Understanding common mental health problems

Knowledge summaryThis knowledge summary provides an introduction to understanding common mental health problems. It covers prevalence, diagnosis, behaviours, causes and interventions that can promote recovery.

The information presented here is adapted from fully referenced source material at Emotional Wellbeing and Mind.

How common are mental health problems?

Common mental health problems, such as anxiety disorders and depression, affect many people and the majority will deal with these without requiring any intervention from health or social services.

It is estimated that 6 million people in England experience depression or severe anxiety conditions at any time yet three quarters of each group get no treatment 1. Recovery is often achieved through self-help or support from families and friends.

The level of psychotic symptoms in the general population also seem to be much higher than was previously understood2. It is estimated that:

  • 0.4% of the population have psychosis (‘schizophrenia’) or bipolar disorder
  • 17% of the population experiences sub-threshold common mental problems
  • 6% of the population have sub-threshold psychosis

Sub-threshold health status can present an important opportunity for prevention and early intervention3.

What are the most commonly diagnosed forms of mental health problem?

Some of the most commonly diagnosed forms of mental health problem are:4

  • Depression lowers your mood, and can make you feel hopeless, worthless, unmotivated and exhausted. It can affect sleep, appetite, libido and self-esteem.
  • Anxiety can mean constant and unrealistic worry about any aspect of daily life. It may cause restlessness, sleeping problems and possibly physical symptoms; for example, an increased heart beat, stomach upset, muscle tension or feeling shaky.
  • Obsessive-compulsive disorder (OCD) includes: obsessions, unwelcome thoughts, ideas or urges that repeatedly appear in your mind; and compulsions, repetitive activities that you feel you have to do.
  • Phobias is an exaggerated or unrealistic sense of danger about a situation or object. The symptoms of phobias are similar to anxiety, and in severe forms people may experience panic attacks.
  • Bipolar disorder can mean people experience mood swings. During ‘manic’ episodes, people can seem overactive and excited. At other times, you may go through long periods of being very depressed.
  • Schizophrenia can mean people may experience confused or jumbled thoughts, hearing voices and seeing and believing things that other people don’t. There is debate about whether schizophrenia is actually one condition or more a collection of unrelated symptoms.
  • Personality disorders can mean people may find it difficult to change patterns of thinking, feeling and behaving, and will have a more limited range of emotions, attitudes and behaviours with which to cope with everyday life.
  • Eating disorders can mean people may eat too much or too little. People with an eating disorder may deny themselves anything to eat, even when they are very hungry, or they may eat constantly, or binge.

What behaviours are most commonly associated with mental health problems?

The behaviours and feelings most commonly associated with mental health problems are:4

  • Self-harm a way of expressing very deep distress
  • Suicidal thoughts can mean that people will consider killing themselves. Many people think about suicide, but the majority do not go on to kill themselves
  • Panic attacks are sudden, unexpected bouts of intense terror. People experiencing an attack may find it hard to breathe, have a choking sensation, chest pain, begin to tremble or feel faint.

What causes mental health problems?

The following factors may play a role in the development of mental health problems:4

  • Stressful life events people who have experienced neglect, violence, abuse, harassment or bereavement are more vulnerable to mental health problems.
  • Social problems such as poverty, domestic violence, isolation, poor housing and addiction have been associated with mental health problems.
  • Physical health problems such as brain damage can have an impact on behaviour and mood. Long-term physical illnesses have also been shown to put people at greater risk of depression and anxiety.
  • Biochemistry hormones such as adrenalin can cause tension and an over-active state of mind.
  • Genetics research suggests that the genetic makeup of certain people might make them more vulnerable to mental health problems than others.

What can promote recovery from mental health problems?

The following interventions can promote recovery from mental health problems:4

  • Promotion of emotional wellbeing includes: access to meaningful employment; reducing stressful life events, especially in childhood; reducing social exclusion; support in managing complex relationships and emotional distress; undertaking regular exercise
  • Early intervention ensures effective treatments are provided as soon as possible with potential to reduce distress, improve people’s life chances and reduce health care costs
  • Self-help can be effective with anxiety, depression and other conditions
  • Medication The National Institute of Health and Clinical Evidence (NICE) recommends that people are offered a choice of therapy including medication for moderate depression and should be offered combined therapy for severe depression; medication has a role in preventing relapse.
  • Therapeutic interventions There are a wide range of effective psychological interventions or psychotherapies available for people with mental health issues. NICE recommends Cognitive Behavioural Therapy (CBT), couples therapy, counselling for depression and brief dynamic therapy.

References

1. The Centre for Economic Performance (2011) How mental illness loses out in the NHS? London: The London School of Economics and Polical Science. https://cep.lse.ac.uk/pubs/download/special/cepsp26.pdf

2. van Nierop M, van Os J, Gunther N, Myin-Germeys I, de Graaf R, ten Have M, et al. Phenotypically continuous with clinical psychosis, discontinuous in need for care: evidence for an extended psychosis phenotype. Schizophrenia bulletin 2011;38(2):231-8. https://www.ncbi.nlm.nih.gov/pubmed/21908795.

3. McManus S, Meltzer H, Brugha T, Bebbington PE, Jenkins R. Adult psychiatric morbidity in England, 2007: results of a household survey. Leeds: NHS Information Centre for Health and Social Care, 2009. https://www.ic.nhs.uk/pubs/psychiatricmorbidity07.

4. Mind (2013) Understanding mental health problems. London: Mind. https://www.mind.org.uk/mental_health_a-z/8034_mental_health_problems