20 Types of Mental Health Issues and Disorders

Mental Health Issues 

Mental health issues are the health issues that influence thinking, mood, natural cognition, emotional regulation and behaviour and cause distress in various areas of cognitive functioning, causing thoughts of self-injury or suicide in severe cases. The other names for these conditions are mental illness, mental disorders and psychological disorders. Mental health is a state of optimum mental well-being that allows a person to learn well, work well, utilise their abilities and contribute positively to the community (WHO).

Mental health determines stress management and enables a person to make appropriate lifestyle choices. It is essential at every stage of life, from childhood to old age. It creates a positive outlook on life, allows a person to enjoy life, better cope with stresses, improve creativity, develop better and stronger relationships, make valuable contributions to the family and community, and improve self-esteem. Poor mental health compromises all these things. 

There are more than 20 mental health issues, and people experience these issues irrespective of ethnicity, financial background, gender and age. The risk of some mental health issues is slightly higher in females (or those designated as females at birth). Eating disorders, anxiety and depression, are more experienced by females, antisocial attitudes and substance abuse are more experienced by people designed as males at birth, and hyperactivity disorders and attention deficiency disorders are more experienced by adolescents. 

Mental health conditions are very common, and 1 in 6 people in the UK above 16 experience some mental health issues (Mental Health and Well-being Survey England, 2014). Irrespective of the type of mental health issues, it is essential to recognise them earlier for better health outcomes. Various common mental health conditions are; 

1. Schizophrenia: It is a complicated psychological disorder characterised by disrupted emotions and distorted feelings about reality. It has a high risk of suicide. 
2. Depression: It is a complex mood disorder characterised by poor energy, loss of enjoyment and attention in different activities and low mood. 
3. Psychosis: It is characterised by confused thinking, hallucinations and delusions. It is experienced in different other mental health conditions like schizophrenia.
4. Schizoaffective disorder: It is a psychological disorder characterised by symptoms of mood disorders like mania and depression and schizophrenia-like delusions and hallucinations.
5. Eating disorders: Eating disorders are a group of health conditions related to both mental and physical health that cause a change in eating behaviour and thinking about various aspects of food like shape, weight and eating.
6. Paranoia: It is an excessive feeling of being threatened by someone and a feeling that someone is following or chasing, even if it is not true.
7. Obsessive-compulsive disorder: It is a mental health condition in which the patient experiences unwanted thoughts at a high frequency that cause a person to perform repetitive behaviours. Severe obsessions and equally strong compulsions cause an urge to do some actions repeatedly.
8. Phobias: A phobia is an anxiety disorder that causes a person to experience irrational and extreme fear about an object, place, creature or situation.
9. Personality disorders: Personality disorders are mental health conditions in which a person has unhealthy and rigid behaviour, functioning and thinking pattern. Personality disorders cause problems with work, social activities and relationships.
10. Panic attacks: Panic attacks are intense and sudden feelings of fear that cause sweating, rapid breathing, and a fast heartbeat. The symptoms occur even in non-threatening situations and ultimately progress towards a panic disorder.
11. Anxiety disorders: The anxiety disorders are characterised by an overwhelming and constant fear and anxiety that causes a person to avoid schools, workplaces, social gatherings and any difficult situations. 
12. Hearing voices: Hearing voices or auditory hallucinations is a condition in which a person hears voices that are not heard by others and are not produced by any real source.
13. Bipolar affective disorder: Bipolar disorder or manic depression is a mood disorder or major affective disorder characterised by hypomanic or manic episodes that cause several episodes of high or low mood and disturbed energy, behaviour, thinking and sleep.
14. Post-traumatic stress disorder (PTSD): It is a mental health condition triggered by some terrifying and traumatic events, causing severe anxiety, uncontrollable thoughts, nightmares and flashbacks.
15. Premenstrual dysphoric disorder (PMDD): PMDD is a complicated type of premenstrual syndrome (PMS) that causes emotional and physical signs every month (or with every menstrual cycle) 1-2 weeks before menstruation (periods).
16. Dissociation and dissociative disorders: Dissociative disorders involve a feeling of dissociation from reality, experiencing memory loss (dementia), and feeling outside of the body. Such disorders develop in response to trauma (both short-term and long-term).
17. Seasonal affective disorder (SAD): It is a form of depression that has seasonal variations. The symptoms occur on and off in different seasons. As the symptoms are more common in winter, it is sometimes known as the winter depression.
18. Body dysmorphic disorder (BDD): It is a mental health condition negatively influences how a person sees or feels his appearance and body. The patients develop negative thoughts and emotions about their physical looks, compromising physical and mental well-being and quality of life.
19. Behavioral and emotional disorder in children: Behavioural and emotional disorders involve disruptive behaviours in children that last for 6 months or more and cause poor performance at home, school and social events. Such issues are not unexpected and are a normal part of development in childhood.
20. Generalised anxiety disorders: GAD is characterised by extreme worries and anxieties about routine life without a solid reason. The patients unnecessarily expect disaster in every situation and are constantly worried about school, work, family, money and health.

1. Schizophrenia

The term schizophrenia is coined by Eugen Bleuler and roughly means ‘splitting of the mind”. It is a severe and chronic mental health condition that influences a person's perception of reality, emotions, actions, and thoughts. It causes disconnection from reality, delusions, hallucinations and psychosis. Psychosis is a mental illness in which a person is unable to differentiate between imagination and reality and sees the world as a mixture of confusing and intermingled images, thoughts and sounds. 

The severity and frequency varies from person to person. Some people experience just one episode, while others experience multiple episodes with periods of normality in between. Still, others experience symptoms that fluctuate between remissions and relapses. Its beginning is independent of age but depends upon gender. Men experience an early onset at 15-25 years, and women experience an onset at a higher age of 25-35. The incidence rates in both genders are the same. It is rare in children under 18, and early onset causes more severe signs. The cases occurring after 40 years of age are more common in women. The lifetime incidence of schizophrenia and related disorders in the UK is 14.5 per 1,000 people (National Institute for Health and Care Excellence). 

Causes

The exact cause is not known, but it seems to have a biological basis. Various factors that influence the development of schizophrenia are; 

• Genetics, as it tends to run in families
• Problems with brain chemistry, like issues with the production, release and degradation of neurotransmitters
• Issues with brain development, like people with structural abnormalities in the brain are more susceptible 
• Pathological factors like exposure to toxins and viral infections 
• Use of drugs like marijuana 
• Hormonal changes during adolescence.

Stressful events often trigger schizophrenia attacks in susceptible people. 

Signs and symptoms 

The symptoms are early, positive, negative, disorganised, and cognitive. 

The early symptoms develop in a period known as the prodromal period, which is the time from the start of symptoms to the development of full psychosis and ranges between a few days to months. The early signs are social withdrawal, sleeping difficulties, temperament changes and loss of or troubled concentration. 

The positive or the psychotic symptoms are the added actions and thoughts far from reality. These include;

Hallucinations: It causes hearing of nonexistent sounds, unreal sensations, feeling strange odours, false feelings of touch on the skin and funny taste in the mouth. The voices cause the person to show insulting behaviour and give random commands. 

Delusions: Delusions are strange as false believes which are not real and causes a person to deny the realities. A common example is the feeling that people are plotting against them. 

Catatonia: It is a situation in which the patient stops responding and remains fixed in a position for a long time. 

The negative symptoms reflect the absence of normal behaviour and include poor emotions, social withdrawal, weakness, poor grooming and hygiene, and a total loss of interest in life. The disorganised symptoms mean a person is unable to think and respond as necessary and include speaking nonsense, shifting from one thought to the other, inability to make decisions, losing things due to forgetting, repeating the movements and moving slowly. 

The cognitive symptoms include poor understanding, lack of attention, poor working memory and lack of recognition of symptoms. 

Treatment

The treatment is aimed to reduce the symptoms and to prevent a relapse. The treatment options are;

Medications: Antipsychotics are used to treat the symptoms of schizophrenia. The first-generation antipsychotics are fluphenazine, chlorpromazine, loxapine HCl, perphenazine and haloperidol. The second-generation drugs are newer and have better efficacy and include aripiprazole, asenapine, clozapine, lurasidone, risperidone etc. Clozapine is effective for patients resistant to other treatments and lessens suicidal tendencies in severe patients. 

Electroconvulsive therapy: During electroconvulsive therapy, the electrodes are attached to the scalp when the patient is in deep sleep or general anaesthesia. Small electric shocks are given at 2-3 per week for some weeks. It causes the release of neurotransmitters and a controller seizure in the patient. It is helpful, particularly when the treatments don't work. The evidence to support its use for schizophrenia is mixed. 

Hospitalisation: Hospitalisation is a good option for people with severe symptoms, suicidal tendencies and who are unable to control themselves. 

Psychosocial therapy: Psychosocial therapies improve the occupational, social, psychological and behavioural issues that come with schizophrenia and allow the patients to manage the symptoms better and identify the early relapses. The issues to be focused on are cognitive remediation, rehabilitation, individual psychotherapy, family therapy and group support. 

Coordinated speciality care: A team approach is employed to treat schizophrenia as soon as the first signs appear. It is a combination of medical, educational and social interventions. The services of family and friends are enrolled to allow the patient to lead a normal life.

2. Depression

Depression is a mental health condition characterised by a persistent feeling of low mood, sadness and changes in actions, eating behaviour, sleeping patterns and thoughts. Sadness is a protective response the body uses to handle stress, and it continues to decrease with time. Depression is different from common sadness in that it is a prolonged condition accompanied by other signs. There are different types of depressive disorders, and clinical depression, or major depressive disorder, is the most severe type. Without proper treatment and management, it worsens and results in suicide or other forms of self-harm. The other types of depression are persistent depressive disorder (PDD), disruptive mood dysregulation disorder (DMDD), premenstrual dysphoric disorder (PDD), atypical depression, prenatal, postpartum depression and seasonal depression. 

Depression is very common, and 19.7% of people above 16 in the UK develop signs of depression. It affects everyone, but females are at higher risk than males, and the incidence rate in females is double (Mental Health Foundation, 2014). Some conditions and risk factors that increase the risk of depression are neurodegenerative diseases (Parkinson's and Alzheimer's), cancer, multiple sclerosis, stroke, seizure disorders, chronic pain and macular degeneration, etc. 

Causes

The exact cause of depression is not fully understood, and many causes and risk factors are involved. Some causes are genetic factors, changes in the levels of neurotransmitters in the brain, social factors like poor social support, exposure to abuse, past history of abuse in childhood and trauma, and psychological conditions like bipolar disorder. Depression results from a combination of different causes and risk factors, and the severity increases as the number and severity of risk factors involved increases. 

Signs and symptoms

Depression causes many observable signs that develop slowly. Some common signs are depressed mood, lack of interest in life, lack of pleasure or interest in the activities that used to be very interesting, poor sexual desire, low or high appetite, unintentional loss or gain of weight, sleep disturbances, pacing down or up, restlessness, agitation, slowed speech and movements, poor energy and fatigue, feelings of guilt and worthlessness, poor decision making, loss of concentration and thoughts of self-harm, suicide and self-injuries in severe cases. 

Signs are more prominent in females than males due to the presence of other risk factors like depression, periods, menstrual pain, pregnancy and menopause etc. Some additional symptoms in males are abusive behaviour, difficulties carrying out social and workplace problems, avoiding social and family issues and abnormal work routines. Students and teens experience loss of interest in schoolwork, lack of sleep or too much sleep, changes in appetite, lack of interest in social events, helplessness, irritability, guilt and crying and vocal outbursts in the children. 

Treatment

Treatment options include using antidepressants, natural remedies, certain diets, supplements, brain stimulation exercises, psychotherapy and physical exercises. Different types of antidepressants available are selective serotonin reuptake inhibitors (SSRIs), selective serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, atypical antidepressants and monoamine oxidase inhibitors (MAOIs) which must be used as asked by the doctor. Leaving treatments early results in relapses. 

Some natural and herbal products like chamomile, ginseng, lavender and St. John's wort are useful and have some evidence to support their use. Non-herbal useful supplements are 5 hydroxytryptophans and S adenosyl methionine. Some foods like olive oil, fruits, vegetables and fish are useful as they promote the release of anti-stress factors (antioxidants) and provide essential vitamins. Some other worthy options are aerobic exercises, psychotherapy, interpersonal psychotherapy, problem-solving exercises and brain stimulation therapies.

3. Psychosis

Psychosis is a condition in which the patient losses contact with reality. Two important clinical manifestations of psychosis are delusions, in which the patient believes unrealistic and false things, and hallucinations, in which the patient hears the sound or sees things that don't exist. It is observed in different psychological conditions for the first time in late teenage and early adulthood. Sometimes, the symptoms are noted without any primary causative illness like bipolar disorder and schizophrenia and are known as secondary psychosis. The episodes of secondary psychosis are associated with issues like diseases or drug abuse and are easily manageable. The incidence rate is low at just 0.7% in adults aged 16 or above (service.gov.uk). 

Causes

Various types of psychosis disorders experienced are brief psychotic disorder (or brief reactive psychosis) which is experienced due to severe stress and recovers as the stress is removed and drug-related psychosis, which is triggered by drugs like alcohol and stimulants like methamphetamine. Steroids and other prescription drugs sometimes cause symptoms and organic psychosis due to brain infection, diseases and head injury. It is experienced in different conditions known as psychotic disorders like bipolar disorder, delusional disorder; schizophrenia, chronic depression, etc. 

Besides these conditions, some other factors that trigger psychosis are stress, past traumatic experiences, excessive alcoholism, drug abuse, side effects of some drugs and diseases like brain cancer, postictal psychosis (PIP), myxedematous psychosis and hormonal fluctuations during pregnancy, menopause and periods etc. It has a genetic predisposition as the children of parents having psychosis are more likely to experience it. For example, children with 22q11.2 deletion syndrome and related genetic mutations are more likely to develop psychosis. (Anton Iftimovici, 2022).

Signs and symptoms

The psychosis is identified by various warning signs that appear before psychosis. These warning signs are lack of performance at a job or school, troubled thinking, loss of or difficulty in concentration, suspicion, paranoia, social withdrawal, no feelings or feelings that are novel and strange, loss of interest in the self, poor comprehension of reality and troubled communication. During an episode of psychosis, the signs appear like disorganised behaviour, delusions, hallucinations, negative emotions and frozen appearance (catatonia). The patients experience confused thoughts like constant talking with disturbed speech patterns, switching topics without any explanation and sudden loss of flow of thoughts causing sudden freezing or pause.

Treatment

Treatment needs a combination of behavioural and medical therapy. Proper treatment ensures recovery of symptoms. Some people experience symptoms like severe agitation and are at risk of self-injury. In such cases, rapid tranquillisation using a fast-acting tranquilliser is administered to calm down the patients. Antipsychotics are the medications used to treat symptoms like delusions and hallucinations. The doctors prescribe the medications based on clinical signs and symptoms.

Another useful option is cognitive behavioural therapy (CBT) which is done to improve behaviour and thinking. It involves regular appointments with mental health professionals, is very effective, and allows a person to manage symptoms and respond to episodes rapidly. It is helpful for severe cases when medications alone don't work. 

Psychosis is a difficult situation, and many patients don't admit it. It is counterproductive, and the patient must understand the gravity of the situation and talk to some family member or close friend for emotional support. Psychosis doesn't cause dangerous complications. However, it severely reduces the quality of life of the patients.

4. Schizoaffective Disorder

Schizoaffective Disorder is a psychological disorder characterised by symptoms of mood disorders like mania and depression and schizophrenia-like delusions and hallucinations. Schizoaffective Disorders are of two types, but symptoms of schizophrenia are present in both. Schizoaffective disorder is either bipolar type, which causes severe episodes of mania and depression, or depressive type, in which only the depressive episodes are experienced. The course of Schizoaffective Disorder is different in both of these types. Left untreated causes problems in social settings, school, and the workplace. The prevalence and incidence are not known. However, the lifetime prevalence of schizophrenia-related conditions is 14.5 per 1000 population (NIHCE). The most common age of development is late teens and early adulthood, between 16-30 years of age. Women are at higher risk than women, and the risk is very low in children.

Causes

The exact cause is unknown. However, several risk factors are involved, e.g., 

Genetic factors: The tendency to develop Schizoaffective Disorder runs in families, and the children of the affected parents are at higher risk.

Brain structure and chemistry: Thinking and mood are controlled by brain circuits, and any abnormality in these circuits increases the risk. Lower dopamine levels due to brain diseases that depress the functions of dopamine-producing areas are among the causes. 

Infections: Some bacterial and viral infections and highly stressful situations increase the risk of episodes in susceptible people. 

Drug abuse: The use or abuse of some drugs, like psychotropic or psychoactive drugs, alters mental conditions and increases the risk. 

Symptoms

The symptoms vary from person to person. Some features, like an episode of manic and depressed mood, occur, and then various psychotic symptoms develop for the next two or more weeks develop. The signs and symptoms depend upon whether it is depressive or bipolar type and include;

• Delusions and rigid believes that do not change despite contrary evidence. 
• Hallucinations that involve seeing things or hearing voices that don't exist.
• Impaired and incoherent speech and poor communication
• Unusual and bizarre behaviour
• Prolonged periods of manic behaviours that cause high energy, less sleep for several days and out-of-routine behaviour.
• Impaired social, academic and occupational functioning
• Loss of interest in personal care like poor grooming and poor hygiene.
• Thoughts of suicide or self-harm sometimes develop, and such a situation needs emergency care. 

Treatment 

Different treatments are; 

Medications: The choice of medications depends upon whether it is bipolar or depressive type. The medications prescribed are antipsychotics, including paliperidone which is effective for schizoaffective disorders and is available in extended-release form (Invega). For mood symptoms, mood stabilisers and antidepressants like lithium (Eskalith) are used. 

Psychotherapy: Psychotherapy and counselling aim to make the patients realise their condition and enable them to manage symptoms. Family therapy is very effective for schizoaffective conditions, and family members and friends need to cooperate with the patient. 

Hospitalisation: Severe psychotic episodes require hospitalisation, particularly if the patient is showing tendencies of self-harm or suicide. 

Skill training: It focuses on the improvements of social skills, improved self-care and grooming and enables the patient to manage the day-to-day activities better and take care of the sources of stress, particularly finance management. 

Electroconvulsive therapy: It is a good and ultimate option for people who don't respond to medications or psychotherapy. In electroconvulsive therapy, a sharp electric impulse is sent into the brain when the patient is asleep or in general anaesthesia. It results in brief seizures. The process is believed to change brain chemistry and reverse some of the responsible negative changes.

5. Eating Disorders

Eating disorders are a group of health conditions related to both mental and physical health that cause a change in eating behaviour and thinking about various aspects of food like shape, weight and eating. These conditions disturb the patient's overall well-being by disturbing both the physical and emotional well-being. Untreated and ignored cases become very serious, potentially causing death. The eating disorders include bulimia nervosa, anorexia nervosa, binge eating disorder and avoidant/ restrictive eating disorder. The patient becomes too worried and nervous about the food, body shape and weight, severely reducing the desired supply of essential nutrients to the body. The negative impact of eating disorders on the mouth, teeth, bones, digestive system and heart pave the way for other diseases, and they are closely related to mental health issues like anxiety, depression and thoughts of self-harm. 

Eating disorders are very common, and various studies have noted that 1.25-3.4 million UK citizens have one or more eating disorders. The risk is higher for women; only 25% of cases are reported in men. The incidence rate is highest in boys aged 10-14 and girls aged 15-19 (BMJ Open, 2013). 

Causes

Like other mental health disorders, the exact cause is elusive, and many risk factors are involved, which are;

Genetics: Some people are more susceptible due to the inheritance of genes from their parents. 

Biological factors: Some biological factors, like structural changes in the brain etc., have a role. 

Presence of other mental health disorders: The risk is high in people with other mental health conditions like obsessive-compulsive disorder, trauma, depression and anxiety. 

Dieting: The risk is higher in people concerned about weight and using various dieting strategies. Such people experience various ups and downs of weight, and excessive worries increase the risk. Women who are worried about weight gain reduce their food intake up to the point of starvation, causing the symptoms of food disorders. Such habits make it difficult to return to previous healthy routines. 

History of weight-related mocking and bullying: The people who are teased or bullied about their weight are at higher risk.

Stresses: Stresses cause different responses by different people. Some people leave food while others resort to more severe eating, both of which cause eating disorders. 

Irrespective of the cause, eating disorders cause anxiety, depression, serious health issues, thoughts of self-harm or suicide, substance abuse, relationship problems, workplace and educational issues and death in severe cases. 

Symptoms 

Symptoms depend upon the problem. In anorexia nervosa, fear of weight gain, low body weight and negative thoughts about body weight and shape are noted. The patients tend to use desperate methods to lose weight, like induced vomiting after eating, use of laxatives, and heavy exercises, causing problems as sometimes weight becomes excessively low and the situation becomes life-threatening. 

In bulimia nervosa, there are several episodes of bingeing followed by similar episodes of purging, and severely restrictive diets increase the urge to repeat it. During bingeing, a person seems to lose control over food intake and takes a very large amount of food quickly. After it, an intense fear of weight gain, shame and guilt cause the patient to induce purging, using laxatives, heavy exercises, and completely avoiding food for a long time. The patients become obsessive about their weight and body shape. 

During binge eating disorder, the bingeing is not followed by induced purgation, and the patients feel uncomfortably full and have feelings like shame, guilt and disgust. The patients resort to excessive hunger, which increases the urge to binge further, setting up an unhealthy cycle. The embarrassment causes the patients to hide while eating. 

During the avoidant/ restrictive food intake disorder, there is severely limited food intake, and daily nutritional requirements are unmet. The patients are not worried about weight gain but are not interested in food or abhor certain food due to taste, texture, colour or smell. The patients are often excessively fearful of choking or vomiting after eating. It is more common in younger children and causes failure to achieve desired growth, weight loss and other major nutrition-related diseases like rickets. 

Treatment

Timely treatment and prevention ensure recovery, but it takes time and patience. The family and friends of the patient must encourage the patient to identify the problem and convince them to seek help. The eating disorder specialist helps to identify the cause and develop a treatment and prevention plan. The adults must focus on a healthy diet, avoid using dietary supplements, stay physically active, and seek help whenever they find mental health issues like depression, anxiety and excessive worries about body shape and image. If the children have such issues, the parents and other elders must avoid eating close to them, talk to the child about healthy lifestyle choices and see if the child is taking wrong information or guidance from unauthorised sources. The parents must encourage the child about body shape and image, avoid criticism, and use positive means to convey such sensitive messages. When there is no relief, the patients must go to the relevant professionals.

6. Paranoia 

Paranoia is an excessive feeling of being threatened by someone and a feeling that someone is following or chasing, even if it is not true. It causes severe suspicion and a lack of trust without adequate reasons to do so, and such patients tend to be excessively alert and fearful. People with paranoid personality disorder (PPD) often feel that there is nothing wrong with their behaviour. It is among the cluster A personality disorders characterised by eccentric and unusual behaviour and thinking. However, no hallucinations or delusions occur, which is common with many other mental health conditions. The signs appear as early as teenage and early adulthood, and the rate is highest in the people assigned female at birth. The people at higher risk are divorced, widowed females, people who never married, Native Americans, African Americans and people of low financial status. The incidence of paranoid personality disorder is less. The incidence rates are variable, and signs are experienced by 10-15% of the population (Lyn Ellet and colleagues, 2022). 

Causes

The exact cause of paranoia is not known. However, it is the result of various biological and environmental risk factors. It is found that emotional, sexual and physical abuse in childhood and parental neglect causes increased risk in adulthood. It has some link to genetics. However, the link is not so strong. The other important causes are;

Lack of sleep: Sleep deprivation for a long time takes a toll on mood and temperament. Such a person is more susceptible to misunderstandings and clashes. Sleep deprivation causes signs like hallucinations. 

Stress: Tensions and stresses cause a person to become more suspicious of others and increase negative emotions. Even a happy occasion causes similar thoughts in such Persons. 

Psychological disorders: Various other psychological issues like schizophrenia, borderline personality disorder etc., increase the risk of paranoia. 

Drug abuse: Some drugs like hallucinogens, marijuana, stimulants (methamphetamine, cocaine) and heavy alcoholism cause paranoia for a short time. However, the signs disappear as soon as the drug leaves the body. The drugs make already ongoing signs worse. 

Memory loss: Dementia, Parkinson's, and Alzheimer's disease cause frustrations and increase suspicious thoughts. 

Signs and symptoms

Some common symptoms of paranoia are;

• Difficulty in believing others and doubting their trustworthiness, commitment and loyalty. 
• Reluctant to share personal information with others and fearful that others will misuse it.
• Holding grudges for a long time and never forgiving others.
• Unnecessarily searching for hidden marks in causal things. 
• Perceiving insults and personal attacks without any such issue.
• Having distance and cold in relationships and being highly fearful of betrayal.
• Never admitting faults and firmly believing one to be always right. 
• Being highly argumentative, stubborn, hostile and very difficult to relax.

A paranoid person is very difficult to convince of the situation and refuses to seek professional help, and it is the job of family, friends, employers and co-workers to refer the patient. 

Treatment

The treatments of choice for confirmed cases are dialectical behaviour therapy (DBT), talk therapy (psychotherapy) and cognitive behavioural therapy (CBT). The treatments train a person to learn coping skills and develop empathy, trust, self-esteem, communication and social interactions. Successful treatment is difficult as a person doesn't trust anyone, and trust between psychologists and a patient is necessary. Such people are likely to distrust the psychiatrist and don't follow the treatment plans. Healthcare professionals generally don't prescribe medications to such patients. However, antipsychotics, antidepressants and anti-anxiety drugs are prescribed in more advanced cases or the presence of other conditions like depression and anxiety.

7. Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder is a mental health condition in which the patient experiences unwanted thoughts at a high frequency that cause a person to perform repetitive behaviours. Severe obsessions and equally strong compulsions cause an urge to do some actions repeatedly. An obsessive person often experiences thoughts like whether certain numbers or colours are good or bad or the urge to wash hands repeatedly after going to the toilet or touching a dirty object. The urge is very strong to stop despite efforts. The thoughts and actions in OCD take at least one hour daily, are uncontrollable, interfere with social life and work and are not enjoyable. One million UK citizens experience it, which makes an incidence rate of 1 out of 50 (Royal College of Psychiatrists). The age of onset is adolescence and adulthood. 

Causes

The exact cause is not known, and there are several risk factors;

Genetics: The problem is more common in people whose biological relatives, like parents, have it. The risk increases as the age of development in the close relative decreases. 

Brain structure: Imaging techniques have shown differences in subcortical, frontal and cortical structures of the brain in people with OCD. Some brain diseases like epilepsy, Tourette's syndrome and Parkinson's disease influence those areas of the brain and increase the risk.

PANDAS disease: It means paediatric autoimmune neuropsychiatric disorders and is caused by streptococcal infections. Brain infections increase the risk of OCD In adult age. 

Childhood trauma: Any childhood trauma, neglect or abuse causes a higher risk in adulthood.

Signs and symptoms

The signs and symptoms fall into various categories;

• Checking certain things repeatedly, like locks, light switches, and alarm systems.
• Continuous thinking about certain conditions like having mental health illness or pregnancy. 
• Feelings that some things are dirty and having strong compulsions to clean them (obsessive cleanliness disorder). The patient feels that their hands are not clean enough after the toilet and wash them repeatedly. 
• Ordering things like the desire to have things ordered in a certain way. 
• Intrusive thoughts, e.g., obsession with a particular thought or idea. The thoughts are occasionally disturbing and violent. 
• Excessive fears like the fear of contamination by germs, fears of being not careful enough to avoid certain dangers and unwanted thoughts about images and body image during sex. 
• Excessive concerns about morality and fear of making mistakes. 
• A constant need for reassurance from others. 
• Hoarding and collecting certain things that don't have any apparent value. 
• Issues related to the numbers, e.g., repeated counts, repeating a task for a certain number of times, being excessively careful to avoid certain numbers, and repeating certain numbers or words while doing certain work. 
• Sometimes, a person develops a phobia of things that cause obsessive behaviours like avoiding handshakes and touching certain objects. 

Treatment

For treatment, psychotherapy and medications are used. If both are ineffective, doctors often recommend more advanced options like transcranial magnetic stimulation (TMS).

Psychotherapy (talk therapy) uses techniques that aim to help change unhealthy and unwanted emotions, behaviours and thoughts and are performed by a professional psychologist. Several types of psychotherapies used are cognitive behavioural therapy (CBT), which helps to change negative habits and replace them with healthier habits; exposure and response prevention (ERP), in which the psychologist exposes a person to certain stimulation and teaches how to avoid compulsions and acceptance and commitment therapy (ACT) that allow the patient to take obsessive thoughts causally and develop the power to avoid them. Some mindfulness techniques like relaxation and meditation are helpful. Some medications useful for OCD are serotonin reuptake inhibitors (SNRIs), serotonin selective reuptake inhibitors (SSRIs) and antidepressants. The SSRIs are most often prescribed for OCD, like Sertraline, Paroxetine, Fluvoxamine and Fluoxetine etc. Regular use for up to 3 months or more is necessary to note benefits.

8. Phobias

A phobia is an anxiety disorder that causes a person to experience irrational and extreme fear about an object, place, creature or situation. The life of a phobic person is adjusted to avoid exposure to the perceived danger, and the imagination of the threat is worse than reality. Intense distress occurs when such a person faces the source of phobia, occasionally causing panic attacks. There are three types of phobias, including specific phobia, which is due to specific triggers; social anxiety or social phobia, which is the fear of being noted, judged or humiliated in a public situation and agoraphobia which is the irrational fear of trapping in a certain situation like facing danger while in an elevator or the toilet. 

The specific phobias are easy to handle. They are related to a known cause like fear of snakes and don't disturb daily life. The other types are complex as their triggers are not well defined, and they cause more risk of panic disorder. Phobias are among the most common anxiety disorders, with 10 million UK citizens having one or more phobias (NHS). 

Depending upon the level of exposure and personal factors, phobias cause issues ranging from mild annoying to severe panic attacks and disability. Depending upon the types of triggers, there are tens of different types of phobias like driving phobia, hydrophobic (fear of water), aerophobia (fear of flying), zoophobia (fear of animals), aquaphobia (fear of water bodies), acrophobia (fear of height), tunnel phobia and many more. Phobias are experienced by both genders equally, but men are more likely to seek treatment. All age groups experience them, and they are mostly first seen in the age group 15-20 years. 

Causes 

There is no single cause, and several genetic and environmental factors are involved. People having close relatives with similar issues have a higher risk. Some traumatic events like a severe electric shock, risk of falling from a height, bites or assaults by animals, near drowning experience, child abuse, depression, substance abuse and traumatic injuries cause phobias. The early age of exposure to these triggers increases the risk, and phobias rarely develop after 30. Sometimes, the phobic experiences of some family members cause similar issues in the children. Complex phobias are the result of exposure to multiple factors. 

Signs and symptoms 

On exposure to the trigger, a phobic person experiences different symptoms, and the severity depends upon the degree of exposure. The signs are;

• Uncontrollable anxiety and fear
• A strong urge (compulsion) to avoid exposure to the risk factor at all costs
• Disability after exposure to the triggers
• An acknowledgement that the fear is exaggerated, irrational and unreasonable and still not being able to control the emotions 

During a panic attack after exposure to the allergens, various physical symptoms include headache, dizziness, nausea, disorientation and confusion, dry mouth, feelings in the stomach, chills or hot flashes, choking sensation, trembling, increased heartbeat, sweating and abnormal breathing. 

In young children, the symptoms like excessive crying, clingy behaviour and a tendency to hide behind the curtain, objects or legs of the parents etc., show phobias.

Treatment

Phobias are treatable, and consulting a psychiatrist is a good option. If there are no severe signs, simply avoiding the triggers is enough, and many people with phobias don't go for treatment. There is nothing like a perfect treatment, and it must be tailored to the individual needs. Both medications and behavioural therapy are useful. 

The medications used for phobias are beta blockers that reduce the signs like anxiety and depression, antidepressants like serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants and tranquillisers. Behavioural therapy includes exposure and desensitisation therapy and cognitive behavioural therapy (CBT). The medications have many side effects and must be used only as asked by the healthcare provider.

9. Personality Disorders 

Personality disorders are mental health conditions in which a person has unhealthy and rigid behaviour, functioning and thinking pattern. Personality disorders cause problems with work, social activities and relationships. Often, the patient is unable to identify the issues and blames others. The start is mostly between teenage and early adulthood. Personality disorders are of various types which are classified into three broader categories;

Cluster A: Cluster A personality disorders cause eccentric and unusual behaviours and thinking and include paranoid personality disorder (PPD), schizoid personality disorder and schizotypal personality disorder. 

Cluster B disorders: The diseases in cluster B cause erratic and irrational behaviours. The patients display impulsive behaviours, unstable emotions and intense feelings. The major disorders are antisocial personality disorder, borderline personality disorder, histrionic personality disorder (HPD) and narcissistic personality disorder. 

Cluster C personality disorders: The diseases in cluster C cause fear and anxiety, including avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. 

Each disorder has its causes, signs, and symptoms are discussed in their respective sections. Personality disorders are very common and are experienced by 5% of UK citizens, mostly in their adult years (Mental Health Foundation). 

Causes

Personality is a blend of genetics, learning, training, emotional upbringing and behaviours. The causes are unique to everyone and depend upon the type of disease too. Some important factors are;

Genetics: Various multifunction genes are involved in obsession compulsion, fear, anxiety and depression and the inheritance of these genes is a risk factor. 

Brain structure and chemistry: The research has found changes in the brain of the patients, e.g., altered functions of the amygdala, a part of the brain that processes threatening and fearful stimuli. 

Child abuse: A history of abuse in childhood increases the likelihood of personality disorders in the coming years. Such people have trust and intimacy issues, which contribute to personality disorders. 

Cultural issues: The personality disorders show changes across various cultures, e.g., the cases of cluster C personality disorders are higher in China, Japan and Taiwan, with lower cases of antisocial personality disorders in the region. These findings suggest that personality disorders are related to cultural norms and practices. 

Signs and symptoms

The signs and symptoms and clinical picture of each personality disorder are different. However, there are two issues common to all. 

Altered sense of self and identity: The patient doesn't have a clear and stable self-image, and their self-perceptions depend upon the company and situation. Self-esteem is either very low or very high. 

Relationship problems: Such people have issues forming close and stable relationships due to their strange and unusual beliefs about themselves. The patients are extremely needy of care and attention, are emotionally detached and lack respect and empathy for others. The patients are mostly unaware that their thoughts and beliefs are influencing others.

Treatment 

The treatment of personality disorders is problematic as the patient doesn't admit any fault in the behaviour and does not go for the treatment or cooperate with the psychiatrist. If the patients cooperate, the medical options are still limited, and currently, no medications are approved. Sometimes, the medications used for depression and anxiety are prescribed. Talk therapy (psychotherapy) uses techniques that enable the patient to identify the signs and change the emotions. The family and friends of the patients need to convince the patient to visit the psychiatrist for support and guidance. Various types of psychological treatments are used for different personality disorders. For example, cognitive behavioural therapy (CBT) is effective for histrionic personality disorder and dialectical behaviour therapy (DBT) is effective for borderline personality disorder.

10. Panic Attacks 

Panic attacks are intense and sudden feelings of fear that cause sweating, rapid breathing, and a fast heartbeat. The symptoms occur even in non-threatening situations and ultimately progress towards a panic disorder and various issues like diseases, stresses, traumas, substance abuse, phobias, mood and anxiety disorders, etc. Panic attacks are not very dangerous and life-threatening, but they reduce the quality of life. Panic attacks differ from anxiety attacks in that panic attacks occur suddenly and unexpectedly. Not everyone experiencing panic attacks develop panic disorder. It is a rare condition; less than 1% of people experience panic disorder, with young and adolescent people at the highest risk. 

Causes

The exact cause is unknown. However, the nervous system and brain chemistry have a role. Some pathological issues like amygdala dysfunction, a part of the brain that processes emotions and fears, are responsible. The imbalances of chemicals like serotonin, cortisol and GABA are among the causes. Some factors that increase the risk are; family history, as many genes responsible for nervous functions are inherited; mental health conditions like anxiety and depression; adverse experiences in childhood; certain phobias like fear of needles (trypanophobia) etc. Sometimes, the fear of a panic attack becomes a trigger in itself. 

Signs and symptoms 

Intense physical and mental symptoms develop during a panic attack. The attacks occur without any known cause causing symptoms like sweating, rapid heartbeat, fainting, chest pain, nausea, hot flashes, shortness of breath, shakiness, chills, trembling, dizziness, choky sensation, dry mouth, numbness, urgent desire to go to the toilet, ringing in ears, fear or feeling of death, tingling in the fingers, churning stomach and feelings of disconnection from the body. The symptoms last for 5-20 minutes and sometimes even longer. The frequency of attacks depends upon the severity of the condition, with some people experiencing 1-2 episodes in a month while others experience several attacks in a week. These symptoms are mostly not a cause of concern and are often signs of other physical and mental health diseases. For example, a racing heartbeat is a sign of hypotension. The diagnosis is confirmed if a patient is experiencing the attacks and spending the period in between attacks in fear. 

Treatment

Treatment aims to ease the symptoms, lower the frequency of panic attacks and prevent the development of panic disorder. Both medications and psychotherapy are used. The medicines used are the antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, and antiepileptic medications like Clonazepam and pregabalin. Regular use of medications for 2-4 weeks and sometimes up to 8 weeks is required to get results. The medications must be used or stopped as asked by the psychiatrist. Some talk therapies, like cognitive behavioural therapy (CBT), are useful if done by a qualified psychiatrist. The psychiatrist trains the patient to recognise the dangers and teaches how to manage the symptoms. Connecting to a social support group like a club, etc., is useful for better motivation. If, however, the symptoms are not improving despite these treatments, the patients are referred to a clinical psychologist who helps the patients to devise a plan to manage the symptoms.

11. Anxiety Disorders 

Anxiety disorder is a response to stress and is a healthy emotion. Experiencing anxiety sometimes is normal. However, anxiety disorders are characterised by an overwhelming and constant fear and anxiety that causes a person to avoid schools, workplaces, social gatherings and any difficult situations. The symptoms last longer than expected and occasionally always persist. An untreated anxiety disorder keeps progressing and hinders normal activities like crossing the road, using the elevator, and even leaving home in server conditions. 

It is a common condition with a prevalence of 7.2% and a lower incidence rate of 9.7 per 1000 (Charlotte Archer and colleagues, 2022). Women are more likely to have anxiety disorders than men. Despite onset at a younger age, severe signs are experienced by elderly people. It often occurs as a part of other mental health conditions like phobias, panic disorder, obsessive-compulsive disorder, social anxiety disorder, the anxiety of separation and disease, post-traumatic stress disorder (PTSD), major depressive disorder, and chronic diseases like diabetes, arthritis, COPD etc., substance abuse and chronic pain disorders.

Causes

There is no single cause, and many causes and risk factors are involved. The common causes are;

Genetics: It runs in families, and the children of patients are more likely to develop signs.

Brain chemistry: The structural and functional abnormalities in the parts of the brain that control emotions and fear cause anxiety disorders.

Stresses: Stressful life events occurring in the present or the past, like the death of a family member or close friend, seeing violence and attacks, near-death experiences, neglect and sexual or emotional abuse in childhood are involved. 

Drug abuse or withdrawal: Alcohol and the drugs used for Parkinson’s disease, seizures, asthma, thyroid issues etc., are linked to the risk of anxiety. 

Diseases: Some conditions like diseases of the thyroid, lungs and heart cause anxiety disorders or make the synonyms of already occurring conditions even worse. 

Risk factors: Besides these causes, several risk factors increase the risk. These include; a history of mental health conditions like anxiety and depression, sexual abuse in childhood, past traumatic experiences (PTSD), stressful life events like parents or siblings' or siblings' death, shy behaviour in early childhood and poor self-esteem. 

Signs and symptoms 

The symptoms are variable and depend upon the person experiencing them. A disconnection between body and mind is experienced, causing symptoms ranging from minor stomach issues to rapid heartbeat. The general feelings of worry and fear cause a person to avoid the specific trigger that causes a panic attack. The common signs of anxiety disorders are anxious and out-of-control beliefs and thoughts, poor concentration, restlessness, irritability, fatigue, poor sleep or loss of sleep, unexplained pains and aches in the body, feelings like uneasiness, panic and fear, false feelings of danger or doom, inability to calm down, faster breathing, breadth shortness, nausea, dry mouth, heart palpitations, dizziness, muscle tensions, inability to stop thinking about a problem, severe compulsions and obsessions. Sometimes, gastrointestinal disturbances, sweating and trembling occur. The presence of these signs for a long time and an inability to control them must lead to consultation with a psychiatrist. 

Treatment 

Many types of treatments for anxiety disorders are available, including medications and psychotherapy.

Medications: The psychiatrist or physician prescribes different medications to manage the symptoms. These include; antidepressants like SSRIs (like fluoxetine and escitalopram) and SNRIs (venlafaxine and duloxetine). Another drug, bupropion, works differently and is used when the SSRIs and SNRIs are ineffective or to be avoided. The other antidepressants used are monoamine inhibitors, tricyclic antidepressants, benzodiazepines, anticonvulsants, beta-blockers, buspirone and antipsychotics. These drugs have many advantages and side effects and must be used after consulting healthcare professionals. 

Psychotherapy is counselling (talk therapy) with a mental health expert that allows people to improve their behaviour and learn how to control emotions. A trained mental health expert identifies the issues by discussion and convinces the patient to adopt certain changes or use medications. A Common example of psychotherapy is cognitive behavioural therapy (CBT), which allows a person to avoid panic and anxiety-causing thoughts and learn how to manage the symptoms.

12. Hearing Voices 

Hearing voices or auditory hallucinations is a condition in which a person hears voices that are not heard by others and are not produced by any real source. The voices are heard during the awakening and are felt like they are produced from a real source but are just illusions created by the brain. Sometimes, the sounds are familiar, and at other times are unusual, pleasant, or frightening. The severity and types of voices depend upon the nature and severity of the condition and include name calls without anyone around, calm voices during sleep, constant reoccurrences of voices in the head, feeling that voices are from outside sources, but then the realisation that they are from the inside of ears, occasion scary voices etc. 

All voices are not essentially negative, and only the negative voices that disturb routine life need treatment. The condition is fairly common, with up to 28% of the UK population experiencing some form of auditory hallucinations (University of Exeter). 

Causes

The voices are often blamed for mental Illnesses. However, there are many other causes, e.g., 

Alcoholism: Heavy alcoholism has variable effects on the brain and causes the hearing of voices both during and after drinking.

Dementia: Many diseases that cause dementia (loss of memory), like Alzheimer's, cause hearing voices in the later stages. Both visual and auditory types of hallucinations occur. The cause seems so real that people often respond to them. 

Drugs: Some common drugs, like LSD and ecstatic drugs etc., cause voices after use. 

Brain tumours: Sometimes, a tumour in the part of the brain that controls the auditory sensation causes voices that range from random voices to actual voices. 

Loss of hearing: Hearing loss in one or both of the ears due to infections and incidents causes random stimulation of the nerve impulses in the ears and causes sounds. 

Epilepsy: Sometimes, epilepsy seizures influence the brain area that controls hearing and cause buzz sounds. 

Infections and fevers: Some infections, like meningitis and encephalitis, cause hearing issues and other signs. The situation often develops in the high fevers associated with infections. 

Miscellaneous causes: Besides these, there are many miscellaneous causes of voices. These include heavy and chronic stress (e.g., hearing voices of loved ones after death), mental health conditions like bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD), borderline personality disorder, major depressive disorder and Schizoaffective disorder, migraines, Parkinson's disease, sleeping issues, side effects of some medications, thyroid issues and tinnitus. 

Signs

The signs and Symptoms depend upon the cause and include hearing normal or abnormal sounds without any known cause. The signs occur repeatedly for a long time and cause discomfort and influence the quality of life. 

Treatment 

Treatment depends upon the cause, and the underlying problem needs to be solved. Proper treatment and cooperation with the doctor ensure recovery or reduce symptoms. Neuroplastic medications, which lower the severity and frequency of auditory hallucinations, like clozapine, and psychotropic medications, like mood stabilisers and antidepressants, help treat auditory hallucinations in people with mania and depression. Another useful treatment is psychotherapy (talk therapy) combined with medications. The psychotherapy treatments help the patients to identify the signs earlier and to respond. It involves educating the patients about the causes, warning signs, and how to respond. Various talk therapies are useful, like cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), and hallucinations-focused integrated treatment (HIT).

13. Bipolar Affective Disorder

Bipolar disorder or manic depression is a mood disorder or major affective disorder characterised by hypomanic or manic episodes that cause several episodes of high or low mood and disturbed energy, behaviour, thinking and sleep. Such people experience periods of being energised and happy at one time and periods of sluggishness, hopelessness and sadness at other times. They are normal in between these periods. So, the episodes of high or low are the two 'poles'; that's why it is called bipolar disorder. 

The condition is fairly common in the UK, with 1.3 million (or 2%) patients (BipolarUK.org). People of all ages experience it, although the most common time or development is between 15-19 years. Both women and men, regardless of ethnicity, are affected. The frequency of episodes is highly variable, with some people experiencing just a few episodes while others have many. 

Causes

Bipolar affective disorder is the outcome of several factors. The most important being;

Biological factors: Different biological factors like the imbalances of the hormones that influence the nervous system and the imbalances in the production or utilisation of neurotransmitters in the brain have a role. 

Genetic factors: The condition is more common in the children of manic people. It is often a result of many genetic mutations inherited from the parents to the children.

Environmental factors: Different outside factors like chronic stress, history of emotional and physical abuse in childhood, mental diseases and past traumatic experiences trigger an episode in susceptible people. 

Signs and symptoms 

The symptoms experienced vary depending on whether there is a manic or depressive episode. During a depressive episode, the patient experiences the same symptoms as experienced in the major depressive disorder like;

• Loss of appetite with weight loss/ or high appetite with weight gain
• Poor concentration, decision making and memory 
• Poor energy and fatigue
• Feelings of worthlessness, guilt and helplessness 
• Sleeping issues like oversleeping, early morning awakening and insomnia 
• Loss of pleasure or interest in the activities that once used to be very entertaining, e.g., sex 
• Persistence of certain physical symptoms that do not respond or respond poorly to the treatment, e.g., digestive disorders, chronic pain and headaches
• Empty mood with anxiety and sadness
• Irritability, restlessness with thoughts or attempt at suicide

During mania, a different set of symptoms are experienced;

• Very rapid and disconnected thoughts
• Inappropriate euphoria and self-elation 
• Grandiose believes
• Irritability and inappropriate social behaviour
• Increased libido (sexual desire)
• Increased volume and speed of talk
• Increased energy
• Poor risk-taking and judgment
• The low desire for sleep or poor sleep due to high energy levels

Treatment 

The extreme highs and lows experienced during bipolar disorder disturb the routine functions of life, and treatment is required. Several treatments are available that control the symptoms during an episode, help to avert an episode and allow a person to have a normal life. 

The treatment options are;

Medications known as mood stabilisers help manage the symptoms. The mood stabilisers need to be used daily for a prolonged time. Antidepressants and tranquillisers are used to treat the severe symptoms of depression or mania. 

Psychotherapy teaches a person about the signs and triggers of manic and depressive episodes and teaches the patient how to deal with the situation and improve relationships. 

Some lifestyle changes like physical activities, outings and improvements in sleep and diet make a difference. A single option is less effective, and combining different methods and approaches gives results. The enrollment in different social associations, support groups and charities is very important. In case of a severe manic or depressive attack or a very high frequency of episodes, the help of healthcare professionals and psychiatrists must be enrolled.

14. Post-traumatic Stress Disorder (PTSD)

It is a mental health condition triggered by some terrifying and traumatic events, causing severe anxiety, uncontrollable thoughts, nightmares and flashbacks. The symptoms are experienced both after experiencing and witnessing a traumatic event. For most people, the symptoms are temporary and get better with time. However, if the symptoms persist for months and worsen and interfere with routine life, it reflects the presence of severe PTSD. Some important events that trigger the symptoms of PTSD are physical and emotional abuse, the death of a family member or friend, crime incidents, wars, fires, severe accidents and different types of near-death experiences. It is very common and affects about 4% of the population (ptsduk.org). Both men and women are susceptible. However, the risk is higher in women. Due to the similarity of the causes and risk factors, various other conditions are closely related to PTSD, like disinhibited social engagement disorder (DSED), adjustment disorder and acute stress disorder. 

Causes

PTSD develops in response to traumatic events like experiencing the suffering or witnessing the sufferings of others during military service, terrorist attacks, serious life-threatening accidents, violent relationships, breakups, divorce, death of a loved one, sexual abuse, e.g., rapes, any victimisation, workplace discrimination, social discrimination and having a life-threatening disease like cancer. In short, anything that triggers helplessness, shock, terror and fear triggers PTSD. 

Signs and symptoms

The symptoms don't develop immediately and take around 3 months and sometimes years to develop. The duration and severity are variable; some people experience high-intensity symptoms for 6 months, while others continue to experience low-intensity symptoms for years. The following types of symptoms are experienced; 

Relieving symptoms: The patients experience sharp and traumatic memories like nightmares, hallucinations and flashbacks. Some factors, like the anniversary of those stressful events, often trigger these symptoms. 

Irritability: Excessively aroused emotions cause problems in the relationships, e.g., showing or feeling affection, anger outbursts, and difficulty in getting sleep, poor concentration and being easily startled by any situation. Some physical symptoms like diarrhoea, nausea, muscle tension, rapid breathing, rapid heartbeat and hypertension often develop. 

Avoidance: The patients tend to avoid the thoughts, places, people and situations that remind them of the incidents. It causes the patient to become detached from family and friends and lose interest in previously enjoyable activities. 

Poor mood and cognition: The negative changes in the mood cause estrangement, the tendency to blame others and showing sensitivity to the memories related to the traumatic events. 

Treatment 

Treatment aims to manage the physical and emotional symptoms and improve the patient's quality of life. Both medications, psychotherapy or a combination of these treatments are used. 

Medications: Antidepressants are used to control anxiety and negative emotions. Various types of antidepressants used are selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, mood stabilisers and antipsychotics. Some hypertension drugs are used to manage specific symptoms. For example, clonidine is used for poor sleep, prazosin for nightmares and propranolol to manage traumatic memories. Using tranquillisers like Clonazepam and lorazepam is not recommended as they are ineffective and carry the risk of addiction and dependence. 

Psychotherapy: It involves training the patient to identify the signs of an episode and learn how to cope with them. Sometimes, the therapist enrols the help of friends and family members for better management. Various psychotherapies used are prolonged exposure therapy, psychodynamic therapy, group therapy, family therapy, eye desensitisation and reprocessing, and prolonged exposure therapy.

15. Premenstrual Dysphoric Disorder (PMDD)

PMDD is a complicated type of premenstrual syndrome (PMS) that causes emotional and physical signs every month (or with every menstrual cycle) 1-2 weeks before menstruation (periods). The common symptoms are breast tenderness, headaches and bloating, depression, anxiety and extreme irritability. The symptoms mostly improve within a few days but cause significant problems with the lifestyle. It is a common issue among females, and 1-6% of the women or people assigned female at birth experience it in their reproductive years (Cambridge University Press and Assessment, 2022). Both PMDD and PMS cause the same type of emotional and physical symptoms. However, PMDD causes more severe mood shifts that often damage relationships by disrupting daily life. 

Causes

It is not known why some people develop the symptoms of PMDD, and others do not. Falling levels of progesterone and oestrogen are believed to have a major role. Serotonin, a brain chemical involved in sleep, hunger and mood, has a role as its levels change throughout the menstrual cycle. Some risk factors increase the risk of PMDD, like; PMS, depression, family history of PMDD or PMS and mood disorders, history of stressful events, trauma and physical or emotional abuse. The untreated cases disturb relationships and cause severe depression and even suicide. The doctors use history and signs and symptoms for diagnosis and monitor the signs over 1-2 menstrual cycles. 

Signs and symptoms

The symptoms develop a week or earlier before the start of periods and continue for a few more days. Most of the time, they are very severe and irritating and disturb the routine life. The common symptoms are feelings of hopelessness, depression, mood swings, conflicting attitude, severe anger, extreme irritability, anxiety, tension, lack of interest in routine activities, appetite changes, fatigue, poor concentration, sleeping issues, bloating, cramps, headaches, breast tenderness, muscular or joint pain and hot flashes. Sometimes, panic attacks, suicidal thoughts, binge eating, and abnormal food cravings are experienced. Sometimes, the symptoms last up to menopause. 

Treatment 

Several treatment options are available to cure the symptoms, which are combined or combined. These include;

• Antidepressants like selective serotonin reuptake inhibitors (SSRIs) to manage serotonin levels and include Paroxetine HCl, Fluoxetine and Sertraline
• Hormonal contraceptives containing ethinyl estradiol and drospirenone 
• Some dietary changes like reducing the intake of some food like caffeine and increasing the uptake of magnesium and vitamin B6
• Over-the-counter painkillers to manage the symptoms like breast tenderness, headaches and cramps 
• Regular exercises and physical activities to improve mood 
• Use of stress management tools like meditation and deep breathing exercises 

Some herbal remedies like chaste berries are promising to reduce the symptoms like food cravings, cramps, breast tenderness, mood swings and irritability. Avoiding emotional and stressful triggers like relationship issues and financial stresses is helpful.

16. Dissociation and Dissociative Disorders

Dissociative disorders involve a feeling of dissociation from reality, experiencing memory loss (dementia), and feeling outside of the body. Such disorders develop in response to trauma (both short-term and long-term). There are three major dissociative disorders;

Dissociative amnesia: It involves memory loss which is either related to a particular event or a complete loss of history. 

Dissociative identity disorder (DID): It causes a person to have a vague sense of identity. The patient often has two or more different identities that influence the behaviours differently at different times and has different dislikes, likes, history and personality traits. 

Derealisation/ depersonalisation disorder: The patient feels detached from the body, environment, feelings or thoughts. 

A similar condition is a dissociative fugue in which the patients experience memory loss and find themselves in unexpected and unplanned places. 

Dissociative disorders often occur in combination with other mental health conditions. People of all ethnicities, socioeconomic statuses and ages experience the disorders, and the diagnosis rate is higher in those designated as females at birth. In the UK, 2% of people have dissociative identity disorder, which is higher than the global average of 1.5% (AATS Reinders, 2021). 

Causes

There is no single cause, and many factors are included including;

Trauma: Some exceptionally bad memories cause episodes of being absent from reality (peritraumatic dissociation). Some traumatic issues causing such problems are natural disasters, accidents, capture by hostile people, torture, combat, childhood abuse and being subjected to physical or sexual abuse. Experiencing such issues, again and again causes the development of dissociative disorders.

Use of drugs: Some drugs, like excessive alcoholism, cause a person to lose the sense of reality and identity. People using some psychedelics, e.g., LSD and psilocybin, experience the signs. 

Meditation: Although useful, meditation and mindfulness techniques sometimes cause the loss of awareness and daydreaming. It causes a person to become less aware of identity and reality. Similarly, using hypnotherapy for addictive behaviour, PTSD, anxiety and pain influence the thoughts. 

Mental health conditions: Various other mental health conditions cause dissociative symptoms. These include eating disorders, obsessive-compulsive disorder, depression, schizoaffective disorders, borderline personality disorder and acute or chronic stress disorder. 

Signs and symptoms 

The presence of dissociative disorders causes the person to have gaps in their memory and the feeling that the material things around them are not real. The other signs are;

• Feelings of being a different person
• Experiencing out-of-body experiences
• Feelings like having lightheadedness and the pounding heart
• Feelings of emotional detachment and numbness
• Loss of sensation resulting in no or very little pain
• Changed sense of time
• Inability to recall the purpose of being at some place
• Experiencing tunnel vision or hearing voices
• Uncomfortable feelings and experiencing flashbacks
• Feeling immobilised for sometime 
• Too much lost in the unreal fantasies

Treatment 

Treatment options are medications and talk therapy (psychotherapy). No specific medications are available to treat the cause. However, antidepressants are prescribed to manage the symptoms like panic attacks, anxiety and depression. 

Psychotherapy involves regular sessions with the psychiatrist for guidance, education and support to manage the symptoms and improve the quality of life. Various psychotherapy treatments used are cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), hypnosis and eye movements desensitisation and reprocessing (EMDR) therapy.

17. Seasonal Affective Disorder (SAD)

Seasonal affective disorder is a form of depression that has seasonal variations. The symptoms occur on and off in different seasons. As the symptoms are more common in winter, it is sometimes known as the winter depression. However, some people experience symptoms in the summer and feel better in winter. Feeling down a little in winter (winter blues) is normal as it gets darker much earlier, and a person has to spend more time inside. However, SAD differs from the winter blues as it severely influences the thoughts, feelings and routine life. 

It is a common condition, and 2 million people develop winter blues in the winter in the UK. All people experience it (NHS). However, women and younger people have a higher risk. The other conditions that increase the risk are other mental health conditions, living at higher altitudes (far north or in the far south near poles) or living in cloudy regions. These regions have less sunlight available. 

Causes

The exact cause is not known. However, it is a consequence of low exposure to the sunlight during winter and late autumn, which causes disturbances in the levels of hormones like melatonin, which regulate sleep, and serotonin, which influences sleep, appetite and mood and the disturbance of circadian rhythm (the internal clock of the body). The condition has a familial disposition, and the genes that control the production of these hormones are inherited from parents. The body produces vitamin D under sunlight; low vitamin D production in winter causes vitamin D deficiency. It influences mood by changing serotonin levels causing negative thoughts, anxiety, and stress.

Signs and symptoms 

The symptoms are like those associated with depression and include;

• Feeling depression and sadness most of the time 
• Cravings for sugary foods and weight gain
• Anxiety
• Poor energy and fatigue
• Poor concentration
• Feeling agitated and irritated
• Heaviness of legs and arms 
• Social withdrawal and loss of interest in the previously enjoyable activities
• Oversleeping and poor-quality sleep
• Thoughts of self-harm and suicide and poor sexual desire

Treatment 

Various treatment options are available, and the doctor and psychiatrists develop a comprehensive plan involving one or more options. Lifestyle changes are useful, like spending more time in the natural sunlight, exercising regularly, and taking measures to manage stress levels. Light therapy uses a special lamp known as the light box to increase exposure to light. Sometimes, the use of antidepressants like selective serotonin reuptake inhibitors (SSRIs) and mood stabilisers is recommended. 

18. Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder is a mental health condition negatively influences how a person sees or feels his appearance and body. The patients develop negative thoughts and emotions about their physical looks, compromising physical and mental well-being and quality of life. The negative beliefs about the self cause a person to spend a lot of time changing the supposed flaws. Immediate action is required as it is a highly dangerous condition causing thoughts of self-harm and suicide. It is a fairly common condition, and 6.8% of UK men and 14.8% of women develop the signs. 

The symptoms mostly start from teenage to early adulthood, and 2/3 of the patients develop it before 18. It nevertheless develops in adulthood too. BDD is of two types; muscle dysmorphia, a condition in which a person believes that the body is not enough stronger and muscular and takes measures to remedy the situation causing bigorexia (reverse anorexia) and body dysmorphia, in which a person is highly focused on the supposed flaws in the body causing feelings of guilt and negative thoughts. The common body parts and issues that are the target of BDD are nose shape, wrinkles and facial blemishes (facial dysmorphia), scalp issues like baldness, hair thinning and shape of the hairs, skin issues, the size and appearance of the breast and the issues about sexual organs.

Causes

There is no single cause, and many different factors are involved. Some experts believe that there is malfunctioning in the areas of the brain that process information about the body shape and image, while others link it to the mental health issues like anxiety and depression. The children of affected parents have more risk, so genetics seems to have a role. Some other triggers are poor self-esteem for any reason, baldness at an early age, childhood emotional abuse like bullying and conflicts and severe criticism about body shape by close ones—often, the narrow definition of beauty in society exerts indirect pressure. Social media often propagates a narrow definition of beauty, causing complexity in many people.  

Signs and symptoms 

Some signs and symptoms and warning signs that a person has BDD are;

• Engaging in excessively time-consuming and repetitive events like skin pricking, social avoidance and spending too much time in front of the mirror
• The attempts to cover up or hide the supposed defects
• Constant comparison of body shape and image to the others and taking reassurances from others that the defect is properly covered
• Unwillingness to believe the compliments of others
• She was repeatedly touching the body parts and taking measurements
• Poor performance at school or workplace and poor concentration
• Social avoidance, the tendency to avoid social settings and poor self-consciousness and anxiety in social events 
• Seeking cosmetic solutions like plastic surgery, hair transplant, etc., to improve our look and are still unsatisfied with our appearance 

Treatment

Treatment involves a combination of medications and psychotherapy. Sometimes, hospitalisation is necessary for severe cases. The medications used are antidepressants like SSRIs, antipsychotics like pimozide and olanzapine etc. The treatments are mostly off-label, and there is no approved medication. Psychotherapy involves training the patient to control negative thoughts and provide guidance. Cognitive behavioural therapy (CBT) is mostly used. It often involves family and friends for better motivation and results. Hospitalisations are needed for people who are at risk of self-harm or suicide.

19. Behavioural and Emotional Disorders in Children

Behavioural and emotional disorders involve disruptive behaviours in children that last for 6 months or more and cause poor performance at home, school and social events. Such issues are not unexpected and are a normal part of development in childhood. However, persistent abnormal behaviours that are outside the spectrum of expected norms and are too severe need attention. The common behavioural and emotional disorders experienced by children are attention deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD). 

Attention deficit hyperactivity disorder: It is a condition that causes impulsivity, hyperactivity and poor concentration and attention in children. At least three subtypes cause different symptoms and include; hyperactive/ impulsive type, inattentive type and combined type. The symptoms of hyperactive/ impulsive ADHD are difficulty in remaining seated or staying still, moving on the seat, tapping the feet and hands, climbing things and running around in abnormal conditions, frequent interruptions in games and conversations, difficulty in waiting for a turn in the game and experiencing problems while playing and talking. The symptoms in the inattentive type are poor attention, easy distraction, a poor focus that makes some tasks, e.g. reading very difficult, starting tasks but not being able to finish them and poor listening and forgetting easily. In the combined type, the symptoms of both types are experienced. 

The most common start is around 5-6 years when the child starts schooling and struggles to adjust to the changes; the signs are experienced by 3-4% of people. 

Conduct disorder (CD): The children in the CD show abnormal conduct and violate other children's social and workplace (school) rights. It is experienced both in childhood and adolescence and causes aggression resulting in bullying behaviour, animal cruelty, forceful sexual activities and physical fights. The other signs are;

• Destructive activities like setting fires and damaging property or possessions
• Deceitful behaviour like tricking and lying
• Rule breaking during school and other activities like stealing, running away from school and unwillingness to go
• Difficulties in understanding the behaviours of others, like falsely believing that someone is aggressive or hostile to them, cause violent clashes and aggressive behaviour 
• Poor empathy

Oppositional defiant disorder (ODD): It is experienced in childhood and early adulthood and causes hostile behaviours towards teachers, caregivers and parents. The children tend to violate social rules and norms. The symptoms are irritability, temper tantrums, constant questioning and arguing over the rules, stubbornness that causes refusal to apologize after inappropriate behaviour and refusal to obey rules and instructions, provoking and annoying others and a vindictive or spiteful attitude. Many signs of ODD are normal parts of the child's behaviour showing anger and annoyance. However, the condition is diagnosed if the symptoms persist for 6 months or more. 

Causes

Behavioural disorders in children result from various environmental and physiological risk factors, and children of all genders and backgrounds experience them. Some risk factors are abnormalities in the brain development and structure, poor brain chemistry due to hormonal issues, complications during pregnancy like premature birth, low birth weight, exposure to toxins in the womb, genetics, gender (risk is higher in male children), social traumas like poor relationships between parents, unstable family life, harsh discipline at the workplace, poor relationships with the caregiver, teacher or parents and emotional and physical abuse. 

Treatment

The treatment and management used different approaches like parent management training, individual therapy of the children, family therapy, interactive school-based or social programs, support programs for learning difficulties and the use of medications for some severe symptoms. The techniques to improve self-esteem, like encouragement, empathy, and patience, are important for recovery. Persistence of signs for a long time needs to be consulted with a child psychologist, psychiatrist, child neurologist, endocrinologist or behavioural paediatrician.

20. Generalised Anxiety Disorder

Generalised Anxiety Disorder or GAD is characterised by extreme worries and anxieties about routine life without a solid reason. The patients unnecessarily expect disaster in every situation and are constantly worried about school, work, family, money and health. Anxiety is a normal body response to emotional stresses; however, the symptoms are too heavy and totally out of proportion in GAD. It is a common condition and affects 6-7% of people in the UK. The most common start is in childhood or early adolescence. However, adults experience it too. Women are more prone to develop than men. 

Causes

The exact cause is not known; however, a combination of biological and psychological factors are involved, e.g., 

Genetics: The tendency to develop GAD is passed in genes from parents to offspring. Although no specific anxiety-related genes are identified, many genetic factors have a role. 

Environmental factors: Some environmental stress factors like the stress of school or workplace, loss of job, death of a loved one, having a chronic disease, divorce, relationship breakups, and physical and emotional abuse increase the risk. 

Nervous system factors: Some diseases influence the brain region involved in emotions and thinking. The chemicals called neurotransmitters are involved in the conduction of messages in the nervous system. The problems related to mood and anxiety is noted if there is any abnormality in such pathways. The presence of other risk factors like depression, anxiety and paranoia increases the risk.

Signs and symptoms 

The GAD negatively influences thoughts and causes physical symptoms. The criteria used by the mental health professionals for the diagnosis of GAD are; 

• Ongoing excessive tensions and worries 
• Unrealistic and out-of-proportion view of the problems
• Feelings of being edgy and extremely restlessness
• Troubled and poor concentration
• Extreme fatigue and tiredness
• Irritability and crankiness
• Troubled and poor-quality sleep
• Muscle aches, tension and soreness
• The presence of signs of other mental health conditions like alcohol or drug abuse, clinical depression, obsessive-compulsive disorder, phobias, panic disorder and anxiety. 

Treatment 

Once the cause is diagnosed, the psychologist or psychiatrist develops a treatment plan, including medications, psychotherapy and home remedies. Psychotherapy allows the patient to identify the earlier signs and symptoms and take appropriate measures timely. The common type is cognitive behavioural therapy (CBT), in which the patient is taught about the patterns and feelings that cause anxiety. Joining some support groups is helpful as it provides motivation and allows one to look at the problems differently. 

Medications do not cure the condition but help to manage the symptoms. Some drugs, like benzodiazepines, provide a short-term solution. The benzodiazepines negatively influence thoughts and memories, cause issues like sedation and addiction, and must be prescribed by a doctor. Common benzodiazipines are alprazolam, chlordiazepoxide HCl, lorazepam and diazepam. Some antidepressants, like Sertraline, Fluoxetine and venlafaxine etc, are effective. Some remedies like a healthy diet, yoga, avoiding caffeine, proper sleep, avoiding alcohol and drugs, biofeedback, meditation and relaxation techniques like deep breathing are effective.

What are the Causes of Mental Health Illness?

Mental health illnesses are unique as they are not due to a single cause like infections and are attributed to a number of causes and risk factors.

Risk factors  

The following factors cause compromised mental health and increase the risk of psychological diseases. 

• Neglect, abuse or trauma in the childhood
• Prolonged loneliness and a sense of social isolation
• Experiencing stigma and social and workplace discrimination like racism 
• Being socially, economically or politically disadvantaged, like having debt or facing poverty
• Experiencing the pain of losing some loved one
• Sever short to long-term stresses
• Losing a job or being unemployed for a long time
• Having a large number of dependents, like having many children without proper sources of income
• Alcoholism and drug abuse
• Domestic violence, abuse during childhood or adulthood or facing bullying
• Experiencing traumas like being in military service and experiencing combat suffering
• Being involved in or part of serious and life-threatening accidents or being a victim of hate crimes
• Some physiological and pathological causes, like having a brain or head injury or a neurological condition, e.g., epilepsy or Parkinson's disease, that influence mood and thoughts 
• Exposure to lifestyle risk factors like lack of proper sleep, poor diet, use of drugs, and excessive work

1. Genetics and mental health conditions: Abundant evidence shows that genes related to mental health are inherited, and the issue runs in families. For example, a person born to schizophrenic parents is more likely to develop it. However, it is not always certain, as gene expression depends upon environmental factors. No specific genes have been identified that are linked to mental health, and many people experiencing mental health conditions don't have any close relatives with the issue, suggesting that genetics increases the risk and is not the paramount factor. 
2. Nature of the human brain: Human brain is very complex, and changes in the brain structure and the levels of some brain chemicals like dopamine and serotonin increase the risk. The arguments supporting it need to be stronger, and the exact mechanisms still need to be fully understood. Besides the meagre evidence to support such claims, the role of brain chemicals is considered important as some psychiatric drugs influence the brain chemicals, which are useful for handling many symptoms. The symptoms of mental health conditions are often very personal and change from person to person, supporting the idea that there are some personal chemical factors involved that are specific to a person. 
3. Exposure to risk factors during pregnancy: Although brain health is sensitive to afterbirth experiences, there is some evidence that the exposure (of mothers) to some environmental risks factors like drugs, alcohol, toxins, inflammatory conditions, personal traumas and environmental stresses increases the risk of mental health conditions in the childhood. 
4. Miscellaneous factors: Some miscellaneous factors like having a chronic condition that influences life, like heart disease, diabetes etc., brain damage and injuries due to severe accidents, very limited social circle, and financial stresses decrease the quality of life and make the risk higher.

What are the Signs and Symptoms of Mental Health Issues?

The changes in emotions, behaviour and thoughts are normal due to day-to-day issues. But, severe changes that compromise the quality of life are indications of the presence of some mental health illnesses. Various forms of mental Illnesses cause different signs and symptoms. However, some signs are common to many. The presence of these signs is a strong indication that mental health is compromised, and consultation with health professionals is necessary. Some general signs of mental health conditions for all people are; 

1. Crankiness and sadness that lasts for months and even longer
2. Withdrawal from family and friends
3. Changes in sleep patterns and eating habits
4. Extreme lows and highs of emotions
5. Fears and worries that are out of proportion
6. Loss of interest in the activities that used to be fascinating
7. Ignoring personal development and grooming
8. Confused and disorganised thoughts
9. Severe anger
10. Ideas that are far from reality
11. Unexplained health issues
12. Hearing and seeing unrealistic things
13. Resorting to alcohol or drug abuse and thoughts of self-harm or suicide

In children, many signs of mental health conditions are common in adults. Some additional signs are; 

1. Unusual or odd behaviour
2. High sensitivity to touch, smell, sound and sight
3. High frequency of temper tantrums and nightmares
4. Disobedience and aggression, and poor performance at school

Occasionally experiencing one or two of these signs is not a serious issue. However, severe signs, particularly after some tragic events, mean a person needs help. The serious signs to look for are the presence of many signs frequently; the signs are present without any known cause, and signs last longer and interfere with life. 

What are the Treatments for Mental Health Illnesses?

Treatment depends upon the type and severity of the exact mental health condition. Many often, a combination of many treatments is effective. In the case of mild conditions with manageable signs, just consultation and treatment with a health professional is enough. However, a group approach involving health professionals, psychologists, psychiatrists, family and friends is necessary in case of complicated issues. The team must include family, primary care provider, nursing practitioner, psychiatrist, physician assistant, psychotherapist or licensed counsellor, social worker, family members and a pharmacist. Both medications and psychotherapy are employed for a successful outcome. 

1. Medications: The medications don't cure the condition; they help to manage the symptoms and improve the effectiveness of other treatments like psychotherapy. The drug of choice depends upon the nature and severity of the condition and must be decided by the concerned professionals. Some common medications are antidepressants that treat anxiety and depression and help improve symptoms like lack of motivation and interest, poor concentration, poor energy, hopelessness and sadness and anti-anxiety medications that are helpful for anxiety and panic disorders and reduce insomnia and agitation. Both fast-acting and long-acting anti-anxiety drugs are available, which are used based on the condition. Mood stabilisers help treat bipolar disorder, and antipsychotics are helpful for psychotic disorders like schizophrenia and related conditions. 
2. Psychotherapy, or talk therapy, involves discussing the condition with a healthcare professional and learning how to manage the symptoms and respond earlier. Several types of psychotherapy treatments are available that are used for various conditions and are to be used on a long-term basis. 
3. Hospitalizations: In severe cases, admissions to the hospital are necessary to avoid self-harm and suicide and in case of other uncontrollable symptoms. There are various options: intensive outpatient treatment, residential treatment, and complete or partial hospitalizations. 
4. Treatment of substance abuse: Often, mental health conditions accompany substance abuse that worsens the condition and interferes with treatment. If a patient cannot leave substances by themselves, the help of a doctor must be enrolled. 
5. Brain stimulating treatments: Some brain stimulation treatments are useful for mental health conditions. These treatments are used when other treatments are not giving relevant results and include vagus nerve stimulation, deep brain stimulation, repetitive transcranial magnetic stimulation and electroconvulsive therapy. The patients must understand the benefits and potential benefits before going for stimulation therapies. 
6. Self-care: All treatments and management programs are ineffective without self-care. The patients must be aware of the signs and admit and cooperate with the professionals and other concerned people for better results.

When do Mental Health Issues start?

Knowing the starting age of different mental health conditions is important for patients and psychologists as it allows diagnosis and early treatment. It improves the disease outcome and life expectancy as the life expectancy for people with mental health issues is 10-15 years less than the general population. The estimates of the onset of mental health conditions are different depending on the sources used. 

A study conducted by Solmi and colleagues in 2021 provided some reliable estimates. It was a meta-analysis that combined the results of 192 studies and the data from over 700,000 patients. The median age of peak onset of mental diseases in these patients was 14.5 years, meaning that the onset was before adulthood for 50%. For various diseases, the estimates are as follows;

• Phobias and anxiety: 5.5 years
• Neurodevelopmental disorders: 5.5 years
• Stress disorders: 15.5 years
• Eating disorders: 15.5 years
• Obsessive-compulsive disorder: 14.5 years
• Eating disorders: 15.5 years.
• Schizophrenia: 20.5 years 
• Addictions: 19.5 years
• Personality disorder: 20.5 years
• Depression and mood disorders: 20.5 years

The data shows median values. It means 50% of the patients develop signs before that age.

What are some Mental Health Issues in students?

The students, particularly school and college students, are highly exposed to the triggers of mental health conditions, and 21.9-26.3% of them experience some mental health issues during the academic years (Johns and colleagues, 2022). The most prevalent issues are mood disorders, followed by many other issues. Although students tend to ignore it as a normal part of youth and student life, ignoring it for long is dangerous for learning and performance at school and college. The students, teachers and parents need to be careful about the following issues; 

Depression: It causes feelings like loss of interest in previously enjoyable activities, hopelessness and persistent sadness. Some other signs to be noted are headaches, unexplained pain, appetite changes and sleeping disorders.

Anxiety: Anxiety is a common response to sadness and worrying events. However, students sometimes experience persistent anxiety due to some emotional issues and the pressure of studies, causing them to become tense, panicked and worried. It disrupts normal life, particularly if experienced for a long time.

Thoughts of self-harm and suicide: Sometimes, severe mental crises lead to thoughts of self-injury and suicide. The suicide rate is high among students as they have low emotional resilience and are highly sensitive to stress. 

Addictions: The use of alcohol and recreational drugs is very common among students, particularly those having poor company. It causes mental health issues and disrupts learning. Addictions cause strong physical and psychological dependence and cause severe and uncontrollable cravings. 

Eating disorders: The students are highly sensitive to their body shape and image, and it causes them to become excessively aggressive about food choices, increasing the risk of food disorders like anorexia nervosa, bulimia nervosa and binge eating disorder. Such issues are predominantly common in the youth.

Post-traumatic stress disorder: Due to their high sensitivity to emotional factors, experiencing or witnessing any traumatic accidents and events cause the students to develop symptoms of PTSD. Some factors like sexual assaults (particularly for female students) are overlooked but are a common cause of PTSD. 

Bipolar disorder: Students in their college years are highly sensitive to developing bipolar disorder, and in fact, most of the cases are diagnosed before 30 (Industrial Psychiatry Journal, 2021). However, the symptoms are often overlooked, and the psychiatric services at the campus are often insufficient to provide the necessary help. It increases the risk of dangerous outcomes like self-harm and suicide.

Are All Mental Health Issues and Disorders Treatable?

No, while treating the symptoms of many mental health disorders is possible, not all disorders are completely treatable. The efficacy of treatment depends upon many factors, like the nature and severity of the condition and the individual responses to the available treatments. It must be remembered that treatment means the interventions or actions taken to manage a disease, curb its progress, and manage the symptoms. The basic objective of the treatment is to improve the patient's quality of life through options like lifestyle changes, physical therapy, surgery, and medications.

Some mental health disorders like PTSD, anxiety, and depression are treated using lifestyle modifications, psychotherapy, and medications, and the individuals experience significant improvement in their quality of life. However, other mental health disorders like personality disorder, schizophrenia, and bipolar disorder are long-lasting and take a regular route. Such issues are not completely treatable; the therapies only partially improve the condition. However, the prospects are promising due to the constant evolution in medicine and psychotherapy. 

Are All Mental Health Issues and Disorder Curable?

No, all mental health issues are not completely curable as they are associated with various diverse causes, all of which are not often treatable. In contrast to the treatment, the purpose of a cure is to eradicate or eliminate disease and restore health completely. The cure is the ultimate goal of all treatment plans. Most mental health conditions are chronic issues without a single cause, like infectious diseases, and are not completely treatable. The conditions like personality disorders, schizophrenia, and bipolar disorder are chronic conditions that require ongoing treatment and management. However, the continuous evolution in psychology and psychotherapy is promising. 

How to improve Mental Health?

Good mental well-being is essential for a quality life. Mental well-being doesn't mean a person is always happy and cheerful. It means that a person is able to cope with the stresses and experience healthy emotions. Here are some practical tips that help boost mental well-being.

Stay connected: Healthy relationships are very important for healthy emotions. Social relationships create a sense of self-worth, provide an opportunity to share emotions, and become a source of entertainment and inspiration. So, spending time with family and friends, reducing time in front of the TV, participating in social groups, and being connected through social media are very effective. 

Improve physical activities: Physical activities and exercises are not only good for physical health but are equally good for emotional and mental health. Physical exercises improve self-esteem, create short-term fitness goals that keep a person engaged, increase emotional resilience, and cause the release of mood-improving chemicals in the body like oxytocin, dopamine, endorphins and serotonin. So, spending time on aerobic, flexibility, and strength exercises according to the physical conditions is very promising. 

Improve mindfulness: Mindfulness means being present in the present movement. Staying in the past is very dangerous for mental well-being, and mindfulness allows one to enjoy life better. It positively influences the outlook on life. Some mindfulness techniques, like relaxation and meditation, etc., are promising.

Become a source of hope and inspiration for others: Research has shown that being kind and open to other improve mental health by creating positive feelings like a sense of reward, self-worth, and a better purpose in life. It improves social worth and usefulness. Small acts of kindness and participating in social help activities are very useful mood boosters. 

Learning new and useful skills: Learning new and useful skills improve self-esteem, and self-confidence, creates a sense of purpose, and allows a person to connect positively with others. Even if someone has no time or needs, engaging in skills like cooking, fixing bike issues, and trying new hobbies like painting and blog writing are very useful. 

Add contemplation and leisure to the priorities: It is easy to be lost in a busy routine and never relax. However, using some days for relaxation, like going out with family and friends, is very good for emotional well-being. Another useful idea is to write a memoir while relaxing and sharing thoughts and ideas with the otters. 

Improve diet and sleep: Adding mood-boosting foods, like nuts, omega 3 fatty acids rich fatty fish, and fresh fruits like blueberries, leafy greens, blueberries, and avocados, is very useful. Likewise, sleep is more important than many think. It allows the brain to rejuvenate and relax. So, techniques to improve sleep, like switching off screens hours before bed, listening to relaxing music, and reading books, are useful options.

How to Help Someone with Mental Health Issues?

Finding a close friend or family member in distress and having an emotional breakdown is a call to action, as a depressed person needs relationships more than ever. Sometimes, knowing if another person is going through difficult situations is easy. However, the symptoms of mental health conditions are not common to all people, and a close eye is needed to identify them. Once identified, the following measures are useful; 

• Set aside time for the patient to discuss the issues without any distractions. Distractions distort thoughts.
• Allow the other person to share what they want and hide what they don't want to share. It creates courage and trust and allows the other person to be open. Forcing the patient to share the thoughts backfires. 
• Don't try to be judgmental about their feelings and actions. These are the jobs of a trained health professional and counsellor. Making assumptions and giving opinions about rights and wrongs don't work. 
• Ask open-ended questions; for example, never question the patient about feelings; ask the patient to share his thoughts and worries. Ask only a few questions, and give proper time to answer before jumping to the next question. 
• Advise the patient about self-care. Discuss the methods to relieve stress and how to practice self-care, like tips for improving sleep and good mental health exercises, etc.
• Be a good listener and not a good speaker as often; the patient is just looking for someone to listen to him with focus and attention. Repeating the same questions adds to the frustration. It is useful to repeat to the patient what they have spoken to show attention.
• Show respect for the feelings and emotions of the patient. It is unnecessary to agree to everything, but showing respect for emotions and feelings is good. 
• Offer the patients help to seek professional help and guide them about it. It is important to convince the patient to seek support as often; the patients are unwilling or resistant to accept that they have any mental health issues.
• Understand the limits as a counsellor; a helping hand must not violate sensitive, emotional limits. It is important to be slow and understanding and take the patient's consent before developing a good network of professionals, family members, and friends. Try not to take anything personally and do not respond to any frustrations and provocations from the patients. Ask only a few things directly and use indirect approaches to achieve the purpose.