Mental health: Know when to get help

Sometimes it can be hard to tell when a concern about mental health signals a need for professional help. In certain situations, the answer is clear. But in others, it isn’t so obvious. For example, if you’re afraid of giving a speech in public, does it mean you have a mental health condition or just a typical case of nerves? Or, when does shyness become a social phobia?

Here’s help understanding how mental health conditions are identified.

Mental health is the overall wellness of how you think, behave and manage your feelings. A mental health condition may be present when patterns or changes in thinking, feeling, or behaving cause distress or disrupt a person’s ability to do daily activities.

A mental health disorder may affect how well you can:

• Maintain relationships.
• Handle social situations.
• Perform at work or school.
• Participate in typical daily activities.
• Learn at a level expected for your age and intelligence.
• Handle change or cope with stressful situations.

Cultural norms and social expectations also play a role. There is no standard measure across all cultures that says when a behavior becomes a problem. What might be acceptable in one culture may be a cause for concern in another.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association that explains the signs and symptoms of several hundred mental health conditions, including anxiety, depression, eating disorders, post-traumatic stress disorder and schizophrenia. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association. It explains the symptoms of several hundred mental health conditions. Examples of mental health conditions include anxiety, depression, eating disorders, post-traumatic stress disorder and schizophrenia.

The DSM has criteria for making a diagnosis based on symptoms. How long symptoms last and the effect they have on a person also make a difference in diagnosis. The DSM describes the typical course of a mental health condition and its risk factors. It lists other conditions that often happen with certain disorders too.

Another guideline often used to identify mental health conditions is the International Classification of Diseases (ICD) from the World Health Organization.

Health insurance companies use the coding system of the DSM and ICD when deciding on insurance coverage and benefits. They also use it to decide how much to pay mental health professionals for the care they provide.

A mental health condition may be diagnosed by a psychiatrist, psychologist, clinical social worker or other mental health professional. A primary healthcare professional also may be involved in diagnosis. Or a primary care professional may suggest a referral to a mental health professional.

A diagnosis may be based on:

• A medical history of physical illness or mental health conditions in you or in your family.
• A physical exam.
• Questions about your current concerns or why you’re seeking help.
• Questions about how recent events or changes in your life have affected how you think, feel or behave. Examples of those events can include trauma, death of someone you care about, relationship changes or loss of a job.
• Questionnaires or other tests that ask for your feedback on how you think, feel or behave in certain situations.
• Questions about past and current alcohol and drug use.
• A history of trauma, abuse, family crises or other big life events.
• Questions about past or current thoughts about violence against yourself or others.
• Questionnaires or interviews completed by someone who knows you well, such as a family member or close friend.

Each mental health condition has its own symptoms. In general, professional help might be needed when a person has:

• Big changes in personality, eating or sleeping patterns.
• An inability to cope with problems or daily activities.
• Lack of connection with or withdrawal from daily activities.
• Exaggerated beliefs or thinking that’s not based in reality.
• A large amount of fear or nervousness.
• Lasting feelings of sadness, helplessness or hopelessness.
• Thoughts or statements about suicide or harming others
• Problems with drinking, smoking or using drugs.
• Large mood swings.
• A lot of anger or hostility.
• Violent behavior.

Many people who have mental health conditions think their symptoms are just part of life and don’t need attention. Some people avoid treatment out of shame or fear. If you’re concerned about your mental health, talk to a member of your healthcare team. Help is available.

Talk to your primary healthcare professional or make an appointment with a psychiatrist, psychologist or other mental health professional. If you feel it’s important for your situation, look for a professional who is familiar with your culture or who understands the cultural or social context of your experiences.

With the right support, mental health conditions often can be successfully identified and treated.