RECOGNIZING SIGNS / SYMPTOMS
OF POTENTIAL MENTAL HEALTH DISORDERS

No single sign means someone has a mental health disorder, but when you notice several signs or those that are prolonged, someone probably needs your help.

 

 

Signs (what we can see) or symptoms (what the person experiences) that someone is suffering from a mental health disorder can occur at any stage of life. At I’ve Got You Project, there is information about those that cross the lifespan, signs that occur at particular life stages, and signs associated with particular disorders. Taken together, this offers you an excellent chance of identifying someone who is struggling with a mental health disorder.

Signs of specific disorders are included because of their prevalence and/or risk for suicide.

Signs of a mental health disorder occur as thoughts, feelings, and behaviors.

SIGNS / SYMPTOMS ACROSS THE LIFESPAN

Signs that indicate a mental health emergency are in red.

These signs mean that an individual is at high risk of harming him/herself or others.
They should be considered especially serious if they are new, worsening, or related to a painful event, loss, or change.

Thoughts

  • Excessive fears
  • Extreme superstitions
  • Extreme self-criticism
  • Lack of self-awareness
  • Lack of remorse
  • Extreme obsessions
  • Chronic poor self-esteem or self-worth
  • Having frightening thoughts or flashbacks, reliving a bad experience
  • Extreme anxiety about physical symptoms
  • Need to be and do things perfectly
  • Obsession with body image
  • Denial of extreme thinness
  • Thinking “I don’t fit in anywhere; I don’t belong; I have no friends; nobody likes me; nobody understands me.”
  • Believing things that are irrational, impossible, untrue
  • Believing it would be better to be dead, that others would be better off if they were dead
  • Believing there is no reason to live
  • Paranoia is a persistent state of constant, irrational, and unfounded distrust. It can range from mildly uncomfortable to severe. When paranoia is severe it becomes a sign of psychosis and is a suicide risk. Also SEE PSYCHOSIS. Paranoia can manifest in many ways including the following:
    • Feeling like a victim
    • Feeling misunderstood
    • Feeling persecuted
    • Mistrust of others
    • Persistent anxiety and stress related to paranoid beliefs
    • Poor relationships with others due to distrust
    • Thinking someone might steal from, hurt, or kill the person
    • Feeling like everyone is staring at and/or talking about the person
    • Thinking people are deliberately trying to exclude or make them feel bad
    • Believing the government, an organization, or an individual is spying on or following the person
    • Interpreting certain facial gestures among others (strangers or friends) as some sort of inside joke that’s all about the person
    • Thinking people are laughing at or whispering about the person behind his/her back
  • Psychosis is a break from reality that involves hallucinations, delusions, and severe paranoia. Those experiencing psychosis are at a significant risk of suicide. SEE PSYCHOSIS

Feelings

  • Frequent, prolonged, excessive, or out of control
    • anger
    • irritability
    • sadness
    • resentment
  • Inability to focus on anything happy or positive
  • Frequent feelings of pessimism
  • Feeling like “everything sucks”
  • Feeling worthless, unlikable or lovable
  • Excessive feelings of guilt
  • Excessive fear of being abandoned or alone
  • Feeeling unable to succeed or contribute
  • Feeling unable to keep up with accomplishments of peers
  • Loss of interest in things, people, and activities previously enjoyed
  • Feeling euphoric/invincible/capable of anything
  • Frequent and/or strong emotional swings
  • Extreme emotional sensitivity
  • Feeling excessively tired and low energy
  • Over-sensitivity to sound, smell, touch, taste, and visual stimuli
  • Frequent nervousness
  • Frequent worry
  • Uncontrolled anxiety, worry, stress
  • Excessive feelings of guilt
  • Feeling isolated
  • Experiencing very few feelings – feeling numb – feeling “flat” – displaying a “flat affect”
  • Feeling chronically hopeless 
  • Feeling highly anxious or agitated
  • Experiencing extreme mood swings
  • Feeling full of rage or the desire to seek revenge
  • Feeling trapped or in unbearable pain
  • Feeling like a burden to others

Behaviors

  • Inability to conduct daily activities
  • Staying in bed
  • Poor self-care like hygiene and washing clothes
  • Frequently cancelling plans
  • Losing touch with friends
  • Inability to take pleasure in most activities
  • Giving up cherished activities/hobbies
  • Physical symptoms like headaches, vomiting, diarrhea, body aches
  • Inability or lack of desire to talk about the future
  • Frequent bouts of crying or lashing out
  • Laughing or crying uncontrollably
  • Difficulty swallowing when anxious
  • Stuttering when anxious
  • Physical/verbal tics that appear especially when nervous
  • Thumb sucking beyond early childhood
  • Forgetfulness, confusion
  • Lack of ability to concentrate or follow through with a task
  • Startling easily
  • Inability to make decisions
  • Behavior that looks like extreme laziness, rudeness, or disregard for others
  • Frequently seeking attention through negative, disruptive behaviors
  • Frequent conflicts with family, friends, and/or coworkers
  • Frequent defiance of rules
  • Bullying or physically harming others
  • Unstable or intense relationships
  • Frequent “neediness” – for attention/acknowledgment, approval, reassurance, praise
  • Extreme jealousy/clinginess in a relationship
  • Frequently being provocative and/or starting arguments
  • Limited range of emotional expression
  • Inability to sympathize or empathize with others
  • Inability to relate to others
  • Inability to pick up normal social cues
  • Disregard for others’ needs or feelings
  • Persistent lying, stealing, using aliases, conning others
  • Hyperactivity
  • Talking and reacting in extremes
  • Being “manic”
    • Expressing grandiose plans and ideas
    • Extremely high energy
    • Not needing to sleep
    • Talking rapidly
    • Uncontrolled spending
    • Poor impulse control – lack of restraint
    • Uncontrolled sexual behavior
    • Uncontrolled spending
  • Self-harm including
    • Cutting
    • Scratching
    • Burning
    • Biting
    • Digging fingernails into skin
    • Hitting/punching self
    • Breaking bones from repeated self-injury
    • Carving messages/symbols into skin
    • Piercing skin
    • Ingesting harmful substances
    • Inserting objects under skin
    • Wearing long sleeeves and pants in hot weather to hide signs of self-harm
  • Picking at skin and hair pulling
  • Making oneself sick in order to get medical attention
  • Obsessive neatness
  • Insisting things must be done a very specific way
  • Needing to do things “perfectly”
  • Repetitive/obsessive acts: washing/showering; cleaning things; checking on things/people; hoarding; counting things; arranging things in a very specific way; needing things to be symmetrical; tapping; repeating words; needing to walk/drive on a specific path
  • Extreme avoidance of places and/or situations
  • Inability to leave home or go outdoors
  • Being physically out of control – thrashing, struggling against attempts to restrain, running away
  • Obsessive exercising
  • Preoccupation with food, dieting, counting calories
  • Extreme weight loss
  • Wearing baggy clothes to hide thinness
  • Evidence of binge eating
  • Evidence of purging – smell or evidence of vomiting, use of diuretics and/or laxatives
  • Using gum, mouthwash, or mints excessively
  • Scabbed or scarred knuckles from repeatedly inducing vomiting
  • Repeating behaviors that have negative consequences
  • Addiction – substances, gaming, gambling, shopping, work, sex, food, internet, computer, etc.
  • Stealing to support addiction
  • Lying about whereabouts, money, companions, absences
  • Asking to borrow money without reasonable explanation
  • Having valuable items disappear (To learn more about substance use disorder go to Mayo Clinic Substance Use Disorder)
  • Committing crimes (between 15-20% of inmates in the jail and prison systems have an undiagnosed mental illness)
  • Sleeping too much or too little – especially if this is new
  • Seeing or hearing things that are not real
  • Extreme withdrawing or isolating
  • Increasing use of drugs or alcohol
  • Behaving recklessly
  • Giving possessions away, talking as though they may not see you again
  • Threatening or committing violence against self or others
  • Talking about having no reason to live
  • Talking about wanting to die or kill oneself
  • Looking for or obtaining a way to kill oneself such as researching methods online, purchasing a gun, or hoarding pills

These signs of suicide risk should prompt you to get help now.

  • Talking about wanting to die or to kill oneself
  • Looking for a way to kill oneself, such as searching methods online, obtaining a gun, hoarding pills
  • Threatening or committing violence against self or others

Go to the emergency room, call a mental health professional who can talk to you NOW, or call the police. If you call the police, be sure to say you have a mental health emergency not a crime or criminal emergency.

If in the US, call the National Suicide Prevention Lifeline, 1-800-273-TALK (8255)

FIND INTERNATIONAL HOTLINES

See more about how to intervene in Helping Someone Who is Suicidal.

The signs of risk for suicide were adapted from the Suicide Prevention Resource Center.

TEXTS, EMAILS, AND SOCIAL MEDIA

Posting Disturbing Messages On Social Media

Social media has become an important source of signs that may mean someone is struggling. It is tricky, however, as it can be very difficult to know if a troubling post is serious. Posts to be concerned about include those that threaten suicide; describe feelings of hopelessness; are extremely angry or sorrowful; are vengeful; are bullying or reactions to being bullied; advocate extremist/potentially violent groups or actions; indicate the world would be better without the person’s presence; and/or describe extreme loneliness, hopelessness, or reckless behavior.

Use your gut to help you decide if a post should be considered a sign of trouble.
If your gut says it does, REACH OUT and check up on the person.

Sending Disturbing Texts Or Emails To Friends, Coworkers, Roommates, And Others

Like social media, texts and emails can convey vitally important information about someone’s thoughts, feelings, and behavior. Please take these communications seriously and follow up with someone if they convey any of the content described above under or throughout the SIGNS on this website.

SUDDEN IMPROVEMENT

This sign can be very difficult to identify but is critical to take into account when considering someone who has struggled chronically or repeatedly over a long period. This may mean that a person has created a plan to die by suicide and has acquired the means to die. At these times, a person may suddenly re-enter life, start or complete projects, be more social, become employed, and re-engage in hobbies. BUT THIS CAN MEAN THEY FEEL RELIEF BECAUSE THERE IS AN EXIT PLAN THAT CAN BE IMPLEMENTED AT ANY TIME.

  • When you know someone like this, it is imperative to keep checking in. Ask “how are you doing?” “You seem like you’re doing better, but are you feeling better?”
  • “Do you have a plan to hurt yourself if you feel bad again?”
  • If the person says yes, they have a plan, this needs to be addressed as soon as possible with help from a professional.

SIGNS ARE OFTEN MISTAKEN FOR BAD CHARACTER

Behavior in public that seems especially awful or disturbingly “over-the-top” is often a sign of a mental health disturbance.

The person who is driving you crazy, infuriating, or frightening  you at home, work, school, or nextdoor may well be the person who is suffering a mental health disorder.

NEVER assume someone is simply “looking for attention.” By looking for attention, they may well be looking for help.

IF YOU OR SOMEONE YOU KNOW FEEL(S) SUICIDAL, go to the emergency room, call a mental health professional who can talk to you NOW, or call the police and say you have a mental health crisis, not a criminal situation!

In the US, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

FIND INTERNATIONAL HOTLINES

Text HOME to The Crisis Textline at 741741. They are available 24/7 in the U.S., Canada, United Kingdom, and Ireland.

See Also: HELPING SOMEONE WHO IS SUICIDAL