What are mental health problems?
Some mental health problems are described using words that are in everyday use; for example, ‘depression’or ‘anxiety’.
This can make them seem easier to understand, but can also mean people underestimate how serious they can be.
Mental ill health feels just as bad, or worse, than any other illness only you cannot see it.
Although mental health problems are very common – affecting around one in four people in Britain –stigma
and discrimination towards people with mental health problems is still very common and there are a lot of myths about what different diagnoses mean.
There is also a lot of controversy about the way mental health problems are diagnosed, what causes them, and which treatments are most effective.
However, despite these challenges, it is possible to recover from a mental health problem and live a productive and
fulfilling life. It is important to remember that having a mental health problem is not a sign of weakness.
Never be ashamed of having bad days, weeks or even months – because they show your inner strength, even if you
can’t see it yourself at the time.
What are the most common mental health problems?
Some of the most commonly diagnosed forms of mental health problem are described below.
Common diagnoses
Depression
Depression lowers your mood, and can make you feel hopeless, worthless, unmotivated and exhausted. It can affect sleep,
appetite, libido and self-esteem. It can also interfere with daily activities and, sometimes, your physical health. This may set off a vicious cycle, because the worse you feel, the more depressed you are likely to get. Depression can be
experienced at different levels e.g. mild or severe, and can be related to certain experiences; for example, postnatal depression occurs after childbirth. Depression is often associated with anxiety.
Anxiety
Anxiety can mean constant and unrealistic worry about any aspect of daily life. It may cause restlessness, sleeping
problems and possibly physical symptoms; for example, an increased heart beat, stomach upset, muscle tension or feeling shaky. If you are highly anxious you may also develop related problems, such as panic attacks, a phobia or obsessive
compulsive disorder.
Obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) has two main parts: obsessions and compulsions. Obsessions are unwelcome thoughts, ideas or urges that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or worrying that you haven’t turned off the oven. Compulsions are repetitive activities that you feel you have to
do. This could be something like repeatedly checking a door to make sure it is locked or washing your hands a set number of times.
Phobias
A fear becomes a phobia when you have an exaggerated or unrealistic sense of danger about a situation or object. You will
often begin to organise your life around avoiding the thing that you fear. The symptoms of phobias are similar to anxiety, and in severe forms you might experience panic attacks.
Bipolar disorder (formerly known as manic depression)
If you have bipolar disorder you will experience swings in mood. During ‘manic’episodes, you are likely to display
overactive excited behaviour. At other times, you may go through long periods of being very depressed. There are different types of bipolar disorder which depend on how often these swings in mood occur and how severe they are.
Schizophrenia
Schizophrenia is a controversial diagnosis. Symptoms may include confused or jumbled thoughts, hearing voices and seeing and believing things that other people don’t share. If you have these symptoms you might also become confused and withdrawn. There is debate about whether schizophrenia is actually one condition or more a collection of symptoms that
are not clearly related.
Personality disorders
Generally speaking, personality doesn’t change very much. Yet it does develop as people go through different experiences
in life, and as their circumstances change. If you have a personality disorder, you are likely to find it more difficult to change your patterns of thinking, feeling and behaving, and will have a more limited range of emotions, attitudes
and behaviour with which to cope with everyday life.
Eating disorders
Eating disorders can be characterised by eating too much, or by eating too little. If you have an eating disorder you may
deny yourself anything to eat, even when you are very hungry, or you may eat constantly, or binge. The subject of food, and how much you weigh, is likely to be on your mind all the time. Your eating disorder is likely to develop as a result of deeper issues in your life and is possibly a way of disguising emotional pain. Anorexia, bulimia, bingeing and compulsive eating are some of the most common eating disorders.
Common behaviour
In addition to the more formal diagnoses above, there are some behaviour and feelings which are strongly associated with
mental health problems.
Self-harm
Self-harm is a way of expressing very deep distress. You may not know why you self-harm, but it can be
a means of communicating what you can’t put into words, or even into thoughts, and has been described as an ‘inner scream’.After self-harming, you may feel better able to cope with life again, for a while, but the cause of your distress
is unlikely to have gone away.
Suicidal thoughts
It is common to have suicidal thoughts if you are experiencing mental health problems – especially if you have a diagnosis
of depression, borderline personality disorder or schizophrenia. The deeper your depression, the more likely it is that you will consider killing yourself. However, you can help yourself and you can get help from other people. A great
many people think about suicide, but the majority do not go on to kill themselves.
Panic attacks
These are sudden, unexpected bouts of intense terror. If you experience an attack you may find it hard to breathe, and
feel your heart beating hard. You may have a choking sensation, chest pain, begin to tremble or feel faint. It’s easy to mistake these for the signs of a heart attack or other serious medical problem. Panic attacks can occur at any
time, and this is what distinguishes them from a natural response to real danger.
What causes mental health problems?
There are many opinions about what causes mental health problems. This is part of a wider debate about whether personality is shaped by life experiences, or determined by genes. The following are some of
the factors that may play a role in the development of mental health problems.
Difficult family background
Coming from a difficult background where you have experienced neglect, violence, abuse or been overprotected can make
people highly insecure and more vulnerable to mental health problems.
Stressful life events
These may be traumatic events, such as the death of someone close, or longer-term struggles, such as being the victim of
some form of harassment or oppression. In recent years, research has shown that being made redundant or spending significant periods out of work can also have an impact on your mental health.
Biochemistry
Your body chemistry can affect your mind. For example, if you are frightened, it triggers the body’s ‘fight or flight’
response to produce a hormone called adrenalin. If physical activity doesn’t use up all the adrenalin, the body remains tense and the mind stays over-active.
Genes
There are genes that cause physical illnesses, so there may be genes that play a role in the development of mental
health problems. Research suggests that genes might make certain people more vulnerable to mental health problems than others. For example, if you have a parent with schizophrenia you are more likely to develop it yourself. However,
most people with schizophrenia do not have a parent with this diagnosis, so it seems unlikely that a gene can be said to cause a mental health problem.
Physical health problems
If the brain is physically damaged by a head injury or a condition such as epilepsy this can have an impact on behaviour
and mood, and lead to symptoms associated with some mental health problems. Long-term physical illnesses have also been shown to put people at greater risk of depression and anxiety.
Social problems
Social factors such as poverty, domestic violence, isolation, poor housing and addiction have been associated with mental
health problems. It is not always clear whether these factors trigger the problems, or whether having a mental health problem can lead to social problems you might not otherwise experience.
How are they diagnosed?
In order to make a diagnosis, psychiatrists (mental health doctors) look for groupings of certain symptoms which have been
present for a defined period of time; for example, to diagnose depression they look for symptoms such as low mood and a lack of interest or pleasure in usual activities for a period of more than two weeks.
Because diagnoses are based on grouping symptoms together, there is a lot of overlap between different conditions; for example, a change in sleeping pattern is a feature of both depression and anxiety. Therefore, if you are experiencing mental health problems, this can mean that you receive more than one diagnosis over a period of time.
Making a diagnosis helps a doctor assess what treatment you need and predict how your condition is likely to develop. But there are different ways of understanding mental health problems.
The ‘medical model’ approach sees them as illnesses and they are therefore diagnosed and treated by a doctor, as described above. However, a lot of people (including some doctors) disagree with using a purely medical model and – as discussed in the previous section on causes – psychological and social factors are likely to play a role.
Labelling
If you receive a diagnosis, you might feel relieved and be glad that you can put a name to what is wrong. However, if a
diagnosis becomes a label, it can be very damaging. For example, instead of being seen as a parent, writer, mechanic or student who has schizophrenia, you may be seen as ‘a schizophrenic’, as though this diagnosis is all that you are.
Many people prefer to see mental health problems as part of human experience rather than distinct illnesses. A diagnosis
does not have to determine the whole course of your life, and may come to be a relatively minor part of your identity or history.
It is not about being classified by your mental illness: it is about learning to accept yourself and seize the day for all it is worth – because tomorrow will be different.
What treatments are available?
The two most common forms of treatment offered though the NHS are talking treatments and medication. Treatments aim to
relieve and help you cope with distressing symptoms.
Medication
The most common type of treatment given by GPs and psychiatrists is prescription medication. These drugs don’t ‘cure’
mental health problems, but aim to ease the most distressing symptoms .Depending on the diagnosis, there are a variety of drugs commonly used:
minor tranquillisers or sleeping pills – to help someone calm down or sleep
antidepressants– to lift depression
antipsychotics– to control disturbing thoughts
mood stabilisers – to control extremes of mood
Many people find these drugs helpful, as they can lessen symptoms and allow them to function at work, look after children or take part in their normal activities. However, drugs can have side effects that may make people feel worse rather than better. They can also be addictive, dfifficult to withdraw from or cause physical damage if taken in too high a dose. Therefore, they need to be used with caution, ideally in the lowest possible dose for the shortest possible time.
Talking treatments
Talking (psychological) treatments can help you to overcome emotional difficulties and free yourself from self-destructive
ways of feeling, thinking and behaving. Some of the more common types are:
Counselling– an opportunity to talk about what is troubling you and be heard
Psychotherapy– aims to help you understand why you feel the way you do
Cognitive behavioural therapy – aims to challenge negative thinking and behaviours
Group therapy – aims to help you deal with problems you may have in relating and communicating with other people and
develop self-awareness
Relationship or family therapy – aims to help you work with your partner or family to understand and deal with problems
you are facing.
The Clubhouse Model
This is a comprehensive and dynamic programme of support and opportunities for people with severe and persistent mental illnesses.
In contrast to traditional day-treatment and other day program models, Clubhouse participants are called "members" (as opposed to "patients" or "clients") and restorative activities focus on their strengths and abilities, not their illness. The Clubhouse is unique in that it is not a clinical program, meaning there are no therapists or psychiatrists on staff. All clinical aspects of the program have been removed so as to focus on the strengths of the individual, rather than their illness. Additionally, all participation in a clubhouse is strictly on a voluntary basis.
The members, staff and volunteers of a Clubhouse work side-by-side to manage all the operations of the Clubhouse, providing an opportunity for members to contribute in significant and meaningful ways; therefore, a Clubhouse is operated in a partnership model with members staff and volunteers, working side-by-side as colleagues.
Through this environment of support, acceptance, and commitment to the potential contribution and success of each
individual, Clubhouses are places where people can belong as contributing adults, rather than passing their time as patients who need to be treated. The Clubhouse Model seeks to demonstrate that people with mental illness can successfully live productive lives and work in the community, regardless of the nature or severity of their mental illness
Some mental health problems are described using words that are in everyday use; for example, ‘depression’or ‘anxiety’.
This can make them seem easier to understand, but can also mean people underestimate how serious they can be.
Mental ill health feels just as bad, or worse, than any other illness only you cannot see it.
Although mental health problems are very common – affecting around one in four people in Britain –stigma
and discrimination towards people with mental health problems is still very common and there are a lot of myths about what different diagnoses mean.
There is also a lot of controversy about the way mental health problems are diagnosed, what causes them, and which treatments are most effective.
However, despite these challenges, it is possible to recover from a mental health problem and live a productive and
fulfilling life. It is important to remember that having a mental health problem is not a sign of weakness.
Never be ashamed of having bad days, weeks or even months – because they show your inner strength, even if you
can’t see it yourself at the time.
What are the most common mental health problems?
Some of the most commonly diagnosed forms of mental health problem are described below.
Common diagnoses
Depression
Depression lowers your mood, and can make you feel hopeless, worthless, unmotivated and exhausted. It can affect sleep,
appetite, libido and self-esteem. It can also interfere with daily activities and, sometimes, your physical health. This may set off a vicious cycle, because the worse you feel, the more depressed you are likely to get. Depression can be
experienced at different levels e.g. mild or severe, and can be related to certain experiences; for example, postnatal depression occurs after childbirth. Depression is often associated with anxiety.
Anxiety
Anxiety can mean constant and unrealistic worry about any aspect of daily life. It may cause restlessness, sleeping
problems and possibly physical symptoms; for example, an increased heart beat, stomach upset, muscle tension or feeling shaky. If you are highly anxious you may also develop related problems, such as panic attacks, a phobia or obsessive
compulsive disorder.
Obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) has two main parts: obsessions and compulsions. Obsessions are unwelcome thoughts, ideas or urges that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or worrying that you haven’t turned off the oven. Compulsions are repetitive activities that you feel you have to
do. This could be something like repeatedly checking a door to make sure it is locked or washing your hands a set number of times.
Phobias
A fear becomes a phobia when you have an exaggerated or unrealistic sense of danger about a situation or object. You will
often begin to organise your life around avoiding the thing that you fear. The symptoms of phobias are similar to anxiety, and in severe forms you might experience panic attacks.
Bipolar disorder (formerly known as manic depression)
If you have bipolar disorder you will experience swings in mood. During ‘manic’episodes, you are likely to display
overactive excited behaviour. At other times, you may go through long periods of being very depressed. There are different types of bipolar disorder which depend on how often these swings in mood occur and how severe they are.
Schizophrenia
Schizophrenia is a controversial diagnosis. Symptoms may include confused or jumbled thoughts, hearing voices and seeing and believing things that other people don’t share. If you have these symptoms you might also become confused and withdrawn. There is debate about whether schizophrenia is actually one condition or more a collection of symptoms that
are not clearly related.
Personality disorders
Generally speaking, personality doesn’t change very much. Yet it does develop as people go through different experiences
in life, and as their circumstances change. If you have a personality disorder, you are likely to find it more difficult to change your patterns of thinking, feeling and behaving, and will have a more limited range of emotions, attitudes
and behaviour with which to cope with everyday life.
Eating disorders
Eating disorders can be characterised by eating too much, or by eating too little. If you have an eating disorder you may
deny yourself anything to eat, even when you are very hungry, or you may eat constantly, or binge. The subject of food, and how much you weigh, is likely to be on your mind all the time. Your eating disorder is likely to develop as a result of deeper issues in your life and is possibly a way of disguising emotional pain. Anorexia, bulimia, bingeing and compulsive eating are some of the most common eating disorders.
Common behaviour
In addition to the more formal diagnoses above, there are some behaviour and feelings which are strongly associated with
mental health problems.
Self-harm
Self-harm is a way of expressing very deep distress. You may not know why you self-harm, but it can be
a means of communicating what you can’t put into words, or even into thoughts, and has been described as an ‘inner scream’.After self-harming, you may feel better able to cope with life again, for a while, but the cause of your distress
is unlikely to have gone away.
Suicidal thoughts
It is common to have suicidal thoughts if you are experiencing mental health problems – especially if you have a diagnosis
of depression, borderline personality disorder or schizophrenia. The deeper your depression, the more likely it is that you will consider killing yourself. However, you can help yourself and you can get help from other people. A great
many people think about suicide, but the majority do not go on to kill themselves.
Panic attacks
These are sudden, unexpected bouts of intense terror. If you experience an attack you may find it hard to breathe, and
feel your heart beating hard. You may have a choking sensation, chest pain, begin to tremble or feel faint. It’s easy to mistake these for the signs of a heart attack or other serious medical problem. Panic attacks can occur at any
time, and this is what distinguishes them from a natural response to real danger.
What causes mental health problems?
There are many opinions about what causes mental health problems. This is part of a wider debate about whether personality is shaped by life experiences, or determined by genes. The following are some of
the factors that may play a role in the development of mental health problems.
Difficult family background
Coming from a difficult background where you have experienced neglect, violence, abuse or been overprotected can make
people highly insecure and more vulnerable to mental health problems.
Stressful life events
These may be traumatic events, such as the death of someone close, or longer-term struggles, such as being the victim of
some form of harassment or oppression. In recent years, research has shown that being made redundant or spending significant periods out of work can also have an impact on your mental health.
Biochemistry
Your body chemistry can affect your mind. For example, if you are frightened, it triggers the body’s ‘fight or flight’
response to produce a hormone called adrenalin. If physical activity doesn’t use up all the adrenalin, the body remains tense and the mind stays over-active.
Genes
There are genes that cause physical illnesses, so there may be genes that play a role in the development of mental
health problems. Research suggests that genes might make certain people more vulnerable to mental health problems than others. For example, if you have a parent with schizophrenia you are more likely to develop it yourself. However,
most people with schizophrenia do not have a parent with this diagnosis, so it seems unlikely that a gene can be said to cause a mental health problem.
Physical health problems
If the brain is physically damaged by a head injury or a condition such as epilepsy this can have an impact on behaviour
and mood, and lead to symptoms associated with some mental health problems. Long-term physical illnesses have also been shown to put people at greater risk of depression and anxiety.
Social problems
Social factors such as poverty, domestic violence, isolation, poor housing and addiction have been associated with mental
health problems. It is not always clear whether these factors trigger the problems, or whether having a mental health problem can lead to social problems you might not otherwise experience.
How are they diagnosed?
In order to make a diagnosis, psychiatrists (mental health doctors) look for groupings of certain symptoms which have been
present for a defined period of time; for example, to diagnose depression they look for symptoms such as low mood and a lack of interest or pleasure in usual activities for a period of more than two weeks.
Because diagnoses are based on grouping symptoms together, there is a lot of overlap between different conditions; for example, a change in sleeping pattern is a feature of both depression and anxiety. Therefore, if you are experiencing mental health problems, this can mean that you receive more than one diagnosis over a period of time.
Making a diagnosis helps a doctor assess what treatment you need and predict how your condition is likely to develop. But there are different ways of understanding mental health problems.
The ‘medical model’ approach sees them as illnesses and they are therefore diagnosed and treated by a doctor, as described above. However, a lot of people (including some doctors) disagree with using a purely medical model and – as discussed in the previous section on causes – psychological and social factors are likely to play a role.
Labelling
If you receive a diagnosis, you might feel relieved and be glad that you can put a name to what is wrong. However, if a
diagnosis becomes a label, it can be very damaging. For example, instead of being seen as a parent, writer, mechanic or student who has schizophrenia, you may be seen as ‘a schizophrenic’, as though this diagnosis is all that you are.
Many people prefer to see mental health problems as part of human experience rather than distinct illnesses. A diagnosis
does not have to determine the whole course of your life, and may come to be a relatively minor part of your identity or history.
It is not about being classified by your mental illness: it is about learning to accept yourself and seize the day for all it is worth – because tomorrow will be different.
What treatments are available?
The two most common forms of treatment offered though the NHS are talking treatments and medication. Treatments aim to
relieve and help you cope with distressing symptoms.
Medication
The most common type of treatment given by GPs and psychiatrists is prescription medication. These drugs don’t ‘cure’
mental health problems, but aim to ease the most distressing symptoms .Depending on the diagnosis, there are a variety of drugs commonly used:
minor tranquillisers or sleeping pills – to help someone calm down or sleep
antidepressants– to lift depression
antipsychotics– to control disturbing thoughts
mood stabilisers – to control extremes of mood
Many people find these drugs helpful, as they can lessen symptoms and allow them to function at work, look after children or take part in their normal activities. However, drugs can have side effects that may make people feel worse rather than better. They can also be addictive, dfifficult to withdraw from or cause physical damage if taken in too high a dose. Therefore, they need to be used with caution, ideally in the lowest possible dose for the shortest possible time.
Talking treatments
Talking (psychological) treatments can help you to overcome emotional difficulties and free yourself from self-destructive
ways of feeling, thinking and behaving. Some of the more common types are:
Counselling– an opportunity to talk about what is troubling you and be heard
Psychotherapy– aims to help you understand why you feel the way you do
Cognitive behavioural therapy – aims to challenge negative thinking and behaviours
Group therapy – aims to help you deal with problems you may have in relating and communicating with other people and
develop self-awareness
Relationship or family therapy – aims to help you work with your partner or family to understand and deal with problems
you are facing.
The Clubhouse Model
This is a comprehensive and dynamic programme of support and opportunities for people with severe and persistent mental illnesses.
In contrast to traditional day-treatment and other day program models, Clubhouse participants are called "members" (as opposed to "patients" or "clients") and restorative activities focus on their strengths and abilities, not their illness. The Clubhouse is unique in that it is not a clinical program, meaning there are no therapists or psychiatrists on staff. All clinical aspects of the program have been removed so as to focus on the strengths of the individual, rather than their illness. Additionally, all participation in a clubhouse is strictly on a voluntary basis.
The members, staff and volunteers of a Clubhouse work side-by-side to manage all the operations of the Clubhouse, providing an opportunity for members to contribute in significant and meaningful ways; therefore, a Clubhouse is operated in a partnership model with members staff and volunteers, working side-by-side as colleagues.
Through this environment of support, acceptance, and commitment to the potential contribution and success of each
individual, Clubhouses are places where people can belong as contributing adults, rather than passing their time as patients who need to be treated. The Clubhouse Model seeks to demonstrate that people with mental illness can successfully live productive lives and work in the community, regardless of the nature or severity of their mental illness