to have mental health problems, and it is exposure to certain forms of stress that causes the problems to appear.
It is difficult to say, sometimes, whether life events are the cause of certain difficulties, or the effect of them. For example, you may have depression, causing you to sleep badly; alternatively, if you are not sleeping well, this may result in you feeling anxious or depressed. The same holds true for changes in appetite or eating habits.
There is evidence that mood problems are linked to changes in brain chemistry, but it isn't possible to say which comes first, the mood change or the chemical change.
What can help?
What help is available?
There is no single guaranteed approach to recovering from a mental health problem. Ideally, you should be offered a range of support, so that you can identify for yourself which treatments, therapies or lifestyle suit you best, reduce your distress, and enable you to develop coping strategies. The National Institute for Health and Carel Excellence (NICE) recommends that people with most common mental health problems should be offered talking (psychological) treatments in the first instance.
Many people experiencing a crisis for the first time contact their GP. In some cases the GP may refer you to specialist services such as counselling or psychiatry for further assessment, treatment and care.
The government has also put increased funding into Improving Access to Psychological Therapies (IAPT), meaning each surgery should have a counsellor trained in Cognitive Behavioural Therapy (CBT). While not suitable for everyone, this can avoid the lengthy waiting lists that often occur. If you are told that you will have to wait some time for treatment, it is important to remember that many therapies are more effective after an initial crisis has passed.
Alternatively, if you can afford it, you may want to try a private therapist. Some of the organisations under ‘Useful contacts’ can provide lists of fully trained professionals.
Medication may play an important role for some people, but for others it doesn't help at all. Most drugs prescribed by GPs or psychiatrists have potential withdrawal and side effects, which need to be considered before consenting to any treatment. Also, once someone has started to use medication it can be difficult to change treatments: if the person decides to reduce the amount they are taking, or if they decide to stop altogether, withdrawal symptoms can sometimes be mistaken for a relapse in the condition and so the drug begins to be used again.
It's very important for anyone who decides to come off prescribed medication to make sure that friends, family or carers are aware of what they are doing. Many people have successfully reduced their medication or come off it altogether. The best way to succeed is by doing it slowly, with as much support as possible from those around you. Changes in mood and perception are common effects of withdrawal. They are less likely if withdrawal is gradual (over 12 months, or longer, is not unusual in some cases), and they are much easier to cope with in a supportive environment. (See coming off psychiatric drugs.)
In a crisis, one option is to go to the Accident and Emergency department of your local hospital. These tend to be busy and unsettling places, and you may have to wait a long time. However, they can sometimes offer you quicker access to a psychiatrist and other mental health professionals.
If you are seriously distressed, wanting to harm yourself or someone else, you may be admitted to hospital. Hospitals tend to rely heavily on medication and keeping someone safe for a short period of time, but may also be able to offer additional therapy and talking treatments.
The Government's priority is for people to receive care in the community via outpatient psychiatric services and Community Mental Health Teams (CMHT). CMHTs are teams of mental health care professionals with different skills, such as social workers, community psychiatric nurses, and occupational therapists. Some CMHTs can provide 24-hour crisis support, either in a person's home or in another community setting (such as a staffed house). They often work with specific sections of the community, such as women, members of minority ethnic communities or young people with a first episode of mental distress.
You may also wish to call a helpline, such as Samaritans, if you need to talk things through with someone immediately.
Friends and family
When visiting a GP, hospital or other health service – particularly for the first time with a mental health problem – you may find taking a friend or family member with you to be a very useful source of support. Having someone you trust with you, can give you confidence; they can also help you ask questions and even speak for you, if you wish.
Family and friends may initially have fears about mental health problems, but will usually want to help. They often aren’t sure how best to do so. Reading information available from organisations like Mind, or support from the organisations listed in useful contacts, will help them to know how to support you. If you feel well enough, you may also want to talk to them about how you feel and how they can help.
You might find it useful to talk to friends and family at a time when you are feeling calm, so you can discuss what you would like them to say or do if you do become distressed.
If you do find it difficult to talk openly to your friends or relatives about your mental health problem – particularly if you feel they may be responsible for some of the feelings you are experiencing – it may be easier to speak to someone who’s had a similar experience e.g. in a self-help group or to a counsellor or therapist.
Taking positive action to help yourself is an important step. It's worth exploring all the options available to you, including those provided by voluntary organisations, such as your local Mind, and organisations focusing on particular problems or therapies. (See ‘Useful contacts’.)
Joining a self-help group may be very helpful in rebuilding confidence. There are many local support groups for a range of mental health problems. Through them, you can meet people with the same kind of problem and share their experiences; learn to identify triggers; develop different strategies for coping; and find meaningful ways to understand your experiences. There may also be linked support groups which cater for friends and family.
It was such a relief to be with people who have gone through similar experiences to mine, in a non-judgemental atmosphere. Also we had a good laugh! I felt better by the end of the morning than I'd felt for ages.
Understand your mental health problem
People often find that certain events or circumstances can trigger mental distress for them. Recognising these triggers can minimise both the likelihood of your mental health problem occurring and its effects when it does occur.
Also, reading information on your specific problem can give you more ideas on how to cope with it and what options are available to you. Mind has a lot of information about specific mental health problems. See 'Information and advice'.
Look after your general health
Many of the problems that accompany mental health problems can have a negative effect on your general health, and this can make coping with distress even more difficult. For example, if you are feeling depressed you may find it difficult to go outside, exercise or carry out your daily routine. Good physical health care, regular exercise and a healthy diet can reduce the depth and duration of mental health problems, and may even help to prevent problems returning. Many people have found it worthwhile exploring alternative and complementary medicines and therapies which have proved very useful to people who want to have more control over their own treatment, health and wellbeing.
How can friends and family help?
How can friends and family help?
This section is for friends or family who would like to support someone they know with a mental health problem.
If someone starts behaving in a way that suggests they may be suffering from a mental health problem, it's vital that you are sensitive to their situation.
Many people with mental health problems find it useful to have someone to talk to openly, when they are ready to do so: being available to listen is often the best way to help. However, sometimes opening up to friends and relatives is very difficult. Some people find it easier to communicate with someone who's had a similar experience, or to a counsellor or therapist. If this is the case, then it is important to be supportive and as understanding as possible of this.
Not all mental health problems result in someone becoming visibly distressed or in crisis. However, if you are worried about this you may want to discuss with your friend or relative, when they are feeling well, what to do if this happens.
It is important to remember that while someone has experienced a mental health problem, they still have the right to react to situations and express emotions. Normal behaviour, such as being angry or upset, is not necessarily a sign of them feeling unwell.
My illnesses do not define me, they are only a part of who I am.
Trust and respect between you and the person experiencing a mental health problem are very important – they help to rebuild and maintain a sense of self-esteem, which mental distress can seriously damage. This will also help you to cope, in most cases, by being able to see your support having a positive impact on the person you care about.
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
tel. 0161 705 4304
Can provide details of accredited therapists.
British Association for Counselling and Psychotherapy (BACP)
tel. 01455 883 300
For Information about counselling and therapy. See website or sister website, itsgoodtotalk, for details of local practitioners.
advice line: 0808 808 7777
Independent Information and support for carers.
tel. 0845 123 2320
Information and support for anyone affected by depression.
Hearing Voices Network
tel. 0114 271 8210
A support group providing nformation, support and understanding to people who hear voices and those who support them.
The Institute for Complementary and Natural Medicine (ICNM)
tel. 020 7922 7980
Has a register of professional, competent practitioners.
tel: 020 7931 6480
Support for people with bipolar disorder (including hypomania) and their families and friends.
PAPYRUS (Prevention of Young Suicide)
helpline: 0800 068 41 41
Advice for young people at risk of suicide.
24-hour helpline: 08457 90 90 90
Freepost RSRB-KKBY-CYJK, Chris
PO Box 90 90
Emotional support for anyone feeling down, experiencing distress or struggling to cope
UK Council for Psychotherapy (UKCP)
tel. 020 7014 9955
Has a voluntary register of qualified psychotherapists.
See our guidance on reproducing our information