Mental Health Conditions

Anxiety

Everyone can experience anxiety, but when symptoms are overwhelming and constant — often impacting everyday living — it may be an anxiety disorder.

Overview

We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.

Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Meanwhile, approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21.

Symptoms

Emotional symptoms:

Feelings of apprehension or dread

Feeling tense or jumpy

Restlessness or irritability

Anticipating the worst and being watchful for signs of danger

Physical symptoms:

Pounding or racing heart and shortness of breath

Sweating, tremors and twitches

Headaches, fatigue and insomnia

Upset stomach, frequent urination or diarrhea

Types of Anxiety Disorders

There are many types of anxiety disorders, each with different symptoms. The most common types of anxiety disorders include:

Generalized Anxiety Disorder (GAD):

GAD produces chronic, exaggerated worrying about everyday life. This worrying can consume hours each day, making it hard to concentrate or finish daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.

Social Anxiety Disorder:

More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.

Panic Disorder:

This disorder is characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid an attack, including social isolation.

Phobias

We all tend to avoid certain things or situations that make us uncomfortable or even fearful. But for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several things that can trigger those reactions; to avoid panic, they will work hard to avoid their triggers. Depending on the type and number of triggers, attempts to control fear can take over a person’s life.

Other anxiety disorders include:

Agoraphobia

Selective mutism

Separation anxiety disorder

Substance/medication-induced anxiety disorder, involving intoxication or withdrawal or medication treatment

Treatment and Support

Treatment and Support for Living with Anxiety Disorders and Their Families:

Psychotherapy, including cognitive behavioral therapy

Medications, including antianxiety medications and antidepressants

Complementary health approaches, including stress and relaxation techniques

We also recommend our NAMI support groups and classes for those living with mental health conditions, as well as their families and loved ones. Find a local support group run by a California affiliate.

Attention-Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a condition in which characterized by inattention, hyperactivity and impulsivity.

Overview

Attention deficit hyperactivity disorder (ADHD) is a condition characterized by inattention, hyperactivity and impulsivity. ADHD is most commonly diagnosed in young people. An estimated 8.8% of children aged 4-17 have ADHD. While ADHD is usually diagnosed in childhood, it does not only affect children. An estimated 4.4% of adults aged 18-44 have ADHD.

With treatment, people with ADHD can be successful in school, work and lead productive lives. Researchers are using new tools such as brain imaging to better understand the condition and to find more effective ways to treat and prevent ADHD.

Symptoms

While some behaviors associated with ADHD are “normal” and not a cause for concern to most people, someone with ADHD will have trouble controlling these behaviors and will show them much more frequently and for longer than 6 months.

Signs of inattention include:

Becoming easily distracted, and jumping from activity to activity.

Becoming bored with a task quickly.

Difficulty focusing attention or completing a single task or activity.

Trouble completing or turning in homework assignments.

Losing things such as school supplies or toys.

Not listening or paying attention when spoken to.

Daydreaming or wandering with lack of motivation.

Difficulty processing information quickly.

Struggling to follow directions.

Signs of hyperactivity include:

Fidgeting and squirming, having trouble sitting still.

Non-stop talking.

Touching or playing with everything.

Difficulty doing quiet tasks or activities.

Signs of impulsivity include:

Impatience.

Acting without regard for consequences, blurting things out.

Difficulty taking turns, waiting or sharing.

Interrupting others.

Treatment and Support

ADHD is managed and treated in several ways:

Medications, including stimulants, nonstimulants and antidepressants

Behavioral therapy

Self-management, education programs and assistance through schools or work or alternative treatment approaches

Ways to support children living with ADHD:

Maintain a Positive Attitude
- Focus on successes and victories and less on the challenges or obstacles of the condition. Always have their strengths, goals and interests help drive the services and supports he receives to manage the symptoms of ADHD.
Create and Maintain the Structure
- Children living with ADHD are more likely to succeed when they have a regular schedule of tasks each day. They can experience serious problems if their daily structure changes, or they are forced to make a big change. Create and sustain a supportive structure so that your child knows what to expect every day.
Communicate Rules and Expectations
- Children living with ADHD do well with clear and simple rules and expectations that they can easily understand and follow. Write down any rules and expectations and post them in a place where your child can easily read them. You may also want to create a chores chart for them to look at every day. They may also respond well to an organized system of rewards and consequences—consistency is key.
Encourage Movement and Sleep
- Children who live with ADHD have energy to burn. Organized sports and other physical activities can help them increase their self-esteem and unleash their energy in healthy and productive ways with other children in their age group. Children living with ADHD who exercise often tend to sleep better, which can greatly reduce ADHD symptoms.
Focus on Social Skills
- Children living with ADHD often have difficulty with peer relationships and making friends. They may have a tough time with reading social cues, talking too much, interrupting frequently, or coming off as inappropriately aggressive. Their emotional immaturity may cause them to stand out among other kids in their age group, contributing to low self-esteem. Model social skills, consider hiring a life coach or work with your child’s therapist to address this issue.
Engage Help from the School

Bipolar Disorder

Bipolar disorder is a chronic illness with recurring episodes of mania and depression that can last from one day to months.

Overview

Bipolar disorder is a chronic illness with recurring episodes of mania and depression that can last from one day to months. This mental illness causes unusual and dramatic shifts in mood, energy and the ability to think clearly. Cycles of high (manic) and low (depressive) moods may follow an irregular pattern that differs from the typical ups and downs experienced by most people. The symptoms of bipolar disorder can have a negative impact on a person’s life. Damaged relationships or a decline in job or school performance are potential effects, but positive outcomes are possible.

Bipolar disorder affects men and women equally, with about 2.8% of U.S. adults experiencing bipolar disorder each year. Approximately 83% of cases of bipolar disorder are classified as “severe.” More than 10 million Americans have bipolar disorder. Although the illness can occur at any point in life, more than one-half of all cases begin between ages 15-25. Bipolar disorder affects men and women equally.

Symptoms

Two main features characterize people who live with bipolar disorder: intensity and oscillation (ups and downs). People living with bipolar disorder often experience two intense emotional states. These two states are known as mania and depression. A manic state can be identified by feelings of extreme irritability and/or euphoria, along with several other symptoms during the same week such as agitation, surges of energy, reduced need for sleep, talkativeness, pleasure-seeking and increased risk-taking behavior. On the other side, when an individual experiences symptoms of depression they feel extremely sad, hopeless and loss of energy. Not everyone’s symptoms are the same and the severity of mania and depression can vary.

Types of Bipolar Disorder:

Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with bipolar I, a person’s manic episodes must last at least seven days or be so severe that hospitalization is required.

Bipolar II Disorder is a subset of bipolar disorder in which people experience depressive episodes shifting back and forth with hypomanic episodes, but never a “full” manic episode.

Cyclothymic Disorder or Cyclothymia is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks.

Bipolar Disorder, “other specified” and “unspecified” is when a person does not meet the criteria for bipolar I, II or cyclothymia but has still experienced periods of clinically significant abnormal mood elevation.

Treatment and Support

Treatment includes psychotherapy, such as cognitive behavioral therapy and family-focused therapy; medications, such as mood stabilizers, antipsychotic medications and, to a lesser extent, antidepressants; self-management strategies, like education and recognition of an episode’s early symptoms; and complementary health approaches, such as aerobic exercise meditation, faith and prayer can support, but not replace, treatment.

We also recommend our NAMI support groups and classes for those living with mental health conditions, as well as their families and loved ones; find a local support group run by a California affiliate.

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a condition characterized by difficulties regulating emotion.

Overview

Borderline Personality Disorder (BPD) is a condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event. This difficulty can lead to impulsivity, poor self-image, stormy relationships and intense emotional responses to stressors. Struggling with self-regulation can also result in dangerous behaviors such as self-harm (e.g. cutting).

It’s estimated that 1.4% of the adult U.S. population experiences BPD. Nearly 75% of people diagnosed with BPD are women. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression.

Symptoms

People with BPD experience wide mood swings and can feel a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:

Frantic efforts to avoid real or imagined abandonment by friends and family.
Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as “splitting.”
Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.
Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, substance abuse or reckless driving.
Self-harming behavior, including suicidal threats or attempts.
Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
Chronic feelings of boredom or emptiness.
Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
Dissociative feelings—disconnecting from your thoughts or sense of identity or “out-of-body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.

Treatment and Support

Treatment options include psychotherapy; medications; and group, peer and family support.

Depression

Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch.

Overview

Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy, and healthy lifestyle choices, many people can and do get better. Some will only experience one depressive episode in a lifetime, but for most, depressive disorder recurs. Without treatment, episodes may last a few months to several years.

More than 17 million U.S. adults—over 7% of the population—had at least one major depressive episode in the past year. Globally, more than 264 million people of all ages suffer from depression.

People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others.

Combined, depression and anxiety disorders cost the global economy $1 trillion in lost productivity each year.

People with depression have a 40% higher risk of developing cardiovascular and metabolic diseases than the general population.

Symptoms

Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:

Changes in sleep
Changes in appetite
Lack of concentration
Loss of energy
Lack of interest in activities
Hopelessness or guilty thoughts
Changes in movement (less activity or agitation)
Physical aches and pains
Suicidal thoughts

More: Get an online screening

Treatment and Support

Leading a balanced lifestyle can help you manage symptoms of depression. Here are some suggestions from people who have lived experience with depression:

Learn all you can. Learn about the many treatment options available. Connect with other people experiencing depression in support groups or meetings. Attend local conferences and conventions. Build a personal library of useful websites and helpful books.
Recognize early symptoms. Identify possible warning signs and triggers that may aggravate your depression symptoms. With this knowledge, you can recognize an emerging episode and get the help you need as soon as possible. Don’t be afraid to ask your friends and family for help—they can help you monitor your symptoms and behavior.
Partner with your health care providers. Give your health care provider all the information he or she needs to help you recover—including any reactions to medications, your symptoms or any triggers you notice. Develop trust and communicate openly.
Know what to do in a crisis. Be familiar with your community’s crisis hotline or emergency walk-in center. Know how to contact them and keep the information handy.
Find emotional support from others who experience depression. Share your story, thoughts, fears and questions with other people who have the same condition. Contact your local NAMI California affiliate about taking the NAMI Peer-to-Peer class or NAMI Connection support groups.
Avoid drugs and alcohol. These substances can disturb emotional balance and interact with medications. You may think using alcohol or drugs will help you feel better, but using them can hinder your recovery or make symptoms worse.
Get physically healthy. Eat well and exercise. To relieve stress, try activities like meditation, yoga or Tai Chi.

Treatments for depression can include:

Psychotherapy, including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
Medications, including antidepressants, mood stabilizers and antipsychotic medications.
Exercise to help with prevention and mild-to-moderate symptoms.
Brain stimulation therapies if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
Light therapy, which uses a lightbox to expose a person to full-spectrum light in an effort to regulate the hormone melatonin.
Alternative approaches, including acupuncture, meditation, faith, and nutrition can be part of a comprehensive treatment plan.

Find out more on NAMI National’s website.

Support for Family Members with Loved Ones Living with Depression

When someone you love and care about experiences the symptoms of mental illness, you face unique challenges yourself, including complex family dynamics, social isolation and often unpredictable behavior. Getting support for yourself is essential for you to be able to be helpful for the person you care about.

Learn more about your loved one’s condition. Learning about the condition your loved one experiences will help you better understand and support them. Read personal accounts of lived experience, full of tips and advice on the NAMI Blog:

Recognize early symptoms. Depression often has warning signs, such as a low mood, feeling fatigued or having trouble sleeping. Discuss your friend or family member’s past episodes with them to help them improve their ability to recognize the signs early.

Communicate. Speak honestly and kindly and avoid stigma. Don’t scold or blame people with depression or urge them to “try harder” to “just be happy.” Instead, make specific offers of help and follow through with those offers. Tell the person you care about them. Ask them how they feel and truly listen.

React calmly and rationally. Even if your family member or friend is in a crisis, it’s important to remain calm. Listen to their concerns and make them feel understood—then take the next step toward getting help.

Find emotional support from others. Share your thoughts, fears and questions with other people who have loved ones with similar conditions. Connect your local NAMI California affiliate about taking the Family-to-Family class or attending a family support group.

Dissociative Disorders

Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory.

Overview

Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.

Up to 75% of people experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes. Women are more likely than men to be diagnosed with a dissociative disorder.

Symptoms

The symptoms of a dissociative disorder usually first develop as a response to a traumatic event, such as abuse or military combat, to keep those memories under control. Stressful situations can worsen symptoms and cause problems with functioning in everyday activities. However, the symptoms a person experiences will depend on the type of dissociative disorder that a person has.

Symptoms and signs of dissociative disorders include:

Significant memory loss of specific times, people and events
Out-of-body experiences, such as feeling as though you are watching a movie of yourself
Mental health problems such as depression, anxiety and thoughts of suicide
A sense of detachment from your emotions, or emotional numbness
A lack of a sense of self-identity

Treatment and Support

Treatment for dissociative disorders often involves psychotherapy and medication. Though finding an effective treatment plan can be difficult, many people are able to live healthy and productive lives.

Dual Diagnosis

Substance use disorders — the repeated misuse of alcohol and/or drugs — often occur simultaneously in individuals with mental illness, usually to cope with overwhelming symptoms. The combination of these two illnesses has its own term: dual diagnosis, or co-occurring disorders. Either disorder (substance use or mental illness) can develop first.

Overview

9.5 million U.S. adults experienced both mental illness and a substance use disorder in 2019 (The National Survey on Drug Use and Health).

Symptoms

Many combinations of dual diagnosis can occur, so the symptoms vary widely. Mental health clinics are starting to use alcohol and drug screening tools to help identify people at risk for drug and alcohol abuse. Symptoms of substance use disorder may include:

Withdrawal from friends and family
Sudden changes in behavior
Using substances under dangerous conditions
Engaging in risky behaviors
Loss of control over use of substances
Developing a high tolerance and withdrawal symptoms
Feeling like you need a drug to be able to function

Symptoms of a mental health condition can also vary greatly. Warnings signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, maybe reason to seek help.

Treatment and Support

The best treatment for dual diagnosis is integrated intervention, when a person receives care for both their diagnosed mental illness and substance abuse. The idea that “I cannot treat your depression because you are also drinking” is outdated—current thinking requires both issues be addressed. Treatment options include detoxification, inpatient rehabilitation, psychotherapy, supportive housing, medications, and support groups.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions).

Overview

1.2% of U.S. adults experience OCD each year.

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don’t make sense, they are often unable to stop them.

Symptoms

Most people have occasional obsessive thoughts or compulsive behaviors. In an obsessive-compulsive disorder, however, these symptoms generally last more than an hour each day and interfere with daily life. Symptoms typically begin during childhood, the teenage years or young adulthood, although males often develop them at a younger age than females.

To be diagnosed with OCD, a person must have:
Obsessions, compulsions or both
Obsessions or compulsions that are upsetting and cause difficulty with work, relationships, other parts of life and typically last for at least an hour each day

About Obsessions: Obsessions are intrusive, irrational thoughts or impulses that repeatedly occur. People with these disorders know these thoughts are irrational but are afraid that somehow they might be true. These thoughts and impulses are upsetting, and people may try to ignore or suppress them.

Examples of obsessions include:

Thoughts about harming or having harmed someone
Doubts about having done something right, like turning off the stove or locking a door
Unpleasant sexual images
Fears of saying or shouting inappropriate things in public

About Compulsions: Compulsions are repetitive acts that temporarily relieve the stress brought on by an obsession. People with these disorders know that these rituals don’t make sense but feel they must perform them to relieve the anxiety and, in some cases, to prevent something bad from happening. Like obsessions, people may try not to perform compulsive acts but feel forced to do so to relieve anxiety.

Examples of compulsions include:

Hand washing due to a fear of germs
Counting and recounting money because a person can’t be sure they added correctly
Checking to see if a door is locked or the stove is off
“Mental checking” that goes with intrusive thoughts is also a form of compulsion

Treatment and Support

There is no cure for OCD, but it can be treated effectively. Treatments for OCD include therapy, use of medications, and exercise. Tips for those living with OCD.

Find out more on NAMI National’s website.

Post-Traumatic Stress Disorder (PTSD)

Traumatic events—such as an accident, assault, military combat or natural disaster—can have lasting effects on a person’s mental health.

Overview

Traumatic events—such as an accident, assault, military combat or natural disaster—can have lasting effects on a person’s mental health. While many people will have short term responses to life-threatening events, some will develop longer-term symptoms that can lead to a diagnosis of Post-Traumatic Stress Disorder (PTSD). PTSD symptoms often co-exist with other conditions such as substance use disorders, depression, and anxiety. A comprehensive medical evaluation resulting in an individualized treatment plan is optimal.

PTSD affects 3.6% of the U.S. adult population—about 9 million individuals. About 37% of those diagnosed with PTSD are classified as having severe symptoms. Women are significantly more likely to experience PTSD than men.

Symptoms

Symptoms of PTSD usually begin within three months after experiencing or being exposed to a traumatic event. Occasionally, symptoms may emerge years afterward. For a diagnosis of PTSD, symptoms must last more than one month. Symptoms of depression, anxiety or substance abuse often accompany PTSD. Common symptoms:

Re-experiencing type symptoms, such as recurring, involuntary and intrusive distressing memories, which can include flashbacks of the trauma, bad dreams and intrusive thoughts.
Avoidance, which can include staying away from certain places or objects that are reminders of the traumatic event. A person might actively avoid a place or person that might activate overwhelming symptoms.
Cognitive and mood symptoms, which can include trouble recalling the event, negative thoughts about one’s self. A person may also feel numb, guilty, worried or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can in some instances extend to include out-of-body experiences or feeling that the world is “not real” (derealization).
Arousal symptoms, such as hypervigilance. Examples might include being intensely startled by stimuli that resembles the trauma, trouble sleeping or outbursts of anger.

Treatment and Support

Treatments include psychotherapy, such as cognitive processing therapy or group therapy; medications; self-management strategies, such as self-soothing and mindfulness; the use of service animals, especially dogs.

NAMI also offers a Homefront program for family, friends and significant others of military service members and veterans, as well as a PTSD Treatment short course.

Find out more on NAMI National’s website.

Psychosis

Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t.

Overview

Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. These disruptions are often experienced as seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. While everyone’s experience is different, most people say psychosis is frightening and confusing.

Psychosis is a symptom, not an illness, and it is more common than you may think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as 3 in 100 people will have an episode at some point in their lives.

Symptoms

Early or first-episode psychosis (FEP) refers to when a person first shows signs of beginning to lose contact with reality. Acting quickly to connect a person with the right treatment during early psychosis or FEP can be life-changing and radically alter that person’s future.

Early warning signs include the following:

A worrisome drop in grades or job performance
Trouble thinking clearly or concentrating
Suspiciousness or uneasiness with others
A decline in self-care or personal hygiene
Spending a lot more time alone than usual
Strong, inappropriate emotions or having no feelings at all

Determining exactly when the first episode of psychosis begins can be hard, but these signs and symptoms strongly indicate an episode of psychosis:

Hearing, seeing, tasting or believing things that others don’t
Persistent, unusual thoughts or beliefs that can’t be set aside regardless of what others believe
Strong and inappropriate emotions or no emotions at all
Withdrawing from family or friends
A sudden decline in self-care
Trouble thinking clearly or concentrating

Psychosis includes a range of symptoms but typically involves one of these two major experiences:

Hallucinations are seeing, hearing or feeling things that aren’t there, such as the following:

Hearing voices (auditory hallucinations)
Strange sensations or unexplainable feelings
Seeing glimpses of objects or people that are not there or distortions

Delusions are strong beliefs that are not consistent with the person’s culture, are unlikely to be true and may seem irrational to others, such as the following:

Believing external forces are controlling thoughts, feelings and behaviors
Believing that trivial remarks, events or objects have personal meaning or significance
Thinking you have special powers, are on a special mission or even that you are God.

Treatment and Support

Treatment for psychosis involves psychotherapy and medication. Several types of therapy have successfully helped individuals learn to manage their condition. In addition, medication targets symptoms and helps reduce their impact. Early treatment of psychosis, especially during the first episode, leads to the best outcomes.

Research has shown significant success using a treatment approach called Coordinated Specialty Care (CSC). CSC uses a team of health professionals and specialists who work with a person to create a personal treatment plan based on life goals while involving family members as much as possible. CSC has the following key components:

Case management
Family support and education
Psychotherapy
Medication management
Supported education and employment
Peer support

Find out more on NAMI National’s website.

Schizoaffective Disorder

Schizoaffective is relatively rare, with a lifetime prevalence of only 0.3%. Men and women experience schizoaffective disorder at the same rate, but men often develop the illness at an earlier age.

Overview

Schizoaffective is relatively rare, with a lifetime prevalence of only 0.3%. Men and women experience schizoaffective disorder at the same rate, but men often develop the illness at an earlier age.

Symptoms

Symptoms can include:

Hallucinations, which are seeing or hearing things that aren’t there.
Delusions, which are false, fixed beliefs that are held regardless of contradictory evidence.
Disorganized thinking. A person may switch very quickly from one topic to another or provide answers that are completely unrelated.
Depressed mood. If a person has been diagnosed with schizoaffective disorder depressive type they will experience feelings of sadness, emptiness, feelings of worthlessness or other symptoms of depression.
Manic behavior. If a person has been diagnosed with schizoaffective disorder: bipolar type they will experience feelings of euphoria, racing thoughts, increased risky behavior and other symptoms of mania.

Treatment and Support

Schizoaffective disorder can be managed effectively with medication and therapy.

Find out more on NAMI National’s website.

Schizophrenia

Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others.

Overview

Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness. The exact prevalence of schizophrenia is difficult to measure, but estimates range from 0.25% to 0.64% of U.S. adults. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women.

Symptoms

Symptoms of schizophrenia include:

Hallucinations. These include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.
Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
Negative symptoms are ones that diminish a person’s abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.
Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosia or “lack of insight.” This means the person is unaware that he has the illness, which can make treating or working with him much more challenging.

To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:

Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative symptoms

Treatment and Support

While there is no cure for schizophrenia, it can be treated and managed with antipsychotic medications, psychotherapy, such as cognitive-behavioral therapy and assertive community treatment and supportive therapy, and self-management strategies and education.

Find out more on NAMI National’s website.

Self-Harm

Self-harm is not a mental illness, but a behavior that indicates a need for better coping skills. Several illnesses are associated with it, including borderline personality disorder, depression, eating disorders, anxiety or post-traumatic distress disorder.

What is Self-Harm?

Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. But any time someone deliberately hurts themself is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing. Extreme injuries can result in broken bones.

Hurting yourself—or thinking about hurting yourself—is a sign of emotional distress. These uncomfortable emotions may grow more intense if a person continues to use self-harm as a coping mechanism. Learning other ways to tolerate the mental pain will make you stronger in the long term.

Self-harm also causes feelings of shame. The scars caused by frequent cutting or burning can be permanent. Drinking alcohol or doing drugs while hurting yourself increases the risk of a more severe injury than intended. And it takes time and energy away from other things you value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting work and relationships.

Why People Self-Harm

Self-harm occurs most often during the teenage and young adult years, though it can also happen later in life. Those at the most risk are people who have experienced trauma, neglect or abuse. For instance, if a person grew up in an unstable family, it might have become a coping mechanism. If a person binge drinks or uses illicit drugs, they are at greater risk of self-injury, because alcohol and drugs lower self-control.

The urge to hurt yourself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, injuring yourself stimulates the body’s endorphins or pain-killing hormones, thus raising their mood. Or if a person doesn’t feel many emotions, they might cause themself pain in order to feel something “real” to replace emotional numbness.

Once a person injures themself, they may experience shame and guilt. If the shame leads to intense negative feelings, that person may hurt themself again. The behavior can thus become a dangerous cycle and a long-time habit. Some people even create rituals around it.

Self-harm isn’t the same as attempting suicide. However, it is a symptom of emotional pain that should be taken seriously. If someone is hurting themself, they may be at an increased risk of feeling suicidal. It’s important to find treatment for the underlying emotions.

Treatment and Support

There are effective treatments for self-harm that can allow a person to feel in control again. Psychotherapy is important to any treatment plan. Self-harm may feel necessary to manage emotions, so a person will need to learn new coping mechanisms.

The first step in getting help is talking to a trusted adult, friend or medical professional who is familiar with the subject, ideally a psychiatrist. A psychiatrist will ask that person questions about their health, life history and any injurious behaviors in the past and present. This conversation, called a diagnostic interview, may last an hour or more. Doctors can’t use blood tests or physical exams to diagnose mental illness, so they rely on detailed information from the individual. The more information that person can give, the better the treatment plan will be.

Depending on any underlying illness, a doctor may prescribe medication to help with difficult emotions. For someone with depression, for instance, an antidepressant may lessen harmful urges.

A doctor will also recommend therapy to help a person learn new behaviors, if self-injury has become a habit. Several different kinds of therapy can help, depending on the diagnosis.

Psychodynamic therapy focuses on exploring past experiences and emotions
Cognitive behavioral therapy focuses on recognizing negative thought patterns and increasing coping skills
Dialectical behavioral therapy can help a person learn positive coping methods

If your symptoms are overwhelming or severe, your doctor may recommend a short stay in a psychiatric hospital. A hospital offers a safe environment where you can focus your energy on treatment.

What To Do When Someone Self-Harms

Perhaps you have noticed a friend or family member with frequent bruises or bandages. If someone is wearing long sleeves and pants even in hot weather, they may be trying to hide injuries or scarring.

Keep in mind that this is a behavior that might be part of a larger condition and there may be additional signs of emotional distress. They might make statements that sound hopeless or worthless, have poor impulse control, or have difficulty getting along with others.

If you’re worried a family member or friend might be hurting themself, ask them how they’re doing and be prepared to listen to the answer, even if it makes you uncomfortable. This may be a hard subject to understand. One of the best things is to tell them that while you may not fully understand, you’ll be there to help. Don’t dismiss emotions or try to turn it into a joke.

Gently encourage someone to get treatment by stating that self-harm isn’t uncommon and doctors and therapists can help. If possible, offer to help find treatment. But don’t go on the offensive and don’t try to make the person promise to stop, as it takes more than willpower to quit.