Here's help understanding how mental health conditions are identified.
Why is it so tough to tell what's normal?
It's often difficult to distinguish normal mental health from mental illness because there's no easy test to show if something's wrong. Also, primary mental health conditions can be mimicked by physical disorders. Mental health conditions are judged not to be due to a physical disorder and are diagnosed and treated based on signs and symptoms, as well as on how much the condition affects your daily life. Signs and symptoms can affect your:
• Behavior. Obsessive hand-washing or drinking too much alcohol might be signs of a mental health condition.
• Feelings. Sometimes a mental health condition is characterized by a deep or ongoing sadness, euphoria or anger.
• Thinking. Delusions — fixed beliefs that are not changeable in light of conflicting evidence — or thoughts of suicide might be symptoms of a mental health condition.
What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association that explains the signs and symptoms of several hundred mental health conditions.
Mental health providers use the DSM to diagnose everything from anorexia to voyeurism and, if necessary, determine appropriate treatment. Health insurance companies also use the DSM to determine coverage and benefits and to reimburse mental health providers.
How do mental health providers diagnose mental health conditions?
To determine if you have a mental health condition, a mental health provider will work with you and your loved ones to assess:
• Your symptoms. Your mental health provider will ask about your symptoms, when they began and how they've affected your life. How you perceive your thoughts and behaviors and how much your signs and symptoms affect your daily activities can help determine what's normal for you. For instance, you might realize that you aren't coping well or that you don't want to do the things you used to enjoy. You might feel sad, hopeless or discouraged. If your sadness has a specific cause, such as divorce, your feelings could be a normal, temporary reaction. However, if you have symptoms that are severe or don't go away, you could have depression. You might also need to have a physical exam to rule out any underlying health conditions.
• Others' perceptions. Your perceptions alone might not give you an accurate picture of your behavior, thoughts or ability to function. Other people in your life can help you understand whether your behavior is normal or healthy. For example, if you have bipolar disorder, you might think your mood swings are just part of the normal ups and downs of life. Your thoughts and actions, however, might appear abnormal to others or cause problems at work, in relationships or in other areas of your life.
When is an evaluation or treatment needed?
Each mental health condition has its own set of signs and symptoms. In general, however, professional help may be warranted if you or a loved one experiences:
• Marked change in personality, eating or sleeping patterns
• Inability to cope with problems or daily activities
• Strange or grandiose ideas
• Excessive anxiety
• Prolonged depression or apathy
• Thinking or talking about suicide
• Substance abuse
• Extreme mood swings or excessive anger, hostility or violent behavior
Many people who have mental health conditions consider their signs and symptoms a normal part of life or avoid treatment out of shame or fear. If you're concerned about your mental health or a loved one's mental health, don't hesitate to seek advice.
Consult your family doctor, make an appointment with a counselor or psychologist, or encourage your loved one to seek help. With appropriate support, you can identify mental health conditions and explore treatment options, such as medications or counseling.
Overcoming the stigma of mental illness
Stigma is when someone judges you based on a personal trait. Unfortunately, this is a common experience for people who have a mental health condition. Stigma may be obvious and direct, such as someone making a negative remark about your mental illness or your treatment. Or it may be subtle, such as someone assuming you could be unstable, violent or dangerous because you have a mental health condition. You may even judge yourself. Some of the harmful effects of stigma can include:
• Lack of understanding by family, friends, colleagues or others you know
• Discrimination at work or school
• Difficulty finding housing
• Bullying, physical violence or harassment
• Health insurance that doesn't adequately cover your mental illness
• The belief that you will never be able to succeed at certain challenges or that you can't improve your situation
Steps to cope with stigma
Here are some ways you can deal with stigma:
• Get treatment. You may be reluctant to admit you have a condition that needs treatment. Don't let the fear of being "labeled" with a mental illness prevent you from seeking help. Treatment can provide relief by identifying what's wrong in concrete terms and reducing symptoms that interfere with your work and personal life.
• Don't let stigma create self-doubt and shame. Stigma doesn't just come from others. You may have the mistaken belief that your condition is a sign of personal weakness, or that you should be able to control it without help. Seeking psychological counseling, educating yourself about your condition and connecting with others with mental illness can help you gain self-esteem and overcome destructive self-judgment.
• Don't isolate yourself. If you have a mental illness, you may be reluctant to tell anyone about it. Have the courage to confide in your spouse, family members, friends, clergy or other members of your community. Reach out to people you trust for the compassion, support and understanding you need.
• Don't equate yourself with your illness. You are not an illness. So instead of saying "I'm bipolar," say "I have bipolar disorder." Instead of calling yourself "a schizophrenic," call yourself "a person with schizophrenia." Don't say you "are depressed." Say you "have clinical depression."
• Join a support group. Some local and national groups, such as the National Alliance on Mental Illness (NAMI) offer local programs and Internet resources that help reduce stigma by educating people with mental illness, their family members and the general public. A number of state and federal agencies and programs also offer support for people who have mental health conditions. Examples include agencies such as Vocational Rehabilitation and Veterans Affairs (VA).
• Get help at school. If you or your child has a mental illness that affects learning, find out what plans and programs might help. Discrimination against students because of a mental health condition is against the law, and educators at primary, secondary and college levels are required to accommodate students as best they can. Talk to teachers, professors or administrators about the best approach and available resources. If a teacher doesn't know about a student's disability, it can lead to discrimination, barriers to learning and poor grades.
• Speak out against stigma. Express your opinions at events, in letters to the editor or on the Internet. It can help instill courage in others facing similar challenges and educate the public about mental illness.
Others' judgments almost always stem from a lack of understanding rather than information based on the facts. Learning to accept your condition and recognize what you need to do to treat it, seeking support, and helping educate others can make a big difference.