When we think about cancer, heart disease, or diabetes, we don’t wait years to treat them. We start way before Stage 4. We begin with prevention. And when people are in the first stage of those diseases, and have a persistent cough, high blood pressure, or high blood sugar, we try immediately to reverse these symptoms.

This is what we should be doing when people have serious mental illnesses, too. When they first begin to experience symptoms such as loss of sleep, feeling tired for no reason, feeling low, feeling anxious, or hearing voices, we should act.

These early symptoms might not ever become serious. Like a cough, they often go away on their own, and are nothing to fear. But when they do not go away, it typically takes ten years from the time they first appear until someone gets a correct diagnosis and proper treatment.

This means that by ignoring them, we lose ten years in which we could intervene in order to change people’s lives for the better. During most of these years most people still have supports that allow them to succeed – home, family, friends, school, and work. So people can often recover quickly, and live full and productive lives.

Even when we don’t intervene right away, and serious mental illnesses get worse and disrupt people’s lives, we can act effectively. We can offer people choices and supports to help them recover. These include clinical services, drugs, peer supports, counseling, family supports, and other therapies that also help them manage their thoughts and emotions. These all help keep people connected to their families and their community. Intervening as early as possible preserves education, employment, social supports, housing – and brain power! It also costs less than the all-too-common revolving door of incarceration, hospitalization, and homelessness.

When you or someone close to you starts to experience the early warning signs of mental illness, knowing what the risk factors and symptoms are will help to catch them early.

Often times, family and friends are the first to support a person through these early stages. Like other health conditions, we need to address the symptoms early, identify the underlying illness, and plan an appropriate course of action on a path towards overall health.

Risk Factors

Genes

17-28% of risk for mental illnesses can be accounted for by variations in common genes.

Much stronger links were found in twin and family studies. Estimates for total heritability, or how much a disease is tied to genetics, are⁽¹⁾:

• ⦿ Schizophrenia: 81%
• ⦿ Bipolar disorder: 75%
• ⦿ ADHD: 75%
• ⦿ Depression: 37%

Biology

In one study, head injury between the ages of 11-15 was the strongest predictor for development of schizophrenia, depression, and bipolar disorder.⁽²⁾

Brain changes like building a “tolerance” or reward response to stress, or abnormalities in the prefrontal and frontal cortex, and irregularities in the function of the neurotransmitter glutamate are also risk factors for mental illness and substance use.⁽⁴⁾

Environment

People who are exposed to adverse childhood events including abuse, neglect, divorce, witnessing domestic violence and having parents who have substance use issues, mental illnesses or are in jail are⁽³⁾:

• ⦿ 2.6 times more likely to have depression
• ⦿ 5 times more likely to have serious alcohol problems
• ⦿ 17 times more likely to have learning or behavioral problems.
• ⦿ 3 times more likely to have serious job problems.

Lifestyle

Substance use can increase chances of developing a mental illness and having a mental illness can increase risk of using substances.

People with any mental illness are⁽⁵⁾:

• ⦿ 2.3 times as likely to develop nicotine dependence
• ⦿ 3 times more likely to develop alcohol dependence
• ⦿ 30 times more likely to develop illicit drug dependence.

Early Warning Signs And Symptoms

Having a combination of symptoms (not just one symptom) indicates that someone might be showing signs of a mental health condition. Be aware of these symptoms when they last longer than a few weeks and start to affect school, work, relationships, or your everyday activities:

Problems With Concentration, Memory, Or Ability To Think Clearly

Changes In Eating Such As Loss Of Appetite Or Overeating

Not Being Able To Complete School Or Work Tasks

Feeling Overly Worried

Feeling Overly Worried

Feeling Sad, Empty, Hopeless, Or Worthless

Sensitivity To Sounds, Sight, Smell, Or Touch

Irritability And Restlessness

Loss Of Interest In Activities That Are Normally Enjoyable, Withdrawal From Others, Or Disconnection

Feeling Like Your Brain Is Playing Tricks On You. Hearing Knocking, Scratching Sounds, Voices, Or Your Name Being Called. Seeing Things That Other People Do Not See, Like Shadows, Changes In Light, Figures.

Changes In Energy Level And Sleep Patterns. Often Someone Will Sleep During The Day And Be Up At Night.

Signs And Symptoms That Require Immediate Attention

• ⦿ Thoughts or plans of killing or hurting one’s self or another person
• ⦿ Hearing voices or seeing things that no one else can hear or see
• ⦿ Unexplainable changes in thinking, speech, or writing
• ⦿ Being overly suspicious or fearful
• ⦿ Serious drop in school or work performance
• ⦿ Sudden personality changes that are bizarre or out of character

You’ve decided to get help—that itself is a big step—now it’s important that you understand options for treatment. You may end up trying a few different options or a combination of treatments, not just one.

That’s okay—it is all about what works best for you. This list doesn’t include everything, and there are many other treatments and providers. Make sure you tell your treatment team about all of the options you’re using.

Common Treatment Types

Therapy

There are many approaches to therapy for individuals and groups, including cognitive behavioral therapy

Provided by: Psychologists, Licensed Clinical Social Workers (LCSWs), Pastoral Counselors, other specialists like Marriage and Family Therapists, some Psychiatrists, Inpatient Care, Hospitals

Medication

Medications aren’t cures, but they can treat symptoms. Every medication has benefits, risks, and side effects.  Keep in mind that it may take 6-8 weeks for a medication to have its full effect.

Provided by: Psychiatrists, Other Medical Doctors, Nurse Practitioners and Physician’s Assistants (under supervision of a doctor), Inpatient Facilities, Hospitals. Some psychologists with special training may also be able to write prescriptions.

Peer Support

While they aren’t counselors, peers can give valuable insight on how to recover from mental illnesses because they have experience.  Peers provide hope, education and advocacy.

Provided by: Certified Peer Specialists, Peer Supporters, Support Groups, Online Support Communities

Community-Based Services

Community-based mental health services are team approaches that help you and your family work on all aspects of life and recovery. Common community services include: evaluations of your mental health and role in the community, education to empower personal recovery, individual and group therapy, case management, and supported education and employment. These services are provided through small or large programs and while some work might be completed in an office, most of the treatment is provided at your home and in your natural environment.

Provided by: Local MHAs, Community Mental Health Treatment organizations and programs. Check out the SAMHSA Treatment Locator at findtreatment.samhsa.gov

Complementary And Alternative Medicine

Many Americans, nearly 40 percent, use health care approaches developed outside of mainstream Western, or conventional, medicine for specific conditions or overall well-being. The most commonly used natural product among adults in the past 30 days was fish oil/omega 3s (reported by 37.4 percent of all adults who said they used natural products).⁽¹⁾

Provided by: Doctors, Pharmacies, Internet (Caution advised—some natural supplements can have serious interactions with medications. Always discuss Complementary and Alternative treatments with a doctor.)

Self-Care

Self-care can include online, self-managed programs like Beating the Blues, which can improve the symptoms of anxiety and depression.⁽²⁾  It can also include things like exercise, which can have a moderate effect on depression.⁽³⁾

Provided by: You

Managing Expectations

Even If You Have Insurance, Not All Providers Will Accept It.

There are many reasons that this happens, including low reimbursement rates and large amounts of paperwork. However, you may be able to get reimbursed for some of your care—ask your insurance company about out-of-network care and their reimbursement process. 

It’s Going To Take A While To See Someone.

Nationally, there’s only 1 mental health provider for 790 adults. With 1 in 5 adults experiencing a mental health condition in a given year, a lot of those providers have their hands full.⁽⁴⁾ This is a network problem that groups like Mental Health America are trying to change at national, state, and local levels.

Some Areas Don’t Have The Care You Need, Even If You Can Pay For It.

This can happen because of your location (if you live in a rural area, you may have to travel a long distance to find a therapist) or because providers in your area don’t offer the supports you need (like community-based services). Thirty to forty percent of children and adults report that they couldn’t get the mental health treatment they needed because of cost, inability to access treatment, or inadequate insurance.⁽⁴⁾ This is an access to care problem that advocacy groups like Mental Health America are working on. Want to help? Find your local MHA Affiliate and see how you can get involved.

It’s Going To Cost Money.

For example, individuals nationwide spent an average of 10 percent of their family’s annual income out of pocket for mental health/substance abuse treatment.⁽⁵⁾ However, the cost of waiting can be worse. If you need help paying for treatment, visit Paying For Care.

Your First Provider May Not Be “The One”.

Choosing a mental health provider can be kind of like dating. Sometimes, you’re just not compatible. You may have to change providers before you feel comfortable. While it can feel like a hassle, it’s worth it to find the right fit.

Some People Are Going To Be Critical Or Doubtful.

More than half of people believe that others are caring and sympathetic to individuals with mental illness, however that may not always be the case.⁽⁶⁾  You may encounter some naysayers, but there are also people who will support you and want you to get better. If you don’t have them in your life, you can find them in support groups or online communities.