What kinds of mental health problems are there?
There are many different mental health problems, and many symptoms are common to more than one diagnosis. So you may experience the symptoms of more than one mental health problem at once.
Depression is a feeling of low mood that lasts for a long time and affects your everyday life. It can make you feel hopeless, despairing, guilty, worthless, unmotivated and exhausted. It can affect your self-esteem, sleep, appetite, sex drive and, sometimes, your physical health. In its mildest form, depression doesn’t stop you leading a normal life, but it makes everything harder to do and seem less worthwhile. At its most severe, depression can make you feel suicidal, and be life-threatening. There are also some common specific forms of depression, such as:
- postnatal depression (PND) – depression that can develop from between two weeks to up to two years after becoming a parent. It’s usually diagnosed in mothers, but can affect partners too.
- seasonal affective disorder (SAD) – depression that is related to day length and usually (but not always) occurs in the winter.
“Depression feels like I am locked in a black room inside myself.”
Anxiety refers to strong feelings of unease, worry and fear. Because occasional anxiety is a normal human experience, it’s sometimes hard to know when it’s becoming a mental health problem – but if your feelings of anxiety are very strong, or last for a long time, they can be overwhelming.
You might experience:
- constant worrying about things that are a regular part of everyday life, or about things that aren’t likely to happen
- unpleasant physical symptoms such as sleep problems, panic attacks, an increased heartbeat, an upset stomach, muscle tension or feeling shaky
- a specific anxiety disorder, such as generalised anxiety disorder(GAD), panic disorder, a phobia, obsessive-compulsive disorder(OCD) or post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)
OCD is a type of anxiety disorder. The term is often misused in daily conversation – for example, you might hear people talk about being ‘a bit OCD’, if they like things to be neat and tidy. But the reality of this disorder is a lot more complex and serious.
OCD has two main parts:
- obsessions – intrusive 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 might hurt someone.
- compulsions – repetitive activities that you feel you have to do. This could be something like repeatedly washing something to make sure it’s clean or repeating a specific phrase in your head to prevent harm from coming to a loved one.
The aim of a compulsion is to relieve the intense anxiety caused by obsessive thoughts. However, the process of repeating these compulsions is often distressing in itself, and any relief you feel is often short-lived.
A phobia is an extreme form of fear or anxiety triggered by a particular situation (such as going outside) or object (such as spiders), even when there is no danger. A fear becomes a phobia if it lasts for more than six months, and has a significant impact on how you live your day-to-day life. For example, you may begin to organise your life around avoiding the thing that you fear.
Eating problems aren’t just about food. They can be about difficult things in your life and painful feelings, which you may be finding hard to express, face or resolve. Focusing on food can be a way of disguising these problems, even from yourself.
The most common eating problems are:
- anorexia – not allowing yourself to eat enough food to get the energy and nutrition you need to stay physically healthy. Sometimes people assume that anorexia is about slimming and dieting, but it is often connected to very low self-esteem, negative self-image and feelings of intense distress.
- bulimia – finding that you eat large amounts of food all in one go, often because you are feeling upset or worried (this is called bingeing); then feeling deeply guilty or ashamed, and taking steps to get rid of the food you have eaten (this is called purging).
- binge eating disorder – feeling that you can’t stop yourself from eating, even when you want to. This is sometimes described as having a food addiction or compulsive eating.
- eating disorder not otherwise specified (EDNOS) – this diagnosis means you meet some of the criteria for one of the above disorders, but not all of them.
Bipolar disorder (previously called manic depression) mainly affects your mood. With this diagnosis you are likely to have times when you experience:
- manic or hypomanic episodes (feeling high)
- depressive episodes (feeling low)
- potentially some psychotic symptoms during manic or depressed
Everyone has variations in their mood, but in bipolar disorder these changes can be very distressing and have a big impact on your life. You may feel that your high and low moods are extreme, and that swings in your mood are overwhelming. In between, you might have stable times where you experience fewer symptoms.
“[At first it’s] loss of interest in doing anything. I have to force myself to do tasks. Then it’s as though I’m in catch up. Mind full of ideas, feel fantastic, doing three things at once.”
You may receive a diagnosis of schizophrenia if you have symptoms such as:
- psychotic experiences, for example hallucinations or delusions
- disorganised thinking
- a lack of interest in things
- feeling disconnected from your feelings
- wanting to avoid people
This diagnosis can be controversial as not all people who experience such things agree that they have a mental health problem, or that the term ‘schizophrenia’ is the best way to describe their experiences.
Personality disorders are a type of mental health problem where your attitudes, beliefs and behaviours cause you longstanding problems in your life. There are several different types of personality disorder, but the two most commonly diagnosed ones are:
- borderline personality disorder (BPD) – you might be given this diagnosis if you experience things like intense, changeable moods, an overwhelming fear of abandonment, an unstable sense of identity and impulsive, risky behaviour. Some people prefer the term ‘emotionally unstable personality disorder’ (EUPD) to BPD, as they feel it’s a more accurate description of the symptoms.
- antisocial personality disorder (ASPD) – you might be given this diagnosis if you experience things like disregard for the feelings and needs of others, manipulating others for your own gain, difficulty maintaining relationships, feeling little guilt for your actions and feeling easily bored or aggressive.
“Having BPD is like the emotional version of being a burn victim. Everything in the world hurts more than it seems to for everyone else and any ‘thick skin’ you are supposed to have just isn’t there.”
If you’re given a diagnosis of a personality disorder, it’s understandable to feel like you’re being told that who you are is ‘wrong’. But a personality disorder does not mean that you’re a bad person, or that you have a bad personality.
Other symptoms, feelings and behaviours
In addition to the diagnoses listed above, these are some common symptoms, feelings and behaviours which are often associated with mental health problems.
Panic attacks are an exaggeration of your body’s normal response to fear, stress or excitement. These are bouts of intense, often very frightening symptoms, usually lasting between 5 and 20 minutes. You may experience overwhelming physical sensations, such as:
- a pounding heartbeat or chest pains
- sweating and nausea (feeling sick)
- feeling faint and unable to breathe
- shaky limbs, or feeling like your legs are turning to jelly
It’s easy to mistake these for the signs of a heart attack or another serious medical problem.
“I’d hyperventilate and cry with panic as the feeling that I was going to fall unconscious was so convincing.”
Self-harm is a way of expressing very deep distress, where you take actions to cause yourself physical pain. You may not know why you self-harm, but it can be a means of expressing feelings that you can’t put into words or think clearly about. After self-harming you may feel a short-term sense of release, but the cause of your distress is unlikely to have gone away.
Many people experience suicidal thoughts and feelings as part of a mental health problem. They can be unpleasant, intrusive and frightening, but having thoughts about suicide doesn’t necessarily mean that you intend to act on them. Lots of people think about suicide, and don’t ever go on to attempt to take their own lives.
However, if you start to feel you may act on suicidal feelings and become unable to keep yourself safe then this a mental health emergency. It’s important to treat it as seriously as you would any physical health emergency, and seek urgent help.
Psychotic experiences or episodes (also called psychosis) are when you perceive or interpret events very differently from people around you. This could include:
- hallucinations, such as hearing voices or having visions
- delusions, such as paranoia or delusions of grandeur
You may experience psychosis as part of a diagnosed mental health problem, but it’s also possible to have a psychotic experience without meeting the criteria for any particular diagnosis.
Could I be going mad?
Experiencing a mental health problem is often upsetting and frightening, particularly at first. If you become unwell, you may feel that it’s a sign of weakness, or that you are ‘losing your mind’, and that it’s only going to get worse. You may be scared of being seen as ‘mad’ by other people in your life. You may also be afraid of being locked up in an institution.
These fears are often reinforced by the negative (and often unrealistic) way that people experiencing mental health problems are shown on TV, in films and by the media. These fears may stop you from talking about your problems, or seeking help. This, in turn, is likely to increase your distress and sense of isolation.
However, in reality, mental health problems are a common human experience. Most people know someone who has experienced a mental health problem. They can happen to anyone, at any time. And it’s likely that, when you find a combination of self-care, treatment and support that works for you, you will get better.