Robert Althoff, MD, PhD, is a child psychiatrist at the University of Vermont Medical Center and associate professor at the Robert Larner College of Medicine at the University of Vermont.

May is Mental Health Awareness Month. Let’s take a moment to consider how to identify someone with a mental health issue. This is especially important because we now have good treatments for many psychiatric problems. The longer one waits to get treatment, the harder it is to get better.

First off, mental disorders are common, very common. In 2015, the National Survey on Drug Use and Health estimated that there were 43.4 million adults in the U.S. with a mental illness. That’s about 18 percent of the adult population. Simply put, nearly 1 in 5 adults experience some mental health problem in any given year. If you add problematic substance use to this list, these numbers increase. So, the chances are high that one of your friends, relatives, or colleagues is suffering from a mental health issue.

With a few exceptions, psychiatric symptoms don’t often pop up quickly. More often, symptoms of mental illness appear slowly, making them difficult to spot initially. In fact, it’s common for symptoms to be present for years before they come to the attention of a medical professional.

Often, as an individual is beginning to show signs of mental illness, it’s the people around them – partners, friends, parents, teachers, co-workers – who first notice differences in the emotions, behavior, or thoughts of the affected person.

Mental Illness Symptoms and Signs

Although mental illness comes in many shapes and sizes, here are 10 symptoms and signs that you might observe as signals that someone is struggling:

  • Withdrawal – People, in general, are social creatures. If someone who has been previously social begins to lose interest in being around others, this could be a sign of any number of psychiatric illnesses.
  • An inability to carry out daily activities – Typically, even with the ups and downs of daily life, when we’re mentally healthy we can take care of our basic needs (such as buying groceries, taking out the trash, paying the bills, etc.,) and hygiene. If these things are slipping, this might be a sign that someone needs help.
  • Excessive fear or worry – Most of us worry and are anxious at times. Worry is a natural human emotion. However, if it is interfering with daily activities or leading to avoidance of important activities, then it might be becoming a problem.
  • Mood changes – Moods tend to go up and down depending on the day or the circumstance. However, if you notice that someone’s moods are changing rapidly or dramatically and in poor relation to the circumstances around them, they may need some help regulating their moods.
  • Confused or illogical thinking – Although less common than some of the other symptoms on this list, there are several reasons why someone might begin to express thoughts that are illogical or unusual. Medical professionals can often find reasons for these changes, and help people to deal with them.
  • Sleep or appetite changes – Taking in food and getting sleep are two basic human needs. When we are sick, our appetite and sleep can change, as can our energy level, which is dependent upon good sleep and nutrition.
  • Prolonged expression of sadness, irritability, or anger – Everyone gets sad, irritable, or angry at times. These are standard human emotions. But, when these symptoms are prolonged, extreme, and/or persistent, this might be a signal that something else is going on.
  • Changes in school or work performance – This is especially true for children and adolescents where one of the first signs of a mental health problem might be a change in grades. If someone is quitting jobs, failing in school, quitting sports, etc., this might be a sign that they need some help.
  • Frequent temper tantrums in children – While temper tantrums are relatively common in young children, tantrums that lead to aggressive behavior, destruction of property, or injury are much less common. When these tantrums are accompanied by extreme disobedience, this might be a sign that a family system needs some additional support.
  • Talking about death or suicide – Suicidal thoughts are more common than people realize. Regardless of whether someone intends to go through with suicide, thoughts of wanting to die and/or thoughts of not wanting to live are signs that someone could use help. There is no evidence that asking a person about suicide makes him or her more likely to commit suicide. Rather, by talking about it we can start someone towards treatment.

These are just a few of the symptoms and signs that you might observe in others that suggest a mental health problem. Do not be afraid to reach out to someone who you think might be struggling. There are resources available to help. A good first place to start would be their primary care clinician who may refer them to a mental health professional.

If you are acutely concerned for someone’s safety, local crisis services are available 24 hours per day, as is the National Suicide Prevention Lifeline at 1-800-273-8255, or you can call 911.

Robert Althoff, MD, PhD, is a child psychiatrist at the University of Vermont Medical Center and associate professor at the Robert Larner College of Medicine at the University of Vermont. 


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