Recognising the signs and symptoms of mental health problems

Many experts have been predicting that various factors will significantly affect mental health. Recent figures suggest an increase in the presentation of mental illness and psychological distress due to these factors (AIHW, 2020). The longer-term impacts on mental illness and suicidality are not yet known and will need to be measured over time.

It’s conceivable that any prolonged period of stress from external pressures can affect well-being and lead to increased occurrences of issues like depression, anxiety, and trauma. The current environment may exacerbate challenges for individuals with mental illness or those experiencing difficulties. Even individuals typically mentally healthy or inexperienced with mental illness may find themselves struggling during times of change and uncertainty.

Additional mental health pressures:

• Distress created by current restrictions and health requirements.
• Uncertainty or worries about the present and future.
• Feelings of disempowerment or hopelessness about the situation.
• Social isolation, loneliness, or feelings of disconnect with others. 
• Financial or economic distress. 
• Employment related stress (work pressures/unemployment/job security concerns).
• Relationship struggles (with family, friends, partners).
• Concerns with parenting or caring for others during the pandemic – including taking on their concerns. 
• Confusion about identity, sense of self, or purpose in life.
• Trouble accessing supports and services that may be limited or hard to reach.
• Developing mental illness (showing signs of onset of a mental illness), worsening mental illness (including increased symptoms, severity, or duration), or mental illness that is reaching a point of crisis (inability to cope/manage without intervention).

Who is at risk?

Regardless of the current environment, statistically we will all be impacted by mental health problems, either personally or through someone we know (Australian Productivity Commission, 2020). 1 in 5 Australians will experience an episode of mental illness in any year. This means that in our everyday lives at home, work, school or when out socialising, we will be in contact with people with diagnosable mental illness or other forms of mental health problems. It makes sense for us all to be armed with common knowledge about mental health and how to offer help to someone who may be struggling with it.

Anyone can struggle with mental health problems. Mental illness impacts people from all walks of life regardless of gender, sex, age, location, race, culture, religion, education level, socio-economic status, or geographic location.

Signs to look out for

Mental illness is complex and affects people in different places, at different times, and in different ways.

The signs and symptoms of someone struggling with their mental health will differ from person to person. The type of mental health problem, the personality of the person, the environment they are in, and their relationship with you, can all impact how signs may present. With this in mind, we can look out for some common flags that may suggest someone we know is not coping well.

Knowing the signs is important because it lets you know when it is time to step forward and offer support. The person may not always need you to help, but it is a conversation worth having, and it can be life changing and even save a life.

Signs that someone is experiencing a mental health problem or crisis: 

• Sudden or concerning changes in behaviour – risk taking, negative behaviours or doing things that seem worryingly out of character. 
• Mood “swings”, erratic moods – intense highs and lows. 
• Seeming sad, low, dark, or dejected much of the time. 
• Crying or other open displays of sorrow.
• Withdrawal from others – socially, emotionally, or physically. 
• Lack of interest in things that once brought joy or dedication. 
• Erratic movements e.g., jittery, jumpy, bodily ticks.  
• Negative talk – seeming pessimistic about themself, their life, or the future. 
• Frequently or overtly expressing anger, frustration, or other intense negative emotions.  
• Preoccupation or talk about death, dying or “morbid” things. 
• Deliberately harming or injuring themselves. 
• Suicidal thoughts, ideas or talk.
• Threatening or aggressive behaviour such as angry outbursts. 
• Seeming lost, unsure, or hopeless about their situation. 
• Lack of interest in work, family, hobbies, or social networks. 
• Sleep disturbances – sleeping too much or too little or experiencing fatigue.
• Increased or dangerous alcohol or other substance use.
• Confusion, disorientation or disassociating behaviours. 
• Outward expressions of not coping or calls for help.

Key tips on recognising the signs: 

• Keep an eye out for family, friends, colleagues, and peers during challenging times.
• Understand that you can make a difference to someone.
• If it seems like something is ‘off’, concerning, or worrying about a person’s demeanour, words, behaviours, or moods then it’s worth exploring.
• Take all signs of mental health problems seriously and be prepared to act.
• Don’t be afraid to offer support – talking about mental health problems does not cause these problems to get worse, it usually helps.
• If you recognise the signs, take action to offer support and if you can’t, find someone who can.
• Don’t assume that a person is over-reacting, exaggerating, or seeking attention.
• Don’t assume that the person is getting the help they need – your offer of support may be their first.
• Normalise talking openly and honestly about mental health and help seeking.
• Use language that is accurate and respectful when talking about mental health and avoid actions or words that create stigma.
• Respect people’s boundaries, rights, and feelings – while you may recognise the signs, a person may not be open to speaking with you.
• It helps to educate yourself on mental health (we have lots of facts and information about different topics on our website).
• Get training to recognise the signs and know how to take action (find out more).

What next? A quick guide to helping if you see the signs:

Approach the person: If you are concerned about someone and recognise signs of developing or worsening mental health problem, or someone in crisis, then the important first step is to connect. You may be the only support the person has received and the first step to getting them the help they need.

Listen openly and supportively: Let the person know you are open to listening to them in a non-judgemental and supportive way. You need to allow the person time to explore their concerns, and this means practising patience and active listening. Sometimes letting someone get their thoughts and feelings out, can be very therapeutic. Don’t underestimate the power of a listening-ear.

Give support: Your role is not to diagnose or to solve their problems, but rather to be a support and to facilitate pathways to further help. Simply by connecting with the person you are likely already making a difference. Acknowledging and validating the person’s experiences, feelings and emotions is important. You can also provide information about the options available.

Encourage help-seeking: An important element in any informal care is providing the person with a next step. If the person is experiencing a developing or worsening mental illness, or in crisis, they will likely need some mix of professional supports. Encourage the person to contact a GP, counsellor, psychologist, or helpline specific to their needs. In a workplace setting they may have access to an Employee Assistance Program, and in a school setting, a school counsellor.

Encourage other supports: You won’t always be available to provide this person support. While you can let them know you are happy to be a contact, you should not be the only source of support for the person. Linking the person up with a plan for self-help and other in-community supports lets them build a network of options. Explore things that have worked in the past, and things that might help now.

How are you coping?

Most of the people who engage with Mental Health First Aid, are motivated by the desire to help others, and to play an active role in community-based care. However, given the current climate, it is important for us all to consider how we are coping.

If you yourself are struggling, then it’s time to stop and think about steps you can take to keep yourself safe and well. This can include practicing self-care, sharing your concerns with friends and family, creating an action plan to improve your situation, or getting help from formal supports including your GP helplines, a counsellor or psychologist.

Related articles that you may be interested in:

Words Matter  – Compassionate Language for Mental Health

Talking about Depression

Mental Health First Aid in Practice

Understanding Panic Attacks 

Mental Health First Aid in practice