Trying to tell the difference between what expected behaviors are and what might be the signs of a mental illness isn't always easy. There's no easy test that can let someone know if there is mental illness or if actions and thoughts might be typical behaviors of a person or the result of a physical illness. Each illness has its own set of symptoms but some common signs of mental illness in adults and adolescents can include the following. Excessive worrying or fear Feeling excessively sad or low Confused thinking or problems concentrating and learning Extreme mood changes, including uncontrollable “highs” or feelings of euphoria Prolonged or strong feelings of irritability or anger Avoiding friends and social activities Difficulties understanding or relating to other people Changes in sleeping habits or feeling tired and low energy Changes in eating habits such as increased hunger or lack of appetite Changes in sex drive Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don't exist in objective reality) Inability to perceive changes in one’s own feelings, behavior or personality (”lack of insight” or anosognosia) Abuse of substances like alcohol or drugs Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”) Thinking about suicide Inability to carry out daily activities or handle daily problems and stress An intense fear of weight gain or concern with appearance (mostly in adolescents) Mental health conditions can also begin to develop in young children. Because they’re still learning how to identify and talk about thoughts and emotions, their most obvious symptoms are behavioral. Symptoms in children may include: Changes in school performance Excessive worry or anxiety, for instance fighting to avoid bed or school Hyperactive behavior Frequent nightmares Frequent disobedience or aggression Frequent temper tantrums - See more at: http://www.nami.org/Learn-More/Know-the-Warning-Signs#sthash.U3onysDd.dpufto edit.
Where to Get HelpDon’t be afraid to reach out if you or someone you know needs help. Learning all you can about mental health is an important first step.
Reach out to your health insurance, primary care doctor or state/country mental health authority for more resources.
Contact Solutions For life to find out what services and supports are available in your community.
If you or someone you know needs helps now, you should immediately call 307-358-2846 or 911.
Receiving a Diagnosis
Knowing warning signs can help let you know if you need to speak to a professional. For many people, getting an accurate diagnosis is the first step in a treatment plan.
Unlike diabetes or cancer, there is no medical test that can accurately diagnose mental illness. A mental health professional will use the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, to assess symptoms and make a diagnosis. The manual lists criteria including feelings and behaviors and time limits in order to be officially classified as a mental health condition.
After diagnosis, a health care provider can help develop a treatment plan that could include medication, therapy or other lifestyle changes.
Getting a diagnosis is just the first step; knowing your own preferences and goals is also important. Treatments for mental illness vary by diagnosis and by person. There’s no “one size fits all” treatment. Treatment options can include medication, counseling (therapy), social support and education.
- See more at: http://www.nami.org/Learn-More/Know-the-Warning-Signs#sthash.U3onysDd.dpuf
Recognizing the Key Role of Social Workers By Angelo McClain, Ph.D., LICSW
March is National Social Work Month and social workers across the U.S. are celebrating this year with the theme “All People Matter.”
Social workers help people overcome life’s most difficult challenges: mental illness, addiction, poverty, discrimination, abuse, physical illness, divorce, loss, unemployment, educational problems and disability. They help prevent crises and counsel individuals, families and communities to cope more effectively with the stresses of everyday life. Social workers focus on improving individual well-being in the context of family and other social structures, such as work and community.
The primary mission of the social work profession is to enhance human well-being and help meet the basic needs of all people, with particular attention to the needs of those who are vulnerable, oppressed and living in poverty. Clinical social workers are the largest group of professionally trained mental health providers in the United States, rendering the majority of counseling and psychotherapy services in the country. There are more clinically trained social workers—over 200,000—more than psychiatrists, psychologists and psychiatric nurses combined. Federal law recognizes social work as one of five core mental health professions. Social workers are highly trained and experienced professionals. Only those who have earned social work degrees at the bachelor’s, master’s or doctoral levels—and completed a minimum number of hours in supervised fieldwork—are professional social workers.
Social workers are employed in mental health clinics, schools, hospitals, homeless shelters, senior centers, universities, social service agencies, and the military. They can be found in all levels of leadership in the non-profit, for-profit and government sectors, including state and federal elected office.
Since the profession began over 100 years ago, social workers have been leaders in social reform movements in the United States. They continue to address the needs of society and bring our nation’s social problems to the public’s attention. Social workers were instrumental in the civil rights movement, the establishment of Social Security, Medicaid and Medicare, efforts to ensure humane treatment for people with mental illness and developmental disabilities, and on-going efforts to expand health care access for all.
I’m honored to belong to a profession that recognizes that all people matter. I hope you’ll join me in celebrating the dedication of social workers throughout our nation.
Angelo McClain is the chief executive officer of the National Association of Social Workers. For more information about social workers, visit www.socialworkers.org or follow hashtags #SocialWorkMonth and #AllPeopleMatter on Twitter.
By Lynda Cortés-Avellaneda, NAMI Multicultural Action Center Program Manager
The New Year is moving quickly and February is already nearly half way through. Aside from the arctic weather conditions, the heart-shaped balloons and the Sochi Olympics, this month is a very unique time to recognize and celebrate the significant role of African Americans and their outstanding contributions to the United States throughout history.
In 1926, African American historian and author Carter G. Woodson initiated the celebration of Black History Week, which, unsurprisingly, coincided with the birthdays of abolitionist Frederick Douglass and Civil War President Abraham Lincoln. In 1976, the year of the nation’s bicentennial, the week grew to encompass the entire month. Since then, every U.S. president has officially declared February as Black History Month.
The Significance of February
Many key events in African American history took place in February. Here are just a few:
The Case of Mental Illness
Mental illness, without any further distinction, affects one in four Americans. However, experiences of mental illness vary across cultures and there is a need for improved cultural awareness and corresponding competence in the health care and mental health workforce.
How You Can Become the Change Starting Today
Observe African American History Month proactively.
Valentine's Day, more than any other day, draws our attention to the importance of love in our lives. However, all too often we think of "love" only in a dreamy, romantic way. Much of the popular advice is based on this "romantic" approach to love. But we need to avoid the pitfalls of this short-sighted, superficial approach because that's actually selling love short. We need to elevate the meaning of a loving relationship beyond just achieving temporary pleasure. Love is not some little fringe issue in your life. When all is said and done, having a long-term, loving relationship ranks near the top of the list of the best of what life has to offer. We need to show more respect for love's significance in the context of life as a whole. Love can provide a solid place to stand in the world. It can be the kind of positive force that lets you go out and face the world on a completely different basis than you could do otherwise. Falling in love is easy, but staying in love is quite another matter. Apparently it's one of the most difficult things any of us ever attempts. Because of the high divorce rate and the large percentage of remaining marriages in which couples don't have a vital love relationship, you may have come to believe it's inevitable that love will fade with time. Or perhaps you've already experienced the discouragement of seeing the love you once shared somehow slip away. Don't settle for thinking that you really can't expect more. You can and you should—regardless of your current situation. While no long-term love relationship is without difficulties, it is possible for love to survive and to be renewed and transformed over time. You can realistically aspire to something better. Relationships can be the source of great joy or great pain. They seldom stand still; they're either getting better or getting worse. You deserve more out of love than just a few brief romantic interludes or an ongoing struggle simply to get along. You don't want life to pass you by while you're waiting (and hoping) for a good relationship. You'll feel better if you're actively doing something toward that end. It's not enough to focus on your relationship only on Valentine's Day (or some other "special" days during the year). Love is the accumulation of the multitude of daily interactions we have with each other. By paying attention to what's happening on a daily basis—and remembering the real importance of love in our lives—every day can be Valentine's Day. (Adapted from Making Love Stay by Peggy Vaughan and James Vaughan, Ph.D.)
And it's no wonder. The holidays present a dizzying array of demands — parties,
shopping, baking, cleaning and entertaining, to name just a few.
But with some practical tips, you can minimize the stress that accompanies
the holidays. You may even end up enjoying the holidays more than you thought
Tips to prevent holiday stress and depression
When stress is at its peak, it's hard to stop and regroup. Try to prevent
stress and depression in the first place, especially if the holidays have taken
an emotional toll on you in the past.
Are You Haunted by Halloween Stigma? Here’s What to Do
By Bob Corolla, NAMI Director of Media Relations
It is Halloween season again. For all the fun that can be had carving pumpkins, eating candy and dressing in costumes, unfortunately October is also a month with Halloween stigma. Typically, horrors involve “haunted asylum” attractions with depictions of residents as violent monsters. In other cases, some stores sell “mental patient” costumes with straitjackets. These images perpetuate stigmatizing, offensive stereotypes of people living with mental illness.
NAMI loves Halloween as much as anyone else. But would anyone sponsor a haunted attraction based on a cancer ward? How about a veterans' hospital with ghosts who died from suicide while being treated for posttraumatic stress disorder (PTSD)? Or one based on racial or ethnic stereotypes? The U.S. Surgeon General has identified stigma as a major barrier to people reaching out for mental health care when they need it. People living with mental illness often internalize stigma as well, impeding recovery.
Mental Patient Costumes
Two British retail stores—one owned by Wal-Mart, Inc.—recently pulled mental patient costumes from shelves and apologized after protests. Unfortunately, the sale of mental patient costumes continues in many U.S.
stores. Last year, NAMI singled out BuyCostumes.com, which claims to be the world’s largest costume retailer. This year, shaming extends to seasonal Spirit Halloween stores (owned by Spencer Gifts). In the face of these large retailers, what can one person do?
However, recognize that it is a tough battle that involves advancing by inches over time rather than yards or miles. A Salon commentary celebrated the right to protest, but noted that the problem is bigger than Halloween: “If you want to be an insensitive jackass, you’re always going to have plenty of opportunity,”
wrote Mary Elizabeth Williams. “If you think it’s cool to parade around in a manner that’s racially tone-deaf or clueless about mental illness, chances are you’re not confining your idiocy to one night a year anyway.”
One of the first stigma reports received this year involves the Psychopath Sanctuary “Devil’s Folly Haunted Barn” near Allentown, Pa. Radio advertisements have proclaimed:
Alert, alert, alert! Several mental patients have escaped the state hospital. They are rumored to be hiding in an abandoned barn. Local residents have been reported missing. Neighbors of the barn have heard strange noises near the barn and believe people are being tortured there.
As reported in the Allentown Morning Call NAMI Lehigh Valley haslaunched a protest. So far, the response from the attraction operator has been dismissive. If you would like to support NAMI Lehigh Valley in their efforts, please send a polite email to the Devil’s Folly explaining why stigma is a serious public health problem: firstname.lastname@example.org.
This brand of haunted house is not confined to Allentown. For example, there’s one called the Insanitarium in Pinson, Ala. But what about Halloween attractions that might haunt your own community?
Do You Agree?
Do you share concerns over Halloween stigma?
Everyone occasionally feels blue or sad. But these feelings are usually
short-lived and pass within a couple of days. When you have depression, it
interferes with daily life and causes pain for both you and those who care about
you. Depression is a common but serious illness.
Many people with a depressive illness never seek treatment. But the majority,
even those with the most severe depression, can get better with treatment.
Medications, psychotherapies, and other methods can effectively treat people
There are several forms of depressive disorders.
Major depressive disorder, or major depression, is
characterized by a combination of symptoms that interfere with a person's
ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major
depression is disabling and prevents a person from functioning normally. Some
people may experience only a single episode within their lifetime, but more
often a person may have multiple episodes.
Dysthymic disorder, or dysthymia, is characterized by
long-term (2 years or longer) symptoms that may not be severe enough to disable
a person but can prevent normal functioning or feeling well. People with
dysthymia may also experience one or more episodes of major depression during
Minor depression is characterized by having symptoms for 2
weeks or longer that do not meet full criteria for major depression. Without
treatment, people with minor depression are at high risk for developing major
Some forms of depression are slightly different, or they may develop under
unique circumstances. However, not everyone agrees on how to characterize and
define these forms of depression. They include:
Bipolar disorder, also called
manic-depressive illness, is not as common as major depression or dysthymia.
Bipolar disorder is characterized by cycling mood changes—from extreme highs
(e.g., mania) to extreme lows (e.g., depression).
Most likely, depression is caused by a combination of genetic, biological,
environmental, and psychological factors.
Depressive illnesses are disorders of the brain. Brain-imaging technologies,
such as magnetic resonance imaging (MRI), have shown that the brains of people
who have depression look different than those of people without depression. The
parts of the brain involved in mood, thinking, sleep, appetite, and behavior
appear different. But these images do not reveal why the depression has
occurred. They also cannot be used to diagnose depression.
Some types of depression tend to run in families. However, depression can
occur in people without family histories of depression too. Scientists are
studying certain genes that may make some people more prone to depression. Some
genetics research indicates that risk for depression results from the influence
of several genes acting together with environmental or other factors. In
addition, trauma, loss of a loved one, a difficult relationship, or any
stressful situation may trigger a depressive episode. Other depressive episodes
may occur with or without an obvious trigger.
Signs & Symptoms
"It was really hard to get out of bed in the morning. I just
wanted to hide under the covers and not talk to anyone. I didn't feel much like
eating and I lost a lot of weight. Nothing seemed fun anymore. I was tired all
the time, and I wasn't sleeping well at night. But I knew I had to keep going
because I've got kids and a job. It just felt so impossible, like nothing was
going to change or get better."
People with depressive illnesses do not all experience the same symptoms. The
severity, frequency, and duration of symptoms vary depending on the individual
and his or her particular illness.
Signs and symptoms include:
Who Is At Risk?
Major depressive disorder is one of the most common mental disorders in the
United States. Each year about 6.7% of U.S adults experience major depressive
disorder. Women are 70 % more likely than men to experience depression during
their lifetime. Non-Hispanic blacks are 40% less likely than non-Hispanic
whites to experience depression during their lifetime. The average age of onset
is 32 years old. Additionally, 3.3% of 13 to 18 year olds have experienced a
seriously debilitating depressive disorder.
"I started missing days from work, and a friend noticed that
something wasn't right. She talked to me about the time she had been really
depressed and had gotten help from her doctor."
Depression, even the most severe cases, can be effectively treated. The
earlier that treatment can begin, the more effective it is.
The first step to getting appropriate treatment is to visit a doctor or
mental health specialist. Certain medications, and some medical conditions such
as viruses or a thyroid disorder, can cause the same symptoms as depression. A
doctor can rule out these possibilities by doing a physical exam, interview, and
lab tests. If the doctor can find no medical condition that may be causing the
depression, the next step is a psychological evaluation.
The doctor may refer you to a mental health professional, who should discuss
with you any family history of depression or other mental disorder, and get a
complete history of your symptoms. You should discuss when your symptoms
started, how long they have lasted, how severe they are, and whether they have
occurred before and if so, how they were treated. The mental health professional
may also ask if you are using alcohol or drugs, and if you are thinking about
death or suicide.
Other illnesses may come on before depression, cause it, or be a consequence
of it. But depression and other illnesses interact differently in different
people. In any case, co-occurring illnesses need to be diagnosed and
Anxiety disorders, such as post-traumatic stress disorder (PTSD),
obsessive-compulsive disorder, panic disorder, social phobia, and generalized
anxiety disorder, often accompany depression. PTSD can occur after a person
experiences a terrifying event or ordeal, such as a violent assault, a natural
disaster, an accident, terrorism or military combat. People experiencing PTSD
are especially prone to having co-existing depression.
Alcohol and other substance abuse or dependence may also co-exist with
depression. Research shows that mood disorders and substance abuse commonly
Depression also may occur with other serious medical illnesses such as heart
disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson's disease. People who
have depression along with another medical illness tend to have more severe
symptoms of both depression and the medical illness, more difficulty adapting to
their medical condition, and more medical costs than those who do not have
co-existing depression. Treating the depression can also help improve the
outcome of treating the co-occurring illness.
Once diagnosed, a person with depression can be treated in several ways. The
most common treatments are medication and psychotherapy.
Antidepressants primarily work on brain chemicals called
neurotransmitters, especially serotonin and norepinephrine. Other
antidepressants work on the neurotransmitter dopamine. Scientists have found
that these particular chemicals are involved in regulating mood, but they are
unsure of the exact ways that they work. The latest information on medications
for treating depression is available on the U.S. Food and Drug Administration (FDA)
Popular newer antidepressants
Some of the newest and most popular antidepressants are called selective
serotonin reuptake inhibitors (SSRIs). Fluoxetine (Prozac), sertraline (Zoloft),
escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa) are some of
the most commonly prescribed SSRIs for depression. Most are available in generic
versions. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are similar
to SSRIs and include venlafaxine (Effexor) and duloxetine (Cymbalta).
SSRIs and SNRIs tend to have fewer side effects than older antidepressants,
but they sometimes produce headaches, nausea, jitters, or insomnia when people
first start to take them. These symptoms tend to fade with time. Some people
also experience sexual problems with SSRIs or SNRIs, which may be helped by
adjusting the dosage or switching to another medication.
One popular antidepressant that works on dopamine is bupropion (Wellbutrin).
Bupropion tends to have similar side effects as SSRIs and SNRIs, but it is less
likely to cause sexual side effects. However, it can increase a person's risk
Tricyclics are older antidepressants. Tricyclics are powerful, but they are
not used as much today because their potential side effects are more serious.
They may affect the heart in people with heart conditions. They sometimes cause
dizziness, especially in older adults. They also may cause drowsiness, dry
mouth, and weight gain. These side effects can usually be corrected by changing
the dosage or switching to another medication. However, tricyclics may be
especially dangerous if taken in overdose. Tricyclics include imipramine and
Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant
medications. They can be especially effective in cases of "atypical" depression,
such as when a person experiences increased appetite and the need for more sleep
rather than decreased appetite and sleep. They also may help with anxious
feelings or panic and other specific symptoms.
However, people who take MAOIs must avoid certain foods and beverages
(including cheese and red wine) that contain a substance called tyramine.
Certain medications, including some types of birth control pills, prescription
pain relievers, cold and allergy medications, and herbal supplements, also
should be avoided while taking an MAOI. These substances can interact with MAOIs
to cause dangerous increases in blood pressure. The development of a new MAOI
skin patch may help reduce these risks. If you are taking an MAOI, your doctor
should give you a complete list of foods, medicines, and substances to
MAOIs can also react with SSRIs to produce a serious condition called
"serotonin syndrome," which can cause confusion, hallucinations, increased
sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm,
and other potentially life-threatening conditions. MAOIs should not be taken
How should I take medication?
All antidepressants must be taken for at least 4 to 6 weeks before they have
a full effect. You should continue to take the medication, even if you are
feeling better, to prevent the depression from returning.
Medication should be stopped only under a doctor's supervision. Some
medications need to be gradually stopped to give the body time to adjust.
Although antidepressants are not habit-forming or addictive, suddenly ending an
antidepressant can cause withdrawal symptoms or lead to a relapse of the
depression. Some individuals, such as those with chronic or recurrent
depression, may need to stay on the medication indefinitely.
In addition, if one medication does not work, you should consider trying
another. NIMH-funded research has shown that people who did not get well after
taking a first medication increased their chances of beating the depression
after they switched to a different medication or added another medication to
their existing one.
Sometimes stimulants, anti-anxiety medications, or other medications are used
together with an antidepressant, especially if a person has a co-existing
illness. However, neither anti-anxiety medications nor stimulants are effective
against depression when taken alone, and both should be taken only under a
doctor's close supervision.
Report any unusual side effects to a doctor immediately.
FDA warning on antidepressants
Despite the relative safety and popularity of SSRIs and other
antidepressants, studies have suggested that they may have unintentional effects
on some people, especially adolescents and young adults. In 2004, the Food and
Drug Administration (FDA) conducted a thorough review of published and
unpublished controlled clinical trials of antidepressants that involved nearly
4,400 children and adolescents. The review revealed that 4 percent of those
taking antidepressants thought about or attempted suicide (although no suicides
occurred), compared to 2 percent of those receiving placebos.
This information prompted the FDA, in 2005, to adopt a "black box" warning
label on all antidepressant medications to alert the public about the potential
increased risk of suicidal thinking or attempts in children and adolescents
taking antidepressants. In 2007, the FDA proposed that makers of all
antidepressant medications extend the warning to include young adults up through
age 24. A "black box" warning is the most serious type of warning on
prescription drug labeling.
The warning emphasizes that patients of all ages taking antidepressants
should be closely monitored, especially during the initial weeks of treatment.
Possible side effects to look for are worsening depression, suicidal thinking or
behavior, or any unusual changes in behavior such as sleeplessness, agitation,
or withdrawal from normal social situations. The warning adds that families and
caregivers should also be told of the need for close monitoring and report any
changes to the doctor. The latest information from the FDA can be found on their
Results of a comprehensive review of pediatric trials conducted between 1988
and 2006 suggested that the benefits of antidepressant medications likely
outweigh their risks to children and adolescents with major depression and
What about St. John's wort?
The extract from the herb St. John's wort (Hypericum perforatum) has been
used for centuries in many folk and herbal remedies. Today in Europe, it is used
extensively to treat mild to moderate depression. However, recent studies have
found that St. John’s wort is no more effective than placebo in treating major
or minor depression.
In 2000, the FDA issued a Public Health Advisory letter stating that the herb
may interfere with certain medications used to treat heart disease, depression,
seizures, certain cancers, and those used to prevent organ transplant rejection.
The herb also may interfere with the effectiveness of oral contraceptives.
Consult with your doctor before taking any herbal supplement.
Now I'm seeing the specialist on a regular basis for "talk
therapy," which helps me learn ways to deal with this illness in my everyday
life, and I'm taking medicine for depression.
Several types of psychotherapy—or "talk therapy"—can help people with
Two main types of psychotherapies—cognitive-behavioral therapy (CBT) and
interpersonal therapy (IPT)—are effective in treating depression. CBT helps
people with depression restructure negative thought patterns. Doing so helps
people interpret their environment and interactions with others in a positive
and realistic way. It may also help you recognize things that may be
contributing to the depression and help you change behaviors that may be making
the depression worse. IPT helps people understand and work through troubled
relationships that may cause their depression or make it worse.
For mild to moderate depression, psychotherapy may be the best option.
However, for severe depression or for certain people, psychotherapy may not be
enough. For example, for teens, a combination of medication and psychotherapy
may be the most effective approach to treating major depression and reducing the
chances of it coming back. Another study looking at depression treatment among
older adults found that people who responded to initial treatment of medication
and IPT were less likely to have recurring depression if they continued their
combination treatment for at least 2 years.
More information on psychotherapy is available on the NIMH website.
Electroconvulsive therapy and other brain stimulation
For cases in which medication and/or psychotherapy does not help relieve a
person's treatment-resistant depression, electroconvulsive therapy (ECT) may be
useful. ECT, formerly known as "shock therapy," once had a bad reputation. But
in recent years, it has greatly improved and can provide relief for people with
severe depression who have not been able to feel better with other
Before ECT begins, a patient is put under brief anesthesia and given a muscle
relaxant. He or she sleeps through the treatment and does not consciously feel
the electrical impulses. Within 1 hour after the treatment session, which takes
only a few minutes, the patient is awake and alert.
A person typically will undergo ECT several times a week, and often will need
to take an antidepressant or other medication along with the ECT treatments.
Although some people will need only a few courses of ECT, others may need
maintenance ECT—usually once a week at first, then gradually decreasing to
monthly treatments. Ongoing NIMH-supported ECT research is aimed at developing
personalized maintenance ECT schedules.
ECT may cause some side effects, including confusion, disorientation, and
memory loss. Usually these side effects are short-term, but sometimes they can
linger. Newer methods of administering the treatment have reduced the memory
loss and other cognitive difficulties associated with ECT. Research has found
that after 1 year of ECT treatments, most patients showed no adverse cognitive
Other more recently introduced types of brain stimulation therapies used to
treat severe depression include vagus nerve stimulation (VNS), and repetitive
transcranial magnetic stimulation (rTMS). These methods are not yet commonly
used, but research has suggested that they show promise.
More information on ECT, VNS, rTMS and other brain stimulation therapies is
available on the NIMH website.